Malaria used to be a serious threat to people's health and lives in China. In the 1940s, there were approximately 30 million cases every year, leading to 30,000 deaths annually.

However, through decadelong efforts, no domestic cases have been reported since 2017 and China was declared malaria free by the World Health Organization (WHO) in 2021. The measures that have been taken include a 1-3-7 strategy: reporting any cases within one day, confirming and investigating them within three days, and undertaking appropriate public health responses to prevent further transmission within seven days.

The success China has achieved in eliminating the disease mirrors the country's overall progress in disease prevention and control over the past decade.

Since the 18th National Congress of the Communist Party of China in 2012, the National Health Commission (NHC) has worked constantly to improve the disease prevention and control system, and made significant progress in the prevention and control of major diseases.

Infectious and endemic disease prevention

The results of national efforts in the prevention and control of key infectious diseases and endemic diseases are clearly visible.

The incidence of the nation's 27 most dangerous contagious diseases dropped from approximately 239 per 100,000 in 2012 to 193 per 100,000 last year, down by 19.3 percent in 10 years, Lei Zhenglong, Deputy Director of the NHC's Bureau of Disease Prevention and Control, said at a press conference held by the NHC on China's progress in major disease prevention and control over the past decade on June 17.

The prevalence of contagious intestinal diseases—such as cholera—went down by nearly 68 percent during the period, and that of respiratory infectious diseases—such as measles—fell by more than 35 percent, Lei said.

Viral hepatitis is a significant public health problem in China. As hepatitis B and C viruses (HBV and HCV) can both be transmitted through blood, medical institutions have strengthened measures to prevent hospital-acquired infection and blood transfusion institutions are now required to screen for the two types of hepatitis. As a result, new infections of the two types of hepatitis through blood transfusion and hospitalization have been brought under control.

As mother-to-child transmission was also a significant cause of the prevalence of HBV in China, the country has focused on blocking mother-to-child transmission to prevent the spread of the virus. Additionally, new-born babies are now vaccinated against HBV. HBV screening is also carried out for pregnant women, and babies borne of mothers who test positive for HBV receive a hepatitis B immune globulin shot, which provides immediate, short-term protection against hepatitis B infection, in addition to the regular HBV vaccination.

These measures have helped significantly reduce China's HBV infection rate. According to an epistemological survey carried out by the NHC in 2014, the hepatitis B surface antigen positive rate among children under 5 in China had been reduced to 0.32 percent by that time.

In 2014, the WHO Western Pacific Regional Office recognized China for its achievement in hepatitis B prevention and control.

HBV and HCV are viral infections that attack the liver and may cause liver cirrhosis, cancer and other complications. To reduce the harm caused by the viruses, the NHC has worked with relevant departments to accelerate the research and development of antiviral drugs and included many new drugs in the list of medicines covered by the medical insurance system, which has improved the accessibility and affordability of the drugs.

However, although new infections have been effectively curbed, there are still a large number of people with HBV and HCV infections in China. According to WHO statistics, there were nearly 80 million HBV carriers in China in 2014, accounting for one third of the global total.

"We will strengthen screening of HBV and HCV infections and provide those infected with standard antiviral treatment to minimize the impact of chronic infections on people's health and lives," Feng Zijian, Executive Vice President and Secretary General of the Chinese Preventive Medicine Association, said at the press conference.

Great progress has also been made in the prevention and control of other infectious diseases such as HIV/AIDS and tuberculosis. People's awareness of HIV/AIDS prevention and control has improved significantly. Transmission of the disease through blood transfusion has been mostly blocked and mother-to-child transmission and transmission through intravenous drug use have been reduced to historic lows.

Further progress has been made in the control of endemic diseases including Kashin-Beck (KBD) disease and hydatid disease. KBD is an endemic, chronic and degenerative disease of the bones and joints that occurs primarily in Tibet Autonomous Region but also in other areas of China, Siberia and the Republic of Korea. Its clinical symptoms include joint pain, morning stiffness, enlarged and shortened fingers, and deformed, enlarged joints with limited mobility in the extremities.

In November 2018, 10 ministries and commissions including the NHC launched a three-year endemic disease prevention and control campaign. Under the program, around 33,000 KBD patients receive treatment every year. Treatment, which normally cost 1,800 yuan ($268.7) per person per year, is provided free of charge to patients in serious condition. The disease has now been eliminated in China, with all current cases being above 50 years of age.

Chronic disease treatment

Steady progress has been made in the prevention and control of chronic diseases. The rate of premature mortality from four major noncommunicable diseases (NCDs)—cardiovascular disease, cancer, diabetes, and chronic respiratory disease—dropped from 18.5 percent in 2015 to 15.3 percent in 2021. According to the WHO, the premature mortality rate from NCDs is measured as the unconditional probability of a 30-year-old person dying from any of four major NCDs before reaching the age of 70.

Wu Liangyou, Deputy Director of the NHC's Bureau of Disease Prevention and Control, said at the press conference that chronic diseases are the main illnesses affecting people's health in China.

"In the past decade, all levels of government have been paying increasing attention to chronic disease prevention and control. Multiple departments have worked together on environmental improvement, tobacco control, the promotion of physical exercise and medical insurance and are aiding the creation of a favorable environment for chronic disease prevention and control," Wu said.

The promotion of a healthy lifestyle featuring a balanced diet and proper exercise has traveled nationwide and people's health awareness and ability to practice a healthy lifestyle have improved.

Early screening, diagnosis and treatment of chronic diseases have been carried out to realize early detection and intervention and improve the prospect of recovery. The NHC provides early screening of cancers and cardiovascular and cerebrovascular diseases to over 4 million residents in areas with high incidence rate for the diseases every year. The NHC also provides free oral examinations, pit and fissure sealing and topical fluoridization to more than 16 million children every year to protect children's oral health. Health management services of high blood pressure and diabetes have been strengthened to prevent major chronic diseases such as myocardial infarction and cerebral stroke. The NHC publishes a report on the state of nutritional status and chronic diseases every five years to provide a reference for the adjustment and improvement of prevention and control policies.

Mental health services

China has also made big strides in mental health services in the past decade. Lu Lin, President of Peking University Sixth Hospital, a mental health hospital, said at the press conference that the most important progress in China's mental health work is the implementation of the Mental Health Law in 2013, which brought the country's mental health work under the rule of law. The law has laid the legal foundation for developing and regulating mental health services and protecting the legitimate rights and interests of those with mental health issues.

The psychological health service system has been strengthened. In 2016, 22 ministries and commissions including the NHC issued a guideline on strengthening mental health services, which aimed to step up prevention and raise awareness. In 2021, the National Center for Mental Health was established under the NHC to provide technical support for this prevention and treatment.

People with serious mental illnesses now have access to improved services. As of late last year, there were 6.6 million registered patients with severe mental illnesses, over 90 percent of whom had received treatment, mostly for free.

As mental health issues have received more attention from the government, more mental health hospitals and departments have been established in the past decade. There are 5,936 mental health institutions in China at present, up by 205 percent from 2010. The number of certified psychiatrists has reached more than 50,000, an increase of 144 percent from 2010.

(Print Edition Title: Safeguarding Health)

Copyedited by G. P. Wilson

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