Authoritarianism is the greatest public health risk

The COVID-19 coronavirus outbreak has made clear the urgency of developing a vital yet overlooked antidote to pandemics — democracy. While the virus spreads, China’s crackdown on freedom of expression has created an environment where doctors are stifled, the free flow of information is curtailed, health recommendations are ignored and the death toll rises.   

This isn’t the first time I have witnessed how the authoritarian Chinese state has fueled the spread of deadly disease. China’s deadly flawed response to coronavirus parallels its past failed strategies to both HIV/AIDS and SARS. The World Health Organization (WHO), the UN and other governments must now recognize: Authoritarianism is a public health risk. Repeated global health crises in China have shown that free speech and the inclusion of civil society are vital to discovering and disseminating an antidote for infectious diseases. Without them, medical professionals are muzzled, health providers kept in the dark and citizens left vulnerable.

When I lived in Hong Kong, I worked with brave HIV/AIDS activists in mainland China. I watched as the Chinese government harassed activists. The Chinese government has continued to systematically target civil society organizations focused on marginalized communities. It is no surprise that in 2018 there was a 14 percent jump in new cases of HIV/AIDS in China. 

Before SARS rapidly spread across China and the world, respected medical leader Dr. Jiang Yanyong raised the alarm on the disease. The government did the opposite, allowing the virus to spread. With Beijing trying to hide the health risks, Dr. Jiang warned foreign colleagues and the press. Those actions alerted the world to the SARS epidemic that would ultimately kill 774 people globally. But Dr. Jiang was subsequently punished and is under house arrest today.

The SARS virus quickly spread to Hong Kong, a city I’ve grown to know and love over nearly a decade living there. Today, the fear of epidemics from China remains in the normally unflappable DNA of my fellow Hong Kongers, an anxiety that has been realized with COVID-19. The epidemic challenge is fueling xenophobia against mainland Chinese in Hong Kong — a city already besieged in a political morass.

In China today, all independent civil society and freedom of expression have been banned. Many of the NGOs I worked with have been shuttered. China is not only attacking political dissidents but engaging in an offensive against “security threats” such as film festivals and even women working to end sexual harassment on public transit. So it is not surprising that the government’s response to the current coronavirus epidemic has included silencing or otherwise covering-up news of the outbreak.

As a result, Chinese citizens are increasingly showing they are fed up with the government’s oppressive control and tired of a system that values authoritarian-dominance over the health of citizens. Online statements and a petition campaign in support of freedom of speech have been trending on China’s internet — and swiftly deleted by the government’s army of censors. Coronavirus is the second time in the 21st century when a global pandemic has been incubated in China, allowed to spread within China and then gone global due to China’s stifling of democracy. 

The WHO’s epidemiological response to communicable diseases is unparalleled. The WHO also acknowledges that human rights and inclusion are necessary components to safeguard public health. It is time for the WHO to acknowledge this requirement in China. The WHO needs to push forward a human rights and democracy approach in China including proactive inclusion of independent media and civil society. The country’s improvement of benchmarks of independent media, civil society and free speech will be required to prevent and respond to this and other epidemics. Congress should also insist on this type of reporting and integration of democracy benchmarks for U.S. funding of the WHO.

Stronger democratic institutions will create environments in which citizens can play an effective role in oversight of public health. Those of us who believe in democracy and human rights in China stand ready to support the WHO in this effort. 

Adam Nelson is a senior adviser at the National Democratic Institute (NDI).