Lessons Learned from China's SARS Crisis
by Chi Fulin

China now is at a critical stage in its economic and social transformation, when any unexpected event, if not handled properly, could lead to a social crisis. This period of transformation of institutions and traditional governance mechanisms is a precarious one. The last thing the government and public wants under these circumstances is sudden disasters, such as the Severe Acute Respiratory Syndrome (SARS) epidemic.

Reviewing Initial Shortcomings

During the recent China-Association of Southeast Asian Nations Summit on SARS in Bangkok, Thailand, Chinese Premier Wen Jiabao admitted that "confronted with the sudden and unexpected outbreak of the SARS epidemic, [China] lacked the experience to prevent and control it." Indeed, not only was the country unprepared to deal with the situation, but also, at least during its early phases, some central government departments and local authorities were not ready to make a 100 percent effort, and even tried to conceal the gravity of the situation. In addition, coordination between government departments and between the government and medical institutions was weak. As a consequence, the epidemic spread quickly and reached serious proportions. While effective countermeasures had practically eliminated the disease by June, the following lessons learned from the SARS epidemics are nonetheless valid:

• Globalization means that events in China will rapidly affect other countries and vice versa.

• The SARS epidemics has exposed some of China’s institutional weaknesses. Clearly the crisis should motivate the government to accelerate institutional reform so as to strengthen its ability to provide public goods and services.

• As social stability is a major prerequisite for sustained economic growth, solving crucial social problems, including creating more jobs and reforming social insurance and the public health care system, has become more urgent.

• A crisis management mechanism should be created that can mobilize financial and social resources without delay. Relevant government departments should be able to issue warnings to the public on short notice and propose responses. In the face of the SARS epidemic the United States launched an emergency warning system and unveiled a prevention and treatment program before China had identified a single SARS case. This serves as a good example to learn from.

Increasing the Role of the Media

The government must make further efforts to regain the public’s confidence, including promoting better media relations in times of crisis. Providing the general public with timely, accurate, and reliable information is the responsibility of the government and the media, especially in the case of sudden disasters. As the SARS case demonstrated, information about crises affects not only the health and safety of the population in a particular country, but can have global consequences. In an open society people have access to many channels of information, and accordingly the Chinese public’s demand to be informed of unexpected events has become stronger than ever before. To satisfy this demand the authorities should accelerate reform of the media.

The current administration of China’s media does not meet the development needs of an open society. If something unexpected happens, the media are unable to adjust to new circumstances, mainly for ideological reasons, a situation that also needs to be reformed. During the recent Iraqi war three channels of China’s state television covered it through live broadcasting. Why couldn’t state television have designated a special channel to provide continuous information about the SARS situation and provided tips on how to prevent its spread? The general public would have been able to keep up with the latest developments of the SARS situation, which in turn would have helped prevent the spread of the disease and the widespread panic among the public. Thus some government rules for administrating the media should be relaxed, and reporting and commenting on situations such as the SARS epidemic should be encouraged. The media should also be able to report on cases of irregularities, including outright corruption, in managing funds that had been assigned to fight SARS.

Ailing Health Care System

The outbreak of the SARS crisis also demonstrated the inability of the current health care system to deal with unanticipated events. It was sheer luck that this epidemic was centered mainly in the cities. If it had spread through the countryside, the consequences would have been too terrible to contemplate. Thus reform of the health care system, especially its development in rural areas, should be accelerated.

In addition, an early warning system and emergency coping mechanism should be reinforced. Furthermore, a public safeguard mechanism to control exceptionally contagious diseases should be created. The central government should offer free treatment to diagnosed and suspected SARS patients, with hospital costs covered from the government’s central budget. Together with the health care system, the social security system also requires thorough changes.

Mobilizing Civil Society

Dealing successfully with unexpected events, such as reining in the SARS epidemic, depends to a large degree on the support and participation of the public at large. Close interactions between the government and a well-developed civil society constitute the key to success in coping with unexpected events. To move ahead in this direction, the following steps should be undertaken:

• Urban communities should establish autonomous governance in order to share responsibility for the prevention of epidemics.

• Development of the NGO sector should be strongly encouraged. NGOs’ role in mobilizing and organizing social forces to deal with unexpected events should be brought into full play. They also can play a useful role in maintaining social stability.

• NGOs should be encouraged to cooperate more closely with international professional and volunteer organizations as well as with foreign private foundations.

Examining Personnel Consequences

The attitude and behavior of officials in some departments of the central government and some local governments in fighting against SARS exposed some shortcomings of the norms of cadre selection and appointments. To change the system, the following measures seem to be necessary:

• The rigid human resource management system should be reformed as soon as possible. Some senior officials consider GDP growth as the most important measure of their performance. As a consequence, they fail to report detrimental events, such as the spread of SARS, afraid of being fired. Many government officials feel responsibility toward their superiors and less responsibility for the safety of the public.

• The media and civil organizations should be encouraged to oversee the government and help improve its decisionmaking processes. If it turns out that a government policy was faulty, it should openly admit so to the public and implement the necessary corrective measures.

• The law should be brought to bear. Officials who are found responsible for mismanaging certain issues, causing huge losses to society, as happened in the SARS case, should be brought to justice through open and fair judicial procedures.

• The government can improve its image and restore its social credibility. The government has a unique opportunity to achieve this during this period when the general public is keeping a close eye on what the government is doing.

Chi Fulin is executive director of the Haikou-based China Institute for Reform and Development, 57 Renmin Avenue, Haikou, Hainan, 570208, China; tel.: 86-898-625-8793, fax: 86-898-625-8777, email: cird2@public.hk.hi.cn.