From SARS To H7N9: How China Handles Infectious Diseases

British Embassy Beijing

July 2013


A decade on from SARS, China has transformed its approach to handling infectious diseases. Overall, China’s health reforms offer increasing commercial opportunities for UK companies and institutions. However, China’s healthcare problem areas – such as indiscriminate prescription and weak governance structures – also present risks for global health and for companies operating here.


SARS 10 years on

Ten years ago, China was shaken by the outbreak of Severe Acute Respiratory Syndrome (SARS). Globally, the virus infected 8096, killing 774.  It was easily transmitted by coughing and sneezing; many victims were medical staff. GDP growth for 2003 fell by 2%.

The emergence of H7N9 avian flu earlier this year inevitably brought comparisons. But the diseases are different. There is no evidence of sustained human to human transmission of H7N9. Most victims (so far 134 cases, including 43 deaths) were already weakened by other health conditions.  The number of new cases has slowed considerably.  There have been no cases outside China and Taiwan.

Crucially, China’s handling of H7N9 is a vast improvement on 2003.

In 2003, information on SARS cases was initially highly restricted. Later, cases were reported monthly, with frequent delays and omissions.  Ten years on, China has the world’s largest internet-based disease reporting system, capable of providing real-time updates. Pneumonia cases of unknown cause must be reported within 24 hours. On H7N9, China has openly collaborated with the WHO, sharing hourly updates, virus samples and giving access to investigators. Frequent updates have been given to the public.

China has also improved its capacity to handle outbreaks.  Since 2003 there have been huge investments across the country. The annual budget for China’s Centre for Disease Control has risen sharply. China has improved the capacity of its hospitals, disease control and prevention centres, and health inspection institutes. Health workers are better trained in disease surveillance.


Remaining challenges

However, China has some way to go to improve inter-government co-ordination, local monitoring and response systems, particularly in rural areas. It could also improve both its capacity to identify new pathogens and reporting.



Infectious disease control is just one of many health challenges China faces. As China continues to improve its healthcare system, there are increasing opportunities for policy exchange and commercial contracts for UK companies and institutions. We are maximising these opportunities through Prosperity projects, the GREAT campaign and realigning UKTI resources.

However, China’s health challenges also present risks. Governance and regulation of the Chinese healthcare sector is light. Doctors and hospitals rely on revenues from drugs to supplement salaries and cover operating costs. From a global health perspective, this practice leads to an increase in drug-resistant viruses. It is also a challenging operating environment to do business.


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Sectors: Bio & Pharma Marketing & Sales, Biotechnology & Pharmaceuticals, Healthcare & Medical, and Pharmaceuticals
Countries: China
Topics: Getting Started
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