Control of Infectious Disease: Challenges to China's Public Health System

The 2003 SARS breakout in China forcefully demonstrated the global importance of controlling for infectious diseases. This paper reviews major problems in China’s public health system and in its ability to deal with a biomedical threat such as an influenza pandemic. We first examine the H5N1 avian influenza outbreak during the 2005 season and the government’s strategy to control the disease. The relatively mild strength of the 2005 avian influenza breakout provided an opportunity for the Chinese government to test its capability of controlling an influenza pandemic. We then describe the current disease surveillance system that has been significantly enhanced after the SARS breakout. We further analyze two problems in China’s disease control system: the split in the structure between financing and administration, and health care among rural floating labor. Finally, we illustrate challenges to control infectious diseases in rural China and conclude that the primary challenges facing the government are (1) to ensure adequate funding to improve disease control at the front lines in rural areas, especially in underdeveloped regions, and (2) to improve administrative efficiency in government agencies.