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健康中國行動有關情況 ——國務院新聞辦公室2019年7月15日國務院政策例行吹風會材料

2019-07-16 10:11:12

經黨中央同意,國務院印發了《關于實施健康中國行動的意見》(以下簡稱《意見》),國務院辦公廳印發了《關于印發健康中國行動組織實施和考核方案的通知》(以下簡稱《實施和考核方案》),國家層面成立健康中國行動推進委員會(以下簡稱推進委員會)并印發《健康中國行動(20192030年)》(以下簡稱《健康中國行動》)。

一、文件出臺的意義

為積極有效應對當前突出健康問題,去年6月以來,國務院組建工作小組,衛生健康委牽頭,會同教育部、體育總局等30多個部門專題研究人民群眾健康需求,研究制定健康中國行動有關文件,突出體現習近平總書記強調的“把以治病為中心轉變為以人民健康為中心”的思想,旨在推動轉變理念,落實預防為主,加強疾病預防和健康促進,讓每個人承擔起自己健康的第一責任,動員各方共同參與,普及健康知識,加強早期干預,延長健康壽命。

一是貫徹落實黨的十九大要求,推動實施健康中國戰略的要求。人民健康是民族昌盛和國家富強的重要標志。黨中央、國務院高度重視人民健康,2016年發布《“健康中國2030”規劃綱要》(以下簡稱《規劃綱要》),提出了健康中國建設的目標和任務。習近平總書記在黨的十九大報告中提出實施健康中國戰略,并多次強調要貫徹預防為主方針,堅持防治結合、聯防聯控、群防群控,努力為人民群眾提供全生命周期的衛生與健康服務。李克強總理多次對實施健康中國戰略提出明確要求,強調要針對健康影響因素,加大干預力度,抓好預防保健,并在2019年《政府工作報告》中對有關工作作出部署。孫春蘭副總理多次專題研究,作出工作安排。

二是落實預防為主方針,統籌解決當前人民健康突出問題的要求。新中國成立特別是黨的十八大以來,各有關部門通力合作,各地積極推進,我國衛生健康事業獲得了長足發展,人民健康水平持續提高,居民主要健康指標總體已優于中高收入國家平均水平。2018年,我國人均預期壽命提高到77.0歲,嬰兒死亡率下降到6.1‰,孕產婦死亡率下降到18.3/10萬,主要健康危險因素得到初步控制。

但是也要看到人民健康還面臨新的挑戰,心腦血管疾病、癌癥、慢性呼吸系統疾病、糖尿病等四類慢性病嚴重威害人民健康。隨著工業化、城鎮化、人口老齡化進程加快,我國居民生產生活方式和疾病譜不斷發生變化。居民健康知識知曉率偏低,吸煙、酗酒、缺乏鍛煉、不合理膳食等不健康生活方式比較普遍,由此引起的疾病問題日益突出。全國現有高血壓患者2.7億、腦卒中患者1300萬、冠心病患者1100萬;糖尿病患者超過9700萬;慢阻肺患者近1億;每年新發癌癥病例約380萬,總體癌癥發病率平均每年上升3.9%左右。慢性非傳染性疾病導致的死亡人數占總死亡人數的88%,導致的疾病負擔占疾病總負擔的70%以上。肝炎、結核病、艾滋病等重大傳染病防控形勢仍然嚴峻,精神衛生、職業健康、地方病等方面的問題不容忽視。此外,一些重點人群有著亟待解決的健康問題,如出生缺陷和兒童早期發展問題、中小學生的近視和肥胖問題、老年人的慢性病問題等。

三是順應國際趨勢,履行國際承諾的重大舉措。從國際上看,聚焦一段時期內影響健康的重大疾病和突出問題,制訂實施疾病預防和健康促進的中長期行動綱領,是國際社會的通行做法。美國政府已連續制訂并實施了四個“國民健康”行動,日本政府陸續實施三次增進國民健康十年計劃。從國際衛生與健康發展趨勢看,健康已經處于人類發展的突出位置,既是國家軟實力的重要組成部分,也是全球發展議程的重要內容。順應國際趨勢,積極參與全球健康發展新變革,發揮我國政治優勢和制度優勢,繼承和發揚愛國衛生運動優良傳統,需要實施新時期全民健康促進行動,向全世界展示健康促進的中國方案,為全球健康促進貢獻中國智慧。

所以說實施健康中國行動,從當前講是為人民謀幸福、謀健康,從長遠講就是為民族謀復興。

二、文件主要內容

《意見》高度凝練了健康中國行動的核心內容,明確了健康中國行動的指導思想、基本原則和總體目標,從干預健康影響因素、維護全生命周期健康和防控重大疾病等三方面提出實施15項行動,并對組織實施做出部署。《健康中國行動》是《意見》中提出的15項行動的目標、指標、任務和職責分工的具體細化。

一是轉變理念,全方位全周期保障人民健康。《意見》提出,健康中國行動堅持以人民為中心,堅持改革創新,貫徹新時代衛生與健康工作方針,強化政府、社會、個人責任,加快推動衛生健康工作理念、服務方式從以治病為中心轉向以人民健康為中心,建立健全健康教育體系,普及健康知識,引導群眾建立正確健康觀,加強早期干預,形成有利于健康的生活方式、生態環境和社會環境,延長健康壽命,為全方位全周期保障人民健康、建設健康中國奠定堅實基礎。

健康中國行動堅持“普及知識、提升素養,自主自律、健康生活,早期干預、完善服務,全民參與、共建共享”的基本原則,注重從源頭預防和控制疾病,聚焦當前影響人民群眾健康的主要問題和重點疾病,突出健康促進和動員倡導。

二是一以貫之,實施十年全民疾病預防和健康促進行動。《意見》是國家層面指導未來十余年疾病預防和健康促進的文件,分別提出了健康中國行動到2022年和2030年的總體目標。到2022年,健康促進政策體系基本建立,全民健康素養水平穩步提高,健康生活方式加快推廣,重大慢性病發病率上升趨勢得到遏制,重點傳染病、嚴重精神障礙、地方病、職業病得到有效防控,致殘和死亡風險逐步降低,重點人群健康狀況顯著改善。到2030年,全民健康素養水平大幅提升,健康生活方式基本普及,居民主要健康影響因素得到有效控制,因重大慢性病導致的過早死亡率明顯降低,人均健康預期壽命得到較大提高,居民主要健康指標水平進入高收入國家行列,健康公平基本實現。

三是靶向施策,明確實施15項專項行動。《意見》從健康知識普及、合理膳食、全民健身、控煙、心理健康等方面綜合施策,全方位干預健康影響因素;《意見》關注婦幼、中小學生、勞動者、老年人等重點人群,維護全生命周期健康;《意見》針對心腦血管疾病、癌癥、慢性呼吸系統疾病、糖尿病四類慢性病以及傳染病、地方病,加強重大疾病防控。有關專項行動也對殘疾預防和康復服務、貧困地區居民健康促進提出了相關措施。

《健康中國行動》細化落實了15項專項行動,共提出124項主要指標。包括結果性指標(36個)、個人和社會倡導性指標(48個)、政府工作性指標(40個)。124項指標中,大部分指標(113個,91%)是預期性(48個)和倡導性(65個)的指標,約束性指標(11個)基本都納入考核方案。在這些指標的選擇和確定過程中,相關部門和地方及有關專家對指標的科學性、可行性都作了充分的研究和論證。

每項專項行動都有目標、有指標、有路徑,不僅有政府的具體任務,還有對社會和公眾的健康建議,把健康中國戰略的理念和要求融入到人民群眾日常生產生活的方方面面,為實現從“以治病為中心”轉向“以健康為中心”提供了有效抓手。通過政府、社會、家庭、個人的共同努力,努力促進人民群眾不生病、少生病,延長健康壽命,提高生活質量。

三、文件的貫徹落實

為確保《意見》和《健康中國行動》有效實施,國務院辦公廳同步印發了《實施和考核方案》,從建立健全組織架構、加強監測評估、做好考核工作三個方面提出了具體要求。國家層面依托全國愛國衛生運動委員會成立推進委員會及其組織架構和工作機制,明確了監測和考核的主體、內容和結果運用,確保健康中國行動高效有序推進落實。

一是建立健全組織架構。依托全國愛國衛生運動委員會,成立推進委員會。負責制定印發《健康中國行動》,統籌推進組織實施、監測和考核相關工作。推進委員會主任由國務院分管領導同志擔任,推進委員會辦公室設在國家衛生健康委,推進委員會設立專家咨詢委員會,下設各專項行動工作組。并要求各有關部門要積極研究實施健康中國戰略的重大問題,及時制定并落實《健康中國行動》的具體政策措施,提出年度任務建議并按照部署抓好工作落實,做好《健康中國行動》的宣傳解讀。

二是要加強監測評估。監測評估工作由推進委員會統籌領導,各專項行動工作組負責具體組織實施,以現有統計數據為基礎,依托互聯網和大數據,對主要指標、重點任務的實施進度進行監測。推進委員會辦公室組織形成總體監測評估報告,經推進委員會同意后上報國務院,適時發布監測評估報告。

三是要做好考核工作。考核工作由推進委員會統籌領導,推進委員會辦公室負責具體組織實施,專家咨詢委員會提供技術支撐。圍繞健康中國建設主要目標任務要求,建立相對穩定的考核指標框架。將主要健康指標納入各級黨委、政府績效考核指標,綜合考核結果經推進委員會審定后通報,作為各省(區、市)、各相關部門黨政領導班子和領導干部綜合考核評價、干部獎懲使用的重要參考。

健康中國行動在建國70周年的重要時間節點啟動,是一個為期十余年的中長期行動,持續推動以治病為中心轉變為以健康為中心,全面落實《規劃綱要》中預防和健康促進有關的重點任務。如果說《規劃綱要》是實施健康中國戰略的綱領,那么《意見》和《健康中國行動》則分別是實施健康中國戰略的“路線圖”和“施工圖”。

實施好健康中國行動,將進一步釋放健康紅利,促進經濟社會協調發展,為全面建成小康社會和建設社會主義現代化國家奠定更堅實的健康基礎。下一步,我們將認真貫徹落實黨中央、國務院決策部署,指導各地結合實際及時制定實施方案,細化各專項行動工作舉措,并加強督導檢查和跟蹤分析,持之以恒,久久為功,推進健康中國建設,努力使群眾不生病、少生病,共建共享健康生活。

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Briefing on the Healthy China Action


Jul. 2019

National Health Commission of the PRC

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With the approval of the Central Committee of the Communist Party of China (CPC), the State Council issued the Opinions on Implementing Healthy China Action(hereinafter referred to as the “Opinions”), and the General Office of the State Council issued the Notice on Printing and Distributing the Plan for Organizing, Implementing and Assessing the Healthy China Action (hereinafter referred to as the “Implementation and Assessment Plan”). The Healthy China Promotion Committee (hereinafter referred to as the “Promotion Committee”)was established at the national level and The Healthy China Action (2019-2030) (hereinafter referred to as the “Healthy China Action”) was issued. We refer to these three documents collectively as documents related to the Healthy China Action.Next, I would like to give you a brief introduction to the three documents mentioned above.

I.?Significance of the Documents

A healthy population is a key symbol of a prosperous nation. Prevention is the most economic and effective measure to maintain people’s health. The CPC Central Committee and the State Council attach great importance to the people’s health. In 2016, the State Council issued the “Healthy China 2030” Planning Outline, which put forward the goals and tasks of building a healthy China. General Secretary Xi Jinping formally put forward to build a healthy China in the report of the 19th National Congress of the CPC, and reiterated that we should carry out the policy of putting prevention first, combing the prevention with treatment together, enforcing holistic measures with full participation and collaboration of all society and at all levels, and ensure the delivery of comprehensive lifecycle health services for all people.

Premier Li Keqiang has made several specific instructions for building healthy China, emphasizing the importance of strengthening intervention and prevention as well as health care tailored to health determinants, and relevant work has been deployed in the Government Work Report 2019. Vice Premier Sun Chunlan has made a number of targeted studies and work arrangements.

Since the founding of the People’s Republic of China, especially the 18th National Congress of the CPC, China’s health services have made profound progress thanks to the concerted efforts made by all relevant ministries and actively pushed forward by local governments. People’s health has been continuously improved, the main health indicators of Chinese people are generally better than the average level of middle- and high-income countries. In 2018, China’s life expectancy was 77.0 years, with an increase of 0.3 years from 76.7 years in 2017, the infant mortality rate dropped to 6.1‰, the maternal mortality rate dropped to 18.3/100,000, and the major health-related risk factors were initially controlled.

However, we also recognize that we’re still facing new challenges regarding to people’s health, which is seriously threatened by five chronic diseases currently. With the acceleration of industrialization, urbanization and population aging, the lifestyle and disease spectrum of Chinese residents are changing constantly. The health literacy level of residents is low, with the unhealthy lifestyles such as smoking, excessive drinking, lack of exercise, unbalanced diet etc., resulting in increasing health problems. In China, there are 270 million hypertensive patients; 13 million stroke patients and 11 million coronary heart disease patients; more than 97 million diabetic patients; nearly 100 million chronic obstructive pulmonary disease patients; about 3.8 million new cancer cases each year, with an annual increase of 3.9%. Chronic non-communicable diseases including cardiovascular and cerebrovascular diseases, cancer, chronic respiratory diseases, diabetes among others account for 88% of the total deaths and more than 70% of the total disease burden. The prevention and control of major infectious diseases such as hepatitis, tuberculosis and HIV/AIDS is still at severe situation. Mental health, occupational health and endemic diseases cannot be ignored. In addition, some health problems or related issues among those vulnerable populations need to be solved urgently, such as birth defects, myopia and obesity among primary and secondary school students, early childhood development, as well as chronic diseases in the elderly.

In order to effectively address the health challenges, the State Council set up a working group in 2018 led by the National Health Commission in collaboration with over 30 government agencies, including the Ministry of Education and the General Administration of Sport, carried out studies in collaboration on health needs of the public and formulated documents relating to the Healthy China Action. These efforts have highlighted President Xi’s thoughts of shifting the priority of health services from treatment to people’s health and are expected to change people’s concepts, make prevention a priority, and strengthen disease prevention and health promotion. While every individual is encouraged to take primary responsibility for his/her own health, the government should mobilize all stakeholders to disseminate health knowledge, strengthen primary intervention programs so as to increase people’s healthy life expectancy. These measures will help people in accessing affordable medical care.

At present, the CPC theme education of "Remain true to original aspiration and keep the mission firmly in mind" is being carried out. In this view, the implementation of the Healthy China Action will make the people live a healthy and happy life, and will contribute to achieving the goal of national rejuvenation.

II. Main Contents of the Documents

Changing concepts and safeguarding comprehensive lifecycle health of the public. The Opinionsput forward that the Healthy China Action should adhere to people-centered approach, insist on reform and innovation, carry out the guiding principles of medical and health work in the new era, strengthen responsibilities of government, society and individuals, accelerate the shift of the concept and service mode of health service from the treatment-centered to the people’s health-centered, and develop and improve health education system, popularize health knowledge, guide the people to form a correct concept of health, strengthen primary intervention, establish healthy lifestyles, ecological environment and social environment in order to prolong healthy lifespan and lay a solid foundation for building a healthy China in an effort to maintain people’s all-round health during full life cycle.

The Healthy China Action adheres to the basic principles of “popularizing knowledge, improving health literacy; keeping self-discipline, advocating healthy life styles; strengthening primary intervention, improving service; involving all people, sharing the benefit through collaborative building”. The action emphasizes preventing and controlling diseases from the beginning, focusing on the main problems and key diseases affecting people’s health with a highlight of health promotion advocacy and mobilization.

Consistently implementing a 10-year national disease prevention and health promotion programmes. The Opinions is a document guiding disease prevention and health promotion at the national level for the next ten years. It sets out the overall goals for the Healthy China Action by 2022 and 2030 respectively. By 2022, the health promotion policy system will be basically established; the health literacy level of the whole people will be steadily improved; the healthy lifestyles will be promoted rapidly; the rising trend of the incidence of major chronic diseases will be curbed; the key infectious diseases, serious mental disorders, endemic diseases and occupational diseases will be effectively prevented and controlled, with a gradual reduction of disability and death caused by these diseases. The health status of the key population groups will be improved significantly. By 2030, the health literacy level of the whole people will be greatly improved; the healthy lifestyle will be basically popularized; the main health determinants will be effectively controlled; the premature mortality rate caused by major chronic diseases will be significantly reduced; the average healthy life expectancy will be greatly improved, and the level of the main health indicators of residents will meet the level of high-income countries, and health equity will be basically realized.

Taking targeted measures and implementing 15 specific programmes. The Opinionsprovides a holistic solution on improving health awareness level, balanced diet, physical activities, smoking control, mental health and other aspects, and addresses health determinants in an all-round way; it focuses on key vulnerable populations such as women and children, primary and secondary school students, laborers, and the elderly, and maintaining of the health during the full life cycle; the Opinions strengthens the prevention and control of four major chronic diseases including cardiovascular and cerebrovascular diseases, cancer, chronic respiratory diseases, diabetes as well as other important diseases such as infectious diseases and endemic diseases. Specific programmes were also proposed with measures for disability prevention and rehabilitation services and health promotion of residents in poor areas.

The Healthy China Action specifies the implementation of 15 specific programmes and a total of 124 main indicators were proposed, including outcome indicators (36), individual and social recommendable indicators (48), and government performance indicators (40). Among the 124 indicators, most of them (113 accounting for 91%) are predictive (48) and recommendable (65), and 11 indicators are compulsive. In the process of selecting and determining these indicators, the scientificity and feasibility of the indicators have been fully studied and demonstrated by relevant authorities and experts.

Every programme specifies its goals, indicators and approaches for implementation. Specific tasks have been assigned for the government along with health advices proposed to all society and the public. The programmes integrate the concept and requirements of healthy China into all aspects of people’s daily work and life, and provide effective approaches to transform the health priority from “treatment-centered” to “health-centered”. All those programmes will be implemented through collaborative efforts of the government, society, families and individuals, striving to prevent people from sickness and less onset of disease, as a result, to prolong their healthy lifespan and improve their quality of life.

III.?Ensuring the Implementation of the Action

In order to ensure the effective implementation of the Opinions and the Healthy China Action, the General Office of the State Council has issued the Implementation and Assessment Plan at the same time, which put forward specific requirements from three aspects: establishing and improving the organizational structure, strengthening monitoring and evaluation, and completing regular assessments. The plan defines to set up the Promotion Committee with a specific organizational structure and working mechanism established relying on the National Patriotic Health Campaign Committee at the national level. Furthermore, it defines the roles of organizations responsible for monitoring and evaluation, data collection and results application in order to ensure the Healthy China Action being implemented efficiently and orderly.

First of all, the organizational structure has been developed. Relying on the National Patriotic Health Campaign Committee, the?? Promotion Committee has been established responsible for formulating and issuing the Healthy China Action, coordinating and enforcing the implementation, monitoring, assessment and other related work. The vice premier of the State Council responsible for health cause was appointed as the head of the Promotion Committee. The Office of the Promotion Committee was established in the National Health Commission, and an Advisory Committee of Experts along with multiple working groups (corresponding to 15 specific programmes) were also created under the Promotion Committee. The document also calls on relevant ministries to actively study the major issues related to building healthy China, formulate and implement specific policies and measures in a timely manner, put forward annual task proposals and implement them in accordance with the general deployment, and properly publicize and interpret the contents of the Healthy China Action.

The second is to strengthen monitoring and evaluation, which is under the overall leadership of the Promotion Committee. Each working group is responsible for organizing and implementing specific programme. Based on existing statistical data, relying on internet and big data, the progress of implementation regarding key indicators and main tasks will be monitored. The Office of the Promotion Committee will develop an overall monitoring and evaluation reports to be submitted to the State Council, thereafter to release them in due time.

The third is to complete regular assessments. The Office of the Promotion Committee is responsible for organizing and implementing assessment under overall leadership of the Promotion Committee, with technical support from the Advisory Committee of Experts. A relatively stable framework of assessment indicators has been established focusing on the main objectives and tasks of building a healthy China. Major health indicators will be included in the performance appraisal of the Party committees and governments at all levels. The results of comprehensive appraisal will be notified after the approval of the Promotion Committee. It will serve as an important reference for the comprehensive appraisal and evaluation of senior management and leading cadres in the Party committee and governments in all provinces (autonomous regions, municipalities) and relevant departments, and also as reference for rewards and punishments.

The Healthy China Action is launched at? important time of the 70th anniversary of the founding of the People’s Republic of China. It is a medium- and long-term action for more than ten years. As a result, it will continue to promote the priority shift from treatment-centered to health-centered, and comprehensively put forward to the accomplishment of the key tasks related to prevention and health promotion in the “Healthy China 2030” Planning Outline. If the “Healthy China 2030” Planning Outline is regarded the guiding principle for building healthy China, the Opinions and the Healthy China Action will serve as the “road map” and “construction drawing” respectively.

Implementation of the Healthy China Action will further release the health dividend, promote coordinated development of economy and society, and lay a solid health foundation for building an affluent society in all respects and a modern socialist country. Next, we will conscientiously implement the decisions and deployments of the CPC Central Committee and the State Council, support local governments to formulate implementation plans in a timely manner tailored to their actual conditions, refine specific action measures, strengthen monitoring, inspection and tracking the results, persist on the efforts persistently to push on the building of a healthy China, and eventually to prevent people from sickness and less onset of disease in a way to share a healthy life through full participation.


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