Governing the Post-Communist Body: Transnational Pressure, State Apparatuses, and Local Social Movements

How do strong authoritarian governments respond to increasing transnational pressure and domestic activism to comply with global standards? This article seeks to understand the innovation in Chinese local governments’ strategies in coping with transnational advocacy networks and the unintended consequences of such innovation by focusing on the case of public health. Since the early 2000s, health departments have been facing strong challenges from international organizations and local advocacy groups to change socialist infectious disease control and allow local communities to participate in policy-making. Contradictory to the existing literature, local health authorities did not passively accepted or object to global models. Instead, as argued in this article, they embraced formal standards symbolically but decoupled them from the actual routines of organizational operation.

Drawing on ethnographic and archival data collected in Beijing and Shanghai between 2012 and 2013, this article demonstrates how local health authorities carefully created and maintained gaps between formal procedures and actual organizational practices by engaging with local communities in health intervention programs. Decoupling enabled health departments to gain external legitimacy and obtain international grants while also sustaining the internal flexibility with which they can address practical bureaucratic considerations. But over time, the interactions between individual health officials and local advocacy groups changed power dynamics inside health departments and eventually led community organizations to become indispensable tools in governing infectious disease. This article grounds the discussion of contested process of policy reform in a detailed case study by identifying the mechanisms through which governmental organizations embrace or resist fundamental new institutional pressure.