But the coronavirus pandemic has revealed some two decades later that some of the same structural problems remain or were not fully addressed by the changes, experts said.

“The imperative to do better has certainly been illuminated by its Covid-19 response,” said Tara O’Toole, executive vice-president at In-Q-Tel, a not-for-profit venture capital firm focused on advanced technologies.

Jennifer Bouey, a senior researcher with the RAND Corporation, told the commission that the China CDC has been underfunded for years amid competing demands from other central government health care priorities. This has occurred even as local government that fund regional offices have seen their budgets squeezed by China’s slowing economy.

And even as China bolstered its disease monitoring and reporting systems after Sars, overworked doctors lack incentives to use the systems, experts said. Furthermore, the China CDC lacks the voice, independence or clout held by government and Communist Party agencies that may want to hide bad news from superiors, as seen in January with the Wuhan outbreak, Bouey said.

Infecting volunteers with Covid-19 may speed up vaccine studies, WHO says

But Covid-19 has also illustrated some of China’s growing medical capabilities, and the crisis will likely spur further Chinese innovation in telemedicine, robots and use of artificial intelligence needed for contract tracing, said Karen Eggleston, a senior fellow at Stanford University.

The resources and political will that Beijing has marshalled for promising health care technology and research, including a 32 per cent annual increase in spending on biomedical research and technology from 2008 to 2013, is evidenced by its early lead in the race for a Covid-19 vaccine, experts said.

“At this time, China has more Covid-19 vaccine candidates approved for human testing than other countries,” said Bouey.

This includes one vaccine candidate with phase-one government approval – the initial stage involving a relatively small sample size focused on safety – and two vaccine candidates with phase-two approval, a larger trial that examines a drug’s efficacy as well as how safe it is, she added.

China’s strict lockdown and closed schools ‘saved rush on hospitals’

But experts also warned that China’s focus on quantity, speed and face can lead to quality problems and dubious statistics. A number of scientific papers published internationally by Chinese scientist were found to rely on falsified data. China also has been embarrassed in recent months after millions of items of exported personal protective equipment (PPE) turned out to be defective.

And some of the coronavirus figures reported by Beijing have faced international scepticism. “Does anyone agree with these numbers?” asked Jeffrey Fiedler, a commissioner and a director with the United Food and Commercial Workers International Union.

As of Thursday, China had officially reported 84,000 cases and 4,600 deaths, according to Johns Hopkins University, compared with more than 1.2 million cases and 75,000 deaths in the US.

Witnesses agreed that Chinese statistics should be taken with a grain of salt. “There’s reason to be sceptical on the numbers,” said Bouey. “We have seen the trend that numbers can change, vary with the political will.”

But political will can also lead to periods of relatively accurate figures, they added. Those from early January probably greatly understated the problem, a period when the medical system was overwhelmed and Wuhan was hiding the outbreak from the central government.

After January 20 – when Beijing declared a “people’s war” against the disease – and into February, the figures were likely more accurate, the US experts added, given the inordinate focus on containing its spread. Then after February, as Beijing prioritised restarting the economy and reopening factories, they became more questionable again.

But they probably aren’t off by an order of magnitude, and China has managed by sometimes draconian methods to contain the virus, witnesses said.

Witnesses warned that China has made biomedicine, data collection, DNA engineering and other health care disciplines a national priority and the United States, which pioneered many of these fields, should not be complacent.

Among the advice that experts relayed to Congress include: greatly expand investment in strategic health care fields; improve science literacy among senior government officials; finance more high-profile projects to build national enthusiasm; and expand the number of students in health care science fields.

“It shouldn’t take seven to nine years to get a PhD,” said O’Toole.

Experts said collaboration with China remains important – especially during pandemics such as the current one – but the US also needs to be more strategic, better safeguard its competitive expertise and build up its strategic stockpile and capabilities.

“The US government dropped the ball and had an inadequately narrow notion of what a central supply needed to protect the national security was,” O’Toole added. “So shame on us.”

“We’ve been, you know, fat and happy for too long.”