I thank Professor Xian Huang for her thoughtful and constructive review of my book. She identifies two ways my book differs from existing studies—its environmental health perspective and its focus on the issue’s international dimensions—which were the two most important reasons for writing this book. I started the book project in 2013, when smog suddenly dominated headlines in Chinese media. Reports on the small and deadly PM2.5, the “cancer villages,” and food safety problems stimulated my interest in studying environment, health, and governance problems in China. They also prompted me to make the connection between China’s domestic challenges and its international ascendance. Although a voluminous literature on China’s rising power highlights China’s economic prowess and military buildup, as well as its ability to project its international influence, relatively little attention has been paid to the state capacity to tackle China’s daunting domestic challenges. Environmental health issues and China’s response serve as a springboard to examine its ability to mobilize resources and enforce rules and regulations across its entire territory.

I appreciate Professor Huang’s suggestions on what could have been done to improve the book. The question of subnational variation is an important one that “deserves more discussion and theorization.” In my book, I discussed the diverse effects of pollution, including the clustering of cancer villages in particular localities (p. 45), the regional distribution of the cost of environmental health (pp. 60–61), and the uneven progress in reducing PM2.5 levels at the provincial level (p. 155). Had subnational-level data been available, I would have conducted more systematic analysis on why some provinces did better than others in pollution control.

I also support the idea of providing more in-depth analysis on how the relationship between political leaders and industry/business elites shapes the environmental policy process in China. Under the Dome, the TED Talk-style documentary released in 2015, blamed large state-owned industrial conglomerates for contributing to China’s pollution crisis. Not surprisingly, the documentary drew the wrath of the elite who represent vested interests in the energy sector. Although the film received support from the then-minister of environmental protection, it was soon taken offline—the order allegedly coming directly from a top political leader. This case illustrates the potential influence of industry and business elites, whom I wish to have an opportunity to interview during future fieldwork in China. Unfortunately, without access to inside information on this aspect of China’s elite politics, it is difficult to evaluate with confidence their influence on agenda setting and policy formulation in the environmental arena.

When the manuscript of my book was submitted to the publisher, China was suddenly caught in an unprecedented public health crisis: the COVID-19 pandemic. Similar to how they tackle China’s environmental health problems, top leaders took decisive and swift actions against the new coronavirus once they recognized a serious crisis was looming. But China’s zealous fight against COVID-19 also reveals the same implementation problems identified in the book: overshooting, one-size-fits-all, and cengceng jiama. In short, China’s pathogen control and pollution control both lay bare a political system that is remarkably resilient and fundamentally flawed.