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SARS Outbreak Sparks Changes in China's Health Care System

The SARS crisis that swept the world earlier this year cost more than 800 lives, billions of dollars in lost commerce, particularly in Asia, and prompted strong international criticism of Beijing. After scientists concluded that the virus probably originated in China, criticism mounted over the Chinese government's failure to contain the spread of the virus and to warn the rest of the world about it.

The SARS epidemic emerged during a leadership transition in China, and stinging international rebukes prompted the nation's new leaders to promise more openness about problems and more resources for public health.

Chinese President Hu Jintao declared in July that his country had defeated the SARS virus. Mr. Hu said China waged a strong and effective campaign against Severe Acute Respiratory Syndrome that should win the confidence of the international community. He also credited the ruling Communist Party, which he has headed since November, with defeating SARS.

SARS first appeared in southern China late last year, but quickly spread by air travel to 30 countries, infecting about 8,400 people and killing more than 800 of them.

In April, months after SARS first surfaced, China's authoritarian government drew accusations, at home and abroad, that it tried to hide the extent of the outbreak by ordering newspapers not to report on it, blocking access to infected areas by World Health Organization experts, and by understating the number of cases.

In the wake of international cooperation, education campaigns and containment efforts, the World Health Organization reported by July that "all known chains of person-to-person transmission" of the virus had been broken.

City University of Hong Kong Professor Joseph Chang says the potential economic consequences of SARS prodded Chinese leaders into action. "The SARS crisis showed that the Chinese leadership has to be responsive to international public opinion, mainly because of the pressure of maintaining a good image since China is eager to attract foreign investment to promote its economic growth," he says.

Professor Chang and other scholars say Hu Jintao, who took over as president of China from Jiang Zemin in March, and new Prime Minister Wen Jiabao, reaped some political benefits from SARS by eventually taking decisive actions, including firing the old health minister.

In the wake of the international criticism, China isolated SARS victims, quarantined thousands of people who had contact with infected patients, and even ordered the military to build a 1,000-bed infectious disease hospital in a matter of days.

The head of the World Health Organization during the SARS crisis said the "first and most imperative lesson" is the need for all disease outbreaks to be reported "quickly and openly." Hiding disease outbreaks for economic or political reasons makes the situation worse.

China's new health minister and vice premier, Wu Yi, admits China made mistakes in the initial stages of the SARS crisis, but pledges to work closely with the international community in the future. She also says local governments in China have been ordered to report disease statistics promptly and accurately in the future. China has also pledged more money to the public health system.

Those changes are likely to be welcomed by epidemiologists, such as the WHO's Dr. Meirion Evans, who fought SARS in China. "I guess that's a feature of our modern day society. There is so much movement about the globe that a disease like this, that is spread through contact with respiratory droplets, can be halfway across the world in a matter of a few hours," he says.

He says the epidemic shows we live in a global village, where a disease outbreak anywhere is a health threat everywhere.

This is part of VOA's series of reports on World Health