ABSTRACT
In 2003, the severe acute respiratory syndrome (SARS) epidemic began its spread across China. This potentially devastating infectious disease constituted a crisis for which the Chinese government was unprepared. Assessments of China’s initial response to SARS pointed to numerous failures that were largely attributed to the inability of the state to provide sufficient public health support (Canadian Department of National Defense 2003). Perhaps unexpectedly, the negative assessments of China’s SARS response changed over time, reflecting China’s success in ultimately bringing under control a disease once expected to spread across the country, infecting millions. What enabled China to turn around what seemed to be a rapidly deteriorating disease control situation? Did non-state actors play an important role in China’s effective SARS response? If so, what does the SARS case teach us about the impact of crises on relations between the state and civil society organizations in the realm of social service provision? I open the chapter with a review of definitions of civil society and crises. I then analyze the Chinese infectious disease control infrastructure, its capabilities and reach. Then, following a brief description of the genesis of the SARS outbreak, I evaluate the different roles played by state and non-state actors in response to the outbreak. I conclude that, in order to control SARS effectively, the state was forced to increase its investment in, and attention to, public health issues even as it turned to a variety of non-state actors for assistance in what reflects a shifting dynamic in state-society relations in China’s public health sphere.
