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Offline: China's rejuvenation in health
Comment
Offline: China’s rejuvenation in health
Richard Horton
Richard Horton
Richard Horton
Last week saw one of the most important gatherings in China’s political calendar—the Two Sessions. China’s system of governance, including its governance of health, is fiercely complex. But at the national level it can be reduced to three fundamental forces. The most significant is the Communist Party of China. The Party’s General Secretary is Xi Jinping (who is also President of the People’s Republic). He leads a 25-member Politburo, as well as China’s elite decision-making body, the sevenmember Politburo Standing Committee. The Communist Party isn’t the only political party in China—for example, Chen Zhu, a former Minister of Health, leads the Chinese Peasants’ and Workers’ Democratic Party—but it is the overwhelmingly dominant voice in national politics. Still, the Party doesn’t run everything. You don’t have to be a member of the Communist Party to be appointed to the State Council. The Council is the day-to-day government of China. Its Premier is Li Keqiang, and he presides over 35 Council members, including the heads of 25 ministries. The Ministry of Health, which in China is known as the National Health and Family Planning Commission (NHFPC), is led by Li Bin. The third force in China’s national government is the Two Sessions, an annual assembly of the National People’s Congress (Chen Zhu is currently a Vice-Chair of the Standing Committee of the National People’s Congress) and the National Committee of China’s People’s Political Consultative Conference. In Tiananmen Square last week, delegates to the Two Sessions were greeted by dozens of red flags rippling in the wind and bright sunshine atop the Great Hall of the People. Chinese Government officials are fully aware that the Two Sessions model “is not perfect”, as an editorial in China’s English-language Global Times put it last week. But at a time when western democracies seem to be struggling not only to manage their ever-more partisan political debates but also to deliver effective government, China’s model does suggest some advantages. The meeting this year is important because it comes in advance of the 19th National Congress of the Communist Party of China, to be held in the autumn. The Congress will likely see a radical reassortment of top political positions. The Politburo and its Standing Committee will be renewed, and a new Chair of the NHFPC will be appointed. *
1086
Why does any of this matter to those concerned about health? The Two Sessions meeting signals important directions in policy. At last week’s gathering, Li Keqiang emphasised the significance of “medium high-speed economic growth” (projected to be around 6·5% in 2017) to boost health care. Wang Longde, a past Lancet author, discussed the current drafting of a national law on health promotion. The law follows last year’s announcement by Xi Jinping of Healthy China 2030, a far-reaching plan to make health the overriding goal of economic growth and political reform. Healthy China 2030 will include proposals for upgrading hospital treatment and management, universal health coverage, improvements in the supply of essential medicines, a revitalisation of traditional Chinese medicine, enhanced health literacy, and stronger disease prevention, all in the context of increasing industrialisation, urbanisation, and an ageing population. China’s Government has made health a foundation for its development. These reforms are part of what China’s political leaders see as the country’s great rejuvenation. And here outsiders can only understand China’s thinking in the context of the country’s turbulent history. Western nations see China as a threat. Its size, military strength, and expanding global role are seen as dangers to the existing western dominated global order. But China’s perspective is utterly different. A clue to this western misunderstanding can be found in the National Museum of China. There one will discover the existential vulnerability China feels. Since the Opium Wars of the mid-19th century, China has seen its future as teetering on the edge of a colonial feudal society. The collapse of the Qing Dynasty and its humiliation at the hands of western imperial powers has sensitised China to its susceptibility to invasion and subjugation. Ever since a time when outside nations “looted our treasures and killed our people” China has sought national independence and liberation. Establishing a strong and prosperous society is seen as the prerequisite for protecting the autonomy and wellbeing of its people. Health is the bulwark of self-sufficiency and security. There are lessons here for all nations. Global security is individual security. And health is, in China’s view, the pre-eminent definition of its long-term security. Richard Horton [email protected]
www.thelancet.com Vol 389 March 18, 2017
Offline: China’s rejuvenation in health
Richard Horton
Richard Horton
Richard Horton
Last week saw one of the most important gatherings in China’s political calendar—the Two Sessions. China’s system of governance, including its governance of health, is fiercely complex. But at the national level it can be reduced to three fundamental forces. The most significant is the Communist Party of China. The Party’s General Secretary is Xi Jinping (who is also President of the People’s Republic). He leads a 25-member Politburo, as well as China’s elite decision-making body, the sevenmember Politburo Standing Committee. The Communist Party isn’t the only political party in China—for example, Chen Zhu, a former Minister of Health, leads the Chinese Peasants’ and Workers’ Democratic Party—but it is the overwhelmingly dominant voice in national politics. Still, the Party doesn’t run everything. You don’t have to be a member of the Communist Party to be appointed to the State Council. The Council is the day-to-day government of China. Its Premier is Li Keqiang, and he presides over 35 Council members, including the heads of 25 ministries. The Ministry of Health, which in China is known as the National Health and Family Planning Commission (NHFPC), is led by Li Bin. The third force in China’s national government is the Two Sessions, an annual assembly of the National People’s Congress (Chen Zhu is currently a Vice-Chair of the Standing Committee of the National People’s Congress) and the National Committee of China’s People’s Political Consultative Conference. In Tiananmen Square last week, delegates to the Two Sessions were greeted by dozens of red flags rippling in the wind and bright sunshine atop the Great Hall of the People. Chinese Government officials are fully aware that the Two Sessions model “is not perfect”, as an editorial in China’s English-language Global Times put it last week. But at a time when western democracies seem to be struggling not only to manage their ever-more partisan political debates but also to deliver effective government, China’s model does suggest some advantages. The meeting this year is important because it comes in advance of the 19th National Congress of the Communist Party of China, to be held in the autumn. The Congress will likely see a radical reassortment of top political positions. The Politburo and its Standing Committee will be renewed, and a new Chair of the NHFPC will be appointed. *
1086
Why does any of this matter to those concerned about health? The Two Sessions meeting signals important directions in policy. At last week’s gathering, Li Keqiang emphasised the significance of “medium high-speed economic growth” (projected to be around 6·5% in 2017) to boost health care. Wang Longde, a past Lancet author, discussed the current drafting of a national law on health promotion. The law follows last year’s announcement by Xi Jinping of Healthy China 2030, a far-reaching plan to make health the overriding goal of economic growth and political reform. Healthy China 2030 will include proposals for upgrading hospital treatment and management, universal health coverage, improvements in the supply of essential medicines, a revitalisation of traditional Chinese medicine, enhanced health literacy, and stronger disease prevention, all in the context of increasing industrialisation, urbanisation, and an ageing population. China’s Government has made health a foundation for its development. These reforms are part of what China’s political leaders see as the country’s great rejuvenation. And here outsiders can only understand China’s thinking in the context of the country’s turbulent history. Western nations see China as a threat. Its size, military strength, and expanding global role are seen as dangers to the existing western dominated global order. But China’s perspective is utterly different. A clue to this western misunderstanding can be found in the National Museum of China. There one will discover the existential vulnerability China feels. Since the Opium Wars of the mid-19th century, China has seen its future as teetering on the edge of a colonial feudal society. The collapse of the Qing Dynasty and its humiliation at the hands of western imperial powers has sensitised China to its susceptibility to invasion and subjugation. Ever since a time when outside nations “looted our treasures and killed our people” China has sought national independence and liberation. Establishing a strong and prosperous society is seen as the prerequisite for protecting the autonomy and wellbeing of its people. Health is the bulwark of self-sufficiency and security. There are lessons here for all nations. Global security is individual security. And health is, in China’s view, the pre-eminent definition of its long-term security. Richard Horton [email protected]
www.thelancet.com Vol 389 March 18, 2017