After SARS in 2002, external pressure has also impacted on the development of Chinaʼs public health.36 During the SARS outbreak, the WHO directly told the Chinese government in its mission report in April 2003 that “[t]here was an urgent need to improve surveillance and infection control” in the country.37 Two years later, in a joint report issued by State Development Research Center (Beijing, China) and WHO, the Chinese government officially admitted its health care system was failing, and it needed to improve its disease surveillance system at the local wet market levels if they were to be seen as a “responsible state.”38