from Global Health Program

Governing Health in Contemporary China

Foreign policy analyses written by CFR fellows and published by the trade presses, academic presses, or the Council on Foreign Relations Press.

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The lack of significant improvement in people's health status and other mounting health challenges in China raise a puzzling question about the country's internal transition: why did the reform-induced dynamics produce an economic miracle, but fail to reproduce the success Mao had achieved in the health sector? This book examines the political and policy dynamics of health governance in post-Mao China. It explores the political-institutional roots of the public health and health care challenges and the evolution of the leaders' policy response in contemporary China. It argues that reform-induced institutional dynamics, when interacting with Maoist health policy structure in an authoritarian setting, have not only contributed to the rising health challenges in contemporary China, but also shaped the patterns and outcomes of China's health system transition. The study of China's health governance will further our understanding of the evolving political system in China and the complexities of China's rise. As the world economy and international security are increasingly vulnerable to major disease outbreaks in China, it also sheds critical light on China's role in global health governance.

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Reviews and Endorsements

Yanzhong Huang's book reflects a deep knowledge of Western theories as well as of Chinese political processes. On the basis of a decade of research, he traces the changes taking places in China in the politics of health policy as 'buck-passing' replaces 'bandwagoning'.

Ezra F. Vogel, Professor Emeritus, Harvard University, and author of Deng Xiaoping and the Transformation of China

Yanzhong Huang has written an important book. He asks—Why have Chinese public health indicators failed to match China's economic performance in the reform era? Indeed, why have they failed to match Mao's performance? The answer resides in the buck-passing, fragmented, unaccountable system that has developed. Public health improvement requires political change. I recommend this book highly.

David M. Lampton, Professor, Johns Hopkins SAIS, and author of The Politics of Medicine in China

This is a meticulously researched book that has made a valuable contribution to our understanding of the crisis in China's healthcare sector. Yanzhong Huang's research is not only theoretically original, but also insightful in its analysis of the underlying causes of the poor delivery of social services in post-Mao China.

Minxin Pei, Professor, Claremont McKenna College, and author of China's Trapped Transition: The Limits of Developmental Autocracy

Ever since the SARS epidemic of 2003 lifted the curtain to reveal the extent of horrors and ineptitude in China's system outsiders have puzzled over why health has remained an Achilles Heel of the transforming state. Yanzhong Huang is arguably the only expert able to solve this paradox, offering bold and startling insights. This is a must-read for anybody interested in global health, pandemic control, or the future of the Chinese state.

Laurie Garrett, Senior Fellow for Global Health, Council on Foreign Relations, and author of Betrayal of Trust: The Collapse of Global Public Health

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