Project description:In 2013, China proposed its Belt and Road Initiative to promote trade, infrastructure, and commercial associations with 65 countries in Asia, Africa, and Europe. This initiative contains important health components. Simultaneously, China launched an unprecedented overseas intervention against Ebola virus in west Africa, dispatching 1200 workers, including Chinese military personnel. The overseas development assistance provided by China has been increasing by 25% annually, reaching US$7 billion in 2013. Development assistance for health from China has particularly been used to develop infrastructure and provide medical supplies to Africa and Asia. China's contributions to multilateral organisations are increasing but are unlikely to bridge substantial gaps, if any, vacated by other donors; China is creating its own multilateral funds and banks and challenging the existing global architecture. These new investment vehicles are more aligned with the geography and type of support of the Belt and Road Initiative. Our analysis concludes that China's Belt and Road Initiative, Ebola response, development assistance for health, and new investment funds are complementary and reinforcing, with China shaping a unique global engagement impacting powerfully on the contours of global health.
Project description:China has made rapid progress in four key domains of global health. China's health aid deploys medical teams, constructs facilities, donates drugs and equipment, trains personnel, and supports malaria control mainly in Africa and Asia. Prompted by the severe acute respiratory syndrome (SARS) outbreak in 2003, China has prioritised the control of cross-border transmission of infectious diseases and other health-related risks. In governance, China has joined UN and related international bodies and has begun to contribute to pooled multilateral funds. China is both a knowledge producer and sharer, offering lessons based on its health accomplishments, traditional Chinese medicine, and research and development investment in drug discovery. Global health capacity is being developed in medical universities in China, which also train foreign medical students. China's approach to global health is distinctive; different from other countries; and based on its unique history, comparative strength, and policies driven by several governmental ministries. The scope and depth of China's global engagement are likely to grow and reshape the contours of global health.
Project description:China's health gains over the past decades face potential reversals if climate change adaptation is not prioritized. China's temperature rise surpasses the global average due to urban heat islands and ecological changes, and demands urgent actions to safeguard public health. Effective adaptation need to consider China's urbanization trends, underlying non-communicable diseases, an aging population, and future pandemic threats. Climate change adaptation initiatives and strategies include urban green space, healthy indoor environments, spatial planning for cities, advance location-specific early warning systems for extreme weather events, and a holistic approach for linking carbon neutrality to health co-benefits. Innovation and technology uptake is a crucial opportunity. China's successful climate adaptation can foster international collaboration regionally and beyond.
Project description:BackgroundOver the past two decades, international health policies focusing on the fight against the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), tuberculosis (TB), malaria, and those diseases that address maternal and child health problems, among others, have skewed disease control priorities in China and other Asian countries. Although these are important health problems, an epidemic of chronic, non-communicable diseases (NCDs) in China has accounted for a much greater burden of disease due to the ongoing rapid socioeconomic and demographic transition.DiscussionAlthough NCDs currently account for more than 80% of the overall disease burden in China, they remain very low on the nation's disease control priorities, attracting marginal investment from central and local governments. This leaves the majority of patients with chronic conditions without effective treatment. International organizations and national governments have recognized the devastating social and economic consequences caused by NCDs in low- and middle-income countries, including China. Yet, few donor-funded projects that address NCDs have been implemented in these countries over the past decade. Due to a lack of strong support from international organizations and national governments for fighting against NCDs, affected persons in China, especially the poor and those who live in rural and less developed regions, continue to have limited access to the needed care. Costs associated with frequent health facility visits and regular treatment have become a major factor in medical impoverishment in China. This article argues that although China's ongoing health system reform would provide a unique opportunity to tackle current public health problems, it may not be sufficient to address the emerging threat of NCDs unless targeted steps are taken to assure that adequate financial and human resources are mapped for effective control and management of NCDs in the country.SummaryThe Chinese government needs to develop a domestically-driven and evidence-based disease control policy and funding priorities that respond appropriately to the country's current epidemiological transition, and rapid sociodemographic and lifestyle changes.
Project description:Product trade plays an increasing role in relocating production and the associated air pollution impact among sectors and regions. While a comprehensive depiction of atmospheric pollution redistribution through trade chains is missing, which may hinder targeted clean air cooperation among sectors and regions. Here, we combined five state-of-the-art models from physics, economy, and epidemiology to track the anthropogenic fine particle matters (PM2.5) related premature mortality along the supply chains within China in 2017. Our results highlight the key sectors that affect PM2.5-related mortality from both production and consumption perspectives. The consumption-based effects from food, light industry, equipment, construction, and services sectors, caused 2-22 times higher deaths than those from a production perspective and totally contributed 63% of the national total. From a cross-boundary perspective, 25.7% of China's PM2.5-related deaths were caused by interprovincial trade, with the largest transfer occurring from the central and northern regions to well-developed east coast provinces. Capital investment dominated the cross-boundary effect (56% of the total) by involving substantial equipment and construction products, which greatly rely on product exports from regions with specific resources. This supply chain-based analysis provides a comprehensive quantification and may inform more effective joint-control efforts among associated regions and sectors from a health risk perspective.
Project description:Although China's 2009 health-care reform has made impressive progress in expansion of insurance coverage, much work remains to improve its wasteful health-care delivery. Particularly, the Chinese health-care system faces substantial challenges in its transformation from a profit-driven public hospital-centred system to an integrated primary care-based delivery system that is cost effective and of better quality to respond to the changing population needs. An additional challenge is the government's latest strategy to promote private investment for hospitals. In this Review, we discuss how China's health-care system would perform if hospital privatisation combined with hospital-centred fragmented delivery were to prevail--population health outcomes would suffer; health-care expenditures would escalate, with patients bearing increasing costs; and a two-tiered system would emerge in which access and quality of care are decided by ability to pay. We then propose an alternative pathway that includes the reform of public hospitals to pursue the public interest and be more accountable, with public hospitals as the benchmarks against which private hospitals would have to compete, with performance-based purchasing, and with population-based capitation payment to catalyse coordinated care. Any decision to further expand the for-profit private hospital market should not be made without objective assessment of its effect on China's health-policy goals.
Project description:Although many young people evince a preference for digital mental health support over face to face, engagement with smartphone apps for mental health remains relatively low, particularly in young people not accessing professional support services. While some of this can be attributed to stigma or embarrassment, there is also a need for developers and researchers to investigate features which promote long-term usage. MoodyTunes is a music-based smartphone app that has been co-designed with young people to help them develop effective self-management strategies for mood through music listening. Four focus groups with young people (N = 24, aged 13-25) were conducted to workshop how MoodyTunes could promote help-seeking behaviours and long-term engagement with the app. Online discussions following a broad topic guide were held in groups of 4-7 in which participants explored topics including the use of social features, promoting help-seeking behaviour, gamification and mood tracking. Participants also viewed visual materials and offered ideas about visual design both verbally and on paper. A general inductive approach was taken to analysis of qualitative data. Three primary themes were identified in the data: privacy; user empowerment; and engagement vs. achievement. Participants voiced a strong desire to remain anonymous and to feel empowered to make their own decisions about accessing professional help. Sensitive use of language was noted as critical, with some participants noting that the use of more directive language could have a negative impact on their mental health and that motivational features should focus on engagement with the primary aim of the app rather than rewarding achievement. Findings highlight the benefits of a co-design approach and provide key insights into how mental health apps may be able to improve long-term user engagement with young people.
Project description:This study aimed to locate the contributing factors of Catastrophic Health Expenditure (CHE), evaluate their impacts, and try to propose strategies for reducing the possibilities of CHE in the context of China's current public health insurance system. The financial data of all hospitalization cases from a sample hospital in 2013 were gathered and used to determine the pattern of household medical costs. A simulation model was constructed based on China's current public health insurance system to evaluate the financial burden for medical service on Chinese patients, as well as to calculate the possibilities of CHE. Then, by adjusting several parameters, suggestions were made for China's health insurance system in order to reduce CHE. It's found with China's current public health insurance system, the financial aid that a patient may receive depends on whether he is from an urban or rural area and whether he is employed. Due to the different insurance policies and the wide income gap between urban and rural areas, rural residents are much more financially vulnerable during health crisis. The possibility of CHE can be more than 50% for low-income rural families. The CHE ratio can be dramatically lowered by applying different policies for different household income groups. It's concluded the financial burden for medical services of Chinese patients is quite large currently, especially for those from rural areas. By referencing different healthcare policies in the world, applying different health insurance policies for different income groups can dramatically reduce the possibility of CHE in China.