The 2015 Report of Disease Prevention and Control Progress in China

Source: en.nhfpc.gov.cn

Updated: 2015-06-03

Optimization of Working Mechanism

The National Patriotic Health Campaign Committee and the State Council Committee of AIDS Prevention and Control have been established, as well as the inter-sector conference systems on prevention and control of schistosomiasis, mental disorders and occupational diseases, respectively. The National Health and Family Planning Commission together with other administrative departments have established an inter-sector cooperation and coordination mechanism that will act in response to any zoonotic disease outbreaks and public health issues caused by climate change, reinforced inter connection with provincial governments with respect to prevention and control of major diseases, and forged effective cooperation mechanism with Hong Kong, Macau and Taiwan. As proposed by International Health Regulations (2005), connections have also been established with WHO and other countries in terms of information disclosure, pathogen sample sharing and technological communication. Interprovincial connections have also been set up for cooperated regional disease prevention and control.

Legislative Improvements

With respect to disease prevention and control, a series of laws have been made or revised, including the Frontier Health and Quarantine Law, Law on Prevention and Treatment of Infectious Diseases, Law on Prevention and Treatment of Occupational Diseases and Mental Health Law. Other legal regulations were enacted such as Regulations on Edible Salt Iodization as a Means to Eliminate Iodine Deficiency Disorders, Regulations on Vaccine Circulation and Vaccination Management, Regulations on Prevention and Treatment of AIDS, Regulations on Prevention and Treatment of Schistosomiasis, Regulations on Prevention and Treatment of Tuberculosis, Regulations on Prevention and Treatment of Sexually Transmitted Diseases. The State Council together with other departments has issued a total of 17 plans for prevention and treatment of prioritized diseases, framing a relatively sound system of laws and policies that lay the legal foundations for disease prevention and control.

Financial Investment on the Rise

The government is constantly increasing its investment in public health-related areas including disease prevention and control. A subsidy of 130.4 billion yuan for public health was totaled in 2014, amounting for 12 times that of 2003. Among that 46.6 billion came from the central finance, a 46-fold increase compared with 2003. It ensured implementation of a range of prevention and intervention measures.

Ⅱ. Prevention and Control of Infectious Diseases Improved Capabilities in Prevention and Control of Infectious Diseases

China has established the world’s largest real-time online reporting system for notifiable infectious diseases and public health emergencies. Simultaneous online reporting of notifiable infectious diseases has been made possible for all CDCs, 98% of healthcare institutions at county level and above, and 94% of grassroots healthcare institutions. Thanks to the new system, the average reporting time duration for notifiable infections disease cases has been decreased from 5 days to 4 hours. A total of 3486 national surveillance sites were set up to actively monitor the epidemic situation of 28 prioritized infectious diseases such as cholera, influenza and growth of biological vectors including mosquitoes, flies, mice and cockroaches. A laboratory surveillance network has been established covering CDCs at national, provincial, prefectural and county levels. National laboratories of influenza, poliomyelitis, measles, and Japanese encephalitis in China CDC have been accredited as Regional Reference Laboratories by WHO. On-site epidemiological investigation capacity has considerably increased among different institutions of disease control and prevention, which technically ensures identification of pathogeny, decision-making on prevention strategies and control. A system for regular information release on notifiable disease outbreaks and public health emergencies has come into effect, providing timely, open and transparent updates, guiding and responding to public concerns.

Expanded Program on Immunization

The number of vaccines included in the national immunization program increased to 14 in 2007, and covering 15 contagious diseases. Since 2009, vaccination has become a part of the Basic Public Health Grant, suggesting a level-up in programmed immunization. The immunization service program cold-chain and vaccine distribution system have been built up across the whole country, covering both urban and rural areas. The vaccination record of every child is required to be checked in entering the kinder gartens and primary schools. The immunization coverage remains over 90% by township level. The morbidity and mortality rates of most vaccine preventable diseases have reached a historical low level.

Effective Control of Prioritized Infections Diseases

First, with strengthened epidemic surveillance and emergency response capabilities, only sporadic plague cases due to mouse-to-human transmission were reported occasionally in recent years. No major outbreak of cholera was detected. China has succeeded in responcity to emergency epidemic outbreaks like SARS, H5N1 highly pathogenic avian influenza, type A H1N1 influenza and H7N9 avian influenza, as well as local outbreaks of prioritized infectious diseases like Dengue fever and hand-foot-mouth disease. Second, the HIV/AIDS epidemic remains low prevalence overall due to the effective implementation of evidence-based comprehensive strategies nationwide. Coverage of free counselling and testing, free ARV treatment and free prevention of mother-to-child transmission (PMTCT), as well as health education, surveillance and behavioral interventions, have been significantly expanded. By the end of 2014, China cumulatively reported 510,000 cases living with HIV/AIDS. HIV screening tests are available at the county level across the country. A total of 766 clinics for methadone maintenance therapy and 3,952 hospitals for accessing ARV have been set up to provide qualified medical services to 184,000 people who use drugs and 295, 000 AIDS patients, respectively. Nearly 80% of most-at-risk populations have been reached by intervention measures. As one of the core components of China's national HIV strategy, PMTCT has covered 1,638 counties and districts, and resulted in a significant reduction of vertical transmission from 34.8% before the intervention to 6.7% in 2013. The case fatality rate decreased sharply from 17.9% in 2005 to 6.6% in 2013 and the HIV incidence rate among patients on methadone maintenance treatment reduced from 0.95% in 2006 to 0.12% in 2014. The financial burdens of people living with HIV/AIDS have been considerably lessened, while the quality of life has significantly improved. A supportive society that actively engages in responding to HIV/AIDS is developing as social discrimination and stigma gradually decrease. Third, prevalence of infectious tuberculosis has dropped dramatically. By adoption of Directly Observed Treatment Short-course(DOTS) and implementation of early diagnosis and standard care, cure rate of TB patients remains above 85%. Free screening tests and first-line anti-tuberculosis drugs are available to every TB patient. Multi-resistant tuberculosis is covered by the New Cooperative Medial System (NCMS) for Major Diseases. With years of efforts, prevalence of infectious tuberculosis across the country showed a 51% decrease from 134/100,000 in 1990 to 66/100,000 in 2010. Forth, success has been achieved in prevention and control of schistosomiasis in China. Using a comprehensive strategy that prioritizes control of infectious sources, affected areas have been tremendously reduced. Schistosomiasis is well controlled in all high-risk counties. As of 2014, 98.9% of 453 counties (cities, districts) had achieved transmission control or transmission block.