Coronavirus tests China’s ambitions as a global health leader

04-Feb-2020 Intellasia | South China Morning Post | 6:02 AM Print This Post

China’s handling of the deadly coronavirus outbreak has become a testing ground for its emergence as a global health power after nearly two decades of stepped-up efforts aimed at overturning its poor track record during the Sars epidemic of 2003.

The Philippines reported the first overseas death from the virus on Sunday, which also marked the end of the extended Lunar New Year holiday. The number of cases is expected to rise as tens of millions of Chinese prepare to travel home, after their plans were delayed in a bid to reduce the spread of the disease.

The World Health Organization’s director general Tedros Adhanom Ghebreyesus has repeatedly lauded China’s efforts in dealing with the new coronavirus, which was declared a “public health emergency of international concern” on Thursday, overturning the WHO’s assessment of the previous week.

The declaration puts the global response to the crisis which originated in the central Chinese city of Wuhan and has so far killed more than 300 people and infected nearly 15,000, with cases reported in more than 20 countries on the same level as severe acute respiratory syndrome, the 2009 H1N1 swine flu, the Ebola outbreaks of 2014 and the Zika virus in 2016.

“Let me be clear, this declaration is not a vote of no confidence in China. On the contrary, WHO continues to have confidence in China’s capacity to control the outbreak,” Ghebreyesus said.

“The speed with which China detected the outbreak, isolated the virus, sequenced the genome, and shared it with WHO and the world are very impressive, and beyond words. So is China’s commitment to transparency and to supporting other countries. In many ways, China is actually setting a new standard for outbreak response, and it’s not an exaggeration,” he said, adding that, if not for China’s efforts, there would have been more cases spreading around the world.’

The expression of confidence from the world’s leading health organisation is a long way from the criticism faced by Beijing 17 years ago, when China was accused of trying to cover up Sars, a previously unknown virus believed to have emerged from the wet markets of Guangdong province before infecting more than 8,000 people and killing 813, 299 of them in Hong Kong.

“The Sars outbreak in 2002-03 seriously tarnished China’s reputation as a self-proclaimed ‘responsible great power’. Since then, China has stepped up its role in managing global health issues, particularly within the WHO, in order to show the world that it is willing and ready to take up the responsibility,” said Lai-Ha Chan, a senior lecturer at the University of Technology Sydney’s China Research Centre in Australia.

The WHO directly told the Chinese government in its mission report in April 2003 that “there was an urgent need to improve surveillance and infection control” in the country.

Two years later, the Chinese government officially admitted its health care system and health reforms of the previous 20 years were “basically failing” in a report issued jointly by the State Council’s Development Research Centre and the WHO.

Since then, China has been stepping up its engagement in the global health sector, starting with a successful campaign in 2006 for its nominee, Margaret Chan Fung Fu-chun, to take on the leadership role at the WHO. Chan Hong Kong’s former director of health who managed the city through the Sars outbreak served as WHO director general for more than a decade.

In 2014, China responded to the Ebola outbreak in Africa in its new role as an emerging major power, for the first time offering help to foreign nationals during the WHO-declared public health emergency. Chinese military medical teams were dispatched to Sierra Leone and Liberia, where they assisted with disease prevention and control, and provided direct clinical care and health training.

Chinese aid to build hospitals and send medical teams to developing countries has become an accepted part of Beijing’s growing relationships with other nations, largely driven through its Belt and Road Initiative which was launched in 2013 to gain influence through infrastructure and other links.

In addition, as China moves towards becoming a global power, Beijing has boosted cooperation with international institutions to deal with other pressing health issues. One significant area is HIV/Aids, in which China is working with multiple actors including UNAIDS, WHO, Unicef, the International Labour Organisation and the World Bank to combat the disease.

Yet, there are still experts who question whether China is living up to its obligations as a global health leader.

Since the coronavirus outbreak in Wuhan was first made public by the Chinese authorities on December 31, Beijing has come under close scrutiny over the accuracy and timeliness of its announcements.

A study in The Lancet, written by Chinese researchers and doctors on the ground in Wuhan and published online on January 24, suggested the virus may have begun spreading among people weeks earlier than reported by Chinese officials, adding to speculation about Beijing’s transparency.

Pak Lee, a senior lecturer in Chinese politics and international relations at Britain’s University of Kent, said there were questions over whether China’s response to the outbreak had been hampered by delays in disseminating information through the government system.

Lee pointed to the 61 per cent increase in confirmed cases from 278 to 448 just one day after Chinese President Xi Jinping urged “an all-out effort to curb the spread of the virus” via state broadcaster CCTV on January 20.

“Was it simply a coincidence? There are grounds for believing that local officials did not disclose the ‘true’ scale of the infection until Xi handed down a strict order to them to toe the line. Can the functions of such a big country as China entirely rely on a single leader at the top?” Lee said.

Chan, who has published multiple papers on China’s health diplomacy, agreed the country’s political and public administration system was limiting its desired role as a leader in global health.

“China has yet to fulfil its goal in being a global health leader. To be a leader/power in global health, a country has to effectively manage its domestic public health before they can be a leader in global health governance,” Chan said.

“The main problem for China is that there is no political will to change its public health system. This is related to how the system is structured, how it is utilised, and how public health information flows within China.

“Although Xi Jinping has taken decisive measures in the fight against the virus, we have to wonder why local leaders didn’t take action earlier to control it. It seems the Sars outbreak did not change their “business as usual” mindset and they continue to put their political careers before the public,” she said.

“To have an impact on the world, China needs more transparent and accountable governments at all levels.”


Category: China

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