This article focuses on issues of alcohol consumption, disease and public health in British North Borneo in the 1920s and 1930s, a colonial territory along the periphery of empire. Drawing upon a range of sources – from reportage and memoranda, to local folk tales and oral tradition – it examines how the North Borneo Chartered Company administration responded to spiralling population decline and ill health amongst indigenous Murut communities. Amidst widespread economic stagnation, the company shunned vital public health infrastructure and medical aid, opting instead to govern behaviour and condemn alcohol consumption. This article shows how the company perpetuated racist assumptions concerning ostensible alcohol addiction amongst indigenous communities. It further suggests that the effects of Northern European and American temperance and prohibition movements impacted the Bornean tropics. While scholarly attention has been paid to issues of alcohol, disease and empire in the tropics, historiography has overlooked the role of lax colonial governance in semi-autonomous, atypical colonial spaces such as British North Borneo. This article ultimately serves as a vital corrective by showing how the legacies of commercial-colonial governance remain perceptible in Sabah today, a region still facing major socio-economic and public health pressures amidst the ongoing COVID-19 pandemic.