Recorded on November 13, 2024, this Authors Meet Critics” panel centered on the book Authoritarian Absorption: The Transnational Remaking of Epidemic Politics in China, by Yan Long, Assistant Professor in the UC Berkeley Department of Sociology.
Professor Long was joined in conversation by Matthew Kohrman, Associate Professor in the Department of Anthropology at Stanford University; and Rachel E. Stern, Professor of Law and Political Science at Berkeley Law, and the Pamela P. Fong and Family Distinguished Chair in China Studies. The panel was moderated by Tom Gold, Professor of Sociology Emeritus at UC Berkeley.
The panel was presented as part of the Social Science Matrix Authors Meet Critics book series, which features lively discussions about recently published books authored by social scientists at UC Berkeley. For each event, the author discusses the key arguments of their book with fellow scholars.
About the Book
Authoritarian Absorption portrays the rebuilding of China’s pandemic response system through its anti-HIV/AIDS battle from 1978 to 2018. Going beyond the conventional domestic focus, Yan Long analyzes the influence of foreign interventions which challenged the post-socialist state’s inexperience with infectious diseases and pushed it towards professionalizing public health bureaucrats and embracing more liberal, globally aligned technocratic measures. This transformation involved a mix of confrontation and collaboration among transnational organizations, the Chinese government, and grassroots movements, which turned epidemics into a battleground for enhancing the state’s domestic control and international status.
Foreign interveners effectively mobilized China’s AIDS movement and oriented activists towards knowledge-focused epistemic activities to propel the insertion of Western rules, knowledge, and practices into the socialist systems. Yet, Chinese bureaucrats played this game to their advantage by absorbing some AIDS activist subgroups—notably those of urban HIV-negative gay men—along with their foreign-trained expertise and technical proficiency into the state apparatus. This move allowed them to expand bodily surveillance while projecting a liberal façade for the international audience.
Drawing on longitudinal-ethnographic research, Long argues against a binary view of Western liberal interventions as either success or failure, highlighting instead the paradoxical outcomes of such efforts. On one hand, they can bolster public health institutions in an authoritarian context, a development pivotal to China’s subsequent handling of COVID-19 and instrumental in advancing the rights of specific groups, such as urban gay men. On the other hand, these interventions may reinforce authoritarian control and further marginalize certain populations—such as rural people living with HIV/AIDS and female sex workers—within public health systems.
Podcast and Transcript
Listen to the presentation as a podcast below or on Apple Podcasts.
[OPENING LOGO]
[MARION FOURCADE] Welcome, everybody. My name is Marion Fourcade. I’m the Director of Social Science Matrix, and I am absolutely delighted to welcome you to this book panel for my colleague from the Sociology Department, Yan Long. Authoritarian Absorption: The Transnational Remaking of Epidemic Politics in China is officially out as of this morning. So there is– yes, that– [CHUCKLE]
[AUDIENCE APPLAUDING]
And you can buy it from an unnamed website starting next week. And the book portrays the rebuilding of China’s pandemic response system through its anti-HIV/AIDS battle from 1978 to 2018.
Yan analyzes the interactions between local officials, Western donors, international organizations, and health activists to understand how public health expertise in China both expanded during this period and also became bureaucratized.
It is really a stunning read. It’s a longitudinal ethnography. I really highly recommend it to you. So today’s event is part of Our Author Meets Critic Series, which features critically engaged discussions about recent books from our division. And it is also co-sponsored by the Department of Sociology.
Before I introduce our moderator, let me just mention a few events that are coming up. The Global Democracy Comments on November 21. We’ll try to make sense of what just happened in the United States. On December 3, another Author Meets Critics by another sociologist. Actually, it’s all sociologists this end of year.
It’s not a particular bias. It just happened that we had books together. So Stephanie Canizales will present her book. And then my own book, I’ll lecture on my own book in December. So this is for the upcoming events. But now let me introduce our intrepid moderator who just came from teaching and is now starting in a new role.
Thomas Gold is Professor of Sociology Emeritus at UC Berkeley– emeritus, but still teaching– where he taught from 1981 to 2018. His research focuses on social, political, and cultural change in China and Taiwan. And his list of publications is very long. So let me just mention the most recent book titled Sunflowers And Umbrellas: Social Movements, Expressive Practices, and Political Culture in Taiwan and Hong Kong that was co-edited with Sebastian Veg.
So, Tom, the floor is yours. And you can introduce the book and the panelist.
Thank you.
[THOMAS GOLD] Thank you.
Thanks, Marion. And I apologize for getting here late. Yes, I retired six years ago, but they pulled me back in. And here I am teaching Soc 1. So should I introduce the whole panel before we start?
[INAUDIBLE]
So, of course, our main speaker is Yan Long– Long Yan. It’s a problem with Chinese with two names. It’s hard to know which is surname, and which is the first. We call first name.
But Long Yan is an Assistant Professor in the Sociology Department here. Political and organizational sociologist studying the interactions between globalization and authoritarian politics across empirical areas such as public health, civic action, urban development, and digital technology with a geographic focus on China.
Her recent research investigates the urban politics around COVID-19 testing in China. She concentrates on how community mobilization facilitates or undermines the utilization of digital tools in public health measures.
Then to her left is Matthew Kaufman, Associate Professor at the Department of Anthropology, and by courtesy, the Department of Medicine. Senior Fellow by courtesy at the Freeman Spogli Institute for International Studies at Stanford. Matt’s research and writing bring anthropological methods to bear on the ways health, culture, and politics are interrelated.
His first monograph, Bodies Of Difference Experiences of Disability and Institutional Advocacy– this is his first book, Experiences of Disability and Institutional Advocacy in the Making of Modern China.
Over the last decade, he’s been involved in research aimed at analyzing and intervening in the bio-politics of cigarette smoking among Chinese citizens. More recently, he’s begun projects linking ongoing interests at the intersection of phenomenology and political economy with questions regarding environmental attunement and the arts.
And Rachel Stern is Professor of Law and Political Science and currently holds the Pamela P. Fong and Family Distinguished Chair in China Studies here at Berkeley. Her research looks at law in mainland China and Hong Kong, especially the relationship between legal institution building, political space, and professionalization. She’s the author of Environmental Litigation in China: A Study in Political Ambivalence.
She’s currently part of a collaborative effort to analyze the 60 plus million Chinese judicial decisions placed online following a 2014 policy change. This massive expansion in the public record of court activity promises to reshape our understanding of Chinese law beyond China, of authoritarian legality. So with that, I will turn it over to Professor Long.
[YAN LONG] Thank you.
[THOMAS GOLD] You’re going to use the PowerPoint?
[YAN LONG] Yeah, I’m going use. Thank you so very much for the introduction. And Thank you very much for coming. This is a great pleasure to share my book. Since I only have 20 minutes, so I’m going to be really brief. And as an ethnographer, it’s a shame that I cannot really share the most important part for me, which is the field work.
But hopefully, you get a little bit of flare from today’s presentation. OK. So Infections. Infections have always been very daunting. But the newly emerging epidemics from HIV/AIDS, swine flu to Ebola and COVID-19 had introduced novel uncertainties about state responses.
So for those of you who are familiar with [INAUDIBLE] might think, OK, of course, medical surveillance that is such a core to the state responses to anything. However, in reality, emerging epidemics actually define such assumptions. So basically, we would see drastically different responses from various governments around the world to COVID-19 as a demonstration.
Even the same government might change its attitude to the same epidemic overnight. So in China, for three years, nobody can actually enter into the hospital without getting COVID-19 test. But nowadays, even with potential symptoms, the doctors will not test you for COVID-19. So basically, this is how my book takes on this questions.
Under what conditions does a state forfeit or acquire the desire and the means to actually consider unfamiliar epidemics as worthy of attention and restructure its administration to manage them? So the state must make a series of very difficult decisions.
First of all, how the transmission and treatment of those diseases shall be regulated or deregulated, which populations pains actually count as suffering, and who shall take on responsibilities to care and treat for those infected? Ultimately, this is about the building of public health institutions, which for whatever reasons, have not received a lot of attention from sociologists, probably a little bit more from political scientists.
So in studying public health or institutions in general, scholars have largely focused on domestic factors. This is particularly true when scholars try to understand authoritarian regimes. After all, for example, countries such as Russia, Cuba, and China had a very long history of using public health as instruments to achieve socialist revolution.
Since the COVID-19 outbreak, many scholars or practitioners or just journalists also come up with this idea of what we call as authoritarian advantages. So basically, the success or failure of authoritarian countries to tackle infectious disease are always considered as a natural functions of their regime type.
So contrary to the conventional wisdom, my first book actually showed that the seemingly distinctive authoritarian public health institutions might not be endogenous to the country. Instead, we shall look at transnational factors or foreign interventions as I focus.
So my book is about how transnational AIDS interventions actually drove China’s infectious disease control systems rebuilding between 1978 to 2018. So nowadays, as we blame or praise China, you’ve got to think about it. It looks really similar to what’s going on here in the United States. And I will get into a little bit more details later.
So hopefully I have some time to use my ongoing research for my second book to talk about how the established characteristics continue or transformed during the COVID-19 era. And here I wanted to emphasize that China is really not an exceptional case. Because health officials in the Global South are often caught between transnational organizations and local situations.
So here is to show you the funding that spend on HIV/AIDS interventions in the Global South, middle, and lower-income countries. Even up to nowadays, almost 50% of that funding comes from the Global North. So I always say you can blame the United States empire. However you want, but global health is actually one of the things that it really contributes to since America is the biggest donor in global health areas.
So it’s a pretty long book. And there are two arguments from the book I want to highlight today. So first, using HIV/AIDS governance as a case study, I wanted to show you that transnational organizations have used every measure, including one billion US dollar, to build a liberty-oriented HIV/AIDS governance in China.
And then secondly, I wanted to talk a little bit about how foreign interventions with the whole process of learning and incorporating transnational rules and practices, especially democratic ones, actually did not weaken but actually strengthened the infrastructure power of authoritarian China.
So in many ways, the book is about how the Democratic liberal world actually contributed to the persistence and consolidation of authoritarianism in China. And liberal interventions actually do matter. It doesn’t work in a way that we imagine.
And there are other two themes that in the book that I don’t have time to go through. One is the life and death enduring epidemic, and different people’s life actually count very differently. And there is definitely a hierarchy of whose life matters more in this process. And secondly, there is a major part of the book that talks about the operation of international agencies in China.
I’m very proud of that part because I think I’m probably the only one whose studies does internal ethnography in that field, but we probably don’t have time to go through it. So my goal is not simply to just contribute to global health studies. Rather, my book is trying to speak to a core debate in international relations and world politics, especially as the United States is spending billions of dollars overseas.
So how do foreign interventions actually matter in authoritarian regimes? In fact, transnational interventions regularly fail. That’s the rule. It fails. It doesn’t work. And similar interventions I’m talking about here had actually happened in many Southern countries. Some authoritarian states, such as Russia, unsurprisingly kept the transnational aid programs completely outside to protect its sovereignty.
But other countries such as Uganda, even Iran, actually accepted quite some transnational practices. So what makes it even more puzzling is that foreign interventions further strengthened the unequal landscape of public health in China as urban HIV-negative gay men benefited the most from foreign interventions.
So how would the transnational law fare in authoritarian countries? Especially why would China, as a very homophobic state, make any concessions when it comes to homosexuality issues?
So foreign efforts to change targeted governments behaviors are very old phenomena. We’re still seeing this huge debate nowadays. And scholars often applaud or praise this kind of interventions into targeted countries to correct the government’s non-democratic behaviors.
I think we see a lot around, for example, Russia. This is what I call a corrective approach. So it basically assumes that as long as you adopt some liberal practices, it is adapt towards integrating or assimilating into the world of Democratic governance. And the corrective effects happen in two ways.
One is directly. You use carrots or you use sanctions, try to change their behaviors. And then there is also indirect mechanism, which is transnational collaboration. Because most governments are not susceptible to the foreign interventions. So sometimes the foreign organizations must collaborate with domestic activists trying to change the government’s behavior.
So as you can see here, this triangular interactions between these three entities, certainly are very important. And I also agree that transnational organizations pushed their way into China exactly because they successfully cultivated a very powerful AIDS movement, which is a major part of the book.
However, the problem is, scholars often assume that the antagonism between transnational organizations and domestic activists on one side, OK, they’re the good guys. And then the authoritarian state on the other. In reality, those entities actions or relations are in constant motion, and they don’t follow any specific scripts for long.
And another problem is scholars often predominantly focus on one set of outcomes, which is basically different degrees of corrections. OK. We want to see Democratic improvement. So it’s either compliance or resistance from the targeted states. So you can see that a lot of the discussion about whether sanctions work. That’s pretty much along that way.
But the problem is, interventions don’t really only achieve intended goals, and it can go various ways. So in my book, alternatively, I argue that interventions don’t just impose negative corrections on existing authoritarian practices as intended.
They can rather prescribe positive incentives, opportunities, and means for government organizations to build what my comments often refer to as specialized capacities or infrastructure power to penetrate and organize the bodies of different people.
So this is what I call authoritarian absorption. Such absorption of transnational resources, networks, cultural rules, and organizational models can create brand-new practices. So this kind of absorption can take place directly through bureaucratic learning The direct interactions between foreign organizations and targeted government agencies can certainly generate new behavior.
But then another major part of the book talks about this indirect mechanism, which is through no one other, but social movements. So interveners can train and cultivate very powerful social movements to carry transnational practices into the targeted domestic context.
Secondly, while activists push for changes, the government organizations can actually respond in ways that re-appropriate those transnational rules and practices for very authoritarian purposes. So for those of you who love Star Wars as much as I do– OK, so just remember Anakin Skywalker, who trained him? We’re talking about the Jedi actually trained him only for him to become Darth Vader.
So in many ways, social movements are not just this rosy good guys. When they formulate, they can serve very different purposes. So just because gay men activism was cultivated by foreign funding and resources, you cannot assume that they would absolutely go up against the homophobic, authoritarian states.
So before I show a little bit of my data– actually just some cases. I wanted to show you a little bit about my multi-sited longitudinal fieldwork. So between 2007 and 2018, over a course of 11 years, I had to trace the development of China’s AIDS politics through conducting fieldwork at three different sites.
One is transnational AIDS institutions and different organizations. The second is the Chinese state, and the third one is the three different groups of community-based organizations. Also, when it comes to Chinese state, I investigated different organizations from health, civil affairs, Foreign Affairs, to police and security.
So here is just a laundry list of various things. It’s a combination of archival research, ethnographic research, as well as interviews with hundreds of officials– government officials, as well as community leaders. If you’re interested, I can show you more details during Q&A.
But here is just to give you some snapshot of what my research site looks like. Especially– for example, I don’t have time. On the left, you can see I don’t have time to talk about, for example, the Global Fund meeting, which is the largest transnational entities in HIV/AIDS, infectious disease overall.
So all the presentations were given in both English and Chinese. I don’t have time to get into details, but for those of you who– I know at Berkeley, we always talk about neoliberalism, the US empire. But come on, like international agencies, life in China, very difficult, very difficult.
And then on the left– the bottom, that was the Beijing government. And then on the right– so you can see the right bottom corner, that was where I usually hang out with the gay activists, which I will talk a little bit more today. But on the top, since I don’t have time to talk about the rural activists, I just wanted to show you a little bit of what one of their rural organizers home looks like.
So there was a mountain of trash and garbage right next door. It was summer when I visited. So I wanted to remind you in that household, there were three children under 10, and two of them were HIV positive. The smell was overwhelming. And you cannot see because all the walls and the floors were covered in flies.
Because at the time, I had an open wound in my leg. So it was just too much. And I ended– that was less than one hour interview. That was the shortest interview I’ve ever done. So that’s one of the things I don’t have time to talk about. But it was very prominent in the book, which is suffering’s, life and death. And it actually matters the least when it comes to epidemic politics.
- So let me quickly show you the 40-year history of public health building revealed in this book. So here is just to show you the funding for HIV/AIDS intervention in China over the years from the 1990’s. I don’t have the data before that. But basically, there was no funding.
So China’s contemporary public health had not really started to develop until the early 2000. So in the 1980s and 1990s, for two decades, the party had completely abandoned the Maoist tradition of emphasizing public health.
So back then, the concept of epidemiology hardly existed as its wealth grew, the state was really not willing to put money into public health. So there was not really institutional building per se. So you can see here on the right, that was the Prime Minister, Li Qiang, visiting China CDC for COVID-19. But this entity was not founded until 2002.
So nobody at the Ministry of Health back in the 1980s would ever imagine that one day it would host an international briefing on the left, on the sharing his experiences about COVID-19 with WHO– World Health Organization. Neither can it imagine that public health would one day become a very important part of China’s growing impact in Africa.
So let’s go back to the book. So first three chapters in my book talk about this unseen infectious era when public health department basically denounced professional expertise and technical knowledge with hardly any funding. Since the public health main task at the time was really to defend the socialist moral boundaries. If you’re interested, I can talk more about it during Q&A.
So at the time, they would treat infectious diseases such as HIV as a foreign disease undeserving of recognition, which resulted in China’s largest HIV/AIDS outbreak in the 1990s. And the transnational organizations began to intervene in the 1990s.
In the late 1990s, as you can see, the funding started to grow. But it didn’t really go anywhere until early 2000, when they brought an unprecedented amount of political pressure. That was when health finally became a very important political issue because of SARS. Then it started this whole process of democratizing public health in China.
So the rest of six chapters in my book demonstrate how such foreign interventions– you can see the huge drive, the rise in the funding, not just in the international side, but also from the domestic side. Just to show you the public health bureaucracy expansion, Chinese health departments began to cultivate the specialized capacities and professional identities by learning from especially the US and the UK experts.
So nowadays, local agents had to study and implement a US-style project managerial skills such as basic accounting and finance, especially, as well as substantial techniques for conducting statistically robust randomized, controlled, and cost-effective interventions.
So departments began to increase their staff with epidemiology background, as well as biology or preventive medicine, instead of just public hygiene degrees from vocational schools. So it’s fast to show you that there is this what I call projectified contracting model. It’s all about the contracts and the projects. And I think we academics know the difference between doing research versus doing research project.
So transnational funding accounted for between 30% to 70% of funding for China’s HIV/AIDS programs in the 2000. And it pushes the whole conception of projects into health departments as a whole. AIDS funding also accounted for almost half of public health funding at the time, which is one of the reasons why it was such a driving force in terms of public health reform.
Even when transnational programs, you can see began to pull out after 2013, the institutionalization of project continued. So nowadays the Chinese government actually took over and injected a large amount of funding. It also applied the projects to tackling other infectious disease as well as chronic disease.
Nowadays, HIV actually has very low prevalence rate in China, but the mortality is very high. So before COVID, it was the biggest killer among all infectious disease in China. But again, before COVID, the central government continued to invest at least 30% of public health funding onto this disease.
- So I want to talk a little bit about how does authoritarian absorption work in this process. So my book focuses on these two mechanisms. One is directly how does the bureaucrats learn the professional knowledge as well as other capacities from foreign agencies. And especially very importantly, I talk about how transnational organizations can breed the government agencies interests to recognize certain disease and affected populations as worthy government objects.
But the second one is to really think about how the social movements play a role in this process. So I’m going to give you one story, one story of Yao Ming. So he had been a leader of gay community in the northern city since the 1990s. Back then, homosexuality was a moral corruption. It was a political taboo that the state refused to acknowledge at all.
So several medical doctors who try to study homosexuality actually was forced to commit suicide at the time. So community leaders like Yao Ming were pretty much hiding away in the shadow trying to avoid police harassment. Thanks to foreign resources and legitimacy, he co-founded Rainbow Group to organize in the name of AIDS Intervention in 2003.
And the group’s relationship with the local authorities had been quite contentious in the 2000s. But the relationship had completely changed in the 2010s when local health department regularly supported the Rainbow Group’s activities. Starting in 2014, local CDC officials would even attend their gay Pride Month activities every year.
By 2018, Rainbow Group had grown to become this very big health organization that provide not only gay men, but also the youth and migrant workers with HIV, STD, Hepatitis C, and other services. They were also a very key factor during the COVID-19 battles.
So this is just one example to show you how homosexuality had changed from a moral to a public health issue. So in this photo, again, the Prime Minister, Li Qiang. This was the first time he ever shook hands with community leaders on TV. And guess what? This was an HIV/AIDS intervention event. And most of the people, the majority of the people there were HIV negative men– OK, gay men.
So gay men organizations– and this was basically displayed in front of– as you can see, the white lady in the picture was a UN representative. It was basically to showcase China was very much committed to this community mobilization style– liberal style of public health campaigns.
So this was really unexpected change. And if you’re interested, I can talk more about the homophobic state. China is still a very homophobic state in this sense. But the point is what had brought this once antagonistic government and urban activists together?
So in my book, I probably don’t have time to get into the details. But let me see. But just to leave this question here, if you’re interested, I could talk more about how those two come together. But just to conclude, since I really only have 20 minutes, one other thing is to really think about– to rethink about infectious disease control and state building in the context of world order, whether this is really just a domestic issue. But to really think about what roles it played in the establishment of China as whole, or the rise of China as a superpower.
But the second one, today I don’t have time to get into details, but really to think about how to bring organizational theories into international relations studies. So it’s not just about the politics, it’s not about democratic or authoritarian, but really to think about why different organizations would operate in certain ways. And that is a very key to understanding why transnational organizations with the mission to democratize the rest of the world actually ended up doing the opposite things.
But the third one is to really think about civil society from a transnational perspective. Obviously, as you can see, when the government leaders were shaking hands with gay men, where were the rural activists? They were on the street protesting during the same period, and they were just sent home. So civil society is a very stratified world, and who got on top and who got on the bottom becomes very important.
And in the end, I wanted to just respond to the people always talk about authoritarians or the advantage in doing certain things. OK? As if Trump becomes this Superman, strongman, the things would change. But one of the things it might be much more subtle, but I want to highlight that China’s nowadays infectious disease control looks very much like US because it absorbed the two key points about the system here.
One is, it is all about disease-oriented rather than system-oriented infectious disease response. So that’s one of the major thing. Another thing is the technical-oriented tendency. So China is even more obsessed with numbers, with labs, with technical preventive measures, rather than providing substantial care and other things that are very important for public health.
So there are several features that actually was established during the HIV era that continues. One is the fluctuation of states wealth and ability to see pandemic. It’s still going to be a battle, and it’s not going to be about the mortality or other factors that takes a role. And secondly is, what I just mentioned, the enhancement of technical bodily surveillance.
It’s very funny that one of the gay activists talk about it because they will become such an important object of state intervention. They were subjected to constant blood tests, and they were very happy during the COVID-19 era because everybody had to go through that test every day. So the prioritization of testing over treatment, that was also one thing that the opposite of United States, but in a similar sort of flare.
The third one is the neglect of rural regions in epidemic infrastructure, and then the pivotal roles of non-state actors in pandemic control. That’s what continue to be praised as community participation that can actually work really well in the authoritarian context. But last but not least is the intertwining of China’s pandemic strategies with its global interactions. Actually, during the Trump era, United States was pretty much giving up its leader roles in global health during COVID. It was when Biden came into office that started this whole new competition with China to use vaccine diplomacy to fight again.
So we don’t know what’s going to happen next in the global health era. And I will just stop there. Thank you so very much for your attention.
[THOMAS GOLD] I want to thank Yan for an exceptional job of summing up an unbelievably rich and complex book. And now we’ll turn to Matt and then Rachel for their comments.
[MATTHEW KOHRMAN] OK. So yeah, thank you so much. This was a pleasure to read from beginning to end. On so many levels, I recommend to you all this breathtakingly sophisticated book. It’s not a hard read. I mean, you would think a book on the AIDS pandemic, oh my gosh, a long 300 page book. It just reads, it just goes. And it goes because of the fantastic design of the argument. It goes, and it flows because the way you interweave historical scope and the way you rigorously chronicle in a very vivid way, the formation of the AIDS epidemic in China. Going back to the mid 1950s and the foundational ways that infection and health were set up in the 1950s under Mao, with the patriotic health campaigns. Which for those of you who don’t know, we’re very much tied to US military intervention in Northeast Asia, particularly the Korean War.
I also just found the book vivid and exciting to read because of its ethnographic depth. The texture, the ethnographic flair that you bring to it based on just really, really what struck me as hard, difficult fieldwork that you were doing across so many different registers– especially in the rural context– was just remarkable. But so is the ethnographic texture that you bring to these institutions, and the way you describe how it was very hard, but how you were able to traverse so many institutional registers. And that, I think is definitely one of the proudest parts of the book.
The analytical and theoretical sophistication of the book– I think you got a sense of that from Yan’s presentation. I want to add that one of the things that I was constantly taken by in the book, and that kept me going and consuming it with such a keen avarice sense, was the way you tenaciously avoid so many received theories and schools of thought, and how you very diplomatically do that. I mean, you’re not dismissive. You’re elegantly showing how they don’t work in these specific cases. And through that, you’re building out an argument about authoritarian absorption that is really quite profound, and I would say trailblazing.
And the concept of absorption that you have, I particularly liked how you worked it at and focused in on what you call this mezzo level, and the interrelatedness, the focus on relationships, the relationships between the registers. So it’s not just a matter of what’s going on at these different registers, and how is particularly at the top of the register and the bottom of the register are these tensions. But it’s really how you help us understand these otherwise obscured mezzo levels.
How am I doing for time, Tom?
[THOMAS GOLD] I don’t–
[MATTHEW KOHRMAN] Eight? 8 to 10 minutes.
[THOMAS GOLD] You still got five.
[MATTHEW KOHRMAN] I still got five. Great, OK. So I would also draw your attention in one of the things that propelled me through the book– is an elegance of writerly élan. There is a flow. There’s a quality to the prose that is spectacular. And in these days when it’s so hard to get people to read books, it’s so hard to get people to read sections of books, it’s so hard to get students to read an academic article. The importance of clarity and writerlyness is so, so essential. And you bring that to us. And I think it’s going to serve the book very, very well.
And other things I want to draw your attention to, which I think Yan didn’t speak to so much, is this is a book that has a very profound ethical rootedness. You are a sociologist by training, this is a book that is highly objective in its analysis. But you bring a subjective positionality that seems to be very, very grounded in a sense of an ethical compass about what you have observed over the years as profoundly wrong, and that you’re trying to speak to and speak back against. And it never comes across as just dismissive or simply argumentative for the stake of that. It’s rather the way this rootedness emerges in a extended metaphor in a very grounded way.
This is definitely much more than a China studies book. And for those of us who work in China studies, we know what that means– that it’s a book about China, gets read by China study scholars. And we seem to have a hard time finding others outside of China studies to look at our work. I don’t think that’s going to be a problem here. I think this is going to be a book that’s going to be picked up and talked about for years to come, as so much more. And so much more than a book about a specific virus. This is a penetrating study at the intersection, I would say, of critical global health and political theory. And I think, for those reasons, it’s going to be picked up and read widely, and I encourage everybody to get a copy quickly before the first run is sold out.
So as a medical anthropologist– as someone who trained with a heavy focus on ethnographic methods– I really, really like the first two chapters. I like the other chapters too. They also have an ethnographic flair and perspective that you’re bringing to these government institutions. But I guess, maybe because I have a sense of those government institutions a little bit more, and I always want to know more about rural life. The first two chapters, which take us back to the viral emergence with the plasma and blood-selling enterprises in central China, I couldn’t put the book down in those sections.
So I would encourage you to look at chapters 1 and 2, especially the first chapter. Chapter 1 pays a deep, deep attention to what you call institutional ignorance out in the countryside, and how that drives the initial rise of infection. And while institutional ignorance sounds dismissive or condescending, it doesn’t come across as that at all. Chapter 2, I really, really loved a lot. I’m only going to talk about this last chapter, and then I’m going to have some concluding questions. This second chapter pays a deep attention to how processes of social exclusion at the village level, with a special attention to gender exclusion, was what lit the fire in the countryside, for people deciding to start to sell their blood. At a time when there was tremendous stigma against people selling their blood. People didn’t want to do it, and they were not eager to do it. And what broke through the stigma of selling blood, which then allowed for the infection to burst out in Central China, was processes of gendered exclusion. And that was just really fascinating to read.
So I have some questions, and I’m not sure if this is the forum for raising questions. And because I don’t know if we’re going to have conversation, but some questions I had that I thought might be worthwhile thinking about as an audience– either when you’re reading the book, or at some future time. The concept of authoritarianism that you use here, I think it works really, really well. And I think you tie in all of these various arguments under it.
It’s a term that we’ve been hearing a lot in the last five, six years, particularly in discussions of China– authoritarianism. But as someone, like others at this table, who’ve been studying China and around for a while, I mean, I think back 10 years ago, we didn’t use the term authoritarianism anywhere to the degree to which we do now. And certainly not in discussing China outright. And I think in other contexts as well. So I’m just wondering what you’re thinking now about that term, and are you at all worried that it will, maybe in years ahead, maybe start to take on different valences that you don’t mean in this book?
I have questions just about the sharing of these findings. The deep commitment you have to the people of Hunan, strikes me as especially kind of problematic– because how do you get this book, how do you get what you’ve learned, what those people that you document as kind of living in the zones of desertion– a really engaging phrase you used, is the zones of desertion, to talk about the people in Hunan? How is it possible in China today for us to get this kind of knowledge back to those kinds of people in those circumstances?
So I’m going to end with one more question. And I think this is a question that I’ve been hearing a lot from China’s studies academics, which is– How, given the Li Qiang and Xi Jinping, and now post Li Qiang era of Xi Jinping China, how do we– is this kind of book possible? Is it possible for graduate students to do the research that you did? Is it possible for assistant professors to do this kind of work today? I mean, look, people are just saying, it’s not possible. So what is possible? What can be done? And how do we do it? And how can this book, maybe even, help open up some doors that– the shaking of the head, that not possible. But might this book actually, in some ways, if circulated back into China, serve to open some doors? Thank you.
[YAN LONG] Thank you.
[APPLAUSE]
[RACHEL STERN] Thanks. I had the advantage of attending an event in this room and sitting in the back row a couple of weeks ago, and I couldn’t see anything. So I’m standing up so I could see you guys. So what a wonderful book. What a wonderful opportunity to be here today and have an opportunity to celebrate a colleague’s work and the culmination of a decade of research. What a special day for all of us today.
One way to frame this book– and I think the top-line finding– is that it’s an effort to map a middle ground about how much international exchange matters. So as I was reading, I thought about an old book by a professor of history at Yale, Jonathan Spence, who is emeritus and has died subsequently, called To Change China, which is a history of Western efforts to change China and never works. That’s what that book is about over 300 years– it never works.
And I think this book is in some ways, in dialogue with that book, to say that it works in unanticipated ways. That transnational practices meld with socialist practices to create a new public health model that has features of global public health models. It’s cognizable– in some ways, it looks like the United States– but is also distinctively socialist and distinctively Chinese.
My own background is I’m a political scientist by training, and I’m a terrible presentist. Like all my efforts are to try to understand the world that we live in right now. So 2024, next year will be 2025.
So for me, coming to this book, and I’m so glad that Matt highlighted the historical chapters because those are wonderful too. But for me coming to this book, what was most interesting was its relevance for the present moment. To think about how the China’s experience with international exchange has led to the emergence of what the book calls epidemic infrastructural power, or I would call state capacity to measure, to manage infectious diseases. And to recognize that this whole COVID response, that people who don’t study China turned on the news five years ago are like, what? What’s going on? that it came out of somewhere. That it was cognizable, and for those– humans instinctively out of the HIV, the HIV/AIDS world.
And I think the book is really convincing. I love the last chapter. That’s the one on COVID, talking about the core features of China’s response being molded by the HIV/AIDS crisis. So all the emphasis on testing, on numbers, on quantifiable targets, the divide between urban and rural China being completely different– all of that is echoed in this earlier period in the context of a different pandemic.
Matt did such a nice job talking about the virtues of the book. There’s so much to admire here. There’s sustained and emotionally challenging fieldwork. I love the efforts to look at a policy area over decades, rather than just flying in and taking a snapshot. And then overall, it’s a complicated book. I love the book’s insistence on nuance and refusal to simply repackage overly simplistic narratives about anyone, about Western funders or the Chinese state, having all the power and authority. And that’s not to say that the book is not attentive to power– it’s very attentive to power. But it’s a book that puts real people at the center, often with beautifully realized, detailed portraits of them, and insists on their agency. Insists that power has to be negotiated and that it’s not absolute, and that there’s agency for everyone and dignity for everyone. That’s maybe a way of saying there are no bad guys. They’re all good guys, working in complex ways.
By way of comments, and to kick off our discussion, I wanted to pull out some themes and some that I think are ripe beneath the surface and to transition into asking some questions. I’m going to focus on the public health professionals that are one of the players– not the only player. I told you it was a complex book, but one of the key groups here. And the themes that I wanted to pull out were status and ambition.
And so what motivates the public health professionals? Why do you bother with transnational exchange? And here, I think a lot is about status. And the chapter on this is really well done in giving us a portrait of how public health officials are delighted with the new found status and training that they get from international contacts. So for one of the public health officials that we meet in the book, named Shangbin, they say HIV/AIDS represented a life-changing chance. And it means personally, like a life-changing chance for them to further their career and to do meaningful work.
So thinking about status, which I think is a main theme of human behavior. It makes me curious about status and what happened to status after the withdrawal of International funding. I’m curious about alternative forms of status that might have emerged– domestic forms of status, alternative forms of hierarchy– and how that withdrawal of International funding changed the public health field.
And then the second theme is ambition that by the end of the book, public health has become an arena for diplomacy and for China to project soft power. So the book ends with China looking for apprentices in the Global South, donating, I’m going to get the scale wrong– billions of vaccines, millions of vaccines– millions, lots and lots of vaccines, a lot of vaccines, donating lots of vaccines around the world and exporting its own project-based model. And this ambition is really familiar to me as someone who studies law, because I think law is also an arena in which China has tried to lead the world in recent years. A place where, to echo one of Xi Jinping’s slogans, China’s story can be told well and a possible arena for diplomacy.
So if you take these two areas together– law and public health– as part of soft power of China’s leadership, I think it’s interesting to put them in dialogue. But then I want to go back to the conceptual framework of the book and use the approach that the book does, and disaggregate the state. And just ask the question, where does this ambition come from in the system? If we disaggregate the state, is the vaccine diplomacy and the rest, the desire to engage internationally? Is this the public health officials? This is another arena for status and authority or institutional legitimacy, depending on what vocabulary you want to use. So is this about them, or are they driving this? Or is this happening even higher up, or in some other agency, as part of a broader soft power diplomacy initiative?
And then last, I wanted to ask, and Yan can push back against this framing, but as I was reading, I was trying to figure out what this book tells us about Xi Jinping’s time in power. Xi barely appears in the book. And in fact, international funding, which changes right around 2013, it disappears relatively quickly and off stage. But of course, there’s a broader context there about the drying up of international funding and programming. There’s a whole legal dimension to it– new laws are passed, and international funders leave, and civil society organizations, in terms of number and robustness, precipitously decline by the end of the period– all of which I know is in the book and is known.
But I was really struck by the periodization. So the periodization of the book has the China model of epidemic control emerging from 2009 to 2018. So that’s a period that predates Xi Jinping and goes through his first term in power. So I just wanted to ask about that. I’m curious about the choice not to periodize by leader, not to periodize by who’s on top of the system. I can imagine that perhaps public health is an arena that is less sensitive to directions from the top, or maybe this is something that just has not been a priority of Xi or of the Politburo. Or maybe this is a disciplinary question. Maybe this is because I’m coming from political science, and we’re just like, this is the question that if a political scientist falls asleep in a job talk, it wakes up, you’ll say, what does this tell me? China studies job talk, you say, what does this tell me about politics under Xi? And say, how is the Xi era different, given that he’s the most powerful and transformative leader since Mao and Deng?
But I did want to at least ask the question and ask about the choices that were made in putting the manuscript together in the way that it is. And then a more subtle version of the question, which I’m starting to grapple with myself is to try to think about change over time, as Xi’s time and power lengthens. So what can we say when someone’s in charge for a really long time. They’re not the same leader at the end of that period as they were in the beginning of that period. So how can we distinguish between early Xi and late Xi? And of course, to some extent, this is an unfair question because the fieldwork for the book ends in 2018. But I feel I know that the second book project is about the state’s response to COVID. So I feel justified in asking it. So maybe if we have time, we can go a little bit beyond the boundaries of the book to talk about what shifted in the last several years in terms of epidemic infrastructural power, and what lessons were taken away specifically from the COVID 19 pandemic. Thank you. Thank you guys for a wonderful book too.
[THOMAS GOLD] Thanks, Rachel and Matt. And Matt, very glad that you came up from Stanford. I appreciate that effort. Just a couple of comments on the point that you made about appealing to a greater audience than just China types. The book, Yan’s early work, has won several awards from the American Sociological Association, which is already a testimony to its greater appeal. And as I read it, I learned so much about so many different subfields in sociology, to tick some off– political globalization, stratification, civil society, social movements, gender, organization, sexuality, public health, medical sociology, and technology. So there’s something here for everybody, I think, and hopefully people will be aware of that.
I also want to single out the whole fieldwork aspect– the unbelievable amount of fieldwork and just the different groups within Chinese society that she was able to deal with, to gain access to, and to humanize them. I think the point that you made about these are real people, and we get a sense of real people grappling with very sensitive and very difficult issues. I have a couple of– in my own experience with INGO, International NGOs in China, it’s been in the environmental space. So the point that Rachel just made, if you’re dealing with HIV/AIDS, a very sensitive issue, it touches on so many different things in terms of Chinese society. But if you were looking instead at human trafficking or labor or the environment, it would be a very different book, it seems to me. You’d come to a very different– possibly that’s a question, I guess– very different set of conclusions about the nature of the Chinese bureaucracy, Chinese state, and its relation with civil society.
Once again, also the point that Rachel made about– both Rachel and Matt– on fieldwork, is this is, of course, a big issue in the China field now– will it be possible to conduct this sort of fieldwork? You, as a Chinese, may have certain advantages, such that you’ve got networks and family and so on within China. But for someone who is not ethnically Chinese or not from the PRC, will it be possible to do in-depth ethnographic fieldwork or interviews in the future?
And because you interviewed people in so many different spheres of life, what did you tell them you were doing? There’s always in fieldwork and ethnography, there’s also a certain amount of deception, in some cases. You don’t want to tell people exactly what you’re asking, especially in something as sensitive as this. How did you present what you were doing? So I’ll give you a chance to respond. And then we have– when are we supposed to end, at 1:30? Yeah, five minutes, if you can deal with that, and then we’ll see how the questions go.
[YAN LONG] OK, thank you so very much for your generous comments. I really appreciate them. There are a lot of questions–
[THOMAS GOLD] It’s up to you, you don’t have to answer.
[YAN LONG] Yeah OK. Let’s see. I guess everybody mentioned fieldwork, so let me respond to that. When I was doing my fieldwork, everybody like– I got a similar reaction. It’s like, It’s too sensitive, it’s too difficult. It’s kind of funny, like the Security Bureau under various professors were telling me the same thing. So now when I look at it, it’s similar, the situation isn’t. I don’t feel like it’s necessarily that much worse. It really depends on the location. The rural areas are much more difficult. But even back then, it was very hard for me. I was carrying two cell phones. In the rural areas, it was just much, much more intense. That’s why now I’m shifting towards urban governance. It’s a conscious decision.
But again, I’m studying COVID-19, which is supposedly one of the most sensitive, taboo again. And I don’t know digital technologies any better. So I think until you do it, you never know what the limit is. And I also think right now it’s becoming even more important because of the disengagement or the separation between China and the US. I don’t think people here– I always have this belief is whenever you’re on the field, on the ground, you are not as afraid. But when you’re in the United States, with all the media, with all the newspapers, there’s just nothing– it’s just sounds like a horrendous monster.
China is just a monster. And I think it’s becoming even more imperative for us to do work. And I actually do think foreigners and Chinese native have very different advantages and disadvantages. Usually does not work free there. And I think the perspective and the closeness and sadness you can also achieve is just a different route. So I still think it’s possible. It’s just more strategic and in terms of how to do it and in what kinds of ways. That’s probably my response to the fieldwork.
But that is also because I appreciate what you guys were talking about, the humanly perspective. I consciously chose that perspective. But to be honest, I am very afraid. I am afraid what people would say. Would the activists push back? Because I’m not necessarily like, oh, you are the good guy. Or would the government?
There was Authoritarian Absorption. Yes, I would never, ever take this book back. And just with retiring, the term itself, I think it’s just not acceptable, even on social media. I posted it, and people asked me to take it down. It’s just not allowed. That’s actually why I insisted on using the authoritarian term, is especially because it is such a taboo in China right now, and also because of, in the United States, the change of the politics.
I think the authoritarian expansion is not just in authoritarian states but also in the whole world. Before 2010, we were talking about authoritarian expansion. But right now, we’re talking about right here, you see the democratic and authoritarian battle. So I think that is still very, very important. But I totally get what you’re saying is the implications.
I think some of my colleagues in political science would use autocracy instead of authoritarianism. So now that’s where I stand. I do not want to go into the autocracy, but authoritarianism, that’s where I stand. On the sharing of finding, I would say, yes, it’s a guilty confession. I feel really horrible about writing this book because it’s based on people’s suffering and misery.
And there is no way I can– some of the people, many of them have passed away. I probably will never see many of them ever again. And I can’t really share, especially in the rural areas. And also, the sad part is when I present the book, I realize people are far more interested in the urban gay man rather than the rural areas because it resonates much better here. People understand it. They have assumptions.
But they don’t understand the rural areas, all the histories. It’s a long, long, long story that feels very strange and foreign to the US audience. So in some ways, I want to tell this story in the book. I think that’s the thing. For me, I want to tell their stories, even if they’re not of theoretical significance to the academic audience here.
But also, not to demonize the state is very important for me. That’s a funny thing. I mean, everybody asked me what’s going to happen after I publish the book. I don’t know. I don’t know. Maybe I can’t go back. I don’t know. But I’m just like, if they read the book, then they will realize it’s not just about politics and power, but also– I also what Rachel was talking about. It’s about humans and their personal desire and ambition, and also a lot of the inequalities, the unequal relationship between Chinese officials, the bureaucrats and technocrats, and their Western counterparts. That is also very real.
And so that’s partially what you were talking about, the status and ambition, because there is the– I don’t like the term postcolonial because it doesn’t apply in China. But there is certainly the idea of suddenly, you have a country of agents. Suddenly, they are rising on the world stage, but then they don’t get the same recognition and the same respect.
So in these areas, Tom was completely right. If I work on a different area, like trafficking, human trafficking, that would be very different because public health is a very technocratic area. Technocratic, knowledge-oriented epidemic, that epidemiology– for authoritarian state or any Global South country, that are considered as really important to boost their status and their reputation.
So in that sense, I think law is actually the same thing. I think that’s also one of the major reasons why an international organization can have a huge impact in China, because it’s not morality driven. It is actually technology driven. So in that sense, it is the different sides of the same sword.
[THOMAS GOLD] Time is running away.
[YAN LONG] OK, I’ll just stop here then.
Yeah.
Yes.
Then you can continue.
[AUDIENCE MEMBER] Thank you very much. My name is Rosy Hsieh, and I’m a Berkeley PhD that’s visiting on campus this semester– or this year, actually, and also, like Rachel, a political scientist and really, very much appreciate the fact that this– just also based on the comments, too, this is a fascinating book, and I cannot wait to pick it up.
I see synergies between– I really like what appears to be the mid-level theorizing, connecting the micro-level developments with your ambition of speaking to macro-level IR kind of issues. And I’m thinking two political scientists. One in China studies is Diana Fu’s work. And you probably know about her work on her book Mobilizing Without the Masses.
And so one argument that she makes is that because of the nature of authoritarianism in China, activists have to adopt different types of methods. And those methods that they have to adopt to work within the environment, in her argument is that it actually is, in fact, empowering, whereas it appears here, you’re showing that, actually– then it actually gets co-opted by the state.
And her work is mainly on labor activists. So I’m wondering if you think your findings could actually travel to other issue areas, or is it really just about public health, and this is where the authoritarian state co-opts some of the practices of international level? And then really quickly, the other one is an IR specialist who I met at Temple University, and she used to be one of my colleagues, Sarah Bush. And she/her book is called Taming of Democracy Assistance.
And she argues that it’s actually because of authoritarian governments you see IOs or INGOs where they operate in, in her context, the Middle East, they become tamed because they cannot actually do democracy assistance. They have to do things that could actually work in the authoritarian context. So is the causal arrow here the IOs changing? I mean, so I see co-optation here, but maybe it’s the authoritarian governments that’s actually changing IOs or NGOs. Anyway, yeah, fascinating. And I very much look forward to reading your book. Thank you.
[OTHER AUDIENCE MEMBER] Thanks.
Yeah. Thank you so much for this very interesting presentation, and I’m looking forward to reading the book. And I find, actually, the title of the book is pretty powerful. The term of authoritarian absorption actually reminds us some other similar notions, such as Professor King– actually, Professor Karman also touched on it. Professor King Ambrose, administrative absorption of politics in Hong Kong under the British governance, and as well as, like Professor Chin Lee’s legal bureaucratic absorption of the grass root protests in China.
So these are some similar notions talking about China. And you are actually showing us how this term, absorption, could be more powerful and fruitful when we are talking about China. So actually, I was curious if you have done some conceptual comparison in this book, or if you could give us a brief interpretation about the conceptualization by this term. Thanks.
[THIRD AUDIENCE MEMBER] Thank you. My name is Min Li, and I’m from Anthropology Department, Medical Anthropology. And I also did field work in China. So I was comparing your book with Katherine Mason’s Infectious Change on SARS. And I was just wondering, since I didn’t read your book yet, if there’s any connection with the SARS system, the systematic change after SARS as well, reflected in your book.
And also, since the timeline ends in 2018– and I know that a lot of civil activists that I met in China. They say that the most critical changes happened between 2016 to 2018, and everything changed into the system of government buying the service like [INAUDIBLE] from all the organizations. And according to that standard, there are the organizations that can cooperate with the government and who are totally out of China.
So I was wondering if your concept of absorption reflects that situation afterwards, 2018? Yeah, thank you for your presentation. And I’m looking forward to your book.
[YAN LONG] Thank you very much for your questions. Those are pretty big questions. I’m just going to give a very simplistic answer. Yes, first is Diana Fu’s book. Yes, I’m very familiar with that book. And I would say that kind of competition, like you were describing, that does happen in different areas. I actually did shadow comparison across different issue areas. So I would see there are certainly similarities.
Secondly is the term democratic assistance. What is the causal link? I would probably also provide a different point of view, that is that China is not just internet nowadays in global health. China is World Health Organization and UNAID’s darling. And there is a reason, not because China bought them off, but because China really played its game really well.
And who set up the game? It was international organizations. So in many ways, from the IO perspective, international organizations nowadays– I’m not talking about NGOs, but really intergovernmental organizations. They’re changing the rule of the game into the expertise. They don’t want to be this just moral authority, exactly like you said, because it doesn’t really work in authoritarian context.
So they shifted their role into a consultant. And they emphasize technocratic innovation. And it’s that kind of game trying to really thrive. OK, different authoritarian regimes might play really well. I would say, yes, it’s the government, but also the international organizations, both ends. The interactions within that kind of way, that’s the causal. I would say, it goes both ways.
My concept, I would say, yes, absorption happens, actually, also in the United States. Administrators always try to absorb different rebellion forces. But the difference, I think here, I emphasize [INAUDIBLE] is just really the moderators because it’s more about the transnational liberal rules, because I wanted to go in against the idea that social movements must be democratic, social movements must be liberal. No, social movements have very dark, dark sides to it.
So from that idea, my absorption is really more about how the Western world influences. So that might be slightly different compared to others. Yes, Mason’s book. We have some similar argument in terms of the bureaucrats, how Chinese bureaucrats position themselves and their interactions with outside the bureaucratic world. I think in that sense, it’s quite similar.
And the SARS did play a huge role in terms of helping to push the health into the world political landscape. That was the beginning. That actually goes back to Rachel’s question, why the timing? The period, for me, is more about the world political changes rather than the leadership change in China. What happens with Trump is never just starts with Trump in that sense.
And I would just say, the contracting model, I think, of my book probably pushes back even further by talking about, where did the outsourcing contracting model started? That was not a Chinese invention. That actually came from nobody else but the United States. So new managerial reform played a huge role in this process. So I wanted to identify that as a source rather– and then the consequences, and it comes. Yes. So you’re definitely right in that. Yes.
[THOMAS GOLD] Great. Well, this has been really fascinating. So I want to thank Matt and Rachel and, of course, Jen for leading us through this really great discussion. And the book is– we don’t have it for sale outside here, do we?
[YAN LONG] No. I got 20 copies.
[THOMAS GOLD] Book talks, there was Cody’s blessed memory.
[YAN LONG] Oh, wow
[THOMAS GOLD] –sell books. Anyway, thanks again and thanks to the audience for participating.
[YAN LONG] Thank you so very much.
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