What China claimed it was not covering up is a much higher incidence of SARS--a virus causing high fever, shortness of breath, and an estimated 4 percent death rate--than it had previously admitted. Two days after Jianchao's statement, Chinese authorities made a rapid about-face, revising numbers upward and admitting cases in provinces where they had previously denied any incidence of the disease. They also increased their cooperation with the World Health Organization, to which China belongs. As a result, a WHO team has finally been allowed access to Guangdong, where the disease apparently started.
Only international pressure brought about China's belated and still ambiguous response, more than four months after the disease first appeared. No matter what new information is now made public, as the WHO's Executive Director of Communicable Diseases, David L. Heymann, says "If the world had known about the disease in November, it might have been able to prevent its spread to the rest of the world." But spread it did, first to nearby Hong Kong, then to Southeast Asia, and beyond. The United States reports 100 cases. As of April 3, the worldwide toll was 2,270 and 79 deaths.
As late as April 2, the Chinese health minister was claiming the disease was under control, even as the WHO issued an unusual worldwide warning against non-essential travel to Guangdong province and Hong Kong. China's response predictably bore the hallmarks of its Communist culture: secrecy, denial, and politicization. The interests of the Communist party trumped those of public health. The government warned Chinese journalists not to write about the disease. The provincial party secretary of Guangdong province, a member of the Politburo and therefore more powerful than the national government's minister of health, told the public to "voluntarily uphold social stability" and "not spread rumors."
While the government is providing more information, its behavior nevertheless follows a familiar pattern of Communist behavior. The director of China's Center for Disease Control made the traditional, Communist self-criticism, apologizing for the "poor coordination" among "medical departments and our mass media." For the international audience, the China Daily, an English-language propaganda organ directed exclusively at foreigners, criticized local authorities for their lax response to the outbreak. Only last week has the Chinese media been permitted to cover the story, and it is still circumscribed in what it may report.
In Hong Kong, under Chinese rule for nearly 6 years, the leadership has shown similar inclinations. The Beijing-appointed chief executive, Tung Chee-wha, eliminated the negative and accentuated the positive. He initially resisted tough measures to isolate the disease and touted the efforts of Hong Kong's scientists to identify the virus (which were, by all accounts, impressive). But two weeks later, he ordered schools shut and a quarantine of those infected. Meanwhile, Tung's Secretary of Health, Welfare and Food, Yeoh Eng-kiong has lashed out at the WHO for causing panic and accused Hong Kong's lawmakers of "sowing discord" after they called him to a public hearing on the outbreak.
At least these absurd performances were exposed. Hong Kong remains freer than the mainland. The media, both local and international, were able to cover the story, including the slow response of the authorities and the distinctive course the disease has taken in Hong Kong. Experts believe that SARS in Hong Kong has been affected by environmental factors in an enormous housing complex, such as the water supply or sewage, causing large numbers of people in the same housing complex to become ill. The numbers there have begun to drop off, and there is no suggestion from international health experts that Hong Kong is hiding the extent of the problem. Whether such environmental factors have come into play in Guangdong and what measures have been taken there to stop the spread of the disease remains unclear because of Beijing's continued failure to be wholly forthcoming.
Then, there is Taiwan. The island's government immediately asked the WHO for assistance. Taiwan, which is not a member of WHO, was rebuffed by the organization, whose officials praised Beijing's response, even as China stonewalled. Nevertheless, Taiwan responded quickly, taking steps to isolate itself from the outbreak and, according to a source at WTO's Geneva headquarters, unofficially provided that organization with information about its own cases of SARS. Taiwan has no reported deaths from the disease, 14 probable cases, and several dozen suspected cases.
The lessons of SARS for China, and for the international community, are unmistakable. Democratic, accountable, transparent governments do a lot better at dealing with a health crisis than a Communist one. Moreover, China's participation in international organizations does not, on its own, bring about responsible, let alone humane, behavior. Meanwhile, Hong Kong deteriorates under the influence of Beijing's Communist culture. By the year 2007, a decision must be made about Hong Kong's future system of governance. Those countries, chiefly the United States, which promised to protect Hong Kong's freedoms and autonomy should declare themselves in favor of a full democracy. Many of Hong Kong's democrats favor a constitutional convention, which is both appropriate and feasible. Meanwhile, Taiwan, already a democracy, must be granted the rights and privileges that go with that status, such as membership in the WHO. SARS is just one example of why anything less doesn't make sense.
Ellen Bork is a deputy director of the Project for the New American Century.