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Lessons Learnt on Public Health
China should attach more importance to its public health care system, the weaknesses of which were highlighted by the outbreak of the severe acute respiratory syndrome (SARS), experts from various circles said on Monday.

The area is not just the domain of the health department, said Hu Yonghua, director of the Institute of Public Health at Peking University and the man responsible for forming a research team to investigate the mysterious SARS virus.

Hu said the team aims to analyze the lessons drawn from the perspective of China's public health care system as a result of the onslaught of the disease.

"This is the first time this infectious disease has broken out and we know nothing about its causative agent and transmission method or the susceptible population," he said.

Another expert, Hu Linlin, a researcher on China's national situation at the prestigious Tsinghua University, said the government should be responsible for epidemic control and prevention.

According to Cai Renhua, director of the National Health Economics Institute under the Ministry of Health, the proportion of money or resources allocated to public health in the national budget has decreased year by year although the actual amount of the fund has risen in the last decade.

This has resulted in the absence of an emergency mechanism in the country's public health care system, he said.

Statistics from the Ministry of Health show that China spent 5.3 per cent of its gross domestic product (GDP) on sanitation and the medical sector in 2000, slightly higher than the floor of 5 per cent set by the World Health Organization (WHO), but much lower than that of developed countries.

The shortage of funds in this area has limited the development of basic health care services for all citizens, said Hu Linlin.

This same criticism was made by the WHO representative in China, Henk Bekedam, who said, following the SARS breakout, that China's investment in its public health care system had long been inadequate.

To combat SARS, the Chinese Government has adopted a series of emergency measures, partly in response to the criticism and suggestions. These include the allocation of 2 billion yuan (US$242 million) to set up a special fund for SARS treatment.

The State Council, China's cabinet, decided to establish a mechanism for emergency public health care and within the year a disease prevention and control network at provincial, city and county levels nationwide will be in place. Some 3.5 billion yuan (US$423 million) from the central budget will be used to finance these projects.

Analyst Hu Angang has suggested that government at all levels should increase spending on public health, with a special focus on the vast rural areas and sanitation agencies which operate at the grass roots level.

Cai Renhua highlighted the importance of disease prevention, saying "good prevention is better than the huge costs of a more serious situation." Hu Yonghua also emphasized the authority of the disease prevention and control agencies.

Analysts here said the suggestions of experts, coupled with government's measures, indicate that improvement of the public health care system has become a priority for policy-makers.

Bekedam said that with concerted and ongoing efforts, China's public health care system will be capable of handling the challenges in this field in about three to four years.

(China Daily May 7, 2003)

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Improving Rural Health
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