Doctor Ji Jiafu operates with his staff on a cancer patient in an operating theatre in the Beijing Cancer Hospital July 12, 2011. (David Gray/Courtesy Reuters)

Foreign Affairs just published its November/December issue, which includes my piece “Sick Man of Asia” (behind paywall).  The title is reminiscent of “Sick Man of East Asia,” a metaphor used to allude to a China too weak to withstand the challenges posed by Western powers in the early 20^th century.  Ironically, as China is regaining its greatness, the disease burden is rapidly increasing, suggesting a sicker China in the post-Mao era.  Here is some epidemiological data:

–The average life expectancy in China rose by only about 5 years between 1981 and 2009.  In countries that had similar life expectancy levels in 1981 but had slower economic growth thereafter–Colombia, Malaysia, Mexico, and South Korea, for example–by 2009 life expectancy had increased by 7 to 14 years.

–While China is still battling a legion of infectious diseases, noncommunicable diseases–including cardiovascular disease, chronic respiratory diseases, and cancer–account for 85 percent of total deaths in the country, much higher than the global average of 60 percent.

–17.5 percent of the Chinese population, or more than 227 million people, suffer from some form of mental problem.  This is one of the highest such rates in the world.

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A married couple from Shenzhen puts cans of milkpowder they bought for their baby into a backpack at a drug store at Hong Kong's northern rural Sheung Shui district, neighbouring Shenzhen on January 31, 2011. China food safety concerns and a strong currency are prompting a flood of Chinese parents to sweep supplies of milk powder from Hong Kong shop shelves, triggering citywide shortages and angering parents. (Bobby Yip/Courtesy Reuters)

Food safety is transforming from a backburner issue to Topic A in China.  While travelling in China recently, I had the opportunity to speak to taxi drivers, government officials, business entrepreneurs and farmers. They all agreed something had to be done to make Chinese food safe (I have to confess that when I was having Peking duck during my trip to China, the issue of food safety, now at the tip of so many tongues, did not come to my mind).

Amid the growing public outcry, the government, led by Vice Premier Li Keqiang, has launched a new campaign to crack down on food safety problems.  Since the dust of power jockeying for the new generation leadership has not settled, Li, who is to succeed Wen Jiabao as China’s next premier, has to work extra diligently in order to claim at least partial success in the areas he has been asked to be in charge of.  Alas, none of the assignments –  healthcare reform, food safety, and price control – seem to be easy tasks.  Interestingly, different segments of Chinese society have already devised their own approaches to grapple with the food safety crisis.  The government’s Special Food Supply Center has been set up to make sure the elite eat organic while farmers are so conscious of the problem that they only trust their own produce.  When I asked a taxi driver in Beijing about his approach, he confided that he avoided small grocery stores and shopped only in shopping malls instead.

To be fair, the food safety crisis is not unique to China.  The globalized food supply chain has also globalized the risk of food borne illness.  Noting recent outbreaks and scandals in Japan, Taiwan, and Germany, I published a piece in the Beijing Review originally titled, “Globalized Food Safety Conundrum”.  For reasons I don’t understand, “safety” was dropped from the title by the editors. The message though is pretty clear: countries need to work together to deal with food safety challenges in the era of globalization. Read more »

A boy from northwest China's Xinjiang Uygur Autonomous Region gets first aid for cigarette-burn wounds in the Baoji Xinxing Aid for Street Kids at Baoji in Northwest China's Shaanxi province. Baoji Xinxing Aid for Street Kids is a Chinese NGO fully funded by donations and provides clothing, food, accommodation, and basic health for street kids from all over China. (Nir Elias/Courtesy Reuters)

Last week, I went to Beijing to attend a conference on “China’s Emerging Global Health and Foreign Aid Engagement” co-hosted by the Washington-based Center for Strategic and International Studies and the China Institute of International Studies. My presentation focused on the evolution of Chinese domestic decision-making on global health and foreign aid programs in Africa.  Prior to my departure, news came out that the Global Fund to Fight AIDS, Tuberculosis and Malaria had frozen payments of grants to China worth hundreds of millions of dollars. According to the New York Times, the Fund’s decision seemed to be “rooted in a collision between the fund’s conviction that grass-roots organizations must be intrinsically involved in the fight to control diseases like AIDS, and the Chinese government’s growing suspicion of any civil-society groups that are not directly under its control.” The Times’ speculation was later confirmed by the Chinese Ministry of Health officials. Read more »

Mexican soldiers unload boxes with medical aid donated by China at the airport in Oaxaca, Mexico on May 5, 2009. (STR New/Courtesy Reuters)

On March 11, I had a debate with Ambassador Jack Chow of Carnegie Mellon University on the question: “Should the United States press China to make the full transition from health aid recipient to global health donor?” The event was hosted by the CSIS Global Health Policy Center as part of its “Fault Lines in Global Health Debate” series. You can listen here to our discussion on China’s status as a recipient of and contributor to global health aid, as well as the prospect for China to make the full transition to a global health donor.

The debate occurred only a few hours after the devastating earthquake and tsunami hit Japan. While I was concerned about the safety of my Japanese friends, I could not help but think of China’s Tangshan earthquake 35 years ago, which resulted in the loss of around 250,000 lives. To the surprise of the international community, China had declined the offer of humanitarian and medical assistance by Japan and other foreign governments. By contrast, China today faces growing pressures to significantly increase its global health aid and other development assistance. Critics find it ridiculous that a country with the largest foreign exchange reserve and the second largest fiscal revenue is still aggressively pursuing grants from the Global Fund to Fight AIDS, Tuberculosis, and Malaria.

While I am sympathetic to the critics’ perspectives, I don’t think the United States has very much leverage to press China to become a full global health donor. Read more »

While Kremlinology is no longer in vogue, our understanding of the inner workings of the elite politics in China still benefits a lot from the cables sent by our nosy and diligent diplomats based in Beijing. But if one anticipated that WikiLeaks would churn out truly juicy stuff on what transpires within the Zhongnanhai compound, he would be deeply disappointed. Not only was there nothing breathtaking, but the use of rumor mills such as wenxuecity.com raises questions on the reliability of some collected information.
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Last week, I took the train from New York City to Stamford, Connecticut to give a talk. The distance between Grand Central Station and Stamford is 33 miles, and it took me 44 minutes to get there. Not bad – at least I got there in time. Two weeks ago, I went to D.C. to participate in a conference, but the train was disabled at Baltimore station (how many times have we heard of a disabled Amtrak train?). I ended up spending six hours on the road. When I was waiting in the silent and dark train, I could not help but comparing the United States and China in high-speed train development. The distance between New York and Washington is about the same as that between Shanghai and Nanjing. The difference is the time it takes to complete the trip: one hour in China and three hours in the United States.
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