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  • Infectious Change: Reinventing Chinese Public Health After an Epidemic by Katherine A. Mason
  • Emilio Dirlikov
Katherine A. Mason, Infectious Change: Reinventing Chinese Public Health After an Epidemic. Stanford: Stanford University Press, 2016. 272 pp.

Severe acute respiratory syndrome (SARS) first appeared in late 2002 in southern China. Symptoms of infection with the novel coronavirus include high fever, body aches, and a dry, nonproductive cough. A proportion of cases require intensive care services, including mechanical ventilation. Fatalities are not uncommon. Following cases reported in Guangdong Province and Hong Kong during February–March 2003, more cases emerged in Beijing and farther afield, with infected travelers seeding hotspots in global centers such as Toronto, Singapore, and Hanoi. By the end of July 2003, more than 8,000 suspected and confirmed cases of SARS were identified in 29 countries, resulting in 774 deaths.

In Infectious Change, Katherine A. Mason provides a captivating analysis of public health in China in the wake of SARS. Mason's research is situated at the regional epicenter of the SARS pandemic, in the city of Tianmai (pseudonym), nestled on the border with Hong Kong. Once a conglomeration of quiet fishing villages, Tianmai rapidly developed through state-sponsored economic liberalization initiated in the early 1980s. Now a thriving megapolis, Mason takes Tianmai as representative of China's future: busy, mobile, and cosmopolitan (32). Working from the Tianmai Center for Disease Control and Prevention (CDC), Mason is ideally placed to research the reinvention of public health in China after SARS, and her work is further informed by public health experts in Guangzhou, Hong Kong, and Beijing.

Mason locates her analysis of public health in China after SARS within the intersection between the literature on governance, science studies, public health ethics, and the global. Broadly, she examines the tension [End Page 855] between service and governance during an era of scientization and global health. This tension exposes new problematics in the lives, work, and aspirations of public health professionals, as they seek to serve commons locally and afar. Mason's work also offers an important underrepresented vantage to understand global health, one that is neither from the perspective of the drivers of global health nor from the recipients of global health assistance. Mason's Chinese informants "are non-Western, but they aspire in some ways to be included in the Western world" (28). She argues that local public health professionals' efforts to serve and govern must be understood within both local and global webs of engagement. Her work follows as a skillful navigation of disparate fields of engagement, local and non-local, which in combination provides a comprehensive, grounded analysis of public health practices in China.

Mason begins by laying down the historical and contextual foundation from which to understand what is meant by a "reinventing" of Chinese public health. Soon after the founding of the People's Republic in 1949, China implemented a public health system drawing on Soviet expertise. The public health system focused on improving hygiene and sanitation, with the aim of eliminating the primary causes of morbidity and mortality. Since the market reforms initiated in the late 1970s and 1980s, the public health system, like many other public services, was dismantled. Funding was dramatically reduced, health insurance coverage levels plummeted, and marketization painted a new healthcare landscape. By the turn of the century, Chinese officials sought to reincarnate public health as a modern, science-driven system, fashioned after the US CDC. The emergence of SARS dovetailed with reforms already underway, and as Mason aptly points out, "SARS and the [Chinese] CDC system were 'co-produced'" (13), as "SARS ultimately functioned…to provide not so much a threat or a push but an opportunity" (33).

Mason's work captures the tensions, aspirations, and possibilities engendered by this critical turning point. In Chapter 1, Mason analyzes the primary target of public health activities: the population. Rather than conceiving of the population as a static, homogeneous whole, Mason's informants at the Tianmai CDC emphasize the risks that distinct subpopulations posed for the salubrity of the city's commoners. As documented elsewhere in China (Solinger 1999, Zhang 2001, Siu 2007), Tianmai's large "floating population" (liúdòng r...

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