Sieren's China: Vaccines against trust

The Panama Papers or corruption in healthcare? The Chinese population seems to be clearly more worried about the latter because it affects it personally. When you are vaccinated against a disease you want to be certain to be immune to it.

Therefore, there was a huge outpouring of anger two weeks ago when it became clear that a pharmacist from the province of Shandong and her daughter had sold vaccines that had almost expired all over China. They included vaccines for diseases such as rabies or influenza. Over 130 people implicated in the case have since been arrested. There has been anger on the Internet regarding the Panama Papers, especially as it seems that even family members of President Xi Jinping had offshore accounts (although these are not being addressed), but it is nothing compared to the outrage over the vaccine scandal despite efforts by China's State Food and Drug Administration (CFDA) to clear things up.

Nationwide crime network

The CFDA has seized 20,000 doses of illegal vaccines in 29 companies and 16 clinics across China. However, millions are thought to have been administered already. The state media estimate them to be worth about $90 million (79 million euros). Most of the vaccines were for rabies or influenza, which are not covered by the state.

When the scandal broke, only private clinics came under suspicion but illegal vaccines have now also been found in state hospitals. The network that sold them nationwide operated for five years. The World Health Organization has said there was a lack of monitoring and oversight on the part of the state authorities, especially in more remote western provinces where the vaccines were distributed in state hospitals. Those who have gone out onto the street are justified in asking how a party and government can run a country if they cannot ensure that medicine is not tampered with.

For years, people spent money on vaccines that had no effect. Reassurances that vaccines that have expired or been stored incorrectly will not have any dangerous side effects can do nothing to change this. The damage to the government is likely to be enormous. Prime Minister Li Keqiang's promises to act against those responsible will not win back the trust of China's parents so easily.

Fear of upsetting citizens

The Chinese government needs the population's trust since it is not elected democratically. It has to be able to gauge discontent before such scandals create an outlet for resentment that Chinese citizens are not able to express at the polls. The importance of the outlet created by elections in mature democracies can be observed in Germany at the moment.

Over the past eight years, several scandals in China's health system have shattered the trust of citizens. The consequences have always been worse than those from scandals regarding rampant corruption. In 2008, milk powder that had been adulterated with melamine killed six small children and made 300,000 ill. In 2012, dozens of pharmaceutical companies used gelatin that had high amounts of chromium in their capsules. Chromium is carcinogenic and causes damage to the liver and kidneys.

Each time, the government tried to improve the situation. Sometimes with success: the immunization rate for measles attained 99 percent compared to 91 percent in the US.

Weaknesses of the system become visible

China's existing immunization system is divided into free, state-funded vaccines that are compulsory, such as for measles, and voluntary vaccines that have to be paid for separately. This second area has been privatized. However, when it comes to health the government cannot weigh up failures against successes. Each crisis is considered to be representative of a bigger problem. The latest scandal is not an isolated case concerning particularly unscrupulous people. It highlights the weaknesses of the system clearly in which local health monitoring centers enjoyed a source of income from distributing vaccines. They monitor which clinic gets which vaccines at which price and exploit this power. A lack of control and oversight on the part of the central government can be blamed for the vaccination scandal and all other such scandals. It does not seem to have found a satisfactory solution yet.

Now that Chinese-made vaccines can no longer be trusted, many prefer to pay 500 yuan (ca. 67 euros; $76) for imported medicine or to go to Hong Kong or Macau. Each time, the government annoys them a little bit more.

Frank Sieren has lived in Beijing for over 20 years.