Margaret Chan: a Mass of Chicken

New WHO Chief: Hong Kong former Director of Health Margaret Chan

Qi Jianguo
November 11, 2006

Margaret Chan
Margaret Chan

Chan was elected by the Executive Board of the WHO on 8 November 2006, and was endorsed in a special meeting of the World Health Assembly on the following day. Chan has previously served as Director of Health in the Hong Kong Government (1994-2003), Representative of the WHO Director-General for Pandemic Influenza, and WHO Assistant Director-General for Communicable Diseases.

As Hong Kong Director of Health

Her profile was raised by her handling, in those positions, of the 1997 H5N1 avian influenza outbreak and the 2003 SARS outbreak in Hong Kong. After the first victim of the H5N1, Chan first tried to reassure the Hong Kong people with her infamous statements like, "I ate chicken last night" or "I eat chicken everyday, don't panic, everyone". When many more H5N1 cases appeared, she was criticised for misleading the public. In the end, the epidemic was brought under control by the slaughtering of 1.5 million chickens in the region in the face of stiff political opposition.

There are currently concerns in Hong Kong about her ability to lead the WHO after her poor job of bringing SARS under control in Hong Kong. She believed misleading information shared by the authoritarian Beijing regime and did not act swiftly, leading to the death of 299 people during the SARS outbreak. Her actions were criticised by the Legislative Council and many SARS victims and their relatives. In the end, she also helped to cover up the actual situation of the SARS pandemic in China.

The following points summarize the assessment of Dr Margaret Chan's performance as Director of Health (D of H) during the SARS outbreak based on Chapter 15 (sections 15.14 to 15.19) "Conclusions and Recommendations" of the "Report of the Select Committee to inquire into the handling of the Severe Acute Respiratory Syndrome outbreak by the Government and the Hospital Authority July 2004" by the Legislative Council of Hong Kong.

During the SARS outbreak, Dr. Margaret Chan was the chief adviser to the Government on public health matters and was vested with statutory authority to enforce measures for the control and prevention of infectious diseases. (section 15.14)

Dr. Margaret Chan was responsible for providing public health advice to The Secretary for Health, Welfare and Food, Dr. Yeoh Eng-Kiong. Dr. Chan was also responsible for "the control and prevention of infectious diseases, including outbreak investigation and control; disease surveillance; contact tracing; enforcement of public health legislation; liaison with the healthcare community; public education; liaison with the Mainland authorities and the international health community; and the provision of pathology laboratory services." (section 15.15)

The report concluded that Dr. Chan should be held responsible for "not attaching sufficient importance to soft intelligence on the AP epidemic in Guangdong in January and early February 2003. In addition, Dr. Chan did not appear to have taken full account of the heavy passenger flow between Guangdong and Hong Kong when formulating policies on infectious disease surveillance and control." (section 15.16)

Furthermore, the report concluded that Dr. Leung Pak-yin, the Deputy Director of Health, "raised the question of whether DH should send a team or an official to Guangdong in February 2003 to learn more about the AP epidemic there with Dr. Chan but the matter was not taken up further." And the report has concluded with the view that Chan "should have explored other avenues to obtain more information on the AP epidemic in Guangdong." (section 15.17)

The report also concluded that Chan "as the chief public health adviser, should be held responsible for not initiating action to amend the law on or immediately after 15 March 2003." (section 15.18)

Finally, the Select Committee finds "the performance of Chan not satisfactory in the handling of the SARS outbreak" based on the aspects stated in sections 15.14 to 15.18.

The following are samples of Hong Kong Legislators' responses to the SARS outbreak report with respect to Dr. Margaret Chan's performance (Legislative Council official translation).

Legislator Dr Yeung Sum () (in Cantonese) stated that the "position of the Democratic Party is that the investigation findings warrant ... the condemnation of former Director of Health Dr. Margaret Chan Fung Fu-chun." Dr. Yeung stated that Dr. Chan was "vested with statutory authority to enforce measures for the control and prevention of infectious diseases. But Dr. Margaret Chan failed to discharge her duties." Yeung also said that Chan failed to "initiate actions to amend the law and add the disease to the Quarantine and Prevention of Disease Ordinance for the isolation of SARS patients."

Legislator Dr. Tang Siu-Tong (H) (in Cantonese) stated that "Dr Margaret Chan ... should bear the greatest culpability for the SARS incident. Given that the DH is responsible for infectious disease prevention and control in Hong Kong, the D of H must therefore be held responsible for her negligence of duty in performing these two tasks during the SARS outbreak."

Legislator Mr. Leung Yiu Chung (ģ) (in Cantonese) emphasized the importance in condemning Dr Chan even she was no longer in Hong Kong. Mr. Leung stated that, "The work of the WHO affects not only Hong Kong, but the whole world. If we cannot say clearly what is wrong with her, then we are just being irresponsible. For what she is doing may have a greater impact."

Legislator Mr. Michael Mak (ꭷ) (in Cantonese) criticized Dr Chan that, "she did not offer any apology in public over the SARS incident, to our great regret. She has left Hong Kong to work in the World Health Organization, holding an important position there. Since SARS has made such serious devastations in Hong Kong, I do not know why Dr Margaret Chan does not offer us an apology in public."