Beyond coronavirus: Healthy China 2030
Robert Lawrence Kuhn

I'm Robert Lawrence Kuhn and here's what I'm watching: While China remains hypersensitive to new COVID-19 outbreaks, it is pursuing its long-term healthcare vision, called "Healthy China 2030". In 2016, President Xi Jinping announced "Healthy China 2030", which made public health a key benchmark to assess economic and social initiatives. It has five goals: improve the level of nationwide health; control major risk factors; increase the capacity of the health service; enlarge the scale of the health industry; and perfect the health service system.

Implementation is based on four principles: health is priority; reform and innovation, leveraging government and markets; scientific development, stressing both prevention and cure and both Chinese and Western medicine; and justice and equity, paying special attention to rural areas to reduce gaps in health services.

In 2019, China's State Council issued guidelines to implement Healthy China 2030, stressing disease prevention, health promotion, and life-cycle health. I like the specific metrics of 15 targeted campaigns. For example, health literacy, 22 percent of the population by 2022, 30 percent by 2030; rational diet to reduce obesity, below seven percent in 2022 and 5 percent in 2030; regular physical exercise, 37 percent increasing to 40 percent; areas protected by tobacco-free regulations, 30 percent in 2022, 80 percent in 2030; mental health literacy, from 20 percent to 30 percent.

Other metrics promote women's and children's health, health of primary and secondary school students, occupational health, and elderly health. In addition, improving metrics for five major diseases: cardiovascular, cancer, respiratory, diabetes, and infectious diseases. Vaccines for children should remain over 90 percent.

China faces many health challenges. These include increasing rates of cancer and cardiovascular disease linked to lifestyle factors like smoking, obesity, and an ageing population. But a healthcare system that relies on treatment and hospitals cannot meet these challenges. That's why Healthy China must promote healthy lifestyles and physical fitness — and a national smoke-free law.

While developing Primary Health Service around community health centers is efficient and cost-effective, there are widespread gaps in quality. The Lancet, a leading medical journal, identified causes of substandard quality of China's primary healthcare: substandard education and training of primary health-care practitioners; a fee-for-service payment system that incentivizes testing and treatment over prevention; fragmentation of clinical care and public health service; and insufficient continuity of care throughout the entire health-care system.

The Lancet's policy recommendations include: training for primary health-care physicians; incentivizing high-quality and high-value care; integrating clinical care with basic public health services, and coordination between primary healthcare and hospitals.

China has embarked on the largest health system reform ever, which includes healthcare insurance for nearly 100 percent of the population. China's goal is to ensure that healthcare quality and equity can be basically achieved by 2030, contributing to a fair and prosperous society. But don't forget those causes of substandard quality.

Scriptwriter: Robert Lawrence Kuhn

Cameraman: Morgan Compagnon

Video editor: Hao Xinxin

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