China's war on SARS (severe acute respiratory syndrome) has yet to end, so it may be too early to make any pronouncements about its effects or consequences. But many of the country's political observers agree on one thing: April 20 marked a turning point in the battle against this unexpected deadly disease, and maybe also in China's governance.
On that day, two senior government officials, Minister of Health Zhang Wenkang and Beijing Mayor Meng Xuenong, were sacked for "negligence of duty" for their delayed response to the SARS outbreak. And the official statistics of SARS infections in Beijing released during a live televised press conference that day was nearly 10 times the previous day's figure.
On the same day, Wang Qishan was appointed deputy secretary of the CPC Beijing Municipal Committee, member of the Standing Committee of the CPC Beijing Municipal Committee and member of the CPC Beijing Municipal Committee.
The CPC Central Committee appointed Gao Qiang secretary of the leading CPC members group of the MOH.
And many other decisive measures were launched in the following days in an effort to curb the spread of the deadly disease.
MOH officials said medical institutions at all levels would be punished in accordance with the relevant laws and regulations if they refused to admit suspected or identified SARS patients. Any individual who failed to fulfill his obligations might face criminal prosecution.
On April 21, the State Council sent out the second group of supervision teams to provinces, autonomous regions and municipalities, including Beijing, Shanxi, Inner Mongolia, Henan, Guangdong and Ningxia.
On April 22, the Standing Committee of the Beijing Municipal People's Congress appointed Wang Qishan Beijing vice-mayor and acting mayor. The committee also accepted Mayor Meng Xuenong's resignation.
The sackings of Zhang and Meng surprised many political analysts. "Seldom have we witnessed so timely a punishment meted out to such high-ranking chief officials for negligence of duty in China," notes Lu Jianhua, a research fellow with the Sociology Institute of the Chinese Academy of Social Sciences (CASS). "It was particularly unusual given that the current government had been formed barely one month before." He calls the reshuffle "a fresh breeze" through China's political sphere.
Similarly surprising, more than 120 central and local government officials from 15 provinces, municipalities and autonomous regions - nearly half of the country's administrative regions - have been demoted or disciplined in the past month for slackness in dealing with the SARS epidemic.
"Never before have we seen so many officials punished so severely in so short a period for breach of duty," says an official with the Organization Department of the Central Committee of the Communist Party of China.
Specifically, these officials were punished for deserting their posts without permission, or delaying or failing to report, or concealing the existence of, SARS cases.
"This is a lawful action," says Qiao Xinsheng, a professor with the Central South University of Economics and Law in Wuhan. He cites a ruling in China's Law on Epidemic Disease Prevention and Control issued in 1989 that anyone proven guilty of dereliction of duty and thereby causing the spread of an epidemic disease, be they health workers or government officials, is to receive administrative penalties or even bear criminal liabilities.
The key to controlling epidemics is to block the transmission of infection in time. But the general public was not alerted when the SARS virus, known as atypical pneumonia in China, first appeared in Guangdong, South China, last November.
Instead, an information blockade was erected in the name of maintaining social stability, says Ren Jiantao, vice-president of the School of Political and Public Affairs of the Guangzhou-based Sun Yat-sen University. "This kind of philosophy puts both public welfare and the government at risk, and could eventually cost the government its credibility among the people."
Ren regards the sacking of Zhang and Meng as a timely warning to officials across the country, urging them to give priority to the people's well-being at all times, and holding them accountable in the SARS battle.
Health-reporting system
To transform the calamity into a blessing, both the government and public are trying to "mend fences" while fighting the epidemic. First on the fix-it list are loopholes in the long-neglected public-health policy.
China actually had a fairly sound public health system up to 1978, enjoying the full support of the central government's funding, according to a professor of public health with Beijing University who spoke on condition of anonymity.
In the 1980s, he says, the administration of epidemic prevention entities was shifted to local governments, with their operation at the mercy of their respective local economies.
The fault inherent in the shift becomes immediately evident in a public crisis such as the SARS outbreak, says the professor. Many local governments, in their pursuit of economic success, were reluctant to invest in the seemingly unproductive and unprofitable epidemic prevention system. To further complicate the issue, because both human and financial resources come under the control of the local government, the epidemic prevention entity has to submit its report to the local bosses first whenever the outbreak of an epidemic appears likely, as in the case of SARS.
As often happens, he says, the local government is overwhelmed by the tremendous political and economic implications at stake once information about the epidemic is made known to the public and, therefore, eludes responsibility by turning to its superior for a decision. Until the approval from above comes, local officials withhold the information from the public.
The SARS epidemic has exposed the inefficiency of this reporting mechanism, says the professor, adding, "the price is too high".
Even if it takes a considerable amount of time to overhaul the collapsed public health system as a whole, a rapid-response mechanism for public-health emergencies is indispensable for the prevention of further disasters, says Professor Ren Haiwen, deputy director of the Health Policy and Management Research Centre at Peking University.
"This mechanism should operate in a vertically-organized administration of the disease control and prevention system, independent of the horizontally structured local government's interference."
In order to hasten the development of such a mechanism and redress the situation, a regulation on public health emergencies was issued on May 12 by the State Council, which prescribes in black and white a mechanism for reporting sudden events like serious epidemics, widespread unidentified diseases, and cases of food and industrial poisoning within a time limit of two to six hours after occurrence. It also states that the State Council will set up a steering group to handle public health crises.
"The regulation, which was drawn up in a mere 20 days, is designed to help minimize the devastation incurred by public health crises like SARS," says Hu Yonghua, director of the Institute of Public Health at Peking University.
"It offers the public a legal basis on which the government is held accountable for coping with public health emergencies," he says.
Transparency
Related to the epidemic-reporting mechanism is the issue of government transparency, says Hu, which is vital to winning the war with SARS.
As shown in the early stages of the SARS outbreak, he notes, some government officials selectively manipulated the data in their favour. "That's why many people did not know exactly how infectious the virus was and assumed that the disease had already been 'brought under effective control' at the same time that Beijing had been listed by the World Health Organization as a heavily affected area," he says.
"The government should have a scientific and fact-based approach towards the data, instead of being selective," warns Chen Xinxin, a CASS law researcher.
Shen Kui, an authority on administrative law at Peking University, suggests that the Chinese Government change its traditional mindset towards the general public. "It should trust the public's maturity and ability to confront a crisis like SARS," he says. "The government is obliged to be fully open with information on such a crisis concerning millions of people's health, both for the sake of curbing its spread and for its own credibility."
Zhu Mang, a professor with the East China University of Politics and Law, shares this view. He cautions that an information cover-up might actually cost the government more dearly in the long run. "China has joined the World Trade Organization and made its commitments to transparency. When public health safety is at stake, the public's right to know must be honoured."
The public response to the government's opening up of the information flow by releasing SARS infection data every day and giving more press conferences since April 20 has been quite positive.
A survey conducted by Horizon Research, a Beijing-based opinion poll agency, among 314 persons living in Beijing, Shanghai and Guangzhou in early May, indicated that although only 20 per cent of the respondents were "fully satisfied" with the government's more open supply of information, about 70 per cent said they were "quite satisfied".
"This is a lesson that bad news cannot be stemmed. The SARS incident should be used to promote government transparency and democracy in decision making," says Lu Xueyi, a CASS researcher.
Many other political observers also see the change in the government's handling of SARS as a sign of progress. Xue Lan, vice-president of the School of Public Administration at Tsinghua University, predicts that such transparency might be the first breakthrough in the war with SARS.
"The ups and downs of SARS should help the government learn to handle crises better, with a greater sense of responsibility, openness and honesty and real care for the people," he says. "That is essential for the government to tide over the crisis and sustain people's support."
(China Daily HongKong edition 23-05-2003)
