What are the lessons to be learnt from the SARS crisis? How do we keep the lines of communication of disease reporting open and accessible to all officials and, more importantly, keep the public in the know?

These were the issues that top Chinese disease control and prevention officials grappled with at a symposium held in Beijing yesterday as they reported on the progress made and what needs to done to strengthen their functioning.

At the initial stages of the SARS (severe acute respiratory syndrome) outbreak in early 2003, the public grapevine was buzzing about the spread of the disease even as some officials remained tight-lipped resulting in the quick spread of the epidemic.

Since then, the central government has spent more than 120 million yuan (US$14 million) strengthening the national network for reporting various infectious diseases and public health issues.

Before the establishment of the network in January 2004, it took at least 24 days for a potentially infectious disease to be reported to the Chinese Center for Disease Control and Prevention (CDC) by a local hospital.

But now, any suspicious case can be reported to the CDC within one day, Wang Longde, vice-minister of health, told the symposium.

So the health authority can now analyze the situation daily and quickly inform the public of any outbreaks, Wang said.

At the end of 2004, the network covered 40,000 agencies including 14,000 above-county-level and 18,000 township hospitals; 3,000 disease control and prevention centers; and 3,000 health authorities at various levels.

However, more than 57 percent of the country's township hospitals are still not plugged into the network, which shows that the system is nowhere near functioning at an optimal level, said Rao Keqin, director of the Information Center of the Ministry of Health.

Reporting, monitoring and treatment in rural areas as well as small urban centers is much tardier than in big cities.

For instance, experts believe that about 70 percent of HIV/AIDS cases and the majority of tuberculosis (TB) patients are in the rural and remote areas of China but nearly 90 percent of the country's estimated 840,000 HIV carriers and most TB patients have not been diagnosed because of poor surveillance.

Another problem is the shortage of qualified people who can collect and report data, especially in western and central regions.

For example, the Ministry of Health plans to buy 16,000 computers for hospitals in remote and poverty-stricken areas so that the network runs more smoothly; but local health workers are not well-versed in the use of the technology, said Rao.

(China Daily April 21, 2005)