TIMELY AID: A disease control worker hands out disinfectants and most commonly used drugs to people who live in tents after a catastrophic earthquake in Wenchuan, Sichuan Province, on May 12, 2008 (ZHANG LING)

"As the country's first ever regulations on public health emergency handling, they define duties and responsibilities of various government departments. They serve as the first legal instrument for building an emergency response mechanism and a complete legal framework for handling public health emergencies in the future, as well as provide guidance for local governments of all levels for building their own emergency response programs," said Song Ruilin, who headed the drafting team of the regulations.

Zeng said that instead of any advanced technology, containing SARS only required timely release of the outbreak status information, quarantine measures to cut off further infection and special protection for high-risk groups. "The severity of the outbreak was due to China's weak public health monitoring system with too many loose links," he noted.

"It became clear to us that public health services and control of major epidemics concern not only health authorities but the whole society. The government should take the primary responsibility," said Wang Longde, then Vice Minister of Health.

A mature mechanism

After the SARS outbreak, the Ministry of Health set up a medical emergency response office in early 2004.

In August 2007, the Emergency Response Law was adopted by the NPC Standing Committee. According to the law, all ministries quickly formulated their emergency response plans, covering circumstances including severe epidemics, natural disasters, poisoning incidents, environmental pollution, nuclear leaks and major railway, civil aviation, power and coalmine accidents.

"The emergency response planning started in China in the field of disease control, which permeated the entire field of public health and eventually covered all kinds of safety hazards. This progress can be regarded as a legacy of the SARS outbreak," Zeng said.

Over the past decade, the Law on the Prevention and Treatment of Infectious Diseases, the Frontier Health and Quarantine Law and the Animal Epidemic Prevention Law were also amended to become more effective in containing the spread of infectious diseases after revision.

According to Wang Yu, over the past decade, China's disease control system has made great progress, where passive reaction to an ongoing pandemic has been replaced by response planning in advance and isolated reactions taken by local authorities replaced by systematic and joint efforts. He said that the whole country has already been covered by a network of controlling and treating infectious diseases.

Wang's daily work includes checking the daily update of infectious disease cases collected by local disease control and prevention agencies from across the country by logging into an internal database from his computer. Even cases of unknown diseases will be reported through this system.

"This system is useful for us to collect information timely and obtain the disease spectrums of specific regions and age groups in the long term, which can be used as reference for the government's decision making and planning of investment in local health services," Li said.

Li is the first person to suggest the establishment of such a unified national information system to the Central Government. When then Vice Premier Wu Yi visited the CDC on April 1, 2003 in the heat of the SARS outbreak, Li highlighted the need for a national information system, which would alert the center of a new SARS case in the country immediately.

The system proved to be pivotal in containing the later spread of avian and swine flu viruses in China.

On April 2, 2009 a four-year-old boy in Mexico was diagnosed with swine flu which is considered the first case of the H1N1 strain infecting humans.

On April 25 that year, the WHO declared the H1N1 outbreak a public health emergency of international concern. Four days later, the WHO raised the influenza pandemic alert from phase 4 to phase 5, signaling that a pandemic was imminent, and requested that all countries and regions immediately activate preparedness plans and be on high alert for unusual outbreaks of influenza-like illness and severe pneumonia.