COMMENTARY
SARS epidemic may spur much-needed reforms in China
By Christopher A. McNally
When the Chinese government's news blackout and attempted cover-up of the SARS epidemic back-fired — massively — the country was, in essence, put on a war footing.
The U-turn in government policy was stunning. Airwaves rapidly filled with advice about hygiene and pleas to remain calm. Media outlets also portrayed the battle against SARS as a test of the whole nation, exhorting people to rally around the communist leadership to overcome the country's hardship.
In classic mobilization, Beijing authorities flattened an old Communist Party resort to build a thousand-bed hospital to house SARS patients. In just over a week a crew of 4,000 construction workers laboring around the clock realized what must be the world's fastest construction of a major health facility.
Looking ahead, China's inherent political and institutional obstacles remain, but the SARS crisis actually might be an impetus for gradual positive change. SARS clearly has exposed the country's social inequality. At a minimum, the crisis will accelerate plans to establish a bare-bones public healthcare system for rural residents. It will also lead to reforms of the country's disease reporting and response mechanisms.
A much more consolidated and better-coordinated public health surveillance system is a necessity, since at present the regulatory functions of China's health system are in shambles. Vice-premier Wu Yi already announced in late April that the government plans to spend about $423 million to set up a nationwide health network to fight SARS and other medical emergencies. With the crisis costing China dearly in economic and diplomatic terms, the internal legitimacy of the regime is under greater pressure than at any time since the 1989 Tiananmen Square incident.
As a response to these pressures, China's new leaders, Hu Jintao and Wen Jiabao, have undergone an image makeover. In particular, they are trying to present a more humane and kinder face to China's public. At the end of the day, of course, they must follow through on their words. More resources for healthcare, substantial efforts at narrowing the gap between rich and poor, and a general movement away from the single-minded pursuit of economic growth to focus more on issues of social welfare and justice are thus likely.
The SARS crisis illustrates how the Chinese party-state combines in often uneasy fashion Maoist mass mobilization with modern methods of crisis management. If the effectiveness of these measures declines and the SARS epidemic persists beyond the summer of 2003 or erupts again in the winter, major political repercussions cannot be ruled out. But at the moment the measures taken by the Chinese government seem to have produced considerable success in reigning in the epidemic.
And if the present measures are successful in containing the epidemic, the Chinese government will not face, as some have argued, its "Chernobyl." Rather, the SARS crisis is likely to imbue some momentum to fundamental trends already present in China's political economy.
At first, the successful handling of the crisis will shift the balance of power within the elite. Some Chinese commentators have pointed their fingers at Jiang Zemin, noting that he had supreme power during the months of the initial SARS outbreak, but had chosen to do nothing. Regardless of how Jiang Zemin's role will be judged, the hands of Hu Jintao and Wen Jiabao are being strengthened. Their candor and highly visible management of the SARS epidemic have improved their legitimacy within the party and among the public. To what degree new policy initiatives will emerge is still uncertain. In fact, it is likely that once the SARS crisis passes, China will return to politics as usual.
Nonetheless, the shock to China's political and social system created by SARS is liable to cause a reorientation of the fourth generation's policies. China's middle classes are disillusioned with how the system handled the epidemic, and foreign investors have lost a degree of confidence in China.
Healthcare reform would necessitate the provision of widely available health insurance, the establishment of sustainable financing mechanisms for this insurance, and the construction of safety nets for the poor. All of these items require far-reaching institutional reforms and large financial contributions by all levels of government. To which extent governments can marshal such funds is questionable.
Fiscal decentralization has created severe budgetary constraints for local governments. Moreover, the Communist Party's commitment to use taxation as a tool for social redistribution is unlikely to be strong, since this will require much higher taxes for China's rich.
The dilemma is that most of China's rich are private entrepreneurs, a segment of the population on which the party is relying more and more for economic growth and political support.
Perhaps most difficult will be the establishment of a more pronounced culture of governmental accountability, since this could directly hurt the interests of local government officials. Despite these obstacles, the battle against SARS and the handling of its aftermath is about shoring up the credibility of China's party-state.
The legitimate rule of Hu Jintao and Wen Jiabao rests on putting their newfound touch of humanity to work. China will remain an authoritarian and repressive state, but it will need to shift its political economy from a raw and brutal form of capitalism to a more humane and compassionate form.
Christopher McNally is a Research Fellow in Politics, Governance and Security Studies at the East-West Center in Honolulu. The full version of this essay will be published in SARS War II, edited by P.C. Leung and E. E. Ooi and published by World Scientific Press.
