WHEN THE CHINESE leadership was forced to admit it had covered up the extent of the infectious disease called severe acute respiratory syndrome, or SARS, it responded with what many called the most serious political shake-up since the Tiananmen Square massacre of 1989. The government sacked the minister of health and the mayor of Beijing from their government and party posts, admitted that the number of patients and deaths in the capital was radically higher than previously disclosed--in other words that it had lied--and launched a mass propaganda campaign to deal with the illness.

If these dramatic moves were intended to distract attention from months of deception and negligence, they succeeded. Senate majority leader Bill Frist, visiting Beijing with a congressional delegation, offered President Hu Jintao "tremendous compliments because he took bold action over the last 48 hours while we were here in China to boldly and courageously address this virus." With all due respect to Dr. Frist, there are exemplars of courage in the SARS fiasco, but Hu is not among them.

Understandably, however, the unusual firings and rapid about-face have fed hopes that China has turned a political corner. "This is the beginning of the end," a senior Chinese official credited with democratic sympathies told the Washington Post's John Pomfret. "This is the spark many of us have been waiting for."

If China's policy reversal in its handling of SARS is a political watershed that signals greater openness and accountability, then we need to know what brought it about. After all, for months, China's government chose the costs that Communist regimes will tolerate--illness and death--over those they cannot accept--political and economic turmoil.

There are two answers. First, international pressure became too intense to ignore. Once the disease spread abroad, via Hong Kong, China's callous neglect of its people's health was no longer only its affair. Foreign governments coping with SARS were furious. Even Hong Kong's favored elite, always quick to take Beijing's side, felt betrayed. China's response to the disease was embarrassing by comparison with that of Taiwan, which sought to cooperate with the World Health Organization even though it is denied membership by the international "One China" policy. Prominent visitors like British prime minister Tony Blair postponed visits. The Rolling Stones cancelled concerts. Business and tourist travel fell off. Even the WHO--which had publicly praised China for its cooperation, while itself being barred from the site of the outbreak in Guangdong province--privately welcomed press scrutiny and external pressure on the regime. Ultimately, the WHO told China, "The international community doesn't trust your figures."

This skepticism arose from the second factor behind the regime's abrupt reversal: truth-telling from inside China. A lone retired military doctor--Jiang Yanyong--contacted the media to say that Beijing was lying about the number of cases in the capital. Personnel from other hospitals followed his example, telling reporters that they had been told to hide patients suffering from SARS in a hotel and in ambulances that were driven around the city while WHO investigators conducted visits.

It is too soon to judge the political impact of SARS on China's one-party rule. The fall of the health minister and mayor of Beijing may have been part of a deal to apportion the fallout among political factions while protecting senior leaders. The health minister was an ally of former president and party boss Jiang Zemin, who seeks to retain influence despite his retirement from key posts, while the mayor is associated with the Hu Jintao camp. The Beijing Communist party leader survived and was even appointed to a new task force on SARS although he is thought at least as culpable as the mayor. As yet, there have been no political casualties in Guangdong, where the problem festered for months without an adequate response, reflecting the regime's desire not to further damage the economically important province's international reputation, or possibly the clout of its party apparatchiks.

The human toll of SARS in China's enormous population is also unclear. It has spread to poorer, inland provinces where health care is woefully inadequate. The impact of the disease on populations like factory workers and the military who live and work together at close quarters is an open question. Failure to include data from military hospitals was a major reason for underreporting in the capital. Resentment from workers and the military could play out unpredictably in the weeks and months ahead.

The SARS outbreak provides yet another object lesson in Chinese politics. A political shake-up, complete with firings and a commitment to eradicating SARS, may not be all that it seems. If, however, it is the beginning of change within the regime, the international community needs to understand why and act to encourage it. There are people in China who are willing to take risks to tell the truth--in this case, to safeguard the health of ordinary citizens rather than of the Communist party. They are the people who deserve to be called courageous. They need support from the international community, and they benefit from pressure on the regime. As one Chinese citizen said of China's leaders, "They are only going to be as open as they have to." Another truth.

Ellen Bork is a deputy director at the Project for the New American Century.

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