Communicable disease control in China: From Mao to now

Hipgrave, David

CHINa'S WaKE-UP CaLL ON CDC: IMPrOVEMENTS SINCE SarS aND HEaLTH SYSTEM rEFOrM For both TB and schistosomiasis, it is evident that cessation of internally-and externally-supported disease control programs in the early 2000s was a major setback. Outside the academic and public health community in China, interest to fund and implement programs to control specific diseases associated with poverty and under-development was low at this time. As a result, despite improvements in nutrition, socio-economic status and health infrastructure, there was little progress in infectious disease rates and suggestions that some were increasing slightly during this period (30) , although it is likely that this also reflected improved surveillance and diagnosis (39) . What was undoubted, however, was the increasing urgency of major reform to CDC and China' s health sector in general (29, (61) (62) (63) due to worsening equity (21, (64) (65) (66) , a high level of public complaint and government acknowledgement of the problem. Crystallising the situation in the most humbling way came the SARS outbreak in early 2003, which forced China' s government and health authorities to act quickly and decisively on the dangerous situation with respect to CDC and, albeit more slowly, on the reform of the health sector.