China toughens disease law

In the wake of SARS, a revised law ensures funding for infectious disease control

Sep 9, 2004
Paul Mooney(pjmooney@mac.com)

International observers reacted with cautious optimism this week to news that China's parliament has beefed up its main infectious disease and control law, warning that the law needs to be properly implemented for it to have the desired effect.

"The new legislation sounds sensible–although the devil is always in the detail," said Vivian Lin, head of the School of Public Health, La Trobe University in Australia, and an expert of public health in China.

"From a Western perspective, we'd always be looking for an appropriate balance between coercive powers to protect the public and protection of individual liberties–privacy, autonomy, and confidentiality," she told The Scientist. "It's important to have reserve powers, but how they are exercised and delegated and scrutinized are important."

The Standing Committee of China's National People's Congress responded to last year's SARS outbreaks by passing a revision of the country's Law on the Prevention and Control of Infectious Diseases, requiring the central government to guarantee funding for disease control around the country.

The law was passed last week at the 11th session of the Standing Committee, which ended August 28. It underscores prevention and early warning of contagious diseases and isolation of patients, according to the official Xinhua newswire. It also puts greater responsibility on medical institutions to monitor the spread of contagious diseases and prevent such spreads within hospitals.

The SARS outbreaks helped health officials realize the urgency of amending the infectious disease prevention laws, a professor of law at Peoples University of China, Beijing, told The Scientist. "It can clearly be seen that the law on infectious diseases has been revised on the basis of the lessons we learned," he said, speaking on condition of anonymity.

Senior Chinese health officials agreed. "The amended law sums up the lessons that China [learned] during its fight against the severe acute respiratory syndrome last year and its control of the bird flu outbreak this spring," Li Yuan, an official with the Legislative Affairs Commission under the Parliamentary Standing Committee told the state-run China Daily.

Gao Qiang, vice minister of health, told Xinhua that a lack of adequate funds had undermined the capabilities of organizations entrusted with the control of infectious diseases. "Due to the lack of money, some patients could not receive timely, effective, and formal treatment and became new sources of infection."

"China's ability to supervise and give early outbreak warnings of an infectious disease is weak," Gao said. "Epidemic reporting is likewise inefficient. The control of cross-infection is lacking and contingency measures for the outbreak of contagious diseases are lagging. All these problems emerged during the efforts to prevent and control SARS."

The legislative revision also specifically targets AIDS, the first time this has been included in Chinese law. It stipulates that governments should strengthen prevention and control of AIDS and take measures to prevent the spread of the disease.

Official Chinese estimates put the number of people infected with HIV at 840,000, but foreign experts say there are many more. In Henan province, in central China, many poor farmers have been infected as a result of poorly managed blood-selling programs. Local officials attempted to cover up the scandal for years, pressuring protesters and trying to prevent news coverage of the problem. UNAIDS, the Joint United Nations Programme on HIV/AIDS, says that the number of infected Chinese could be as high as 10 million by 2010 unless an aggressive program is adopted.

A spokesman for the World Health Organization in Beijing declined to comment on the revision to the law, saying a full translation of the document into English had not been completed yet.

The parliament also passed a law regulating the buying and selling of blood to halt the spread of HIV infections connected with unsafe blood buying around the country. China Daily reported that 11% of reported AIDS cases in China were infected during the process of having blood drawn or blood transfusions.

The new law calls on all levels of government to improve HIV prevention and control, and for hospitals and blood collection centers to report any signs of infectious diseases among donors and patients.

The US-based group Human Rights Watch welcomed the change, and urged the Chinese government to enforce the law and to use public information campaigns to combat discrimination against people living with HIV/AIDS.

"This law is long overdue. Now the Chinese government needs to ensure that violations are effectively monitored and that the law is enforced," Joanne Csete, director of the HIV/AIDS Program of Human Rights Watch, told The Scientist. "At the same time, the Chinese authorities need to address the nationwide lack of awareness about AIDS that fuels discrimination."