Centralization vs decentralization in Covid-19 responses: lessons from China

Lv, A., Luo, T. and Duckett, J. (2022) Centralization vs decentralization in Covid-19 responses: lessons from China. Journal of Health Politics, Policy and Law, 47(3), pp. 411-427. (doi: 10.1215/03616878-9626908) (PMID:34847219)

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Researchers have begun to examine whether centralized or decentralized (or federal) political systems have better handled the COVID-19 pandemic. In this paper, 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 show that after the SARS epidemic of 2003, China adjusted the central–local balance of authority over systems to handle both the detection and early response phases of health emergencies. In an attempt to overcome problems revealed by SARS, it sought both to centralize early infectious disease reporting and to decentralize 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. As a result, local leaders had both the authority and the incentive 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 shows just how difficult it is to get it right, especially in the early phase of a pandemic.

Item Type:Articles
Additional Information:The research for this paper was funded by the United Kingdom’s Medical Research Council and National Institute for Health Research (Grant MC_PC_19072).
Glasgow Author(s) Enlighten ID:Duckett, Professor Jane and Lv, Dr Aofei
Authors: Lv, A., Luo, T., and Duckett, J.
College/School:College of Social Sciences > School of Social and Political Sciences > Politics
Journal Name:Journal of Health Politics, Policy and Law
Publisher:Duke University Press
ISSN (Online):1527-1927
Published Online:29 November 2021
Copyright Holders:Copyright © 2021 Duke University Press
First Published:First published in Journal of Health Politics, Policy and Law 47(3): 411-427
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
310684COVID-19: Understanding Chinese government containment measures and their societal impactsJane DuckettMedical Research Council (MRC)MC_PC_19072BS - Accounting & Finance