Preventing Epidemics Requires a Global View

Cover Editorial - EO print edition no. 425
Translated by Paul Pennay
Original article: [Chinese]

A glance at the WHO statistics regarding the number of confirmed cases of (A)H1N1 influenza detected in various countries and regions around the world, reveals an obvious correlation: The number of cases detected in a country or region is in direct proportion to its level of economic development.

The number of cases of H1N1 in the U.S. has already passed that of Mexico, the origin of the outbreak, to top the list. England, Japan, Australia, Canada and other developed countries also appear high up the list.

One possible explanation for this phenomena, is that a country's economic power is closely related to its level of openness to the outside world - that more openness brings greater risk.

China is the world's third largest economic zone, therefore cases of imported disease are not only to be expected, but are unavoidable.

Thanks to the appropriate and timely measure taken by the government to prevent the spread of the disease, there have thankfully been no large-scale domestic outbreaks of the influenza.

This success owes a lot to the lessons learnt from dealing with SARS six years ago.

In the fight against H1N1, some episodes stand out. Take for instance the case of the fourteenth patient detected in Beijing. When this individual entered the country, they failed to truthfully complete the health inspection form, and were subsequently charged and fined by the Beijing Disease and Inspection Bureau.

This largely symbolic act perhaps did more than any concrete move in reminding the general populace that - in preventing the spread of H1N1, every citizen has responsibilities.

Strengthening border health checks, doing their best to treat those who have been infected, these are the responsibilities of government.

Completing health inspection forms when entering the country and to spend time at home monitoring ones health when returning to China, these are the duties that each citizen ought to complete.

There's no doubt that the entire population are involved in the fight against H1N1.

On another note, although preventing the spread of H1N1 is not the responsibility of government alone, it's clear that the government should be the main actor.

With the changing nature of the epidemic, the health department has had to change its strategy.

From the initial concerns with controlling China's borders, the focus has now changed to monitoring the situation in residential areas, schools, hospitals and other susceptible areas so that if an outbreak does occur, they'll be able to limit the scale and harm caused.

These preventive measures have drawn on the lessons of history.

In particular, the Japanese government's experience in battling the Spanish Influenza epidemic that swept the world from 1918 to 1920 is very informative. The Japanese government had from the very start implemented strict measures aimed at limiting the spread of the disease, but because most of their attention was focused on border controls at the expense of other preventative measures, the epidemic ended up claiming 390,000 Japanese lives.

Recently, the Beijing government announced that they have ordered 5 million doses of a H1N1 vaccine. This makes them the fist local government on the mainland to arrange such an order.

Previously, only the governments of Hong Kong and Macao had announced plans to purchase a H1N1 vaccine.

Of the 5 million doses of the vaccine ordered by the Beijing government, top priority has been given to inoculating children, the elderly, medical personnel and others who have a greater risk of catching the influenza. It's expected that the vaccine will be available in August this year.

Beijing's methods are a sign that the government is shouldering its responsibilities. But we think that in regard to preventing the spread of H1N1, a more integrated approach is required.

In regards to the Beijing government, we believe that the vaccine should not only be offered to those who possess a Beijing household registration (hukou), but should also be available to all residents of the capital regardless of where they're originally from.

In terms of the total population of Beijing, residents number far more than the those tightly defined as Beijingers. If you want to protect Beijing, you need to protect them too. Beijing's health, is not just about the health of Beijing natives.

Now, the number of cases of H1N1 in the various provinces and autonomous regions of China also reflects the same correlation observed in regard to the international situation: those more economically developed areas have witnessed a higher number of cases.

The coastal cities in China's east have witnessed more cases than less-developed western areas.

This is not to say that areas that currently have few or no cases of H1N1 should be less vigilant.

In the process of preventing the spread of H1N1, any kind of "local consciousness" or focus on the demands of one area at the expense of others,  has the ability to develop into a global disaster.

Not long ago, the Secretary General of the United Nations, Ban Ki-moon, wrote an article stressing how important it is that countries cooperate with each other: "the current situation demands that we come together and strengthen our efforts. When a new strain of disease spreads across the world, we can't just let the rich be the ones who receive a vaccination or anti-viral drugs. If poor countries aren't healthy, then wealthy countries won't be able to avoid the crisis."

These words are also clearly applicable to China's own domestic strategy for preventing the spread of disease - we too must take a global view.