健康中国行动有关情况 ——国务院新闻办公室2019年7月15日国务院政策例行吹风会材料

经党中央同意，国务院印发了《关于实施健康中国行动的意见》（以下简称《意见》），国务院办公厅印发了《关于印发健康中国行动组织实施和考核方案的通知》（以下简称《实施和考核方案》），国家层面成立健康中国行动推进委员会（以下简称推进委员会）并印发《健康中国行动（2019—2030年）》（以下简称《健康中国行动》）。

一、文件出台的意义

为积极有效应对当前突出健康问题，去年6月以来，国务院组建工作小组，卫生健康委牵头，会同教育部、体育总局等30多个部门专题研究人民群众健康需求，研究制定健康中国行动有关文件，突出体现习近平总书记强调的“把以治病为中心转变为以人民健康为中心”的思想，旨在推动转变理念，落实预防为主，加强疾病预防和健康促进，让每个人承担起自己健康的第一责任，动员各方共同参与，普及健康知识，加强早期干预，延长健康寿命。

一是贯彻落实党的十九大要求，推动实施健康中国战略的要求。人民健康是民族昌盛和国家富强的重要标志。党中央、国务院高度重视人民健康，2016年发布《“健康中国2030”规划纲要》（以下简称《规划纲要》），提出了健康中国建设的目标和任务。习近平总书记在党的十九大报告中提出实施健康中国战略，并多次强调要贯彻预防为主方针，坚持防治结合、联防联控、群防群控，努力为人民群众提供全生命周期的卫生与健康服务。李克强总理多次对实施健康中国战略提出明确要求，强调要针对健康影响因素，加大干预力度，抓好预防保健，并在2019年《政府工作报告》中对有关工作作出部署。孙春兰副总理多次专题研究，作出工作安排。

二是落实预防为主方针，统筹解决当前人民健康突出问题的要求。新中国成立特别是党的十八大以来，各有关部门通力合作，各地积极推进，我国卫生健康事业获得了长足发展，人民健康水平持续提高，居民主要健康指标总体已优于中高收入国家平均水平。2018年，我国人均预期寿命提高到77.0岁，婴儿死亡率下降到6.1‰，孕产妇死亡率下降到18.3/10万，主要健康危险因素得到初步控制。

但是也要看到人民健康还面临新的挑战，心脑血管疾病、癌症、慢性呼吸系统疾病、糖尿病等四类慢性病严重威害人民健康。随着工业化、城镇化、人口老龄化进程加快，我国居民生产生活方式和疾病谱不断发生变化。居民健康知识知晓率偏低，吸烟、酗酒、缺乏锻炼、不合理膳食等不健康生活方式比较普遍，由此引起的疾病问题日益突出。全国现有高血压患者2.7亿、脑卒中患者1300万、冠心病患者1100万；糖尿病患者超过9700万；慢阻肺患者近1亿；每年新发癌症病例约380万，总体癌症发病率平均每年上升3.9%左右。慢性非传染性疾病导致的死亡人数占总死亡人数的88%，导致的疾病负担占疾病总负担的70%以上。肝炎、结核病、艾滋病等重大传染病防控形势仍然严峻，精神卫生、职业健康、地方病等方面的问题不容忽视。此外，一些重点人群有着亟待解决的健康问题，如出生缺陷和儿童早期发展问题、中小学生的近视和肥胖问题、老年人的慢性病问题等。

三是顺应国际趋势，履行国际承诺的重大举措。从国际上看，聚焦一段时期内影响健康的重大疾病和突出问题，制订实施疾病预防和健康促进的中长期行动纲领，是国际社会的通行做法。美国政府已连续制订并实施了四个“国民健康”行动，日本政府陆续实施三次增进国民健康十年计划。从国际卫生与健康发展趋势看，健康已经处于人类发展的突出位置，既是国家软实力的重要组成部分，也是全球发展议程的重要内容。顺应国际趋势，积极参与全球健康发展新变革，发挥我国政治优势和制度优势，继承和发扬爱国卫生运动优良传统，需要实施新时期全民健康促进行动，向全世界展示健康促进的中国方案，为全球健康促进贡献中国智慧。

所以说实施健康中国行动，从当前讲是为人民谋幸福、谋健康，从长远讲就是为民族谋复兴。

二、文件主要内容

《意见》高度凝练了健康中国行动的核心内容，明确了健康中国行动的指导思想、基本原则和总体目标，从干预健康影响因素、维护全生命周期健康和防控重大疾病等三方面提出实施15项行动，并对组织实施做出部署。《健康中国行动》是《意见》中提出的15项行动的目标、指标、任务和职责分工的具体细化。

一是转变理念，全方位全周期保障人民健康。《意见》提出，健康中国行动坚持以人民为中心，坚持改革创新，贯彻新时代卫生与健康工作方针，强化政府、社会、个人责任，加快推动卫生健康工作理念、服务方式从以治病为中心转向以人民健康为中心，建立健全健康教育体系，普及健康知识，引导群众建立正确健康观，加强早期干预，形成有利于健康的生活方式、生态环境和社会环境，延长健康寿命，为全方位全周期保障人民健康、建设健康中国奠定坚实基础。

健康中国行动坚持“普及知识、提升素养，自主自律、健康生活，早期干预、完善服务，全民参与、共建共享”的基本原则，注重从源头预防和控制疾病，聚焦当前影响人民群众健康的主要问题和重点疾病，突出健康促进和动员倡导。

二是一以贯之，实施十年全民疾病预防和健康促进行动。《意见》是国家层面指导未来十余年疾病预防和健康促进的文件，分别提出了健康中国行动到2022年和2030年的总体目标。到2022年，健康促进政策体系基本建立，全民健康素养水平稳步提高，健康生活方式加快推广，重大慢性病发病率上升趋势得到遏制，重点传染病、严重精神障碍、地方病、职业病得到有效防控，致残和死亡风险逐步降低，重点人群健康状况显著改善。到2030年，全民健康素养水平大幅提升，健康生活方式基本普及，居民主要健康影响因素得到有效控制，因重大慢性病导致的过早死亡率明显降低，人均健康预期寿命得到较大提高，居民主要健康指标水平进入高收入国家行列，健康公平基本实现。

三是靶向施策，明确实施15项专项行动。《意见》从健康知识普及、合理膳食、全民健身、控烟、心理健康等方面综合施策，全方位干预健康影响因素；《意见》关注妇幼、中小学生、劳动者、老年人等重点人群，维护全生命周期健康；《意见》针对心脑血管疾病、癌症、慢性呼吸系统疾病、糖尿病四类慢性病以及传染病、地方病，加强重大疾病防控。有关专项行动也对残疾预防和康复服务、贫困地区居民健康促进提出了相关措施。

《健康中国行动》细化落实了15项专项行动，共提出124项主要指标。包括结果性指标（36个）、个人和社会倡导性指标（48个）、政府工作性指标（40个）。124项指标中，大部分指标（113个，91%）是预期性（48个）和倡导性（65个）的指标，约束性指标（11个）基本都纳入考核方案。在这些指标的选择和确定过程中，相关部门和地方及有关专家对指标的科学性、可行性都作了充分的研究和论证。

每项专项行动都有目标、有指标、有路径，不仅有政府的具体任务，还有对社会和公众的健康建议，把健康中国战略的理念和要求融入到人民群众日常生产生活的方方面面，为实现从“以治病为中心”转向“以健康为中心”提供了有效抓手。通过政府、社会、家庭、个人的共同努力，努力促进人民群众不生病、少生病，延长健康寿命，提高生活质量。

三、文件的贯彻落实

为确保《意见》和《健康中国行动》有效实施，国务院办公厅同步印发了《实施和考核方案》，从建立健全组织架构、加强监测评估、做好考核工作三个方面提出了具体要求。国家层面依托全国爱国卫生运动委员会成立推进委员会及其组织架构和工作机制，明确了监测和考核的主体、内容和结果运用，确保健康中国行动高效有序推进落实。

一是建立健全组织架构。依托全国爱国卫生运动委员会，成立推进委员会。负责制定印发《健康中国行动》，统筹推进组织实施、监测和考核相关工作。推进委员会主任由国务院分管领导同志担任，推进委员会办公室设在国家卫生健康委，推进委员会设立专家咨询委员会，下设各专项行动工作组。并要求各有关部门要积极研究实施健康中国战略的重大问题，及时制定并落实《健康中国行动》的具体政策措施，提出年度任务建议并按照部署抓好工作落实，做好《健康中国行动》的宣传解读。

二是要加强监测评估。监测评估工作由推进委员会统筹领导，各专项行动工作组负责具体组织实施，以现有统计数据为基础，依托互联网和大数据，对主要指标、重点任务的实施进度进行监测。推进委员会办公室组织形成总体监测评估报告，经推进委员会同意后上报国务院，适时发布监测评估报告。

三是要做好考核工作。考核工作由推进委员会统筹领导，推进委员会办公室负责具体组织实施，专家咨询委员会提供技术支撑。围绕健康中国建设主要目标任务要求，建立相对稳定的考核指标框架。将主要健康指标纳入各级党委、政府绩效考核指标，综合考核结果经推进委员会审定后通报，作为各省（区、市）、各相关部门党政领导班子和领导干部综合考核评价、干部奖惩使用的重要参考。

健康中国行动在建国70周年的重要时间节点启动，是一个为期十余年的中长期行动，持续推动以治病为中心转变为以健康为中心，全面落实《规划纲要》中预防和健康促进有关的重点任务。如果说《规划纲要》是实施健康中国战略的纲领，那么《意见》和《健康中国行动》则分别是实施健康中国战略的“路线图”和“施工图”。

实施好健康中国行动，将进一步释放健康红利，促进经济社会协调发展，为全面建成小康社会和建设社会主义现代化国家奠定更坚实的健康基础。下一步，我们将认真贯彻落实党中央、国务院决策部署，指导各地结合实际及时制定实施方案，细化各专项行动工作举措，并加强督导检查和跟踪分析，持之以恒，久久为功，推进健康中国建设，努力使群众不生病、少生病，共建共享健康生活。

Briefing on the Healthy China Action

（Jul. 2019）

National Health Commission of the PRC

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.