China responds to bird flu under shadow of Sars

BEIJING: In the blaze of speeches, meetings and regulations about bird flu that China's leaders have fired off in recent days, Sars has never been mentioned.

But memories of that epidemic two years ago are shadowing China's increasingly urgent response to the latest health threat, say Chinese experts and journalists.

Severe Acute Respiratory Syndrome, which started in southern China in early 2003, killed 349 Chinese after officials hid or underplayed the flu-like illness, and China faced international censure after Sars spread to Hong Kong, then Asia and North America, killing hundreds more.

China dismissed two senior officials and blamed them for the cover-up.

On Friday, China announced that it was mobilizing a national "command headquarters" under the country's top emergency official, Hua Jianmin, to bring together six government and party departments and co-ordinate the fight against bird flu.

With rising global fears about the H5N1 avian flu virus, even parts of China's state-dominated press have recently said habitual government secrecy and cumbersome bureaucracy could again undercut efforts to contain an epidemic.

Scientists fear H5N1 could mutate into a form communicable between people, triggering a pandemic that could kill millions and overwhelm health systems.

"At present, the information about avian influenza cases released to the public here is clearly too tardy and inadequate," the outspoken business weekly, Caijing, said in an editorial that cited parallels with Sars.

While several Chinese experts interviewed also called for more official candour, they also said Chinese officials appeared to be reporting outbreaks of bird flu faster than they did during the Sars epidemic.

And central leaders have stepped in to ensure that disparate government agencies, especially the agriculture and health ministries, pull together.

"Sars is the model nobody wants to repeat. The public health system and official incentives have changed and I wouldn't expect the same problems," said Mao Shoulong, a government policy expert at the People's University of China who has studied official reactions to both Sars and the bird flu.

China's leaders have good reason to improve transparency. Bird flu has already killed more than 60 people in Asia and China on Friday reported its fourth outbreak in birds in a month. But so far, the country has not had any cases of humans being infected with H5N1, officials have said.

If China does succumb to bird flu, it will not be for lack of official plans. On Tuesday, China's Ministry of Agriculture issued an "emergency response" for any bird flu epidemic among birds and livestock in coming months, joining dozens of similar documents from central and local bureaucracies.

The agriculture ministry's plan demands that local officials report suspected cases of infection to the ministry within four hours.

"Those responsible for hiding, overlooking or delaying reports will be harshly punished according to the law," Chinese Premier Wen Jiabao told a high-level meeting about bird flu on Tuesday.

Mao, the policy expert, said these demands from national leaders mean central government agencies will co-operate more and local officials will be much less likely to hide cases of bird flu than they were Sars.

"Officials have no incentive to hide bird flu outbreaks," he said. "Their political career won't be damaged if they report, but they would be ended if they hid information." Farmers are also given compensation for culled poultry, he noted.

Pressure on local officials to report all possible cases may even lead to "systemic overload", as junior officials report even unlikely cases out of fear of punishment, said Lan Xue, a public policy researcher at Tsinghua University in Beijing who has advised China's leaders about dealing with emergencies.

Since Sars struck, China has also invested in a new nationwide network of emergency offices and plans. These preparations include one master plan, 25 plans for specific emergencies such as disease outbreaks, floods and earthquakes, and 80 plans for government departments, Xue said.

The government has established a national office to co-ordinate response to emergencies, and it has also drafted a law to encode the responsibilities and powers of officials in emergencies and pumped over 5 billion yuan ($NZ908.95 million) into local disease surveillance offices, Xue said.

"Once the government realises something is wrong, it can really go all the way. But now the challenge is implementation," he said.

But rapid response to a large outbreak among birds or possible human infection could be made more difficult by official reluctance to share information about specific outbreaks with citizens, said Chinese experts.

"Risk communication is not an easy task – there's always the problem of over-reaction – but the best way to deal with this is to get the general public educated," Xue said.

In a country as large as China, even the $US248 million that Prime Minister Wen promised to fight bird flu may be stretched if the virus spreads.

Each Chinese province has received tens of thousands of yuan to monitor migratory birds, which are thought to carry the virus, said Chu Guozhong, a Beijing-based ornithologist who is advising Chinese wildlife authorities on the disease.

"Local officials are now paying attention, but that's not much money to build up monitoring, and in some places it hasn't arrived yet."

source: reuters