Sieren's China

Health-related scandals are currently what is causing most damage to trust in the Chinese government. China's growing middle classes want safer food, better air quality and decent healthcare. The latter affects all Chinese citizens, as opposed to the territorial dispute in the South China Sea, or the debate about China's "market economy status". People do not want to have doubts each time they are prescribed medication. Many are asking how the government can run such a big country, if it cannot ensure safe drugs.

A chain reaction was triggered by the nationwide vaccine scandal that erupted about two months ago. Ever since, the government has been trying to contain the damage. Last week, 135 people thought to have been involved in selling expired or badly stored vaccines, including ones for children, to hospitals and private clinics all over China, were arrested across 22 provinces.

The government has favored competition and the growing number of private pharmaceutical companies because of the fall in prices. However, it has not been able to keep up with all the new companies and has failed to monitor and test all new drugs.

Exploiting the chaos

Since the market is so lucrative, some criminals have exploited the situation. In 2014, $105 billion worth of drugs were sold in China, which replaced Japan as the world's second-largest drugs market after the US, where drug sales total some $379 billion. China's market is expected to grow to $200 billion over the next four years. Drug companies are interested in investing in China because of favorable R&D conditions, which are less restrictive than in Europe, making it easier to test new drugs for cancer or Ebola for example.

Another example is genome editing using "DNA scissors," which in Europe is still very controversial, but in China has already been used on human embryos. The market is growing, despite the ethical concerns.

Last year, Chinese drug exports amounted to $25 billion, 10 times higher than in 2002. The figure is expected to double by 2020.

Authorities are overwhelmed

The China Food and Drug Administration (CFDA) is responsible for approving new drugs but is struggling to do its job correctly. Only 130 employees are in charge of monitoring and testing new drugs, compared to 5,000 at the CFDA's US counterpart, the FDA. Moreover, they are not as well qualified, as CFDA head Bi Jingquan has admitted.

Furthermore, a third of the staff has left over the past three years, lured by the private sector where salaries can be up to 10 times higher. An average CFDA employee will get 120,000 yuan (16,000 euros) while salaries in private companies can reach 600,000 yuan (ca. 82,000 euros). It is not hard to understand why people are tempted to leave. One former CFDA employee said that working conditions were easier in the private sector and that at the CFDA people were not allowed to go online during working hours. The result is that it is taking longer for new drugs to come out on the market.

Next scandal on the cards

If the situation at the CFDA remains as it is, the future of Chinese healthcare looks bleak, and the government will have to brace itself for more problems. Bi Jingquan has announced tougher drug evaluation, but has not addressed the staffing issue. The problem is exacerbated by the fact that the tougher the regulations become, the more expertise the drug companies need. The state will not be able to keep good staff unless it is willing to increase salaries. So, the government is in a tricky situation and the next scandal is already on the cards. Whatever happens, the government will get the blame..

DW's Frank Sieren has lived in Beijing for over 20 years.