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SARS, An Opportunity to Reshuffle Public Health System
Xu Xiangyu, five years old, grabbed a disinfected gauze cloth and started cleaning a table and door handles, just like his mother, in China's May Day holiday.

The little boy was not alone on Labor Day, as most Chinese families converted the holiday to a national "hygiene day", cleaning their apartments and airing quilts and blankets as a measure to prevent sever acute respiratory syndrome (SARS).

A large-scale public health plan has been launched nationwide, sweeping all the cities, provinces and regions throughout the country.

In south China's Guangdong Province where the country's first SARS case was reported, more than 80 million residents have been mobilized to clean private residences, wash public facilities and attend lectures on public health.

Zhang Jianhua, director of a public health service in Liwan district in Guangzhou, said lectures on SARS prevention were held every day.

He said more than 30,000 SARS prevention booklets, which had been praised by the World Health Organization, had been distributed to citizens with advice on SARS symptoms, spread channels and prevention measures.

In Dezhou city in east China's Shandong Province where no SARS case have been reported, people practiced SARS prevention with hats, face masks and glasses.

The term "patriotic public health campaign", a uniquely Chinese campaign originally conceived by the late Chinese president Mao Zedong in 1952, begins to be repeated time and again after long absence in the Chinese press.

Ma Xiaowei, vice-minister of health said that with the help of the "patriotic public health campaign", Chinese authorities had eliminated a variety of epidemic diseases like smallpox, cholera, leprosy and tuberculosis in the 1950s and 1960s. Those diseases claimed millions of lives in China during the first fifty years ofthe 20th century.

The World Bank once pointed out that China fulfilled basic medical services requirements for 22 percent of the world's population by using only one percent of the world's total health finance. The general health status of Chinese people was better than that of people in any other developing country.

The life expectancy of Chinese people has increased to 70, from 35 five decades ago.

However, when challenged by the sudden SARS outbreak, China's disease prevention system, praised by WHO several times, was described as "not prepared for the sudden public health issue and not effectively communicating with the public."

As of May 2, total SARS cases on the Chinese mainland had reached 3,799, including 181 deaths.

Prof. Mao Shoulong of the Public Affairs Management College of the People's University of China said the biggest problem was not Chinese doctors' incomplete understanding of the newly-emerged virus, but the embarrassing situation in which the country's old public health and disease prevention system had become out of date, before the new one had been established.

He said that before China launched the reform and open-up policies in the late 1970s, citizens' medical securities were paid for by their work units. But when the market economy system was introduced, more and more work units had left healthcare to resident communities.

However, China's new community based public health system has not had time to develop fully and the SARS outbreak could not be immediately controlled.

In late April, the Chinese government removed the Minister of Public Health and Beijing Mayor from office, demonstrating its dedication to speeding up the redevelopment of its public health and disease prevention system.

And the fact that female Vice-Premier Wu Yi was appointed as minister of health, showed the resolution and confidence of the Chinese government to fight SARS.

To date, there are more than 5,900 disease prevention organizations in China, covering the country's major cities and counties.

One year ago, the China Disease Prevention and Control Center was established, aiming to frame a new public health and disease prevention system to better cope with sudden disease outburst.

Now, China's legislative and administrative bodies as well as its medical and scientific departments are racing to keep up with the spread of the SARS epidemic.

The virus has been recognized as an epidemic disease by law in a very short time so that SARS prevention work could have a legal basis. Meanwhile the SARS virus is under emergent research by the country's scientific research organizations.

Hu Angang, a noted researcher, said the changes underway in China's public health system would bring more changes to the country's whole government administrative mechanism.

An old Chinese saying goes: "disaster can be converted to be good fortune at the right time".

(People's Daily May 3, 2003)

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