The People’s Republic of China fails to protect its citizens from contaminated food and health products, eroding trust in government
At the start of the 2019 Chinese New Year, the People’s Republic of China (PRC) revealed that HIV-contaminated blood products had been distributed to its citizens. A tainted batch of intravenous human immunoglobulin, which is mainly used to treat patients with compromised immune systems, was sold and distributed in the eastern province of Jiangxi by China’s second largest medical blood products supplier, Shanghai Xinxing, which is overseen by a state-run parent company.
“The faulty batch comprised 12,229 50-ml [milliliter] bottles of plasma due to expire in June 2021,” according to an account in the South China Morning Post newspaper. Investigators from China’s National Health Commission stopped production and ordered a recall of the blood products even though the same agency that made the original announcement, the National Medical Products Agency, later announced its tests were negative for HIV, the virus that causes AIDS, and for various strains of hepatitis.
The conflicting reports only fueled concern by Chinese patients and consumers over the safety of their nation’s food and medical supplies. “The cleanup is always fast. Pretty soon they’ll say injecting this product is good for your health,” Cui Yongyuan, a Chinese television host and producer, wrote on the microblogging site Sina Weibo, commenting on a report about the investigation’s preliminary results, according to The New York Times newspaper. “Tainted milk powder, no problem. Tainted vaccines, no problem. Tainted inoculations, no problem,” he added, referring to the litany of health debacles in China in the past decade or so. “In short, if a few people die, no problem.”
The PRC continues to be riddled with product safety and manufacturing scandals despite the Chinese Communist Party’s (CCP’s) recent and repeated pledges of reform. The contaminated plasma scare is just one of the latest incidents. Myriad vaccine scandals in recent years have imperiled young children and
their families and also put the population as a whole
at risk by enabling potential outbreaks to occur.
The government disclosed in January 2019 that more than 145 Chinese children in Jiangsu province had received expired polio vaccines from a local center, sparking protests by thousands of angry parents outside a local health center and government office. The disclosure came a mere six months after a major scandal was revealed in July 2018 in which Changchun Changsheng Life Sciences, a subsidiary of the state-run company Changsheng Biotechnology, one of the nation’s largest vaccine manufacturers, produced and distributed more than 250,000 defective vaccines for diphtheria, whooping cough and tetanus (DPT). The vaccines were administered to thousands of babies under a PRC program in Shandong province in 2017. Investigators also found that Changchun Changsheng Life Sciences had faked production records on more than 100,000 rabies vaccines and had been fraudulently reporting vaccine data for more than four years, according to the South China Morning Post.
Mo Li, in her late 20s, is the parent of a child who may have received one of the shoddy DPT doses. “I thought about all the people involved, from the vaccine company to the regulators. They cannot be called human. They are devils in hell,” Mo told The Guardian newspaper in late July 2018 after news of the scandal broke.
Angry parents like Mo protested in front of the PRC’s National Health Commission in July 2018, demanding better oversight of China’s pharmaceutical industry. Inspectors discovered the defective vaccines in 2017 but didn’t disclose the information until July 2018.
“The problem is not solved,” He Fangmei, the mother of a 2-year-old girl, told The New York Times after the July protest. “Our concerns have not been addressed.”
China’s rank-and-file citizens, who are not members of the small, privileged percentage who belong to the governing CCP, are becoming increasingly frustrated with the PRC’s shortcomings in protecting public health. Despite PRC claims to have set up a world-class regulation system, its agencies are failing to protect the research, production, distribution and administration of vaccines and other pharmaceuticals.
Chinese parents’ mounting dissatisfaction with unfulfilled PRC promises seems more than justified. Soon after the Changsheng scandal, regulators disclosed that the state-owned Wuhan Institute of Biological Products also sold ineffective vaccines. In May 2018, the company began recalling some 400,000 doses and was ordered to pay an undisclosed fine, according to Bloomberg.com. Prior to the recent spate of incidents, the PRC disclosed in 2016 that millions of compromised vaccines, roughly U.S. $90 million worth, had been administered to Chinese children nationally. In 2015, out-of-date vaccines caused two deaths and severe health problems in nearly 400 children in Henan province, according to Radio Free Asia. In 2010, unrefrigerated vaccines killed four children in Shanxi province and sickened 70 others, the China Economic Times newspaper revealed. Problems with the quality of vaccines have existed for a long time and “everyone inside the loop knows it,” a director of a Chinese disease control center for about half a million people told the South China Morning Post.
The PRC established the China Food and Drug Administration in March 2013 to address such problems, but the scandals kept coming. After each of the vaccine scandals, regulators neither notified the public in a timely fashion nor did much initially to punish companies or their officials. And after each crisis, the PRC implemented measures to supposedly improve food and drug safety, but the scandals continued into 2019. In one of the latest attempts at reform, the PRC announced in April 2018 that it would reorganize the China Food and Drug Administration into the China Drug Administration, which would be overseen by a new State Administration for Market Supervision. Meanwhile, the responsibilities for regulating food would shift to other agencies.
Largely in an apparent response to the protests and public uproar, the PRC levied a U.S. $1.3 billion fine in October 2018 against Changsheng Life Sciences and blocked 15 executives, including its chairwoman, from working in the drug industry, according to Reuters. It also fined Changsheng Biotechnology about U.S. $89,000. The parent company plans to pay patients harmed by the vaccine roughly U.S. $29,000 to $96,000 in compensation, Reuters reported. The PRC is also drafting a law that would enable citizens to sue drug manufacturers for punitive damages if defective vaccines cause serious illness or death, but until the law is implemented, victims’ families have little recourse.
Historically, the parents who protest the vaccine manufacturers have received harsher treatment than the offending executives and companies who continue production after making public apologies or paying relatively small fines averaging U.S. $1.4 million, according to an analysis by The New York Times. Originally, Changsheng was only fined U.S. $500,000 for its defective vaccines until a complaint on social network WeChat, which was deleted a day later, revealed the details publicly, The Guardian reported. The newspapers also reported that the PRC silences or detains parents who protest. Even so, the PRC was unable to quash protests on social media and elsewhere in the past year against the government’s handling of public health, according to various media accounts, and the systematic problems remain, industry insiders and health experts say.
Citizens of other countries should also be alarmed. PRC failures have global implications because China also produces drugs distributed in other countries. In late July 2018, for example, Zhejiang Huahai Pharmaceutical, the Chinese manufacturer of the blood pressure medication Valsartan, was forced to issue an international recall of the drug after the active ingredient in it was found to be contaminated with a cancer-causing agent, according to CNN. The Chinese company provided more than half of the drug’s supply in the United States, and the brand was widely prescribed in Europe as well. “Not only is there a potential to be harmed from the product that has been recalled, the secondary problem is there’s not enough of the products that haven’t been recalled out there,” Craig Beavers, cardiovascular clinical pharmacy coordinator at the University of Kentucky Medical Center, told WebMD.com website.
The steady stream of such potential disasters has continued to erode trust in the PRC and faith in President Xi Jinping’s ability to reform China’s corrupt food and drug production system. Although Xi has labored to sell citizens on his brand of consolidated autocratic power by promising to take care of them, the repeated health scandals continue to damage his credibility and legitimacy, many analysts say.
“The vaccine scandal once again shows the Chinese government’s failure in law enforcement and monitoring the healthcare industry, even after years of reports about other cases,” Patrick Poon, China researcher for Amnesty International, told The Guardian.
The majority of Chinese families have only one child because of past PRC policies restricting family size. As a result, offenses by the government that affect the health of children are perceived as especially horrifying, according to Merriden Varrall, a China expert at the Lowy Institute, a think tank in Australia.
“How is this still happening in a China that people are told is really on track for rejuvenation?” she told The New York Times in July 2018. “Scandals like this are simply not going to be accepted as par for the course anymore.”
The PRC has a long history of allowing dangerous products to reach Chinese consumers. To this day, more than a decade after the baby formula tragedy, many parents won’t feed their infants formula manufactured in China, according to media accounts. In 2008, baby formula contaminated with melamine, a chemical used in plastic and fertilizer manufacturing, killed six babies and sickened more than 300,000 other infants in China. The chemical causes kidney stones, which are rare in children and extremely painful, and eventual kidney failure and death. At least 1,200 babies in China were later diagnosed with serious kidney disease. An investigation determined 22 Chinese companies were linked to the tainted formula, including several state-owned firms, Reuters reported.
One of the top offenders, Sanlu, learned as early as August 2008 that local farmers had added melamine to their milk to increase its protein levels. The formula from these farms was found to have more than 4,000 times the acceptable level of melamine, according to World Health Organization guidelines. The company had been receiving complaints about its product for at least nine months before that, according to a July 2018 report on Quartz, an aggregated and curated news website. Because China was hosting the Summer Olympics in Beijing that year, Sanlu, which held almost 20 percent of the formula market, worked to suppress the news. Sanlu started as a state-owned company and later expanded into a joint venture by selling 43 percent of its shares to a New Zealand company, Quartz reported.
Sanlu’s top executive, Chairwoman Tian Wenhua, also a member of the Chinese Communist Party, was sentenced to life in prison for producing and selling the contaminated formula even after the company knew it could be deadly, The New York Times reported. Several other executives received lighter sentences. In 2009, a dairy farmer and a supplier who had distributed the contaminated product were executed, The Guardian reported. That same year, Sanlu filed for bankruptcy, according to the china.org.cn website.
As a result of the PRC’s contributions to and mismanagement of the crisis, more than 53 percent of consumers still prefer a foreign brand for baby formula, according to a 2017 survey of 10,000 people in 44 Chinese cities by McKinsey & Co. The demand is strong enough to cause formula shortages in nearby Hong Kong, Quartz reported. In recent years, China purchased half of Australia’s retail supply of formula via consumer-to-consumer channels, according to The Washington Post newspaper. In 2015, Chinese demand for formula exceeded U.S. $200 million in sales, The Sydney Morning Herald newspaper reported.
Ongoing HIV Fears
China has also been rocked by previous HIV scandals afflicting entire communities. In the 1990s and 2000s, thousands of Chinese citizens contracted HIV after selling their plasma or receiving transfusions or products made from tainted blood products collected at what the PRC refers to as illegal donation centers. The contamination occurred because the facilities lacked safe procedures for collecting plasma and transfusing blood products, according to a report by National Public Radio, a nonprofit news organization headquartered in the U.S. More than 43 percent of people who provided blood at such centers contracted HIV, China’s Ministry of Health said. The citizens in provinces where the blood was collected are still suffering the consequences of AIDS, according to Sixth Tone, a Chinese media startup, which vividly describes the so-called AIDS villages created by the debacle.
“The root of AIDS in China was the plasma market,” Gao Yaojie, a doctor who helped uncover the cause of the epidemic in Henan province, told The New York Times in 2016. “This was a man-made catastrophe. Yet the people responsible for it have never been brought to account, nor have they uttered a single word of apology.”
The disaster led the PRC to eventually put in place better screening procedures for blood products, but Chinese authorities continued to let their citizens down in terms of managing the disease and conducting health education campaigns. For one thing, widespread efforts to screen affected communities didn’t begin until 2004, according to Sixth Tone.
Today, although the spread of HIV has slowed worldwide on the whole, the number of citizens in China living with HIV and AIDS continues to increase at an alarming rate. The PRC’s Centre for Disease Control said in November 2018 that 850,000 people in China have tested positive for HIV, according to The Economist magazine. The numbers are 12 percent higher than the previous year and nearly triple the number reported in 2010. Meanwhile, global new HIV infections have declined by 18 percent from 2.2 million in 2010 to 1.8 million in 2017, the most recent year for which data are available, according to Avert, an international HIV and AIDS charity.
About 40,000 new cases were reported in China in the second quarter of 2018 alone, according to a BBC report. Cases involving 15- to 24-year-olds rose by more than one-third every year between 2011 and 2015, according to a July 2018 study published in The Lancet medical journal.
More than 81 percent of new cases are generally thought to be linked to sexual intercourse and not blood donations, The Lancet reported. Chinese officials attribute the rising numbers at least in part to more widespread testing, yet some public health officials contend that more could have been done to stop its spread.
Besides the baby formula catastrophe, there have been past food scandals in China from melamine-contaminated eggs to formaldehyde-coated cabbage to 40-year-old frozen meat and cooking oil recycled from dumpsters. Consumers worry on a daily basis that other foods might be contaminated, according to assorted media reports. A leading reason for worries over food safety is the PRC’s widespread overuse of pesticides and fertilizers in the 1980s and 1990s that contaminated farmland for crops and animals, as reported in 2001 by the Centre for Chinese Agricultural Policy, Chinese Academy of Agricultural Sciences in a paper titled, “Farm Pesticides, Rice Production, and Human Health in China.” Acres have also been contaminated by industrial processes that went unchecked for decades.
The PRC has only begun to address this problem of contaminated agricultural soil, Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations (CFR), told Quartz in July 2018.
The recent outbreak of African swine fever in China has done little to assuage overall food safety fears. China reported more than 100 outbreaks in 25 of the country’s 34 provinces, according to the United Nations Food and Agricultural Organization. Nearly 1 million of the nation’s 340 million pigs were slaughtered between August 2018 to January 2019, CNN reported in early February 2019. Although the virus has yet to infect humans, there is no treatment or cure available for swine fever, which causes lesions to form on the skin and organs of pigs, and in its most virulent form, is deadly to nearly all pigs, according to United Nations health officials.
The disease spread faster in China than in other countries, according to a February 2019 Reuters report. As the outbreak progressed, PRC officials repeatedly maintained that the “epidemic on the Chinese mainland was effectively dealt with and is under control,” as the state-run media Xinhua reported, but month after month, more cases were reported. The PRC’s lack of transparency likely contributed to the pace of the epidemic, some experts said. The epidemic continued after the then latest round of denials. Chinese officials in southern Hunan and northwest Gansu provinces found traces of the virus in pork products, including frozen dumplings, in February 2019, Voice of America reported.
China’s biomedical and food production problems stem from deep-seeded systematic shortcomings, many analysts say. For starters, China’s top-down regulatory process shuts citizens and many other key players out of the process. “Since the regulation of food safety incorporates several mutually reinforcing activities (production, marketing and consumption) and involves various stakeholders (e.g., manufacturers, traders, consumers, governmental actors), it is highly unlikely that pure top-down, state-centric regulatory and legal frameworks will be sufficient to defuse China’s food and safety crisis,” Huang wrote in a 2014 CFR blog post. His insights continue to hold true, given the ongoing blunders.
Until better reforms and more transparency are in place systemwide, Chinese citizens and the rest of the world, especially members of trading nations, will remain concerned about the quality of food and health products manufactured in China. Perhaps President Xi summed it best himself in a moment of clarity in 2013, the year he assumed office: “If our party can’t even handle food safety properly while governing China, and this keeps up, some will wonder whether we’re up to the job,” he said, according to an account in The New York Times.