What Do China's Scandals Mean For Public Health?

Given the recent spate of stories about the risks to public health coming from Chinese factories - toys, and dog food and pharmaceuticals and sea food and pigs - I've been waiting for someone to write a definitive story on the public health lessons to be learned. But since nothing definitive has been forthcoming - aside from the very good but incremental reporting in the NYTimes and elsewhere, which is more about global politics than public health - I figure it's just as well that I throw down a few conclusions. 1) Regulation is a good thing. Government oversight of trade products - especially those that impact public health - are essential. Establishing clear standards for, say, the presence of lead in children's toys - and then having the governmental appartatus in place to enforce such regulations is not just important, but essential for the US. The fact that the US has recently reduced its funding for FDA inspection and other threshhold checks on imports is the opposite of what the government should be doing.

2) Regulation isn't a solution. Conservatives often paint government regulation as a symptom of leftist, if not socialistic, tendencies. But - hey! - here's a reality check: China is a communist country and they CLEARLY have terrible regulatory enforcement. And on this side of the ocean, it's not acceptable to have rules against lead content or contaminated meat or what have you - we also must have a robust surveillance and detection infrastructure that lets us detect stuff that's bad before it's on our shores. This isn't a technology issue - there are great scanning and sensor devices available that could enable smart and early detection of banned substances or potentially infectious diseases. We just need a policy that privileges those technologies, rather than parades them as panaceas.

3) Global trade is messy. There are all sorts of products out there that we don't know really what they're made of or where they come from. Trust is a huge issue. China is a big toss-up here. The upside of trust: China wants to produce goods for the US market. The downside: if they give the US bogus goods, the US will overreact and ban lots of Chinese goods. Finding the right balance - between where China's access to the US market matches our trust and appetite for their goods - is tenuous, and if safety concerns persist, that see-saw will continue to waver.

4) Global health via trade is disgusting. It may be okay to let that balance waver and wander as far as free trade concerns. It is unacceptable to allow it to waver insofar as health is concerned. We cannot allow a 'free market' to find the balance of acceptable losses for dangerous goods. The US needs to clearly articulate and enforce importation laws that put the onus on dangerous goods entirely on the exporting nation.

5) Don't be an official in China. Odds are you'll wind up dead, one way or another.