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Health Conditions of the Chinese Nationals Significantly Improved over the Past 60 Years

(September 28, 2009)

Ministry of Health

The medical and health sector concerns health of hundreds of millions of people, and well-being of millions of households, thus it is a major livelihood issue. The Chinese government has always attached great importance to the development of health sector, emphasizing the protection of people's health and safety. Governments at all levels and all departments concerned, especially health workers and professionals of medical and health system have adhered to the policy of “to focus on rural areas, to prioritize prevention, to emphasize equally traditional Chinese medicine and western medicine, to rely on science, technology and education, to mobilize the whole society, in order to serve people's health and the socialist modernization drive ”, has vigorously developed China's medical and health services to protect public health and safety, meet the growing medical and health demand of the general public, and improve health conditions of the whole nation.

Since new China was founded 60 years ago, especially since the reform and opening up, China's medical and health sector has made remarkable achievements, medical and health service system covering urban and rural areas has basically taken shape, disease prevention and control capacity has gradually improved, health insurance coverage has been expanding, health science and technology has improved rapidly. At present, people's health conditions significantly improved, and key health indicators of the residents are in the forefront of the developing countries.

I. Effectively control major diseases and continuously improve health of urban and rural residents

At present, China's average life expectancy is 73 years, a substantial increase from 35 years before the founding of new China; the maternal mortality rate has dropped from 1500 per 100000 to 34.2 per 100000 in 2008, infant mortality rate has dropped from 200‰ in the early stage of new China to 14.9‰ in 2008. All these indicators are in the forefront of the developing countries.

In six decades, through great efforts of the patriotic public health campaign, national immunization programs, major disease prevention and control policys, the major infectious diseases threatening people’s health have been kept under effective control. Morbidity of type A&B national statutory infectious diseases has dropped from 20000 per 100000 in 1949 to 268.01 per 100000 in 2008. China has successfully eradicated smallpox and filariasis, achieved the polio-free goal, eliminated iodine deficiency disorder in general, and effectively controlled leprosy, schistosomiasis, malaria, which have been serious threats to people's health. Control of TB, HIV/AIDs, hepatitis B has made significant progress. Prevelence of endemic diseases has been effectively contained and the outcome of prevention and treatment is steadfast. Prevention and control of chronic non-communicable diseases has gained with remarkable results.

Under the CPC Central Committee and State Council's unified leadership and guidance, the national health system has taken prevention and treatment measures in a scientific manner in response to major challenges of emerging infectious diseases. We won the victory in fight against SARS, effectively contained the spread of human avian influenza, made initial achievemnets in prevention and treatment of H1N1 influenza, and has safeguarded lives of the people, social stability and the great achievements of reform and opening up.

Prevention and control of chronic non-communicable diseases has gained remarkable results. Since 1990s, the Chinese government has actively promoted the prevention and control of major chronic non-communicable diseases, such as high blood pressure, diabetes, cardiovascular and cerebrovascular disease, mental illness, malignant cancer, oral disease and etc. We launched a nationwide health lifestyle campaign to enhance national health education, advocate healthy lifestyles, and prevent chronic disease related risk factors, focusing on community and grassroots level. Chronic non-communicable disease prevention and control framework has been initially in place with government advocacy, coordination among departments, efforts of experts and social participation.

II.Continuously strengthen health system and improve access to services

In the early days of the foundation of China, there were only 3670 medical and health institutions, 84600 hospital beds, 505000 health professionals. At that time the medical institutions and medical staff were largely concentrated in cities and towns, medical equipment was extremely simple, and medical technology was poor. The general public, especially farmers, lacked medical treatment and medicine, and did not have access to basic health insurance.

After 60 years of construction and development, China's medical and health services have made considerable progress. By the end of 2008, China has 278000 health institutions, and another 613000 village clinics, health system covering urban and rural residents has been basically established; the total number of hospital beds nationwide is 4.036 million, hospital beds per 1000 population is 2.83; number of health personnel nationwide amount to 6.169 million, rural doctors and health workers amount to 938000 million; number of health professionals per 1000 population is 3.8.

In the meantime, services and support capabilities as well as technical levels of the health system have been greatly enhanced, and the general public have enjoyed benefits brought by development. In 2008, medical institutions (excluding village clinics) in China diagosed and treated 3532 million people times, with 114.83 million inpatients; 91% pregnant women underwent prenatal examination, 87% paid post-natal visits, and hospital delivery rate was 94.5%; rural wate supply projects benefited 93.6% of the total rural population, rural tap water supply coverage reached 65.5%, and coverage of sanitary latrines in rural areas reached 59.7%.

At present, China has built a number of large-scale modern general hospitals and specialist hospitals, which represent the highest level of clinical medicine in China and enjoy high reputations in the international arena. Urban medical service system has been basically formed, including community health service institutions, all levels of general hospitals, and specialized hospitals; the rural three-tier medical service network has taken initial shape, lead by county hospitals, supported by village clinics and township hospitals. The urban and rural medical service system has kept improving and has provided the urban and rural residents with comprehensive, continuous, safe, effective, convenient and inexpensive medical and health care services. The system has played an important role in safeguarding people’s lives and safety and maintaining social stability in public health emergencies and major natural disasters.

III.The basic medical insurance system has been improved continuously, and medical insurance level for urban-rural residents has been raised.

The Chinese government attaches great importance to the establishment and development of medical insurance system. In the early years after the founding of People’s Republic of China, free medical care and labor insurance medical system were established; in the 1960s, the rural cooperative medical care system was formed in the rural areas. The establishment and improvement of these systems played an important role in protecting the health of employees and farmers. In the 1990s, China launched the reform of medical insurance system, which helped actively and steadily push forward the improvement of medical insurance system via significant progress. The basic medical insurance for urban workers was implemented steadily, covering a population of 318 million by the end of 2008. In October 2002, the Chinese government introduced the policy of establishing a new rural cooperative medical care scheme. Starting from 2003, the new rural cooperative medical care scheme was put into pilot programs and gradually advanced across the country, covering all of the counties (cities, districts) with agricultural population, which reaches 833 million at present. The new rural cooperative medical insurance scheme has brought about more and more benefits for farmers, and played an increasingly important role to mitigate or reduce the economic burden of diseases on farmers.

The urban and rural medical assistance system has been initially established. The rural medical aid covers the entire rural population in counties (districts), while 65% of counties (districts) have seen pilot projects of urban medical assistance in place. Commercial health insurance industry is flourishing. At present, various types of insurance systems cover more than 1.1 billion urban and rural residents; a multi-level medical insurance system framework is taking shape, providing a protective shield for the vast number of urban and rural residents from medical risks.

IV. The legalization process in health has gone through in-depth development, which continues to protect people’s health rights.

Since reform and opening policy was adopted, the National People’s Congress and its Standing Committee have promulgated and implemented 11 health-related laws, including the "Communicable Disease Prevention and Control Law," "Food Safety Law", "Maternal and Child Health Care Act", etc.; the State Council enacted 37 administrative regulations, such as the "Medical Institution Regulation Rules", and “Public Health Emergency Response Ordinance". The Ministry of Health has issued more than 200 departmental rules, for instance, the "Prescription Management Rules"; at present, 1,300 existing health standards are effective. A legal system of health laws has been initially built composed of laws concerning public health, medical services, health-related product management and health insurance, among others, which has played a critical role in protecting the health and life safety of citizens, regulating the market economy behaviors and promoting economic and social development.

V. The reform on deepening medical and health care system was officially launched and efforts have been made to achieve universal access to basic medical and health services for all.

The Chinese government has always attached great importance to the development of health, emphasizing the protection of people's health and safety as a priority. In April 2009, the Chinese government issued "Opinions on Deepening the Medical and Health Care System Reform," and "Short-term Major Implementation Plans on Medical and Health Care System Reform", clearly formulating direction and major principles and policies for Chinese medical and health sector reform and development in a new era, placing emphasis on provision of basic medical and health care system as public goods to all people and achieving the overall goal of universal access to basic medical and health services.

The overall goal for deepening medical and health system reform is to establish basic medical and health care system covering urban and rural residents, and provide safe, effective, convenient and affordable medical and health services to the people. By 2011, the basic medical insurance system will cover all urban and rural residents, the essential drugs system will be initially established, urban and rural primary health care system will be further improved, the basic public health services will be universally accessible, the pilot reform projects of public hospitals will achieve breakthroughs, and the accessibility of basic medical and health services markedly increased. All these progresses will effectively reduce the economical burden on residents for medical treatment and ease the problem of "difficulty and inaccessibility to seek medical treatment ". By 2020, a basic medical health system covering urban and rural residents will be established. We will have built a relatively sound public health service system, health care system, health insurance system, a fairly regulated drug supply system, more scientific management system and operational mechanism for medical and health organizations, and form the configuration of multi-run medical institutions. Everyone will have access to basic health services by then. The health care system will be suitable to multi-level medical and health needs of the people, and further raise people's health to a higher level.

The focus of reform in the near future highlights basic, foundation, and the grassroots level. We will focus our efforts on five key reform tasks from 2009 to 2011, namely, accelerating the basic medical insurance system construction, the initial establishment of national essential drug system, improving basic health services system, steadily promoting the equal access of basic public health services and pushing ahead the pilot reform of public hospitals. At present, all work is being actively and orderly conducted, supporting documents of the reform are being issued one after another, a number of major reforms are being gradually implemented, the basic health insurance coverage continues to expand, and the construction of primary health care facilities and health institutions have progressed smoothly. The six major public health services programs and nine major categories of basic public health services projects in the country have entered the implementation phase, ranging from supplementing hepatitis B vaccines to population under 15 years of age, screening 35-year-old to 59-year-old rural women for cervical cancer and breast cancer to performing cataract surgeries free of charge for poor patients. The national essential drug system construction has started and preparatory work for pilot reform in public hospitals is being stepped up. In a whole, the medical and health care system reform is progressing smoothly in general.

New China's health industry has gone through nearly 60 years of development, and important experiences have been accumulated. We need to firmly grasp the gist of our past experiences in the future work, and continue to carry them forward: the strong leadership of the Party and the government on health work must be adhere to and strengthened; we must use the theory on socialism with Chinese characteristics, and health work guidelines to direct health reform and development; we must stick to the approach of reform and development to continue to solve new contradictions and problems; health work must serve economic and social development; health work must place safeguarding and protecting the people's health rights and interests as the highest mission; the public nature of public health must be upheld; health cause development must adhere to the combination of focusing on key points and overall planning; and health work must adhere to the combination of government-led mechanism and the introduction of market mechanisms.

China's health industry is facing an unprecedented development opportunity now, and the Chinese government will continuously improve the health of the people by adhering to people-oriented principle, governing for the people, comprehensively implementing the scientific concept of development, seizing opportunities, meeting challenges, and promoting the health reform and development.

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