The change we bring : progress report 2016-2017

WORLD HEALTH ORGANIZATION WHO REPRESENTATIVE OFFICE CHINA PROGRESS REPORT 2016–2017 THE CHANGE WE BRING World Health Organization :+25HSUHVHQWDWLYH2ɝFH&KLQD 2 WORLD HEALTH ORGANIZATION WHO REPRESENTATIVE OFFICE CHINA PROGRESS REPORT 2016–2017 THE CHANGE WE BRING World Health Organization :+25HSUHVHQWDWLYH2ɝFH&KLQD 4 WPR/2018/CHN/002 © World Health Organization 2018 Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO licence. The Change We Bring 5 Message from the WHO Representative A Snapshot: China’s Health Status Strategic Direction Adding Value in China WHO China as an Advocate WHO China as a Convener WHO China as an Enabler WHO China as Transformative Change Looking Forward 1 2 4 6 8 16 20 24 36 World Health Organization :+25HSUHVHQWDWLYH2ɝFH&KLQD 6 The Change We Bring 1 Message from the WHO Representative Dr Bernhard Schwartländer WHO Representative in China Contributing to transformation in China meant starting at home, ZLWKLQ:+2ȇVRɝFHV:H literally tore down the walls that inhibited collaboration, adopted policies that get us out of cars and onto bikes, and every day assess how to adapt and sharpen our engagement in a rapidly FKDQJLQJHQYLURQPHQW “ “ The China of today bears little resemblance to the China of 35 years ago. Now an upper-middle-income country, it has built world-class health systems to address communicable disease – a necessary foundation to address the rising burden of noncommunicable diseases, which now account for 85% of deaths in China. 5HȵHFWLQJWKLVFKDQJLQJODQGVFDSHWZR\HDUVDJR:+2DQG&KLQDȇV National Health and Family Planning Commission (NHFPC) launched a new WHO China Country Cooperation Strategy. The new strategy and the ways in which it is implemented in China is, in many ways, a window into a new WHO. In today’s China, we actively partner with world-class researchers and experts who are often leading global health advancements. Beyond traditional capacity-building, accelerating and safeguarding these advancements requires us to work in the space between sectors and across ministries – breaking silos that impede Health in All Policies from taking root and completing the transformation of China’s health landscape. 0XFKRIWKLVLVDFFRPSOLVKHGE\JURXSLQJRXUVWD΍DURXQGLVVXHDUHDVWKDW move beyond traditional technical disciplines. Some platforms, such as those focused on legislative reforms, are short-term to take advantage of narrow windows of opportunity; others, such as building Healthy Cities, are long-term to build a multisectoral response. Beyond the platforms, our work is animated and accelerated by robust communications and outreach strategies that engage nontraditional partners, WKHSULYDWHVHFWRUDQGWKHPHGLD7KH:+25HSUHVHQWDWLYH2ɝFHLQ&KLQD through our communications creates space and pushes forward the evidence- based reforms that WHO advocates. Communications in WHO China is not an add-on: it is the fuel that drives conversation and debate among the general public, and between the public and decision-makers. )XQGDPHQWDOO\WKHYDOXH:+2R΍HUVWRLWV&KLQHVHSDUWQHUVLVRXUDELOLW\ to convene, advocate, enable and ultimately contribute to health-care transformation. Supporting China’s health advancements over the past two years has been, and continues to be, a rewarding endeavour for all members of our team. WHO China looks forward to the next phase in China’s health systems reform and to bringing the lessons of China’s development to the world. World Health Organization :+25HSUHVHQWDWLYH2ɝFH&KLQD 2 A Snapshot: China’s Health Status Rapid health progress over the past 35 years Basic health insurance coverage from 24% of the population in 2005 to now more than 95% of the total population 20112005 Infant chronic hepatitis B infections from 9.7% in 1992 to 0.32% in 2014 20141992 Maternal mortality ratio reduced from 80 deaths per 100 000 live births in 1992 to 23 deaths per 100 000 live births in 2013 Out-of-pocket payment from nearly 60% out-of- pocket payment in 2001 to less than 30% in 2016 20162001 Essential vaccine coverage (e.g. polio, measles and hepatitis B) remained above 95% over the last decade HIV/AIDS mortality rate from 69% to 5.6% over the last decade  Premature deaths from infectious diseases reduced from 15% in 1990 to around 45% in 2010 Life expectancy at birth from 67.0 years to 76.3 years between 1990 and 2015 20151990 Under-5 mortality dropped 75% between 1996 and 2014 The Change We Bring 3 8QȴQLVKHGEXVLQHVVȂ+HDOWKFKDOOHQJHVUHPDLQ The Government of China is well aware of the challenges borne of “unbalanced, uncoordinated and unsustainable development” and set out an ambitious path of reform. The Government remains committed to further reforms DQGZLWKVXVWDLQHGFRRUGLQDWHGH΍RUWVZLOOEHRQWUDFN to achieving the President’s vision of Healthy China 2030. Air pollution One million people died prematurely in China in 2012, with the majority from strokes, heart disease and lung cancers. Noncommunicable diseases More than 85% of deaths in China are related to non- communicable diseases, which equals more than 3 million people in China each year. Diabetes By 2040, there will be approximately 150 million adults with diabetes in China. Ageing population The proportion of the population aged 60 years and over will increase from 12.4% (168 million people) in 2010 to 28% (402 million) in 2040. Smoking One million people in China die each year from tobacco-related illnesses; 100 000 from exposure to second- hand smoke. 60 Y 28% 85% NCDs 1 M 100K 2040 150 M 1 M 2012 World Health Organization :+25HSUHVHQWDWLYH2ɝFH&KLQD 4 Strategic Direction 2YHUWKHSDVW\HDUV:+2ȇVUROHLQ&KLQDKDV FKDQJHGΖQ:+2ODXQFKHGWKH&KLQDȫ:+2 &RXQWU\&RRSHUDWLRQ6WUDWHJ\&&6ȫ IHDWXULQJVL[VWUDWHJLFSULRULWLHV The Change We Bring 5 Priority 6 Address the impact of the environment and climate change on health. Priority 5 Promote the Healthy Cities movement and the attainment of Health in All Policies. Priority 4 Enhance China’s contribution to global health. Priority 3 Strengthen regulatory capacity in health services, food safety, and health products and technologies. Priority 2 Reduce morbidity and mortality from major diseases and risks of public health importance. Priority 1 Strengthen health systems towards universal health coverage. World Health Organization :+25HSUHVHQWDWLYH2ɝFH&KLQD 6 Adding Value in China The Change We Bring 7 Achieving progress across the six strategic areas compels WHO 5HSUHVHQWDWLYHRɝFH&KLQDWRIRFXVRQWKRVHIXQFWLRQVWKDWPD[LPL]H WHO’s added value. This includes WHO’s ability to: ConveneAdvocate Enable Transform World Health Organization :+25HSUHVHQWDWLYH2ɝFH&KLQD 8 7KURXJKDZDUHQHVVFDPSDLJQVWUDLQLQJSURJUDPPHV DQGH[SHUWUHFRPPHQGDWLRQVZHDGYRFDWHFRQFUHWH KHDOWKVROXWLRQVIRUWKHSHRSOHRI&KLQD7KHH΍RUWV EXLOGDQGDPSOLI\SXEOLFFRQYHUVDWLRQDURXQG LPSRUWDQWKHDOWKUHIRUPVDQGSDYHWKHZD\IRUPRUH WKRXJKWIXODQGHQJDJLQJGLDORJXHZLWKGHFLVLRQ PDNHUVDERXWUHIRUPDOWHUQDWLYHV6RPHH[DPSOHV IURPWKHSDVWWZR\HDUVIROORZ WHO China as an ADVOCATE The Change We Bring 9 World Health Organization :+25HSUHVHQWDWLYH2ɝFH&KLQD 10WHO China as an ADVOCATE Vaccine crisis response Advocacy and information sharing are particularly important during times of crisis. WHO Representative 2ɝFH&KLQDZDVDFWLYHLQSURYLGLQJ accurate information to the media and directly to the general public about immunizations, as the media broke WKHVWRU\RIDȴYH\HDULOOHJDOYDFFLQH reselling ring in Shandong Province. We modelled best practices for crisis response and communications, which can inform China’s own response practices in the future. Medical product standards Advocacy is not always public – :+25HSUHVHQWDWLYH2ɝFH&KLQD also engages in direct advocacy with JRYHUQPHQWRɝFLDOV)RUH[DPSOH through a series of closed-door roundtables with international experts, we continue to engage Chinese regulators on how best to ensure that medicine produced in China meets the highest international standards and, with support from the Bill & Melinda Gates Foundation, to identify key areas for regulatory upgrade. The Change We Bring 11 :+25HSUHVHQWDWLYH2ɝFH China partners with Bloomberg Philanthropies to advocate road safety policies. We have trained Chinese journalists in how to FRPPXQLFDWHPRUHH΍HFWLYHO\DERXW road safety issues. We have also built a partnership with the Ministry of Public Security on proposed legislative reforms and are building a new partnership with the Ministry of Transport on public transit. :HRUJDQL]HFUHDWLYHRɞLQH events that complement technical discussions, such as a shared-bike ride IRUPD\RUVDQGQDWLRQDORɝFLDOV participating in a WHO-organized Healthy Cities forum. This paved the way for more engaging conversations about road safety and healthy transportation systems in the forum’s seminars that followed. Helping journalists communicate PRUHH΍HFWLYHO\ World Health Organization :+25HSUHVHQWDWLYH2ɝFH&KLQD 12 Public Health Communications Campaigns The Chinese population is highly Internet savvy, with 700 million Internet users in 2016. Of these users, more than 90% access the Internet on their mobile devices and more than 95% have a social media account. Social media platforms in China are transforming the way real-time information is shared. The population has become more concerned and vocal about health issues, creating an opportunity to improve public health literacy and engagement. In the past two years, WHO China has integrated communications into each of its health interventions. The following page is a snapshot of some of the major communication and advocacy campaigns we have launched. WHO China as an ADVOCATE # (Hashtag) Reads for some of WHO China’s most popular social media campaigns (as of October 2017) Hashtag (Chinese) Hashtag(English) Number of reads to date (millions) #世界无烟日# #WorldNoTobaccoDay 280 #无烟下一代# #SmokefreeNextGeneration ΂ #你有控吗# #RUFree ΂ #拒绝肝扰OK一生# #NoHepatitisOkForLife 74.4 #慎重对待抗生素# #HandleAntibioticsWithCare  #活该健康# #GetHealthy ΂ #世界母乳喂养周# #WorldBreastFeedingWeek 46.7 #打败糖尿病# #BeatDiabetes 36.0 #关注抑郁症# #PayAttentionToDepression 22.8 #我们聊聊吧# #LetsTalk ΂ The Change We Bring 13 World Health Organization :+25HSUHVHQWDWLYH2ɝFH&KLQD 14 Smoke-Free Next Generation Smoke-Free Next Generation – a high-fashion and entertainment media savvy campaign with young Chinese celebrities – meant to challenge the P\WKWKDWVPRNLQJLVFRROΖQWKHȴUVWWKUHHGD\VWKHFDPSDLJQZDVYLHZHG more than 34 million times online and was ranked the #1 social good hashtag. In the following months, the campaign reached tens of millions of viewers with videos shared on state television platforms and on hundreds of LED screens across the country – and even in Times Square in New York. $VDȴUVWIRU:+25HSUHVHQWDWLYH2ɝFH&KLQDWKHFDPSDLJQDOVRDSSHDUHG on the cover issue of GRAZIA fashion magazine and Southern Metropolis Entertainment, and the campaign video was featured by Xiamen Airlines DVSDUWRIWKHLULQȵLJKWSURJUDPPLQJ “There’s nothing cool about VPRNLQJ%XW there is something empowering about choosing to live a healthy, smoke- IUHHOLIHȋ –DR BERNHARD SCHWARTLÄNDER WHO China as an ADVOCATE The Change We Bring 15 Depression: Let’s Talk Mental health has become a major public health issue in China: only 20 000 psychiatrists practise in the country. During 2016 and 2017, WHO Representative 2ɝFH&KLQDHQJDJHGLQDUDQJHRIDFWLYLWLHVWRDGYRFDWHLPSURYHGPHQWDOKHDOWK services and to reduce stigma. In support of the Government’s 2015–2020 National Mental Health Work Plan, the WHO Representative in China attended a televised talk show in December 2016 on mental health, which reached almost 7 million YLHZVRQOLQH7KH:+2&KLQDDOVRRUJDQL]HGDSXEOLFȴYHNLORPHWUHȊ:DONDQG7DONȋ to eliminate stigma around mental health as part of the World Health Day 2017 campaign, a “TED”-style multimedia talk, and a robust online campaign that reached PLOOLRQV7KHFDPSDLJQH[WHQGHGWKURXJKWKH\HDUZLWKSODQVIRUDQRɞLQHF\FOLQJ event with a local partner to bring attention to depression in the LGBT community. “The more we reduce stigma and increase awareness, the better we can manage and overcome this KLGGHQGLVHDVHȋ –DR BERNHARD SCHWARTLÄNDER World Health Organization :+25HSUHVHQWDWLYH2ɝFH&KLQD 16 WHO China as a CONVENER :+2&KLQDVHHNVRXWRSSRUWXQLWLHVWRHQJDJH DFURVVPXOWLSOHVHFWRUVLQDQH΍RUWWREUHDNWKH VLORVWKDWLPSHGH+HDOWKLQ$OO3ROLFLHVIURPWDNLQJ URRW%XLOGLQJSDUWQHUVKLSVZLWKQRQWUDGLWLRQDO DFWRUVKHOSVWRDFFHOHUDWH&KLQDȇVWUDQVIRUPDWLRQ RILWVKHDOWKODQGVFDSHDQGWKH3UHVLGHQWȇV+HDOWK\ &KLQDYLVLRQ The Change We Bring 17 World Health Organization :+25HSUHVHQWDWLYH2ɝFH&KLQD 18 2016 APRIL Standards strengthening WHO China launched a multi-year engagement with the Chinese Food and Drug Administration on regulatory strengthening to international standards for quality-assured medicines. 2016 JULY Jack Ma meets with WHO Representative Dr Bernhard Schwartländer, WHO Representative in China, met with Alibaba founder Jack Ma to discuss Big Data and its crucial role in the future of health provision. 2016 NOVEMBER World Antibiotic Awareness Week The culmination of a series of projects engaging China on anti- microbial resistance work, WHO China and the NHFPC gathered 300 health professionals, policy- makers, patients, members of the general public and media in a joint event. 2016 NOVEMBER 9th Global Conference on Health Promotion Over 1200 participants – including 80 ministers and 120 mayors – attended the largest Global Conference on Health 3URPRWLRQWRGDWHDQGWKHȴUVW one to be held in China. The conference in Shangai aimed to put health at the core of the United Nations Sustainable Development Goals. WHO China as a CONVENER The Change We Bring 1919 2017 AUGUST Next generation speaks: Conversation with the WHO Director-General WHO China organized an exciting panel discussion where over 200 youths and young leaders from China met with the WHO Director-General, Dr Tedros, in Beijing to discuss issues related to global health and youth health. This platform provided an excellent opportunity for Dr Tedros to engage with and hear from young people. 2017 JANUARY Xi Jinping visits WHO China’s President visited the 2UJDQL]DWLRQIRUWKHȴUVWWLPH During his visit, WHO signed a memorandum of agreement with the Government of China on building a Healthy Silk Road through China’s Belt & Road Initiative. 2017 MARCH Joint seminar and press event on a WHO/UNDP report on the economic costs of smoking Bringing together leading Chinese economists and public KHDOWKȴJXUHVDVZHOODVJXHVWV from the World Bank, WHO and the United Nations Development Programme (UNDP) jointly convened a discussion on the unsustainable economic costs of China’s addiction to tobacco. 2017 MAY Engaging the private sector on smoke-free policies $VSDUWRIH΍RUWVWRSURWHFWWKH Chinese public from the deadly harms of second-hand smoke, which still kills more than 100 000 innocent victims every year, WHO China launched partnerships to support smoke-free businesses and workplaces with Baidu, Inc., one of China’s leading Internet companies, and with GRAZIA magazine, a leading high-fashion publication. They supported raising more attention for the issue of smoking, especially targeting youth and young people. Private sector voices are critical to not just driving health reforms but also implementing them at the local level. World Health Organization :+25HSUHVHQWDWLYH2ɝFH&KLQD 20 :+2&KLQDKHOSVWRVHFXUHUHDOLPSURYHPHQWV LQSHRSOHȇVOLYHVE\LGHQWLI\LQJWKHKXUGOHVWKDW DUHOLPLWLQJWKHIXOOLPSDFWRIUHIRUPDQGXVLQJ SDUWQHUVKLSVWRHQDEOHFKDQJH WHO China as an ENABLER The Change We Bring 21 World Health Organization :+25HSUHVHQWDWLYH2ɝFH&KLQD 22 Focusing reforms around priority interventions WHO China delivered a series of key recommendations to China’s senior leadership on priority reforms that could overcome key obstacles in delivering high- quality health services. Partnering with the World Bank, we delivered a policy brief on “Deepening health reform in China: Building high-quality and value-based service delivery” to the State Council’s Vice Premier Liu Yandong and to the Ministers of NHFPC, Finance, and of Human Resources and Social Security in March 2016. This policy brief encouraged China to shift from its current hospital-centric model, focused on volume and sales, to one centred on primary care with a focus on YDOXHDQGHɝFLHQF\ WHO Emergency Medical Teams Initiative After assessing the global response to the Ebola outbreak, WHO is building capacity in country teams around the world to respond in emergency situations. Working with relevant stakeholders, WHO 5HSUHVHQWDWLYH2ɝFH&KLQDDVVLVWHGLQWKHH΍RUWWR register a Shanghai team in November 2016 and a team from Guangdong in May 2017. WHO China as an ENABLER The Change We Bring 23 Essential health law WHO China continues to provide expert recommendations and inputs into China’s draft Essential Health Law. We partnered with Peking Union Medical College to summarize key messages and recommendations from the November 2015 International Health Legislation Symposium. These were shared with NHFPC to facilitate in drafting the Essential Health Law. WHO China provided substantial comments to the preliminary draft of the law. Strategies for disease elimination WHO China successfully engaged with the Government and other stakeholders in setting a vision and country agenda aligned with WHO’s global health sector strategies for HIV, viral hepatitis, and sexually transmitted infections in 2016. Among them are: ȏ triple elimination of HIV, syphilis, and viral hepatitis, ȏ tightening the national hepatitis B prevention strategy, aiming for zero paediatric hepatitis B infections, and ȏ agreement on targets for national action plans on viral hepatitis and HIV. World Health Organization :+25HSUHVHQWDWLYH2ɝFH&KLQD 24 The Change We Bring 25 WHO China as TRANSFORMATIVE CHANGE :+2ȇVXOWLPDWHJRDOLVWRVXSSRUWWUDQVIRUPDWLRQDO FKDQJHLQ&KLQDȇVKHDOWKFDUHV\VWHP%\FRPELQLQJ RXUUROHDVFRQYHQHUDGYRFDWHDQGHQDEOHU:+2 &KLQDKDVEHHQSULYLOHJHGWRFRQWULEXWHWRWKH KLVWRULFFKDQJHVKDSSHQLQJLQ&KLQD 26 World Health Organization :+25HSUHVHQWDWLYH2ɝFH&KLQD The Change We Bring 27 Objective: The establishment of a national smoke-free law in China, to allow all 1.4 billion people to live in smoke-free areas. A recipe for success: :+25HSUHVHQWDWLYH2ɝFH&KLQDLQWHJUDWHGLWVYDULRXVUROHVDV advocate, convener, and enabler to support transformative change in China’s tobacco policies. Working with national counterparts both in and out of Government, we have worked across multiple fronts: Advancing smoke-free legislation :+25HSUHVHQWDWLYH2ɝFH&KLQDFRQWLQXHVWRVXSSRUWLPSOHPHQWDWLRQ and enforcement of a national smoke-free law, and in May 2016 hosted the International Symposium on Tobacco Control and Law. Speakers shared experiences regarding successful enforcement of smoke-free SROLFLHV:HKDYHDOVRHQJDJHGWKH6WDWH&RXQFLO/HJLVODWLYH$΍DLUV 2ɝFHRQWKHFXUUHQWGUDIWOHJLVODWLRQIRUWKH1DWLRQDO6PRNH)UHH/DZ advocating a total comprehensive ban in line with standards outlined in the WHO Framework Convention on Tobacco Control. A case study in transformative change: TOBACCO CONTROL Legislative support + + +Evidence-based analysis Public awareness Strategic partnerships World Health Organization :+25HSUHVHQWDWLYH2ɝFH&KLQD 28 While work on the national law continues, WHO played a key role in the adoption of three municipal smoke-free laws. In 2016, WHO supported the adoption of legislation in Beijing, and in 2017 in Shenzhen and 6KDQJKDL:LWK%HLMLQJ6KHQ]KHQDQG6KDQJKDLWKUHHRIWKHIRXUȴUVW tier cities in China have comprehensive smoke-free laws in place. This sets the stage for other cities to follow, and is a positive development in regard to dialogue surrounding a national smoke-free law, which is still being debated. Adopting advertising restrictions China has also adopted stronger restrictions on tobacco advertising LQWKH$GYHUWLVLQJ/DZZKLFKFDPHLQWRH΍HFWRQ6HSWHPEHU The new law bans tobacco advertising in mass media, public places, outdoors and public transport. Increasing tobacco taxes In May 2015, the Ministry of Finance announced an increase in tobacco WD[HVȂDFUXFLDOO\LPSRUWDQWPHDVXUHIRUUHGXFLQJWKHD΍RUGDELOLW\RI WREDFFRSURGXFWV6LJQLȴFDQWO\WKHLQFUHDVHZDVSDVVHGRQIRUWKHȴUVW time to the retail price of cigarettes, which led to higher average tobacco prices and overall reduction in volume of cigarettes sold. Changing public sentiment Together with legislative inputs and expert recommendations, WHO China has implemented hugely successful public awareness campaigns that increase public engagement and directly challenge tobacco industry marketing, especially to youth. Beyond reaching large numbers of the population, the awareness campaigns have increased public support for smoke-free legislation. Recent surveys in Beijing show more than 90% of the population – including smokers – support the recent smoke-free legislation. These results are critical for demonstrating to leading decision-makers the political power of policies that protect public health. Ʌ The Change We Bring 29 World Health Organization :+25HSUHVHQWDWLYH2ɝFH&KLQD 30 The Change We Bring 31 ΖQ-XO\&KLQDSURPXOJDWHGLWVȴUVWSROLF\JXLGHOLQHRQ+HDOWK\&LWLHV:+2&KLQD has been supporting the Government in both development and implementation of this policy. What began as a series of conversations has blossomed into a wide-ranging series of interventions with multiple partners and points of engagement across sectors: A case study in transformative change: HEALTHY CITIES In September 2017, WHO China VXSSRUWHGH΍RUWVE\WKH0LQLVWU\ of Transport and Ministry of Public Security, the two ministries responsible for road safety and people-centred transportation development, to highlight the importance of public transportation in improving the environment, quality of life and healthy lifestyles. By working with the two national ministries, WHO is able to VXSSRUWH΍RUWVLQFLWLHVDFURVVWKH country to highlight the importance of municipal policies around road safety. WHO launched a biennial cooperation project to support NHFPC on the development of guidelines to pilot community-based actions in 38 Healthy Cities pilot locations across China. In September 2016, with support from WHO, Sichuan Province launched its QHZ+HDOWK\&LW\PRYHPHQWWKHȴUVW province in China to do so. In November 2016, 1200 attendees gathered at the 9th Global Conference on Health Promotion, held in Shanghai. More than 100 mayors committed to the Shanghai consensus on Healthy Cities 2016. In July 2017, over 100 mayors joined a conference organized by NHFPC and WHO China in Weihai to discuss road safety, Health in All Policies, community development and Healthy Cities leadership. 2016–2017 2016– 2017– 32 World Health Organization :+25HSUHVHQWDWLYH2ɝFH&KLQD The Change We Bring 33 2030 The target year for the elimination of viral hepatitis in China. By convening meetings DQGDGYRFDWLQJH΍HFWLYHO\:+2 China played a crucial role in China’s endorsement of this vision, providing a framework for LQWHQVLȴHGH΍RUWVLQWKHȴHOG A case study in transformative change: HEPATITIS TREATMENT 400 000 The amount of money (in Chinese RMB) that WHO China mobilized towards funding a national stigma survey of hepatitis B (HBV). We also served on the advisory group for the survey. 69 000 000 The number of reads on a two- week social media campaign that WHO China led to increase awareness of hepatitis prevention, and treatment for hepatitis B and C. The campaign prompted 220 000 online discussions. World Health Organization :+25HSUHVHQWDWLYH2ɝFH&KLQD 34 ȏ Reduction in the price of Tenofovir, a treatment drug for HBV ȏ Acceleration of CFDA’s hepatitis C drug registration ȏ Declaration of action for triple elimination of mother-to-child transmission of HIV, syphilis, and viral hepatitis in the 13th National Maternal and Child Health Plan ȏ Drafting of a national action plan on viral hepatitis (ongoing) WHO China played a critical role in these major policy shifts: China has the highest burden of hepatitis B and C in the world. The country has made remarkable success in hepatitis B prevention via vaccinations, prevention of mother-to-child transmission, harm reduction for those injecting drugs (including methadone substitution and needle exchange programmes), improved hospital infection control, and safer health-care-related injections. Yet, China still faces a tremendous burden of people living with chronic hepatitis B and C. WHO, together with partners, developed “An Investment Case for Viral Hepatitis”, which demonstrated that paying for the most recent drugs to treat hepatitis B and C is cheaper to the health system in the long run than the costs resulting from patients who do not access treatment. The case is supported by economic and epidemiological analysis conducted with leading Chinese institutions. 6LJQLȴFDQWȊȴUVWȋVKLIWVLQ&KLQHVH*RYHUQPHQWSROLF\VLQFHKDYHLPSURYHG access to hepatitis B medicines (such as Tenofovir) to treat chronic active infection. China also has accelerated the medicines regulatory process for drugs treating chronic active infection associated with hepatitis C. Ongoing challenges remain due to health system restructuring. In response, WHO China focuses on access to treatment and prevention in the elimination of viral hepatitis. The Change We Bring 35 World Health Organization :+25HSUHVHQWDWLYH2ɝFH&KLQD 36 LOOKING FORWARD ΖQWKHQH[WVHYHUDO\HDUV&KLQDLVH[SHFWHGWREHFRPHDKLJK LQFRPHFRXQWU\7KLVLVDVLJQLȴFDQWPLOHVWRQHWKDWWHVWLȴHV WRWKHH[WUDRUGLQDU\SDFHRIFKDQJHHFRQRPLFJURZWKDQG LPSURYHPHQWLQKHDOWKRXWFRPHVLQWKHSDVWWKUHHGHFDGHV 'XULQJWKLVWLPH:+2VXSSRUWIRURQJRLQJUHIRUPVZLOOEH HVVHQWLDOIRUDGGUHVVLQJOLQJHULQJGLVSDULWLHVDQGVDIHJXDUGLQJ &KLQDȇVWUDQVLWLRQWRDPRUHHTXLWDEOHFRPSUHKHQVLYHDQG VXVWDLQDEOHKHDOWKV\VWHP&KLQDȇVUHODWLRQVKLSZLWK:+2ZLOO FRQWLQXHWRFKDQJHDQGLQGHHGWKDWFKDQJHLVDOUHDG\XQGHU ZD\DVZHIRFXVRXUH΍RUWVPRUHRQEULQJLQJ&KLQDȇVOHVVRQV DQGH[SHULHQFHVWRWKHLQWHUQDWLRQDOFRPPXQLW\:HKRSHWR FRQWLQXHWRDGGYDOXHWR&KLQDȇVWUDQVIRUPDWLRQDQGWRLWVJOREDO KHDOWKOHDGHUVKLSLQWKHIXWXUH The Change We Bring 37 Thanks to Partners WHO would like to thank all our partners in the Government, universities, nongovernmental organizations, donors, other agencies and institutions both in and outside China for their support and collaboration for a healthier China.