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A positive SARS
side-effect
By Antoaneta Bezlova
BEIJING - As the SARS outbreak here appears to
ease a bit, hopes are growing that China's tardy
tackling of the epidemic might have a positive
side-effect - and force its leaders to confront the
country's lopsided reforms in public health.
By
taking too long to reveal the real dimensions of a
health crisis that had the potential to travel around
the globe, China set in motion a chain of negative
reactions - from the loss of its international standing
in the region and beyond, to economic losses and social
tensions across the country.
The global number
of severe acute respiratory syndrome (SARS) cases stood
at 8,141 as of the weekend. China, where the virus is
believed to have originated, is the worst-hit country,
with at least 2,491 cases and 163 deaths.
To
prevent a repetition of a SARS scenario in the future
when an infectious disease becomes a major social,
economic and political problem, experts say that China
would have to initiate genuine reform of its neglected
and underfunded public health system.
"SARS is
perfect in a way of showing to the whole world the
entrenched problems in China's public health sector,"
said Han Deqiang, professor of politics and management
at the Beijing University of Aeronautics.
"Medical care in China, especially in the rural
areas, has been weakened greatly. The peasants and the
laid-off workers have no place to have their disease
checked and treated," Han explained. "What is more, they
have no money. Families of laid-off workers are having
problems feeding themselves, not to speak of putting
money aside for health care."
World Health
Organization (WHO) officials contend that the government
is drawing lessons from the crisis. "We are really
seeing an increased level of cooperation and
mobilization on many levels," said Dr Keiji Fukuda, a
WHO expert in Beijing. "I hope this is the beginning of
rebuilding of the public health sector in China."
Daniel Chin, the head of WHO's Beijing team of
experts, is even more positive. "I believe Vice Premier
and Acting Health Minister Wu Yi sees the SARS outbreak
as an opportunity to launch reforms in the health
system," he asserted. "One can even say she believes the
change in the health care system is her mandate."
The collapse of China's rural communes in the
early 1980s brought to an end the era of free preventive
health care and universal medical treatment.
Under the collective system, 90 percent of the
rural population had access to free health services.
Today only 10 percent of rural residents are insured,
leaving some 700 million Chinese having to pay
out-of-pocket for all of their health care.
The
worst affected by the government's withdrawal from its
role as free provider of medical services in the early
1980s have been public health services such as
preventive care, disease surveillance and medical
control.
Fiscal decentralization has meant that
poor local governments have less to spend on health than
their wealthier counterparts. As a consequence, there
has been less investment in hospitals and drugs, and
lower pay for medical staff has led to lower standards
of health care.
Single-minded economic growth
should cease to be the government's only priority,
argues Mao Shoulong, a professor of public
administration at People's University. In an article in
Nanfengchuan magazine, he criticized the government for
overlooking the public interest in favor of economic
growth and social stability.
This is a harsh
accusation against a government that was installed early
this year with widely proclaimed goals of building "a
well-off society".
Chinese officials had played
down SARS outbreak and concealed information about it
for months, aiding the spread of the killer virus from
southern Guangdong to Beijing and other parts of the
country as well as nearly 30 other countries.
Shocked by worldwide criticism of China's slow
response to the crisis, the authorities have promulgated
a set of regulations for emergency public measures. They
cover outbreaks of infectious diseases, mass food
poisoning and other serious threats to public health.
Unveiled by Premier Wen Jiabao in mid-May, the
new regulations lay the basis for the establishment of a
new Emergency Response Bureau expected to coordinate the
country's efforts in combating new outbreaks.
The new rules require local officials to report
epidemics to Beijing immediately, and demand that local
governments set up reserve funds to tackle future
outbreaks.
The central government has also begun
pumping funds and resources into a rural health care
system that for decades has been drained of funds.
Beijing has already allocated 1.5 billion yuan (US$180
million) for the construction of a nationwide disease
prevention and control network and an additional 800
million yuan to improve infrastructure.
Officials also said they are extending another 2
billion yuan to improve standards for rural medical and
health care. "The focus of the funding would be to
support the central and western rural regions," said Liu
Jian, head of the task force for rural affairs at the
National SARS Prevention and Control Headquarters.
Yet there are those who doubt that these new
measures amount to a real change of government policy.
"Social spending can't sustain economic growth, and the
Chinese government is well aware of it," said Robert
Ross, a political scientist at Boston College who was in
town recently.
He added: "China's strategy so
far has been a race - pumping money into infrastructure
and hoping to close the gap between rural and urban
areas before any serious social crisis erupts. I believe
it [will] stick to this."
(Inter Press
Service)
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