2014: The Top Ten Stories in China’s Health Sector

1. China formally enters post-Global Fund era

By the end of 2013, the Global Fund to Fight AIDS, Tuberculosis, and Malaria officially closed its portfolio in China. Having approved $1.81 billion to support China’s fight against the three diseases, the Global Fund was the largest international health cooperation program in China. One decade of the Global Fund’s presence in China has left behind a mixed legacy. With the departure of the Global Fund, sustaining the existing level of achievement becomes a daunting challenge. Already, the government has eliminated one trademark of the Global Fund: the Country Coordinating Mechanism (CCM).

2. China declares war on pollution

In March, Premier Li Keqiang declared at the opening of the annual meeting of the National People’s Congress (China’s parliament), “We will resolutely declare war against pollution as we declared war against poverty.” This is believed to have been the first time that an official at the highest level of government has formally acknowledged the presence of an environmental crisis. China is on track to invest more than five trillion RMB ($817 billion) in tackling the crisis during the Twelfth Five-Year Plan (2011-2015). The order of magnitude of this government response reflects a growing recognition of the health implications of the environmental crisis: outdoor air pollution, for example, has been linked to 1.2 million premature deaths in China, nearly 40 percent of the global total.

3. China is anointed a world leader in tuberculosis control

In March, the World Health Organization (WHO) announced that China has achieved the Millennium Development Goal target for reversing tuberculosis (TB) incidence by 2015. According to the Lancet, between 1990 and 2010, China more than halved the prevalence of smear-positive TB. The WHO representative in China noted that “over the last 20 years, China has been the single country that has shown the biggest gains in TB control in the world.” The Lancet piece attributes China’s success in TB control to the government’s commitment to the directly observed therapy, short course therapy, or DOTS.

4. Debate over genetically modified food intensifies

The debate and public scrutiny over the safety of genetically modified (GM) food have grown more intense in China. Chinese scientists and Ministry of Agriculture officials have supported the application of GM technologies to staple crops such as rice and corn. But the public remains skeptical about the safety of the GM food. The debate has heated up since a well-known TV host travelled to the United States to investigate American attitude toward GM food. In May, the PLA banned all GM grains and oils from military supply.

5. There is growing consensus on the limits of China’s healthcare reform

Following a survey released by the independent Horizon Research Consultancy Group, it has become increasingly clear that that the healthcare reform has not been as successful as the government would like the public to believe. Over the past five years, the government has spent more than $657 billion on healthcare.  But in March, Professor Zhong Nanshan said that there had been no significant progress in increasing access and affordability, or in improving relationships between patients and healthcare providers. The former Minister of Health Gao Qiang shared Zhong’s sentiments in a recent speech. China’s failing healthcare reform has also received extensive coverage by leading magazines such as the New Yorker and Time.

6. China fines Glaxo nearly $500 million for bribery

Chinese crackdown on corporate corruption claimed a major victim in September, with GlaxoSmithKline being fined $485 million—the largest ever corporate fine in China—for its role in a corruption scandal that came to light in the summer of 2013. The verdict not only marked the end of big pharma’s go-go years in China, but also highlighted the political risk of doing business in China.

7. China sends emergency health aid during the Ebola outbreak

China has responded to the Ebola outbreak in West Africa with unprecedented generosity. In October, it announced a fourth round of emergency funding to Western African countries, bringing its total commitments to $123 million. In November, it announced plans to send an additional five hundred medical personnel to West Africa, bringing the total number of medical workers and experts at the forefront of fighting Ebola to one thousand. The WHO welcomed China’s new commitment, calling it “a huge boost, morally and operationally.”

8. China releases its first proposed nationwide smoking ban in public spaces

In November, the State Council’s Legislative Affairs Office released draft regulation on tobacco control for public consultation. The proposed regulation bans smoking in all indoor public areas and certain outdoor ones, as well as all forms of tobacco advertising, promotion, and sponsorship. China is the world’s largest producer and consumer of tobacco, which causes roughly one million deaths annually in China. China joined the Framework Convention on Tobacco Control in 2005, but due to resistance from the tobacco industry its anti-tobacco policies are among the least effective in the world. The former Ministry of Health in 2011 issued its own ban on smoking in indoor public areas, which was largely disregarded.

9. There is significant increase in private investment in the healthcare industry

In contrast to the lack of progress in China’s healthcare reform, there has been a significant increase in private investment in China’s healthcare sector. Driven by economic growth and demographic change, private equity groups, pharmaceutical makers, healthcare providers, and Internet and E-Commerce companies all poured record amounts of money into hospitals, biopharmaceutical businesses, and medical device industries. A new round of mergers and acquisitions has been underway, involving deals worth a record total of $11.3 billion in the first eleven months of this year.

10. China plans to stop using the organs of inmates beginning next year

In response to longtime international pressures, Chinese officials say that China will halt harvesting the organs of executed prisoners for transplant beginning in 2015. This new development could add uncertainty to China’s organ supply. It is estimated that each year three hundred thousand patients need organ transplants, but only around ten thousand organ transplants are conducted in China annually. According to an article published in the Lancet in 2011, about 65 percent of transplants are organs from deceased donors, 90 percent of whom were death row prisoners.