Learning from China’s public health policies

China’s public health planning holds useful insights for health policymakers around the world as they prepare for a post-pandemic world, Henry Kwan writes.

On 11 March 2021, the Chinese Government ratified the Outline of the 14th Five-Year Plan (2021-25) for National Economic and Social Development and Long-term Objectives Through 2035 – commonly known as the 14th Five-Year Plan.

It is the country’s primary overarching policy framework and covers all areas of development for the period of 2021 to 2025.

Notably, the Plan contains a number of public health measures. As the COVID-19 pandemic has made clear, public health is an international matter, so not only do these measures seek to benefit China, but they also matter significantly to other countries.

The Plan itself is not yet officially available in English, and existing English-language news briefings currently focus on the plan’s economic or environmental policies and impacts, but these public health announcements shouldn’t be forgotten, as they illustrate China’s determination to strengthen the public health system and impact global public health policy-making.

There are two key things leaders can take away from the Chinese approach in the Plan. First is that the focus of modern public health policy should be not only on the national level, but also on the transnational level, especially in a post-pandemic world where the globally interconnected nature of public health has been made clear.

More on this: How a ‘new normal’ can create a better, healthier future

One way the Plan will do this is by strengthening public health and epidemiological cooperation with Belt and Road countries. This will be also cultivated by the implementation of digital technology designed to assist the public health system.

Getting this right means facilitating the exchange and sharing of information both nationally and internationally and shows that China recognises the transnational nature of public health issues. It may also indicate that it is keen to establish closer connections and collaborate with other countries, something policymakers can and should get on board with.

Second, it is crucial for policymakers to focus on both small- and large-scale aspects of public health policy, especially at the national level. In other words, focused improvement measures should be spread throughout the whole system, not just large-scale change.

The Plan follows this logic, with measures that range from large-scale work, such as risk assessment, prevention and control, the training of public health specialists, to small-scale ones projects, like focusing on hygiene education or the promotion of a healthy lifestyle.

More on this: How China has been working through its population problems

Something else policymakers can look to is the investment in public health training and research centres in the Plan. It specifies a target of creating 15 new public health centres at the provincial level and 20 centres for disease prevention and control at the national level.

Setting such goals ensures valuable resources are directed to public health and other governments should follow suit.

The Plan also highlights the importance of promoting good hygiene practices and replacing certain customary practices at the day-to-day level. A good example of this is the Plan’s promotion of the use of serving utensils, usually in the form of an extra pair of chopsticks designated solely for distributing food.

Before the pandemic, it had been common practice to share food communally with personal utensils. This cultural practice – communal dipping – is also common in a number of Asian countries, such as South Korea. While such choices may seem small, simple steps like these can have a large cumulative impact, and policymakers in other countries should look at ways their own governments can make similar changes.

Finally, and crucially, the Plan outlines a promising an increasing emphasis on preventative medicine. For example, it contains plans to discourage unhealthy habits, such as excessive smoking and drinking.

Health is more on the public’s mind than ever, and in coming years governments across the region will be drawing up their own public health policy documents.

When they do so, some of the measures in the 14^th Five Year Plan may provide a useful framework that emphasises both domestic and global public health, and combine large-scale transformation with small-scale behavioural change in the community.