China, with its state-controlled media and strong government presence, has traditionally tried to keep news of a pandemic under wraps. An outbreak of an illness can weaken public confidence and scare away tourists, business travelers, and investors. But as China has discovered, this strategy in fact can help deadly diseases boil over and become epidemics.

The Chinese government’s slow and secretive response to a mysterious disease that appeared in 2003 damaged their credibility at home and abroad.

It was not even the first time that this strategy had backfired. Their unconcerned reaction to HIV/AIDS in the 1990s allowed the virus to spread throughout China. Recently, however, officials are applying what they learned from their mishandlings, and are leading a more open campaign against infectious diseases.

When HIV entered China in the late 1980s, officials refused to acknowledge that it was a threat. They insisted that China was immune to a disease that, they claimed, afflicted immoral societies. This initial denial led to deception as local and national officials began burying evidence that HIV/AIDS was a mounting problem.

In the early 1990s, a doctor named Wan Yanhai disclosed that government officials in Henan province had run illegal and unsafe blood-selling schemes. Thousands in Henan and possibly millions worldwide had received tainted blood and became infected with HIV. This proved what international experts had suspected: that HIV/AIDS was in China and that it was spreading. Even worse, the government seemed willing to sacrifice people’s lives rather than admit that they were wrong.

The Chinese government had a chance to handle things differently when a new and deadly respiratory disease suddenly appeared in China during the winter of 2003. The disease was eventually named Severe Acute Respiratory Syndrome, or “SARS” and it infected over 8,000 and killed 774 worldwide. SARS was easily transmissible and health care workers trying to treat patients were particularly susceptible. The dramatic appearance and rapid spread of SARS grabbed international headlines, even though it killed far fewer people that year than the common flu.

In China, though, the state-controlled press barely mentioned the health emergency. When the government did begin to allow reports, they downplayed the number of infections. Dr. Jiang Yanyong exposed the cover-up, saying that his hospital in Beijing had more SARS patients than the government was reporting country-wide. In response to a public outcry, both the national Health Minister and Beijing mayor were fired and the government published daily tallies from that point on.

The damage, however, was already done. Mistrust of the news and the government led to panic as thousands tried to flee the capital. The government declared military-enforced quarantines of thousands in their homes or in hospitals. Travel in Asia plummeted and China’s economic growth was harmed. Meanwhile, by not allowing the World Health Organization officials to investigate the crisis in China for months, the Chinese government enabled the disease to become an international crisis.

SARS has since been declared “eradicated” and it appears that China’s government is mending both their credibility and their effectiveness in protecting their citizens’ health. China's new "Four Frees and One Care" program, announced in 2005, will improve education, reduce stigmas, and provide treatment for those living with HIV/AIDS. The government pledges to provide free voluntary counseling, testing, and antiretroviral drugs to pregnant women, rural residents, and the urban poor. They pledge also to give free schooling for children orphaned by AIDS, and economic assistance to people living with HIV/AIDS.

China has also been more frank about bird flu. The government recently admitted to covering up the first human death from bird flu in 2003. As of 2006, they are routinely disclosing outbreaks among poultry flocks and stepping up public education campaigns.

"SARS loosened them up," Eric Goosby, president of the Pangaea Global AIDS Foundation, (quoted in an article on the Kaiser Family Foundation website) has said, "They found they could reveal a vulnerability and not get criticized for it."

Author: Heather Clydesdale