China has largely controlled COVID-19. A country of
1·4 billion people and a size similar to Europe or the USA
now reports only clusters of cases rather than widespread
community transmission.

China has been widely criticised for its role and responsibilities during the pandemic because of censorship, transparency, and human rights concerns. But the rest of the world can still learn from China’s successes in bringing its outbreak under control.China’s response shows the importance of domestic research and public health capacity.

Huge investments have left China much better prepared for COVID-19 than for severe acute respiratory syndrome (SARS). When SARS broke out in 2002, China was unprepared initially, especially as the pathogen was unknown. When COVID-19 emerged in December, 2019, Chinese scientists were quickly able to identify the virus and shared genomic sequencing data internationally on Jan 11, 2020.

By the end of January, doctors from mainland China and
Hong Kong had characterised the clinical features of
patients with COVID-19, person-to-person transmission,
genomic characteristics, and epidemiology, warning
the world about the threat of COVID-19 with research
papers published in The Lancet. China has also been at
the forefront of vaccine research, with promising results
of early trials of a recombinant adenovirus type-5-
vectored COVID-19 vaccine developed in China published
in The Lancet in May and July. Such research was done
incredibly fast and rigorously through close cooperation
within China at a time of national emergency. For other
countries, particularly low-income and middle-income
countries, China’s experience shows the importance of
investing in national health and research systems to
enhance laboratory capacity as well as workforce. They are

fundamental to a quick and effective national response to
health emergencies and to global health security.
A second lesson is that a robust foundation of research
cannot guarantee effective control without strong top-
level political commitment to use science to tackle the
outbreak decisively. Governments and their leaders
must respect science, understand its value, and act
on it in a way that is best for society. China’s National
Health Commission sent three groups of national
infectious disease experts to Wuhan at the beginning
of the outbreak to investigate the risks and transmis-
sion of COVID-19, and their recommendations informed

the decision to lockdown Wuhan on Jan 23. When
Chen Wang, president of the Chinese Academy of Medical
Sciences, and colleagues saw the need for Fangcang
shelter hospitals, the government was quick to respond.
Third, achieving rapid and effective implementation
of control measures for COVID-19 requires broad
community engagement. Community solidarity has
been unprecedented during the COVID-19 outbreak in
China. Control measures that could sacrifice individual
freedom, like mandatory mask-wearing in public areas,
were accepted readily by the public. Millions of China’s
community workers have “built the first line of defense
against COVID-19”, according to Xinhua News Agency,
in their work to provide essential health checks and
support for people with fever, severe diseases, pregnant
women, and those quarantined at home. There are
tensions between freedom and security that each country
has to reckon with, and some of China’s approaches
to surveillance, for example, would not be acceptable
elsewhere. But China’s experiences show the importance
of community solidarity and what it can achieve.

So, there are lessons for health to learn from China.
But how will Chinese and global health communities
work together in the future? China’s Foreign Minister
Wang Yi has said that globalisation needs to be more
inclusive and beneficial to all, that multilateralism must
be safeguarded and promoted even more firmly, and that
global governance needs to be reformed and improved
where it is most lacking. The health community is waiting
to see if China will become a multilateral leader in global
health, what role it wants in international global health
security, and whether it will aspire to fill the vacuum in
global health left by the USA.

China is facing legitimate questions in many areas
of its domestic and foreign policy, but when it comes
to COVID-19, scapegoating China for the pandemic is
not a constructive response. “Now is the time for global
leaders to decide: will we succumb to chaos, division
and inequality? Or will we right the wrongs of the past
and move forward together, for the good of all?”, as
UN Secretary-General António Guterres asked in his 2020
Nelson Mandela Annual Lecture. Tackling a global health
emergency like a pandemic requires open collaboration.
The lack of global solidarity to address COVID-19 amid
geopolitical instability is a threat to us all.


The Lancet



https://www.thelancet.com/pdfs/journ...NhiVKq6UgcWIpM