China's Health Challenges

The Director-General of the World Health Organization (WHO) says China has a series of chronic illnesses to deal with, including cardiovascular, cancer, diabetes, tobacco, obesity and environmental health threats.

Dr Margaret Chan gave a briefing to the press today about her five-day trip to Beijing. She alternatively praised the Chinese government for its efforts on improving healthcare but at the same time urged it to do more.

"China is making good progress," she said, "but it has serious health problems and it must keep working on it. The WHO is ready to provide technical assistance."

She went on to say tobacco is a big problem worldwide, topping all mortality compared to tuberculosis, HIV/AIDS and malaria combined.

"China has one-third of the world's tobacco smokers," Chan said. "And if the government does its economic assessment right, it will realize the health burden of problems like lung disease far outweigh the revenue from tobacco sales. It's in the country's interest to control tobacco."

Chan did elaborate on specific measures the government could take, such as increasing tobacco tax, ban tobacco advertising and make it hard for people to get cigarettes. But she didn't disclose whether she explicitly told health officials to do this.

As for other chronic illnesses, the WHO chief said these afflictions were previously only problems in affluent countries, but are now found in low and middle income countries, such as China.

"We're now seeing the 'double disease burden' - communicable diseases and chronic diseases'," she said. "Globalized trade and marketing have a huge impact on people's behaviour."

Chan added the WHO is giving the Chinese government advice on how it should reform its healthcare system.

"China needs to find its own model," she explained. "What works in one country may not work in China, mainly because of the sheer size of the population."

Her big concern for China is the wide health gap between the rural and urban areas, with many in the countryside falling into poverty because of high medical bills. She urged the government to do more to help the rural population as recent WHO research shows disease is the source of poverty for 30 to 50 per cent of the 737 million rural population.

The government is trying to address this with a Rural Cooperative Medical Scheme, where each subscriber is funded 50 yuan (US$6.40), 20 yuan contributed each by central and local governments, and 10 yuan by the individual.

"This is small compared to other parts of the world," Chan noted, but added she hoped China would design a healthcare model relevant to the rural areas.

She suggested perhaps the government could come up with different healthcare models for different parts of the country. For example in cities like Beijing and Shanghai, some medical services could be privatized, whereas the minimum basic care could be given to other parts of the country.

"China is sensitive to the WHO telling them what to do," she hinted.

After the press conference I told some of my colleagues what Chan said. They commented the main problem is that people don't go see doctors because they don't trust them.

"They might charge you more money because you have a more serious illness, or you have to buy several hundred yuan of medicine, like antibiotics that you might not need," they said.

Sounds like the best medicine is preventive one -- don't get sick.