Communicable disease control in China: From Mao to now

Hipgrave, David

Alongside these two broad CDC initiatives, a number of disease-specific, donor-and particularly government-funded initiatives have also demonstrated an increased commitment to CDC in China. These include massive increases in funding for control of TB, schistosomiasis, malaria and STDs; treatment and prevention of maternal-to-child-transmission of HIV/AIDS; prevention, screening and treatment of other STDs; vaccine-preventable diseases (such as control of measles through various provincial campaigns and a national campaign in September 2010; control of hepatitis B through catch-up vaccination of older children; expansion of routine immunization to cover 12 antigens since 2007; an enormous program of subsidies to encourage hospital delivery and prevention of neonatal tetanus (also enabling dramatic increases in birth-dosing with hepatitis B vaccine) and introduction of a national child immunisation registration and information system); infectious disease surveillance during emergencies (including use of mobile phones to report on disease incidence in the areas affected by the Sichuan earthquake) and public education campaigns and research to reduce the risk of emerging threats such as recrudescence of dengue fever; increases in brucellosis, zoonoses and the impact of annual outbreaks of influenza and EV71 infection (data available upon request). Both GAVI and the Global Fund for AIDS, TB and Malaria have also supported large scale CDC activities in China in recent years. These developments have since 2009 been taking place in the context of other major developments in China' s health sector, some of which are likely to directly benefit CDC. Among the initiatives being rolled out as part of China' s health system reform (HSR) are a 15 (now 25) yuan-percapita public health subsidy for grassroots-level providers, to facilitate their implementation of nine public health activities at village level; including health promotion and implementation of CDC; a National Essential Drugs Scheme intended to control prescribing practices and profiteering by village and township doctors, including in the treatment of infectious diseases (26) , and even more funding to im-prove the staffing and physical infrastructure of China' s health system (69) .