[Analytics] China epidemic exposes flaws in ‘Toilet Revolution’

A “Toilet Revolution” was launched in China five years ago. The aim was to eliminate epidemics such as the deadly Covid-19 outbreak, which has so far claimed nearly 1,800 lives and infected more than 70,000 people. Gordon Watts specially for the Asia Times.

Geared to upgrade hygiene and sanitation in urban and rural parts of the world’s second-largest economy, up to 68,000 toilets were built or refurbished between 2015 and 2019.

By the end of this year, an additional 64,000 will come online as part of the ultimate goal to have a 100% “civilized” toilet culture by 2030.

“The toilet issue is not a small issue. It is an important part of civilized construction in both urban and rural areas,” President Xi Jinping said at the launch of his ambitious building program.

Five years later, and what has become crystal clear is that the government needs to roll out a new Belt and Bathroom policy. Probably, with the same fanfare that preceded Xi’s vision of new Silk Roads crisscrossing the globe, which later became known as the trillion-dollar Belt and Road Initiative.

In 2018, a major report entitled the Toilet Revolution in China, which was published in the Journal of Environmental Management, illustrated what was at stake if the country failed to get it right.

Apart from rural regions, there are more than 100 city clusters with populations of one million-plus, according to Demographia’s World Urban Areas report.

“The toilet revolution requires a concerted effort from many governmental departments. It needs to address not only technology implementation, but also social acceptance, economic affordability, maintenance issues and, increasingly, gender considerations,” a team of academics and scientists mainly from the University of Science and Technology Beijing stressed.

“Aligned with the ecological sanitation principles, it calls for understanding issues across the entire sanitation service chain. Public-private partnership is also recommended to absorb private capital to make up the lack of funds, as well as arouse the enthusiasm of the public,” they added.

Yet that last statement has failed to materialize, despite a succession of high-profile campaigns and programs from the central government in Beijing.

Massive urbanization over the past three decades has further exposed weak links in the sanitation system and a deteriorating state of overall healthcare.

“Since the early 1990s, China has undergone an unprecedented scale of urbanization, driving millions of rural villagers into cities. These cities create ever greater health risks: air pollution and pandemics such as SARS [Severe Acute Respiratory Syndrome] in 2003, avian influenza in 2013 and now the new coronavirus outbreak have become the largest threats to people’s health in urban areas,” Xun Zhou, of the University of Essex in the United Kingdom, wrote for The Conversation, an academic website.

“Making the current outbreak worse is the state of the Chinese health system: overloaded, ineffective, expensive and chaotic. While there have been some attempts to reform the Chinese health system, most were carried out in a haphazard fashion. For example, in the aftermath of the SARS crisis, many public health units were reconfigured into local centers for disease control, but a systematic prevention program for infectious diseases remains absent,” she added.

While hard numbers for Xi’s “Toilet Revolution” policy are sketchy, up to last year US$4 billion had been pumped into the project.

Unlike rural areas, the standard of urban facilities in China has improved dramatically in the past 30 years with upgraded sewage networks. But more needs to be done.

“Arguably, the biggest investment the government has made to address the broader public health problems associated with disease outbreaks is the toilet revolution. Started a few years ago to bring flush toilets to rural households and improve public toilets in crowded urban centers, it lifts sanitation standards,” Christopher Balding, of the Fulbright University Vietnam in Ho Chi Minh City, told the Nikkei Asian Review. “A fundamental problem in Chinese public health is low hygiene standards in toilets, restaurants, hospitals and meat markets.”

Tackling these problems has now become a priority for Xi’s administration, which has been rocked by public anger on how the crisis has been handled.

Xun Zhou, of the University of Essex, is convinced there needs to be a fundamental shift in Beijing’s approach to sanitation and health issues even at the cost of economic growth.

“In the PRC [the People’s Republic of China], protecting people’s lives and their physical health has remained largely political rhetoric,” she said.

“Seventy years after the founding of the PRC, China is a long way from being the disease-free ‘socialist garden’ imagined in the CCP’s [China’s Communist Party] utopian plans. If the SARS outbreak in 2003 was a wake-up call, the current coronavirus crisis should be an urgent warning: protecting lives should be given priority over the growth of GDP before it’s too late,” Xun Zhou added.

It appears the “Toilet Revolution” needs to be just that … a social revolution to stamp out further epidemics in the world’s most populous nation.