China's Medium-to-Long Term Plan for the Prevention and Treatment of Chronic Diseases (2017-2025) under the Healthy China Initiative.

A new milestone in the prevention and treatment of chronic diseases

The General Office of the State Council of the People's Republic of China issued the “Medium-to-Long Term Plan of China for the Prevention and Treatment of Chronic Diseases (2017–2025)” (hereinafter referred to as “Plan”) on January 22, 2017. This marked a milestone in the history of the prevention and treatment of chronic diseases in China, a major breakthrough based on China's “National Plan on Non-Communicable Disease (NCD) Prevention and Treatment (2012–2015)” jointly issued by 15 ministries and commissions including the former Ministry of Health, in 2012. While it is another embodiment of the Communist Party of China (CPC) and the Government's people-oriented, health-centered political ideology, it also indirectly reflects two prominent issues, one of which is the severity of the current situation of chronic disease prevention and control in China. According to the “Report on Chinese Residents' Chronic Diseases and Nutrition” issued by the Information Office of the State Council of the People's Republic of China in 2015, chronic diseases accounted for a national mortality rate of 533/100,000, 86.6% of all death tolls and more than 70% of the total burden of disease. Due to their high incidence, disability and mortality rates, chronic diseases not only severely harm people's health and consume a massive amount of medical resources, but also reduce labor productivity and socio-economic development. Rapid urbanization, industrialization, population ageing, and changes in the ecological environment and lifestyles have further accentuated the domestic problem of chronic diseases. The second issue is the feasibility of prevention and control measures. After years of effort and accumulation of prevention and treatment methods, we have laid a relatively concrete foundation that corresponds with China's actual conditions, including prevention and treatment strategies, control patterns, organizational systems, and information systems for chronic diseases. Based on this foundation, we can develop more explicit goals, operable work content, and assessable performance measures.

Eight cohesive measures to ensure the plan's practicability

The “Medium-to-Long Term Plan of China for the Prevention and Treatment of Chronic Diseases (2017–2025)” has proposed eight concrete strategic measures: promoting health education to boost national healthy quality; enforcing early diagnosis and treatment to lower the morbidity risk of high-risk groups; reinforcing standardized treatment to improve therapeutic effects; facilitating the cooperation between medical treatment and prevention to achieve comprehensive healthcare management; refining medical security policies to effectively reduce the public's medical burden; controlling risk factors to construct a healthy supportive environment; arranging social resources in an innovative way to drive the development of the healthcare service industry; and bolstering technological support to enhance monitoring, evaluation, and innovation in research and development. These eight measures are grounded on the primary tasks and regular patterns of prevention and treatment of chronic diseases. They are interconnected to ensure the fulfillment of the objectives of the Plan. Measures 1 to 4 represent comprehensive healthcare management with the control of risk factors, an early diagnosis and treatment, and standardized treatment. Although the health policy of prioritizing disease prevention and combining it with treatment is not exclusive to chronic diseases, certain distinctive characteristics of chronic diseases—such as their close connection with individual lifestyles and health behavior, the long-term accumulation of risk factors, their prolonged course, the difficulty in self-healing and curing, the development of severe complications and disability, and high mortality—not only pose greater challenges to the prevention and control task, but also render it feasible to adopt measures from diverse perspectives. Measures 5 to 8 add up to a concrete macro-strategy that assures the practicability of the first four measures. While chronic diseases are closely related to personal lifestyles, the choices of human behavior are influenced by multifarious social determinants including education, employment, and living environments. It is imperative that the Government creates a supportive environment for individuals and families to be able to make healthy choices. It should also rapidly expand the healthcare industry to meet the public's diverse service needs and endeavor to improve medical security measures to reduce the public's medical burden, as well as conducting dynamic monitoring and evaluation of public health conditions and policy implementation. Essentially, the core value of these eight measures is to focus on controlling the risk factors of chronic diseases and constructing a healthy supportive environment through health promotion and health management, for the purposes of improving national health quality, reducing the morbidity risk of high-risk groups, raising patients' quality of life, lowering incidence rates, mortality, and disability of preventable chronic diseases, transitioning from a treatment-based to a health-based orientation and promoting health throughout the entire life cycle.

Interpreting and implementing the plan in the context of constructing a “Healthy China”

The “Medium-to-Long Term Plan of China for the Prevention and Treatment of Chronic Diseases (2017–2025)” is the primary agenda in chronic disease prevention and treatment that has been issued since the release of the “Healthy China 2030 Planning Outline” by the CPC Central Committee and the State Council of the People's Republic of China. After reading through the Plan, we can clearly perceive that it corresponds perfectly with the key principle of the “Healthy China 2030 Planning Outline”—a comprehensive view on hygiene and health that focuses on prevention, prioritizes health, and places chronic disease prevention and treatment in the hands of the whole society for joint contribution and construction as well as shared outcomes. From this aspect, the Plan is both a realization and an extension of the “Healthy China 2030 Planning Outline,” bringing the issue of chronic diseases into sharper and more concrete focus. It also exerts an important guiding and cohesive effect on the prevention and treatment of chronic diseases over the next 10 years.

Under such circumstances, we must seize every opportunity and resolve to pursue innovation and improve our competencies to ensure the practicability of the policies. There are a few important abilities: the first is policy comprehension—integrating different knowledge for a thorough understanding; the second is policy implementation—learning how to promote health to the public; the third is policy transformation—formulating actual, viable work content and execution plans; the fourth is initiation of social actions—mobilizing various sectors to shoulder healthcare responsibility to the greatest extent. Only through these can we put the Plan into practice to achieve health outcomes and create a new pattern of health promotion.

Actualizing the global plan for chronic disease prevention and treatment with actions

In 2013, the 67th World Health Assembly endorsed the “Global Action Plan for the Prevention and Control of NCDs (2013–2020)” and the “Global Monitoring Framework on NCDs.” They are strategic documents issued by the World Health Organization (WHO) after the United Nations (UN) High-level Meeting on Non-Communicable Diseases in 2011, to direct the global effort in chronic disease prevention and control. The Action Plan has established six objectives: to raise the global priority accorded to the prevention and control of chronic diseases; to strengthen the national response for the prevention and control of NCDs; to reduce modifiable risk factors for NCDs and underlying social determinants by creating health-promoting environments; to reinforce and reorient health systems; to perform high-quality research; and to monitor and evaluate. The integrated monitoring framework has determined 25 global monitoring indicators across three main areas, including mortality and morbidity of chronic diseases, risk factors, and the responses of national health systems. The “Medium-to-Long Term Plan of China for the Prevention and Treatment of Chronic Diseases (2017–2025)” has aptly interpreted and adhered to the spirit of the “Global Action Plan for the Prevention and Control of NCDs (2013–2020),” while the work and indicative system established in the former have also taken into detailed consideration their cohesion with the “Global Monitoring Framework on NCDs.” Therefore, it is fair to say that China is actualizing the spirit of the UN High-level Meeting on Non-Communicable Diseases and the WHO's “Global Action Plan for the Prevention and Control of NCDs (2013–2020)” with concrete actions. This is a solemn pledge that the Chinese Government has given to the world since the improvement in the health standards of Chinese people, who constitute a large population, will undoubtedly affect the world significantly. Meanwhile, due to disproportionate economic development in China, the distinctive characteristics of different tasks across the country will offer the world diverse and valuable experiences.