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Centralization vs. Decentralization in COVID-19 Responses: Lessons from China.

Authors
  • Lv, Aofei1
  • Luo, Ting2
  • Duckett, Jane1
  • 1 University of Glasgow.
  • 2 Manchester Metropolitan University.
Type
Published Article
Journal
Journal of health politics, policy and law
Publication Date
Jun 01, 2022
Volume
47
Issue
3
Pages
411–427
Identifiers
DOI: 10.1215/03616878-9626908
PMID: 34847219
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Researchers have begun to examine whether centralized or decentralized (or federal) political systems have better responded to the COVID-19 pandemic. In this article, we probe beneath the surface of China's political system to examine the balance between centralized and decentralized authority in China's handling of the pandemic. We focus not on the much-studied later response phase but on the detection and early response phases. We show that after the SARS epidemic of 2003, China sought to improve its systems by both centralizing early infectious disease reporting and decentralizing authority to respond to local health emergencies. But these adjustments in the central-local balance of authority after SARS did not change "normal times" authority relations and incentive structures in the political system-indeed they strengthened local authority. As a result, local leaders had both the enhanced authority and the incentives to prioritize tasks that determine their political advancement at the cost of containing the spread of COVID-19. China's efforts to balance central and local authority show just how difficult it is to get that balance right, especially in the early phases of a pandemic. Copyright © 2022 by Duke University Press.

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