As the COVID-19 pandemic continues to spread, citizens and leaders around the world are rethinking what it means to keep people safe. The meaning of national security is being recast: according to one recent survey, many Americans now consider infectious disease to be a greater threat than terrorism, nuclear weapons proliferation, or the rise of China. 

What does it mean for health and security to become so intertwined? Democracies and autocracies around the world will approach that question in their own ways, given their disparate views on privacy, surveillance, and civil liberties. But some are closer to having an answer than others. As the pandemic’s first epicenter, China has had a head start, and the vision its leaders have laid out—constant surveillance in the name of both biological and political health—is troubling. Democracies must develop a clear and distinct vision for the future relationship between health and security so that China’s approach does not become the world’s.


In Chinese discussions of public health, one word appears repeatedly: fangkong, or “prevent and control.” Chinese President Xi Jinping has used the term on multiple occasions, including in high-profile speeches. So have other senior officials. In the highly formalized language of Chinese politics, key terms often carry great meaning—and fangkong is no exception. It refers to crisis management involving control over diffuse forces (inside or outside of the country); a conveniently broad term, it can be applied to possible threats to both health and security. Fangkong encapsulates Beijing’s perception that these two kinds of threats share similar features and can be tackled using similar approaches. In May, when Xi called for COVID-19 to be managed through “early warning” systems and “timely and accurate monitoring,” he was echoing the language Chinese officials use to describe the country’s enormous public security intelligence apparatus, which monitors society to prevent unrest and instability that could challenge the party’s rule. China’s National Security Commission, a high-ranking body chaired by Xi, met this spring to address the pandemic’s impact on social stability.

But the parallels run deeper. Fangkong became a common term in the late 1990s and early 2000s, primarily in reference to domestic security. The Chinese Communist Party (CCP) saw society as a kind of engineering project that could be improved with better systems and technologies. Fangkong was one concept deployed in this effort. In March 2000, for example, the northeastern city of Dalian allocated a special fund of 450 million yuan over seven years for public security investments, with the goal of expanding “the fangkong system” and using it to crack down on pornography, gambling, fugitives, and Falun Gong practitioners.

China appears to have gotten its outbreak under control for now, but that achievement has come at a price.

Over time, the term took on additional significance in relation to public health. It appeared frequently in official media in 2001, for instance, when the Chinese leadership began ramping up measures to address HIV/AIDS. “The work of [AIDS] prevention and control (fangkong) has a long way to go,” the People’s Daily reported that April. Fangkong soon became standard doctrine for subsequent public health emergencies—SARS in 2003, avian influenza in 2003, and swine flu in 2009. A version of the term appears in the official name of China’s CDC.

Under Xi, who ascended to the presidency in 2013, the term regained currency as a public security slogan. Xi’s predecessors preferred what they called “stability maintenance”—addressing threats to public order if and when they emerged. The current president, by contrast, has embraced a more preventive vision of social control, encapsulated by the focus on fangkong. Indeed, Xi has spent years overhauling the country’s domestic security apparatus to pursue this ambition, focusing on intensified surveillance, tracking and control of citizens’ movements, and harsh, often preemptive punishment for anyone who the party thinks intends to violate the rules.

When the novel coronavirus hit Wuhan in 2019, the party-state intensified its already formidable surveillance apparatus, expanding data collection to include health-related indicators and placing citizens’ movements under even closer scrutiny. Local public security authorities helped companies develop new health-monitoring apps, which gathered data on individuals’ body temperatures, their movements, and their social contacts. App developers, in turn, shared that data with police and other local authorities, who merged it with existing databases to facilitate lockdown enforcement. Although these measures emerged initially as a crisis-coping mechanism, many of them look likely to become permanent.

China appears to have gotten its outbreak under control, at least for now. But that achievement has come at a price: the outbreak has embedded public health into China’s “comprehensive security” concept—allowing the country’s architecture of surveillance and social control to expand even further. 


Under Xi’s watch, the securitization of public health has been matched by an equally troubling medicalization of public security. Metaphors of political and ideological illness abound. “For harmful infectious diseases, we must strike early to preventively immunize and strengthen immunity,” one senior official, Meng Jianzhu, explained in a 2016 speech in which he invoked the doctrine of “prevention and control.” But Meng was not a public health official—he was the country’s internal security chief, describing his vision for maintaining social control.

Similar medical language has been employed in official discourse on Xinjiang, where authorities have detained more than one million Uighurs and other religious and ethnic minorities. Chinese officials routinely liken perceived threats there (usually the “three evils” of separatism, religious extremism, and terrorism) to cancer and infectious disease. The implication is that the state, in locking up citizens en masse, is acting on the caring, curative intent of a doctor rather than the repressive impulses of a totalitarian regime. Thus, one university work team sent to identify targets for reeducation described its work as finding “tumors” to be excised, presumably before they could metastasize and grow, and party documents speak of eradicating “ideological viruses” from the population.

An October 2017 recording released by the Xinjiang Communist Youth League took the medical analogy to chilling lengths, prescribing preventive measures for those “already infected by the disease” of “religious extremism”:

There is always a risk that the illness will manifest itself at any moment, which would cause serious harm to the public. That is why they must be admitted to a re-education hospital in time to treat and cleanse the virus from their brain and restore their normal mind. . . . [G]oing into a re-education hospital for treatment is not a way of forcibly arresting people and locking them up for punishment, it is an act that is part of a comprehensive rescue mission to save them.

Of course, it is the regime that decides who could be “infected,” and those alleged to be susceptible have no say in whether they wish to be “rescued” or “treated.” This is the harsh logic of fangkong: it focuses on the danger of the disease, not the well-being of the patient, and elevates fears of public disorder above the protection of individual rights. Meanwhile, the logic of “immunization,” as invoked by Meng and others, dictates that security depends on targeting and “treating” citizens long before they have shown any symptoms of threatening behavior. This leaves few limits on what the regime can do in the name of security.

Recent commentary has extended the “political virus” analogy beyond purely internal politics. China’s Hong Kong and Macao Affairs Office has called the Hong Kong protest movement a “malignant virus” and an “infection,” which the new National Security Law evidently aims to eradicate. Chinese spokesperson Hua Chunying also referred to an anti-China “political virus” spreading in the United States. Such “diagnoses” by Beijing raise the possibility that the CCP will approach Hong Kong, and possibly even its broader foreign policy, with the same “prevention and control” doctrine applied within its own borders.


Using disease as a metaphor for nonmedical threats is not unique to Xi’s China. Nor, of course, is such rhetoric the only factor shaping Chinese policy—bureaucratic politics, resource constraints, and public opinion, to name just a few, also affect how political concepts are transformed into policy. But in the context of a deadly and ongoing pandemic, the CCP’s approach to linking health and security could, nevertheless, leave a significant mark on world politics.

Beijing’s logic of “immunization” leaves few limits on what the regime can do in the name of security.

China has already begun to promote its approach to coronavirus management around the world. This effort employs a wide range of foreign policy tools, from government-to-government outreach and foreign aid to propaganda and disinformation. The Chinese government recently published a formal white paper to “share its experience for the world to defeat the global pandemic.” The paper praised the CCP’s leadership in weathering the crisis, arguing that it allowed China to create a “tight prevention and control (fangkong) system involving all sectors of society.” Other official messages explicitly describe China’s “prevention and control system” as an example for countries to emulate.

Few countries have the capacity to replicate China’s extensive system of surveillance wholesale. And some, such as Germany, New Zealand, and Vietnam, have successfully combated the virus using their own approaches. Nonetheless, the pandemic could heighten the appeal of China’s surveillance-intensive model. Even before the pandemic arose, Chinese surveillance and public-security technology had spread to at least 80 countries—in part because Chinese tech companies were able to offer those countries a way to clamp down on violent urban crime and other challenges. The use and export of surveillance technology is subject to very few global regulations, and where international standards exist, they have been written largely by Chinese tech companies. If Chinese firms, bolstered by aid and propaganda from Beijing, can convince enough people that their approach to health surveillance is best-in-class for coping with infectious disease, then COVID-19 is likely to accelerate global reliance on Chinese technology, as well as acceptance of its associated model of “prevention and control”—with little protection built in for data security, privacy, or the protection of civil liberties.

The United States and other democracies should not make the mistake of underestimating the appeal of China’s approach in countries desperate for solutions to the extraordinary challenges posed by COVID-19. Some may not know where else to turn, especially in light of global perceptions of the United States’ struggle to cope with the pandemic and the Trump administration’s decision to withdraw from the World Health Organization. But democratic leaders must weigh these very real exigencies against the long-term costs of relying on autocratic precedents, since policies adopted in the heat of a crisis can endure after the immediate peril subsides.

There are compelling alternatives to the Chinese approach, many of them offered by U.S. allies and partners in Asia. South Korea and Taiwan, among others, have demonstrated that it is possible to combat an urgent global health crisis without giving up on privacy, civil liberties, and democratic freedoms. Their approaches have still involved some surveillance and restrictions on individual freedom, but legislation has carefully circumscribed these measures as limited in scope, temporary, and subject to democratic review. In South Korea, for example, legislation passed after a MERS outbreak in 2015 allows emergency surveillance measures but requires the government to release certain data in the name of transparency and delete its data once the crisis has passed. In Taiwan, quarantines must be time-limited and compensated, and President Tsai Ing-wen has resisted calls for emergency decrees, saying that existing legislation is sufficient. Should an emergency decree be issued, moreover, it would still be subject to legislative debate and ratification.

Democratic societies will continue to debate the right limits as they grapple with new technologies, especially in health surveillance. Not all of their initial answers will satisfy all constituencies, and they are unlikely to converge on a single, static “democratic model.” But the fact that democracies can debate openly, compare frameworks, and adapt to address citizens’ concerns makes the contrast to China’s model all the more clear.

Meanwhile, those who already have a tried and tested democratic strategy to handle COVID-19, as South Korea and Taiwan do, cannot—and should not have to—promote their vision alone. Their chances of success will be much greater if they have the support of other democracies, especially the United States. China is already promoting an autocratic vision for the fusion of health and security; it is past time for democratic leaders to join together to provide a real alternative.

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  • SHEENA CHESTNUT GREITENS is an Associate Professor at the LBJ School of Public Affairs at the University of Texas at Austin and the author of Dictators and Their Secret Police: Coercive Institutions and State Violence.
  • JULIAN GEWIRTZ is an Academy Scholar at Harvard’s Weatherhead Center for International Affairs and the author of Unlikely Partners: Chinese Reformers, Western Economists, and the Making of Global China.
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