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The “Under the Dome” commotion in China and lessons for health

By Jin Xu
on March 13, 2015

A recent (online) film, ‘Under the Dome – investigating China’s smog’ examining severe air pollution in China and its causes, has gone viral in just a couple of days in my country. ‘Under the dome’ seems to have hit a nerve for many Chinese people and has attracted hundreds of millions of hits by now. Although the video has been taken off line recently, the momentum initiated by the documentary is not likely to end soon.

The video was made by journalist Chai Jing, a former China Central Television (CCTV) journalist, and financed by herself. Her own personal experience – she feared for her unborn child, when pregnant – was a key driving force for her to make the movie. It was first published on the website of the People’s Daily (a mouthpiece of the Communist Party of China) and the popular website on 28 February 2015, just before the National People’s Congress (NPC) and the National Committee of the Chinese People’s Political Consultative (CPPCC National Committee) convened in Beijing. The film feels a bit like a Chinese version of the movie “An Inconvenient Truth”, directed by Davis Guggenheim and presented by Al Gore, which went viral around the world in 2006. ‘Under the Dome’ probes the content and sources of smog, a huge problem in China (like in many other LMICs), and tries to suggest actions to tackle the problem. The video shows that burning substandard fossil fuel is one of the main causes of the grey, depressing skies you are all familiar with, even if you live abroad. But the story doesn’t end there. Perhaps more importantly, the film also demonstrates that smog is a governance problem.

Local government officials trading off both economic and environmental concerns tend to downplay the latter. For example, the movie shows that polluting steel enterprises (major economic contributors ànd employers) in Hebei, the province surrounding Beijing, could without much trouble from government officials continue burning unwashed coal. Oil standards were determined (and kept at a low level) by oligopolistic state-owned oil companies, for which cleaner oil would have meant a huge economic loss. However, as a vendor of – probably substandard – diesel oil says in the film, the environment authority “has the obligation but not the authority” to enforce regulation. The film also shows a network of corrupted officials in the energy system (xitong, including both industries and authorities) who were brought down in the recent anti-corruption campaign. In other words, the movie claims that the smog is fundamentally caused by interference from strong vested interests in energy and environment policy making and reinforcement. While also asking for the actions of ordinary citizens to help protect the environment, Chai mainly suggests that opening the energy market to competition is among the fundamental solutions. To a certain extent, the film echoes some priorities of the new Xi-Li administration: anti-corruption, promotion of industrial upgrading, upholding the rule of law, as well as liberalisation of the energy market.

So the film convincingly shows that the Chinese environmental problem is to a large extent an issue of energy policy, and ultimately of governance. As mentioned, the timing was particularly interesting as the release came right before the annual meeting of the key legislating and political advisory bodies in Beijing. On March 5, the film was taken offline  as requested by the Department of Propaganda. Sources also indicate that the government forbade further discussion around the topic in the media. This should not simply be considered as censorship due to a (supposedly) “national embarrassment”. As mentioned before, besides being the first to release the film, the People’s Daily’s website also published an interview with the director of the film, Chai Jing. Major media gave, conspicuously, very positive feedback on the film initially. The most telling public response came perhaps from Chen Jining, the Minister of Environmental Protection: “I think this work has an important role in promoting public awareness of environmental health issues, so I’m particularly pleased about this event.”

Observers wonder whether the film can become China’s “Silent Spring”, the American classic (by Rachel Carson) that Minister Chen compared “Under the Dome” with. “Silent Spring” galvanized the environmental movement in the US decades ago. Whether something similar can happen in China, will probably depend on the joint effort of the state and society.  In Beijing, citizens have coined the term ‘APEC-Blue’ for “something that is pretty, but temporary. A mirage of sorts” – Beijing’s leaders usually try to make sure that the capital’s skies are clean for Asia-Pacific Economic Co-operation (Apec) summits, hence ‘APEC-blue skies’. President Xi promised to the international community that the policies ensuring “APEC Blue” would be preserved, but remarked on environment improvement during the national conference last week that “human effort is the decisive factor”. The fact that the film was taken down after initial government support is probably a sign that the government wants to control the degree of sensation(alism) around the issue and take the lead again in the anti-pollution drive. It’s one of the preferred tactics of the neo-authoritarian style of governance, typical of China in recent years: emphasis is on centralised authority, modernisation of the economy and society, as well as on social stability, inhibiting radicalism and restricting policy hijacking from interest groups. Along these lines, there are speculations about strong official underpinning of the film, which perhaps allowed it to have been widely advertised and watched in the first place.

In sum, “Under the Dome” is more than just an ecological milestone for China. It reveals problems deeply rooted in China’s political and economic institutions and also offers some hope that more fundamental discussion and actions will take place soon, in response to these upstream problems.

For the public health community, the comment on the environment authority that it “has the obligation but not the authority” should ring a bell. My point in this intro definitely relates to the concept of “health in all policies”, but also concerns other current health policies & reforms. Universal health coverage, public hospital reform, primary care strengthening, public hospital reform, food and drug safety, etc  are all in some ways political issues that hinge on balancing different interests at different government levels, and not just within the health system. For health policies to be made and implemented, the concerted efforts of central and local governments and related departments and communities are crucial in committing the resources, providing regulations and reinforcing incentives for health improving activities. In China, the idea of “mega health” (stressing health-related responsibilities of political leaders and related departments at various government levels) was advocated by the (then) Health Minister against the backdrop of decentralisation in the 1990s. The idea of a national cross-ministerial commission on health has also been advocated to coordinate health related policies. Stimulating and operationalising such (or perhaps even better) institutional innovations seems crucial for improving health fundamentally in China (and elsewhere). For scholars in health systems and policy research, the ‘Under the Dome’ video also sheds light on the urgent need to conduct interdisciplinary research and particularly to use an institutional lens and try to understand the political realities of health-related policies.

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