Public health system in urgent need of overhaul
(Xinhua)
Updated: 2004-03-04 14:32

How to overhaul the public health service system -- this is a problem that has tormented public health expert Li Liming for numerous sleepless nights.

As director of the three-year-old national center for disease control, Li said that the 2003 SARS outbreak has awakened the government and people to the importance of a sound public health service system that used to be a pride of New China.

Before the SARS crisis, no one had ever thought that China's public health service system, which had been held up as a model of success more than 20 years ago, would be thrown into a serious crisis.

After the founding of New China, the central government spent more than 30 years building up the public health service system. The life expectancy of the people was raised from 30.5 years before 1949 to 67.8 years up to the 1980s and infant mortality rate was brought down from 265 per thousand to 47 per thousand. The public health service system won extensive acclaim from international organizations.

Things did not change until the late 1990s. China was reported to rank first in the world in the number of hepatitis virus carriers and second in the number of TB cases. Other rare diseases such as VD and AIDS also spread fast. The rural medical and health service system was almost paralyzed, with only one-third in normal operation, another one-third struggling on the verge of disintegration and the rest one-third completely collapsing. In cities, hospitals and patients came into serious conflict.

Li Liming attributed the dramatic changes to negligence, under- investment and erroneous approach to development.

Now coming for the annual session of the National Committee of the Chinese People's Consultative Conference, which opened Wednesday afternoon, Li said that although the government investment in the public health service system has been increasing in terms of absolute figure since 1992, the proportion of such spending in the total fiscal expenditure has been dropping, until it reached its nadir in 1995-1996.

Furthermore, Li noted, public health service is mainly covered by local finances rather than by the central finance and that has resulted in the great regional disparities.

Then, there is too much stress on GDP growth target to the neglect of public health service that would help sustain economic growth.

"The SARS crisis has dealt a heavy blow at some of the erroneous ideas," said Zhong Nanshan, an academician of engineering and a hero in fighting against SARS. "It has made the government and people understand what is the correct approach to development."

In June 2003, the Chinese government, waking up from the SARS trauma, pledged to knock up an emergency system against breaking public health events, a disease prevention and control system and a public health law enforcement and oversight system in about three years.

The government also promised to improve the rural medical and health system, urban elementary medical service delivery system, environmental hygiene system and financial support system.

It was until then that the public confidence had been restored and it was further reinforced when Premier Wen Jiabao was seen shaking hands with an AIDS patient and Vice Premier Wu Yi inspecting what is known as AIDS village in Henan Province.

"The ultimate purpose of public health service is to benefit the common people," said Han Qide, vice chairman of the Standing Committee of the National People's Congress. "We have owed too much to the public health service system and what we are doing now is to make up for what has been left undone."

"If we say that the SARS crisis has awakened the government to the importance and urgency of investing in the health of the people," said Li Liming, "the crisis has offered an opportunity of reshaping China's public health service system."

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