Good governance matters in virus fight

Even until a few weeks ago, the majority of Chinese people believed that the Ebola epidemic, which has claimed more than 4,900 lives, mostly in Guinea, Sierra Leone and Liberia, was too far from home to worry about. But with the deadly virus traveling across the Atlantic, alarm bells have started ringing in China, which encountered Severe Acute Respiratory Syndrome 11 years ago.

Given the rapid flow of people between China and Africa, the Ebola virus could strike the country earlier than feared. While it is hard to predict the exact time and place in China where the virus might first strike, Guangdong province seems rather vulnerable because it has a sizable number of African people, including those from Sierra Leone, Guinea and Nigeria. In fact, an estimated 40,000 African people travel to Guangdong every month.

A drill staged by Guangdong authorities recently reflected the level of the province's preparedness to combat an epidemic. The central government, too, has announced a series of measures, including more stringent screening at ports of entry and raising the alertness level of the medical and public healthcare sector.

These are reassuring moves, especially because the SARS outbreak in 2003 exposed the deficiencies in China's public healthcare system. While the attention paid to disease control and prevention as opposed to curative care was weak, technological prowess and staff's skills were weaker. The painful lessons learned at the time prompted China to improve its public healthcare "hardware" and "software" both. But despite now being equipped with state-of-the-art technologies and better-trained professionals, the healthcare system has not yet been put to a real test.

A critical lesson the world has learned in the past fights against epidemics is that capacity building per se is not the only important factor in times of mass medical emergencies, governance also matters. As many commentaries have emphasized, the outbreak of Ebola in Africa has revealed not only the incapacity of the healthcare systems of the affected countries, but also, and more importantly, failure of governance. Governance is the mechanism, institution and process through which governmental and non-governmental warriors battle an epidemic. The complexities involved in the combat against epidemics in today's world demand good governance, for which three sets of factors are very important.

First is preparedness and coordination. Logistical and technological preparedness is important and relatively easy to accomplish. But institutional preparedness is arguably more important in public health emergencies, for which the Chinese government has to use its super mobilization power. Effective response to a crisis requires seamless coordination among immigration, quarantine, disease control, healthcare and other departments. In fact, coordinated action among departments has to be on an unprecedented magnitude. So, despite promulgating emergency management protocols, local governments have to timely modify their line of action, communicate with other departments and sectors, and train (or retrain) personnel to strengthen institutional preparedness.

The second set of factors are transparency and information dissemination. "Never attempt to hide the truth" was perhaps one of the key lessons local governments learned from the SARS outbreak. Two senior officials even lost their posts for trying to hide facts. Transparency is indeed indispensable during a mass medical crisis. In the absence of truth, rumors fill in the information gap. Keeping people well informed by disseminating accurate information on time has proved effective in reducing social costs which come with public overreaction and panic, and spreading of rumors.

Global governance and international cooperation form the third set of important factors. Since epidemics are no longer bound by national boundaries in this era of globalization, good governance at the global level, facilitated by international organizations, especially the World Health Organization, will enable national and local governments to share critical information on, say, effective disease-combat measures and access to key scientific results. Global health governance and international cooperation have never been so crucial.

The author is associate head of and assistant professor at the Department of Asian and Policy Studies, Hong Kong Institute of Education.