China’s Response to NCDs

1. China’s Response to NCDs Dr. Xiaoming Shi, M.D.,MPh. Director, Division of NCDs Control and Community Health, China CDC

2. Behaviral Risk Factors of NCDs Behavioral Risk Factors of NCDs among 18-year-old and above 80.9% 83.4% 52.8% 47.0% 17.4% 11.9% Proportion of consuming <400 g F & V Proportion of consuming salt>5 g per day Proportion of consuming oil >25 g per day Proportion of alcohol overconsumption proportion of doing PA regularly Male current daily smoking rate Doing physical activity regularly: doing recreational physical activity at least 3 times a week, and at least 10 minutes per time. Source：2010 PRC BRFSS

3. Populations with physiological RFs 305 million 236 million 120 million 96.8 million 32.9 million Overweight Obesity Hypertension Raised cholesterol Diabetes Source：2010 China Annual Cardiovascular Report（Hypertension）; 2010 PRC BRFSS （Overweight、Obesity、Raised cholesterol、Diabetes）.

4. Proportions of NCDs deaths

5. NCDs Prevention and Control System: Within health sectors

6. Main achievements • Government Commitment to NCDs • 5th Plenary Session, 17th National People’s Congress • Strive for securing and improving people’s living • Promote equal access to essential public health services • 12th Five Year Plan • Increase the average life expectance by 1 year within the next 5 years. • Policy formulation • China is implementing the FCTC, and Harbin passed the law on public place smoking ban which meets the FCTC requirements. • China is implementing the Regulation on Physical Fitness formulated by the State Council. • China is implementing the Ban on Smoking in Public Places

7. Health Care Reform Provides Policy and Financial Support for NCDs Coverage of Basic Health Insurance System 31.3US$ 3.1US$ Health insurance schemes coverage NRCMS Essential Medicine Policy Public Health Services Programs lowering down the price of common essential drugs by 30 to 40 percent Essential public health services programs: 3.9US$ per person Priority public health services (NCDs）investment 780 000 US$ 38.5 Million US$

8. Healthy Cities Ten Year Action Plan for Health Promotion（public access to exercise facilities, free hypertension screening at pharmacies Kelamayi Changchun Government takes leadership Tangshan Health education, services, food, physical and cultural activities/entertainment, environment, so-called 5 health related engineering Beijing Dalian Shandong Multisectors collaboration Zhangjiagang Suzhou Shanghai Chengdu Evidence-based approach Chongqing Hangzhou Panzhihua Yichun Community-based activities Guangzhou Peer education Healthy CQ, SH, GZ, CD, SZ and PZH, etc. Whole society participation

9. The 12th-Plan on Healthy Beijing • Government commitment • Healthy Beijing as a new strategy and new action of the capital city development • Health perspective of developing public policy • view point of health promotion, Health in all policies (HiAP) • Establishing the mechanisms of health impact evaluation • To evaluate potential health effects and risks of major capital construction projects, public policy, legislation • Developing 35 health-promoting core evaluation indexes including social, economic, environmental, urban safety • Focusing on controlling the social impact factors of health: noise, pollution, sewage, garbage, road traffic and accidents in production

10. Demonstrational Sites for Integrated NCDs Prevention and Control Most importantly, local government takes the leadership; multisectors gets involved. Implementing comprehensive prevention-oriented services, to promote healthy lifestyles Collect and disseminate best practices At the first phase, central government supported 46 counties/districts,

11. 0%~9% 10%~29% 30%~49% 50%~100% Healthy Lifestyles for All Initiative All the provinces in China launched. Covered 39.9% of counties/districts across China Up to date Over 3500 Model communities/workplaces were implemented Over 1000 Supportive physical environment were implemented “Health Gas Station" was implemented in some province.

12. Shandong Salt Reduction and Hypertension Control Program(2011-2015)

13. Hypertension and Diabetes management has been included in Essential Public Heath Services. Hypertension and Diabetes Management Hypertension Diabetes 42 million 35.5 million 14.8 million 10.8million 9.2 million 4.6 million

14. Incremental Progress g/day Chinese Dietary Guideline Recommended Intake (6g) Urban area Rural area (Year) Salt intake for each person per day Data source: Nutritional Survey; PRC BRFSS

15. Incremental Progress Current smoking rates among Chinese aged 15- to- 69 year-olds Male FemaleUrban Area Rural Area (Year) Source: Yang Gonghuan, Hu Angang. “Tobacco Control and Future of China”

16. Although China has done a lot of work, we still have many difficulties in winning this battle. We need to learn from other countries. Uneven distribution of health resources Imperfect health information system Weak capacities of health workforce Insufficient basic health facilities Inadequate financial resources for NCDs Uncoordinated response to NCDs Challenges of NCDs Prevention and Control Faced by China

17. Next steps • National Strategy on NCDs Control and Prevention • Involved 15 ministries, to be issued in June 2012 • National Action Plan on specific NCDs includingCVDs, diabetes, Cancers, COPD and Risk Factors • Monitoring and Evaluation • National Surveillance Framework and its implementation • Monitoring diseases, risk factors and social determinants • Implementing National Surveillance, Intervention, Management, Health Promotion Programs • Advocate political will and establish efficient multi-sector collaboration mechanism • Promote legislation on tobacco ban in Public Places at national, provincial and city level • Mobilize food production and processing company

18. Thanks！