China's strong political will to advance healthcare, together with its emphasis on equity and community engagement, has accelerated the country's health progress and offers valuable lessons for the world, said Richard Horton, editor-in-chief of the medical journal The Lancet.
Over the past two decades, the Chinese government has ramped up health investment through coordinated and multisectoral action — from the 2009 rollout of a national reform to expand basic healthcare services to the release of Healthy China 2030, a strategic blueprint for ensuring health equity, he said.
"There was this wake-up call to the Chinese government that to protect the Chinese people, you have to have a strong health system. And the past 20 years have seen the political commitment of the Chinese government to strengthening health," he said during a recent interview with China Daily.
Horton stressed that health promotion requires consolidated efforts that align health with education, housing, employment, water, sanitation and nutrition.
"What the Chinese government has been able to do in the past decade is force these departments to work together to advance health," he added.
According to a report commissioned by The Lancet, which was released in Beijing on Oct 29, a significant achievement is China's health-centered poverty alleviation initiative, which lifted about 55.8 million people out of poverty and eliminated absolute poverty across all county-level regions between 2015 and 2020.
The report found that the initiative drew cumulative investment of 1.4 trillion yuan ($210 billion), representing an average annual funding growth rate of 11.6 percent.
It concluded that the program's success rested on combined efforts in areas such as health, education and agriculture, as well as the mobilization of administrations at multiple levels and sectors.
"It (poverty alleviation) is a remarkable success story. Poverty and health, or rather poverty and ill health, are very tightly linked," said Horton.
"There's a connection between the two, and what government and medicine have to do is break the connection between poverty and poor health — and that's what this initiative did."
In a rapidly urbanizing society where the gap between urban and rural healthcare access remains significant, Horton said that China has also maintained a focus on health equity, particularly through a dramatic expansion of primary healthcare.
"In other words, this means leaving nobody behind and bringing everybody in Chinese society forward together," he said.
With regard to poverty alleviation efforts, the pro-equity focus has led to improvements in coverage for treating common conditions such as high blood pressure and diabetes, he said.
The report said that the treatment rates for 30 curable severe diseases reached 99.6 percent, while the high blood pressure control rate rose from 33 percent in 2019 to 45.4 percent in 2022.
Horton added that China has also managed to engage local communities in the process of building a healthy nation.
"China has the central government objective of Healthy China 2030, and then engages local communities to interpret that objective for the context in which those communities live — a top-down and bottom-up approach to advancing health," he added.
Looking ahead, Horton said that it is important for China to sustain its political commitment, continue addressing inequalities and tackle the rising burden of noncommunicable diseases, including heart conditions, cancer, respiratory diseases and diabetes, as it pursues the visionary goal of building a Healthy China by 2035.
He noted that a newly released report on chronic obstructive pulmonary disease, or COPD, by Chinese medical experts in The Lancet Respiratory Medicine journal estimates that about 100 million people in the country live with the condition.
"That's an astonishing figure. Most of them don't know they have COPD. So there are still big challenges against the background of great progress," he said.
As one of the world's most prestigious medical journals, The Lancet has launched a number of projects with Chinese researchers and institutions in recent years, aiming to bring Chinese and international experts together to collaborate and provide solutions.
The report on COPD calls for intensified efforts in tobacco control, improved air quality, and early diagnosis and intervention for early-stage patients to rein in the disease.
Another report on the global prevention and control of liver cancer, which was led by Chinese researchers and released last year in Shanghai, proposed a three-tier strategy to rein in new cases and deaths, including expanding mass hepatitis B vaccination and liver fibrosis screening for high-risk groups.
Horton said that the overarching message from these China-related reports by The Lancet is that health is a crucial determinant of social and economic progress in all countries.
"The focus on health in the past 20 years has secured the future of hundreds of millions of Chinese people and is protecting them from the threat of infectious diseases and noncommunicable diseases," he said.
"As part of China's continued development, health needs to be absolutely at the center of policymaking. That's not just a lesson for China, that's a lesson for every country in the world," he added.
The Lancet has more projects involving China in the pipeline, with themes covering population medicine, mental health, primary healthcare, adolescent health, ecological civilization, stroke, artificial intelligence and skin health.
All of these projects will engage with academic communities in China and around the world, as well as Chinese policymakers, to help solve problems and challenges facing the nation, said Horton.
"What I also want to do is to have the outside world hear the story of China through health, because I think there's a great story to tell about China," he said.
"There's a lot of misinformation about China in the Western world, and I want to use health and medicine and medical science as a way to correct that misinformation."
wangxiaoyu@chinadaily.com.cn
