Briefing on theHealthy China Action
National Health Commission of the PRC
With the approval of the Central Committee of the Communist Party of China (CPC), the State Council issuedthe Opinions on Implementing Healthy China Action (hereinafter referred to as the “Opinions”), and the General Office of the State Council issued the Notice on Printing and Distributing the Plan for Organizing, Implementing and Assessing the Healthy China Action (hereinafter referred to as the “Implementation and Assessment Plan”). The Healthy China Promotion Committee (hereinafter referred to as the “Promotion Committee”) was established at the national level and The Healthy China Action (2019-2030) (hereinafter referred to as the “Healthy China Action”) was issued. We refer to these three documents collectively as documents related to the Healthy China Action. Next, I would like to give you a brief introduction to the three documents mentioned above.
I. Significance of the Documents
A healthy population is a key symbol of a prosperous nation. Prevention is the most economic and effective measure to maintain people’s health. The CPC Central Committee and the State Council attach great importance to the people’s health. In 2016, the State Council issued the “Healthy China 2030” Planning Outline, which put forward the goals and tasks of building a healthy China. General Secretary Xi Jinping formally put forward to build a healthy China in the report of the 19th National Congress of the CPC, and reiterated that we should carry out the policy of putting prevention first, combing the prevention with treatment together, enforcing holistic measures with full participation and collaboration of all society and at all levels, and ensure the delivery of comprehensive lifecycle health services for all people.
Premier Li Keqiang has made several specific instructions for building healthy China, emphasizing the importance of strengthening intervention and prevention as well as health care tailored to health determinants, and relevant work has been deployed in the Government Work Report 2019. Vice Premier Sun Chunlan has made a number of targeted studies and work arrangements.
Since the founding of the People’s Republic of China, especially the 18th National Congress of the CPC, China’s health services have made profound progress thanks to the concerted efforts made by all relevant ministries and actively pushed forward by local governments. People’s health has been continuously improved, the main health indicators of Chinese people are generally better than the average level of middle- and high-income countries. In 2018, China’s life expectancy was 77.0 years, with an increase of 0.3 years from 76.7 years in 2017, the infant mortality rate dropped to 6.1‰, the maternal mortality rate dropped to 18.3/100,000, and the major health-related risk factors were initially controlled.
However, we also recognize that we’re still facing new challenges regarding to people’s health, which is seriously threatened by five chronic diseases currently. With the acceleration of industrialization, urbanization and population aging, the lifestyle and disease spectrum of Chinese residents are changing constantly. The health literacy level of residents is low, with the unhealthy lifestyles such as smoking, excessive drinking, lack of exercise, unbalanced diet etc., resulting in increasing health problems. In China, there are 270 million hypertensive patients; 13 million stroke patients and 11 million coronary heart disease patients; more than 97 million diabetic patients; nearly 100 million chronic obstructive pulmonary disease patients; about 3.8 million new cancer cases each year, with an annual increase of 3.9%. Chronic non-communicable diseases including cardiovascular and cerebrovascular diseases, cancer, chronic respiratory diseases, diabetes among others account for 88% of the total deaths and more than 70% of the total disease burden. The prevention and control of major infectious diseases such as hepatitis, tuberculosis and HIV/AIDS is still at severe situation. Mental health, occupational health and endemic diseases cannot be ignored. In addition, some health problems or related issues among those vulnerable populations need to be solved urgently, such as birth defects, myopia and obesity among primary and secondary school students, early childhood development, as well as chronic diseases in the elderly.
In order to effectively address the health challenges, the State Council set up a working group in 2018 led by the National Health Commission in collaboration with over 30 government agencies, including the Ministry of Education and the General Administration of Sport, carried out studies in collaboration on health needs of the public and formulated documents relating to the Healthy China Action. These efforts have highlighted President Xi’s thoughts of shifting the priority of health services from treatment to people’s health and are expected to change people’s concepts, make prevention a priority, and strengthen disease prevention and health promotion. While every individual is encouraged to take primary responsibility for his/her own health, the government should mobilize all stakeholders to disseminate health knowledge, strengthen primary intervention programs so as to increase people’s healthy life expectancy. These measures will help people in accessing affordable medical care.
At present, the CPC theme education of "Remain true to original aspiration and keep the mission firmly in mind" is being carried out. In this view, the implementation of the Healthy China Action will make the people live a healthy and happy life, and will contribute to achieving the goal of national rejuvenation.
II. Main Contents of the Documents
Changing concepts and safeguarding comprehensive lifecycle health of the public. The Opinions put forward that the Healthy China Action should adhere to people-centered approach, insist on reform and innovation, carry out the guiding principles of medical and health work in the new era, strengthen responsibilities of government, society and individuals, accelerate the shift of the concept and service mode of health service from the treatment-centered to the people’s health-centered, and develop and improve health education system, popularize health knowledge, guide the people to form a correct concept of health, strengthen primary intervention, establish healthy lifestyles, ecological environment and social environment in order to prolong healthy lifespan and lay a solid foundation for building a healthy China in an effort to maintain people’s all-round health during full life cycle.
The Healthy China Action adheres to the basic principles of “popularizing knowledge, improving health literacy; keeping self-discipline, advocating healthy life styles; strengthening primary intervention, improving service; involving all people, sharing the benefit through collaborative building”. The action emphasizes preventing and controlling diseases from the beginning, focusing on the main problems and key diseases affecting people’s health with a highlight of health promotion advocacy and mobilization.
Consistently implementing a 10-year national disease prevention and health promotion programmes. The Opinions is a document guiding disease prevention and health promotion at the national level for the next ten years. It sets out the overall goals for the Healthy China Action by 2022 and 2030 respectively. By 2022, the health promotion policy system will be basically established; the health literacy level of the whole people will be steadily improved; the healthy lifestyles will be promoted rapidly; the rising trend of the incidence of major chronic diseases will be curbed; the key infectious diseases, serious mental disorders, endemic diseases and occupational diseases will be effectively prevented and controlled, with a gradual reduction of disability and death caused by these diseases. The health status of the key population groups will be improved significantly. By 2030, the health literacy level of the whole people will be greatly improved; the healthy lifestyle will be basically popularized; the main health determinants will be effectively controlled; the premature mortality rate caused by major chronic diseases will be significantly reduced; the average healthy life expectancy will be greatly improved, and the level of the main health indicators of residents will meet the level of high-income countries, and health equity will be basically realized.
Taking targeted measures and implementing 15 specific programmes. The Opinions provides a holistic solution on improving health awareness level, balanced diet, physical activities, smoking control, mental health and other aspects, and addresses health determinants in an all-round way; itfocuses on key vulnerable populations such as women and children, primary and secondary school students, laborers, and the elderly, and maintaining of the health during the full life cycle; the Opinions strengthens the prevention and control of four major chronic diseases including cardiovascular and cerebrovascular diseases, cancer, chronic respiratory diseases, diabetes as well as other important diseases such as infectious diseases and endemic diseases. Specific programmes were also proposed with measures for disability prevention and rehabilitation services and health promotion of residents in poor areas.
The Healthy China Action specifies the implementation of 15 specific programmes and a total of 124 main indicators were proposed, including outcome indicators (36), individual and social recommendable indicators (48), and government performance indicators (40). Among the 124 indicators, most of them (113 accounting for 91%) are predictive (48) and recommendable (65), and 11 indicators are compulsive. In the process of selecting and determining these indicators, the scientificity and feasibility of the indicators have been fully studied and demonstrated by relevant authorities and experts.
Every programme specifies its goals, indicators and approaches for implementation. Specific tasks have been assigned for the government along with health advices proposed to all society and the public. The programmes integrate the concept and requirements of healthy China into all aspects of people’s daily work and life, and provide effective approaches to transform the health priority from “treatment-centered” to “health-centered”. All those programmes will be implemented through collaborative efforts of the government, society, families and individuals, striving to prevent people from sickness and less onset of disease, as a result, to prolong their healthy lifespan and improve their quality of life.
III. Ensuring the Implementation of the Action
In order to ensure the effective implementation of the Opinions and the Healthy China Action, the General Office of the State Council has issued the Implementation and Assessment Plan at the same time, which put forward specific requirements from three aspects: establishing and improving the organizational structure, strengthening monitoring and evaluation, and completing regular assessments. The plan defines to set up the Promotion Committee with a specific organizational structure and working mechanism established relying on the National Patriotic Health Campaign Committee at the national level. Furthermore, it defines the roles of organizations responsible for monitoring and evaluation, data collection and results application in order to ensure the Healthy China Action being implemented efficiently and orderly.
First of all, the organizational structure has been developed. Relying on the National Patriotic Health Campaign Committee, the Promotion Committee has been established responsible for formulating and issuing the Healthy China Action, coordinating and enforcing the implementation, monitoring, assessment and other related work. The vice premier of the State Council responsible for health cause was appointed as the head of the Promotion Committee. The Office of the Promotion Committee was established in the National Health Commission, and an Advisory Committee of Experts along with multiple working groups (corresponding to 15 specific programmes) were also created under the Promotion Committee. The document also calls on relevant ministries to actively study the major issues related to building healthy China, formulate and implement specific policies and measures in a timely manner, put forward annual task proposals and implement them in accordance with the general deployment, and properly publicize and interpret the contents of the Healthy China Action.
The second is to strengthen monitoring and evaluation, which is under the overall leadership of the Promotion Committee. Each working group is responsible for organizing and implementing specific programme. Based on existing statistical data, relying on internet and big data, the progress of implementation regarding key indicators and main tasks will be monitored. The Office of the Promotion Committee will develop an overall monitoring and evaluation reports to be submitted to the State Council, thereafter to release them in due time.
The third is to complete regular assessments. The Office of the Promotion Committee is responsible for organizing and implementing assessment under overall leadership of the Promotion Committee, with technical support from the Advisory Committee of Experts. A relatively stable framework of assessment indicators has been established focusing on the main objectives and tasks of building a healthy China. Major health indicators will be included in the performance appraisal of the Party committees and governments at all levels. The results of comprehensive appraisal will be notified after the approval of the Promotion Committee. It will serve as an important reference for the comprehensive appraisal and evaluation of senior management and leading cadres in the Party committee and governments in all provinces (autonomous regions, municipalities) and relevant departments, and also as reference for rewards and punishments.
The Healthy China Action is launched at important time of the 70th anniversary of the founding of the People’s Republic of China. It is a medium- and long-term action for more than ten years. As a result, it will continue to promote the priority shift from treatment-centered to health-centered, and comprehensively put forward to the accomplishment of the key tasks related to prevention and health promotion in the “Healthy China 2030” Planning Outline. If the “Healthy China 2030” Planning Outline is regarded the guiding principle for building healthy China, the Opinions and the Healthy China Action will serve as the “road map” and “construction drawing” respectively.
Implementation of the Healthy China Action will further release the health dividend, promote coordinated development of economy and society, and lay a solid health foundation for building an affluent society in all respects and a modern socialist country. Next, we will conscientiously implement the decisions and deployments of the CPC Central Committee and the State Council, support local governments to formulate implementation plans in a timely manner tailored to their actual conditions, refine specific action measures, strengthen monitoring, inspection and tracking the results, persist on the efforts persistently to push on the building of a healthy China, and eventually to prevent people from sickness and less onset of disease in a way to share a healthy life through full participation.