Africa can learn from China

It has been more than six months, and there is no sign of the Ebola epidemic in West Africa declining. In fact, its spread may have accelerated in some parts of the region. The outbreak has reached its current scale largely due to the inadequate public health infrastructure and a general lack of social trust. This is especially apparent in Sierra Leone, Guinea, and Liberia, where the outbreak is particularly troublesome. The vast number of unreported cases was just another indication of a governance crisis in the region. The most affected countries still suffer from internal strife, and most critically do not have the necessary human, financial, and organizational capacities to break the negative spiral of death, destitution and destruction.

Despite the growing international assistance in fighting other outbreaks of infectious diseases over the past three decades, most took the form of stand-alone, "vertical" programs that have focused on particular diseases such as HIV/AIDS and malaria. These programs have proven difficult to significantly contribute to overall health system capacity building at the horizontal and institutional level. Also, because major disease outbreaks such as SARS and H1N1 have thus far largely spared Africa, combating acute infectious disease outbreaks has not been the top of policymakers' priorities. So it should come as no surprise that countries in West Africa were caught off guard when Ebola hit the region in full force.

Like Ebola, the SARS virus led to a similar governance crisis in China in the first half of 2003. While SARS killed no more than 800 people, its profound and negative impacts on development and stability made the outbreak a large socio-political crisis in China. But once the issue reached the top of the political agenda, the Chinese government was able to rapidly mobilize the whole of society to cope with the crisis. Furthermore, in the wake of SARS, China moved to invest tremendously in the health system capacity building, which has been crucial in handing other disease outbreaks, including H5N1, H1N1 and H7N9.

China's relatively robust capacity in disease surveillance and response is built on a strong State system that makes it easier for Chinese leaders to mobilize the necessary resources for crisis management compared with their African counterparts.