中国的医疗卫生事业
Medical and Health Services in China
中华人民共和国国务院新闻办公室
Information Office of the State Council, the People’s Republic of China
2012年12月
December 2012, Beijing
目录
Contents
前言
Foreword
一、卫生基本状况
I. Basic Conditions
二、医药卫生体制改革
II. Reform of Medical and Healthcare Systems
三、传染病防治与卫生应急
III. Infectious Disease Prevention and Treatment, and Health Emergency Management
四、慢性非传染性疾病防治
IV. Prevention and Treatment of Chronic Non-communicable Disorders
五、妇女儿童健康权益保护
V. Protecting Women and Children’s Right to Health
六、中医药发展
VI. Development of Traditional Chinese Medicine
七、卫生国际合作
VII. International Medical and Healthcare Cooperation
结束语
Conclusion
前言
Foreword
新浪微博@高斋翻译TransElegant的翻译讲解：
健康是促进人的全面发展的必然要求。提高人民健康水平，实现病有所医的理想，是人类社会的共同追求。在中国这个有着13亿多人口的发展中大国，医疗卫生关系亿万人民健康，是一个重大民生问题。
Good health is a prerequisite for the all-round development of humans/a person. It is a common pursuit/aspiration of human societies to improve people’s health and ensure their right to medical care. For/In China, a large developing country, health care is of vital importance to its population of over 1.3 billion, and is a major issue concerning its people’s well-being.
新浪微博@高斋翻译TransElegant的翻译讲解：
For/In China, a large developing country, Health care has a bearing on the health of its population of over 1.3 billion, and is a major issue concerning its people’s well-being.
欠佳译文：
For China, a large developing country, Health care is of vital importance to its population of over 1.3 billion, and is a major livelihood issue.
淘汰译文：
In China, a large developing country with over 1.3 billion population, Health care is of vital importance to hundreds of millions of people, and a major issue concerning its people’s well-being.
@高斋翻译TransElegant的翻译讲解：
中国高度重视保护和增进人民健康。宪法规定，国家发展医疗卫生事业，发展现代医药和传统医药，保护人民健康。围绕宪法，中国逐步形成了相对完善的卫生法律法规体系。
China pays great attention to protecting and improving its people’s health. As the Constitution stipulates, “The state develops medical and health services, promotes modern medicine and traditional Chinese medicine..., all for the protection of the people’s health.” Based on this constitutional stipulation, China has put in place a complete system of laws and regulations concerning medical and health services.
@高斋翻译TransElegant的翻译讲解：
多年来，中国坚持“以农村为重点，预防为主，中西医并重，依靠科技与教育，动员全社会参与，为人民健康服务，为社会主义现代化建设服务”的卫生工作方针，努力发展具有中国特色的医疗卫生事业。经过不懈努力，覆盖城乡的医疗卫生服务体系基本形成，疾病防治能力不断增强，医疗保障覆盖人口逐步扩大，卫生科技水平日益提高，居民健康水平明显改善。
Over the years, China has worked hard to develop its medical and health services with Chinese characteristics in accordance with the policy of “making rural areas the focus of our work, putting disease prevention first, supporting both traditional Chinese medicine and Western medicine, relying on science, technology and education, and mobilizing the whole of society to join the efforts, improving the people’s health and serving socialist modernization.” Thanks to unremitting efforts that have been made, medical and healthcare systems covering both urban and rural residents have taken shape, the capabilities of disease prevention and control have been enhanced, the coverage of medical insurance has expanded, continuous progress has been made in medical science and technology, and the people’s health has been remarkably improved.
为建立起覆盖城乡居民的基本医疗卫生制度，保障每个居民都能享有安全、有效、方便、价廉的基本医疗卫生服务，中国深入推进医药卫生体制改革，取得了重要阶段性成效。
To put into place basic medical and healthcare systems covering both urban and rural residents, and ensure that every resident has access to safe, effective, convenient and affordable basic medical and health services, China has kept advancing the reform of its medical and healthcare system, and made important achievements in the current stage.
一、卫生基本状况
I. Basic Conditions
居民健康状况不断改善。从反映国民健康状况的重要指标看，中国居民的健康水平已处于发展中国家前列。2010年人均期望寿命达到74.8岁，其中男性72.4岁，女性77.4岁。孕产妇死亡率从2002年的51.3/10万下降到2011年的26.1/10万。婴儿死亡率及5岁以下儿童死亡率持续下降，婴儿死亡率从2002年的29.2‰下降到2011年的12.1‰，5岁以下儿童死亡率从2002年的34.9‰下降到2011年的15.6‰，提前实现联合国千年发展目标。微博@高斋翻硕 公众号:高斋翻译学堂
The people’s health has been improved. Judging from important indicators that give expression to national health, the health of the Chinese people is now among the top in developing countries. In 2010, the life expectancy was 74.8 years - 72.4 years for males and 77.4 years for females; the maternal mortality rate went down from 51.3 per 100,000 in 2002 to 26.1 per 100,000 in 2011; the infant mortality rate and the mortality rate of children under the age of five have kept dropping, with the former going down from 29.2 per thousand in 2002 to 12.1 per thousand in 2011, and the latter, from 34.9 per thousand to 15.6 per thousand, attaining ahead of schedule the UN Millennium Development Goal in this regard.
建立起覆盖城乡的医疗卫生体系。一是公共卫生服务体系。包括疾病预防控制、健康教育、妇幼保健、精神卫生、卫生应急、采供血、卫生监督和计划生育等专业公共卫生服务网络，以及以基层医疗卫生服务网络为基础、承担公共卫生服务功能的医疗卫生服务体系。二是医疗服务体系。在农村建立起以县级医院为龙头、乡镇卫生院和村卫生室为基础的农村三级医疗卫生服务网络，在城市建立起各级各类医院与社区卫生服务机构分工协作的新型城市医疗卫生服务体系。三是医疗保障体系。这个体系以基本医疗保障为主体、其他多种形式补充医疗保险和商业健康保险为补充。基本医疗保障体系包括城镇职工基本医疗保险、城镇居民基本医疗保险、新型农村合作医疗和城乡医疗救助，分别覆盖城镇就业人口、城镇非就业人口、农村人口和城乡困难人群。四是药品供应保障体系。包括药品的生产、流通、价格管理、采购、配送、使用。近期重点是建立国家基本药物制度。
Medical and healthcare systems covering both urban and rural residents have been put in place. Of these systems, the first is the public health service system, which covers disease prevention and control, health education, maternity and child care, mental health, health emergency response, blood collection and supply, health supervision, family planning and some other specialized public health services, and a medical and healthcare system based on community-level healthcare networks that provides public health services. The second is the medical care system. In the rural areas, it refers to a three-level medical service network that comprises the county hospital, the township hospitals and village clinics, with the county hospital performing the leading role, and township hospitals and village clinics service at the base. And in the cities and towns, it refers to a new type of urban medical health service system that features division of responsibilities as well as cooperation among various types of hospitals at all levels and community healthcare centers. The third is the medical security system. This system comprises mainly the basic medical security, supported by many forms of supplementary medical insurance and commercial health insurance. The basic medical security system covers basic medical insurance for working urban residents, basic medical insurance for non-working urban residents, a new type of rural cooperative medical care and urban-rural medical aid, which cover, respectively, the employed urban population, unemployed urban population, rural population and people suffering from economic difficulties. And the fourth is the pharmaceutical supply system, which covers the production, circulation, price control, procurement, dispatching and use of pharmaceuticals. The recent work is focused on establishing a national system for basic drugs.
卫生筹资结构不断优化。卫生筹资来源包括政府一般税收、社会医疗保险、商业健康保险和居民自费等多种渠道。2011年，中国卫生总费用达24345.91亿元人民币，同期人均卫生总费用为1806.95元人民币，卫生总费用占国内生产总值的比重为5.1%。按可比价格计算，1978～2011年，中国卫生总费用年平均增长速度为11.32%。个人现金卫生支出由2002年的57.7%下降到2011年的34.8%，卫生筹资系统的风险保护水平和再分配作用不断提高。2011年，医院、门诊机构费用为18089.4亿元人民币，公共卫生机构费用为2040.67亿元人民币，分别占卫生总费用的71.74%和8.09%。医院费用中，城市医院、县医院、社区卫生服务中心、乡镇卫生院费用分别占64.13%、21.28%、5.17%、9.3%。
The health financing structure has been constantly improved. China’s health expenditure comes from the government’s general tax revenue, social medical insurance, commercial health insurance, residents’ out-of-pocket spending, etc. In 2011, the total health expenditure in China reached 2,434.591 billion yuan, 1,806.95 yuan per capita. The total expenditure accounted for 5.1% of the country’s GDP. In comparable prices, the health expenditure grew by an average annual rate of 11.32% from 1978 to 2011. Individual “out-of-pocket” spending declined from 57.7% in 2002 to 34.8% in 2011, showing that health financing is working better in the areas of risk protection and re-distribution. In 2011, the spending on hospitals and outpatient establishments was 1,808.94 billion yuan, and that on public health agencies, 204.067 billion yuan, comprising 71.74% and 8.09%, respectively, of the total health expenditure. Of the total spending on hospitals, those on urban hospitals, county hospitals, community health service centers and township health service centers stood at 64.13%, 21.28%, 5.17% and 9.3%, respectively.
卫生资源持续发展。截至2011年底，全国医疗卫生机构达95.4万个（所），与2003年比较，医疗卫生机构增加14.8万个（所）。执业（助理）医师246.6万人，每千人口执业（助理）医师数由2002年的1.5人增加到1.8人。注册护士224.4万人，每千人口注册护士数由2002年的1人增加到1.7人。医疗卫生机构床位数516万张，每千人口医疗卫生机构床位数由2002年的2.5张提高到3.8张。微博@高斋翻硕 公众号:高斋翻译学堂
Health resources have been developing in a sustained way. By the end of 2011, medical and healthcare institutions around the country totaled 954,000, an increase of 148,000 over 2003. Licensed doctors (assistants) reached 2,466,000, or 1.8 per thousand people, as compared with 1.5 per thousand people in 2002. Registered nurses totaled 2,244,000, or 1.7 per thousand people, as compared with one per thousand people in 2002. The number of hospital beds reached 5160,000, or 3.8 per thousand people, as compared with 2.5 per thou-sand people in 2002.
医疗卫生服务利用状况显著改善。2011年，全国医疗机构诊疗人次由2002年的21.5亿人次增加到62.7亿人次，住院人数由2002年的5991万人增加到1.5亿人。中国居民到医疗卫生机构年均就诊4.6次，每百居民住院11.3人，医院病床使用率为88.5%，医院出院者平均住院日为10.3天。居民看病就医更加方便，可及性显著提高。15分钟内可到达医疗机构住户比例，由2003年的80.7%提高到2011年的83.3%，其中农村地区为80.8%。医疗质量管理和控制体系不断完善。建立无偿献血制度，血液安全得到保障。
Marked improvement has been seen in the utilization of medical and health services. In 2011, medical institutions throughout the country hosted 6.27 billion outpatients, as compared with 2.15 billion in 2002; and admitted 150 million inpatients, as compared with 59.91 million in 2002. That year, Chinese residents went to the medical institutions for medical treatment 4.6 times on average; 11.3 of every 100 people were hospitalized; the utilization rate of hospital beds reached 88.5%; and the hospital stay of the inpatients averaged 10.3 days. These figures show that it has become increasingly convenient to see a doctor and more easily accessible to get medical services. In 2011, 83.3% of all households (80.8% in rural areas) could reach medical institutions within 15 minutes, as compared with 80.7% in 2002. Medical service quality management and control systems have been constantly improved. A system of blood donation without compensation has been established, so as to ensure blood supply and safety.
二、医药卫生体制改革
II. Reform of Medical and Healthcare Systems
经过多年努力，中国卫生事业取得显著发展成就，但与公众健康需求和经济社会协调发展不适应的矛盾还比较突出。特别是随着中国从计划经济体制向市场经济体制的转型，原有医疗保障体系发生很大变化，如何使广大公众享有更好、更健全的医疗卫生服务，成为中国政府面临的一个重大问题。从20世纪80年代开始，中国启动医药卫生体制改革，并在2003年抗击传染性非典型肺炎取得重大胜利后加快推进。2009年3月，中国公布《关于深化医药卫生体制改革的意见》，全面启动新一轮医改。改革的基本理念，是把基本医疗卫生制度作为公共产品向全民提供，实现人人享有基本医疗卫生服务，从制度上保证每个居民不分地域、民族、年龄、性别、职业、收入水平，都能公平获得基本医疗卫生服务。改革的基本原则是保基本、强基层、建机制。微博@高斋翻硕 公众号:高斋翻译学堂
With years of effort, China has made remarkable achievements in the development of its healthcare undertakings, which, however, still fall far short of the public’s demands for healthcare as well as the requirements of economic and social development. Especially when China turned from a planned economy to a market economy, the old medical care system has undergone great changes. So it became an issue of major importance for the Chinese government to provide better and more accessible medical and health services to the public. In the 1980s, the Chinese government initiated reform of the medical and healthcare systems, and speeded up the reform in 2003 after a success was won in the fight against the SARS. In March 2009, the Chinese government promulgated the “Opinions on Deepening Reform of the Medical and Health Care Systems,” setting off a new round of reform in this regard. The basic goal of this reform was to provide the whole nation with basic medical and health services as a public product, and ensure that everyone, regardless of location, nationality, age, gender, occupation and income, enjoys equal access to basic medical and health services. And the basic principles to be followed in the reform were to ensure basic services, improving such services at the grass-roots level and establishing the effective mechanisms.
医改是一项涉及面广、难度大的社会系统工程，在中国这样一个人口多、人均收入水平低、城乡区域差距大的发展中国家，深化医改是一项十分艰巨复杂的任务。三年多来，中国政府大力推进医药卫生服务与经济社会协调发展，积极破解医改这一世界性难题。通过艰苦努力，中国的新一轮医改取得积极进展。
Medical reform is a social program that covers a wide range and involves difficult tasks. And it is a hard and complicated task to deepen this reform in China, a developing country with a large population, low per-capita income and a wide gap between urban and rural areas. For over three years, the Chinese government has worked hard to strike a balance between improving medical and health services on one hand and economic and social development on the other, trying to find a solution to this worldwide problem. Thanks to the persistent efforts made, China has made positive progress in this new round of medical reform.
——基本医疗保障制度覆盖城乡居民。截至2011年，城镇职工基本医疗保险、城镇居民基本医疗保险、新型农村合作医疗参保人数超过13亿，覆盖面从2008年的87%提高到2011年的95%以上，中国已构建起世界上规模最大的基本医疗保障网。筹资水平和报销比例不断提高，新型农村合作医疗政府补助标准从最初的人均20元人民币，提高到2011年的200元人民币，受益人次数从2008年的5.85亿人次提高到2011年的13.15亿人次，政策范围内住院费用报销比例提高到70%左右，保障范围由住院延伸到门诊。推行医药费用即时结算报销，居民就医结算更为便捷。开展按人头付费、按病种付费和总额预付等支付方式改革，医保对医疗机构的约束、控费和促进作用逐步显现。实行新型农村合作医疗大病保障，截至2011年，23万患有先天性心脏病、终末期肾病、乳腺癌、宫颈癌、耐多药肺结核、儿童白血病等疾病的患者享受到重大疾病补偿，实际补偿水平约65%。2012年，肺癌、食道癌、胃癌等12种大病也被纳入农村重大疾病保障试点范围，费用报销比例最高可达90%。实施城乡居民大病保险，从城镇居民医保基金、新型农村合作医疗基金中划出大病保险资金，采取向商业保险机构购买大病保险的方式，以力争避免城乡居民发生家庭灾难性医疗支出为目标，实施大病保险补偿政策，对基本医疗保障补偿后需个人负担的合规医疗费用给予保障，实际支付比例不低于50%，有效减轻个人医疗费用负担。建立健全城乡医疗救助制度，救助对象覆盖城乡低保对象、五保对象，并逐步扩大到低收入重病患者、重度残疾人、低收入家庭老年人等特殊困难群体，2011年全国城乡医疗救助8090万人次。
The basic medical care systems cover both urban and rural residents. By 2011, more than 1.3 billion people had joined the three basic medical insurance schemes that cover both urban and rural residents, i.e., the basic medical insurance for working urban residents, the basic medical insurance for non-working urban residents, and the new type of rural cooperative medical care, with their total coverage being extended from 87% in 2008 to 95% in 2011. This signaled that China has built the world’s largest network of basic medical security. Medical care financing and the reimbursable ratio of medical costs have been raised, and the government subsidy standards for the new rural cooperative medical care system were increased from 20 yuan at the beginning to 200 yuan per person per year in 2011, benefiting 1.315 person/times in 2011 as against 585 person/times in 2008. The reimbursement rate for hospitalization expenses covered by relevant policies has been raised to around 70%, and the range of reimbursable expenses has been expanded to include outpatient expenses. Real-time reimbursement has been adopted for medical expenses, making it more convenient for people to have their medical costs settled. Reform has been carried out in respect of the forms of payment to include payment by person, payment by disease and total amount pre-payment, enabling medical insurance to play a better restrictive role over medical institutions as well as to control expenses and compel the medical institutions to improve their efficiency. Critical illness insurance has been included in the new type of rural cooperative medical care system. By 2011, some 230,000 patients of congenital heart disease, advanced rental diseases, breast cancer, cervical cancer, multidrug-resistant tuberculosis and childhood leukemia had been granted subsidies for major and serious diseases, with the actual subsidies accounting for 65% of their total expenses. In 2012, lung cancer, esophagus cancer, gastric cancer and eight other major diseases were included in the rural pilot program of insurance for the treatment of major diseases, and the reimbursement rate reached as high as 90%. Critical illness insurance has been introduced for both urban and rural residents, in which certain amounts of money are earmarked in the medical insurance fund for non-working urban residents and that of the new type of rural cooperative medical care to buy critical illness insurance policies from commercial insurance companies, aiming to relieve urban and rural families of the heavy burden of catastrophic medical spending. The policy of subsidy for critical illness insurance, which covers no less than 50% of the actual medical costs, provides a guarantee for the compliance costs to be shouldered by the individual after reimbursement from the basic medical insurance. This has effectively reduced the financial burden of individuals. An urban-rural medical assistance system has been established and improved, which at first covered urban and rural subsistence allowance recipients and childless and infirm rural residents who receive the so-called “five guarantees,” and is now extended to cover those who are severely ill and have low comes, the severely disabled, senior citizens from low-income families, and some other groups with special difficulties. In 2011, the urban-rural medical assistance was granted to 80.90 million cases across the country.
——基本药物制度从无到有。初步形成了基本药物遴选、生产供应、使用和医疗保险报销的体系。2011年，基本药物制度实现基层全覆盖，所有政府办基层医疗卫生机构全部配备使用基本药物，并实行零差率销售，取消了以药补医机制。制定国家基本药物临床应用指南和处方集，规范基层用药行为，促进合理用药。建立基本药物采购新机制，基本药物实行以省为单位集中采购，基层医疗卫生机构基本药物销售价格比改革前平均下降了30%。基本药物全部纳入基本医疗保障药品报销目录。有序推进基本药物制度向村卫生室和非政府办基层医疗卫生机构延伸。药品生产流通领域改革步伐加快，药品供应保障水平进一步提高。
A basic system of drugs has been developed from scratch. A system for the selection, production, supply and use of basic drugs, and cover of them in medical insurance has been put into place. In 2011, the coverage of this system was extended to all grass-roots medical and health-care institutions run by the government, where these drugs were sold at zero profit, practically eliminating the practice of hospitals subsidizing their medical services with drug sales. A national guideline for the clinical application of basic drugs and a formulary have been drawn up to ensure that basic drugs are used according to due procedures at grass-roots medical institutions. A new mechanism has been established for the procurement of basic drugs, under which the basic drugs are to be purchased by provinces. As a result, the prices of basic drugs at grass-roots medical and healthcare institutions have dropped by 30% on average, as compared with those before the reform. The basic drugs have all been included in the list of reimbursable drugs covered by basic medical insurance. Also, efforts have been made to supply basic drugs in an orderly way to village clinics and non-governmental medical institutions at the grass-roots level. The steps of reform have been quickened in drug production and circulation, and the supply of drugs has been better ensured.
——城乡基层医疗卫生服务体系进一步健全。加大政府投入，完善基层医疗卫生机构经费保障机制，2009—2011年，中央财政投资471.5亿元人民币支持基层医疗机构建设发展。采取多种形式加强基层卫生人才队伍建设，制定优惠政策，为农村和社区培养、培训、引进卫生人才。建立全科医生制度，开展全科医生规范化培养，安排基层医疗卫生机构人员参加全科医生转岗培训，组织实施中西部地区农村订单定向医学生免费培养等。实施万名医师支援农村卫生工程，2009—2011年，1100余家城市三级医院支援了955个县级医院，中西部地区城市二级以上医疗卫生机构每年支援3600多所乡镇卫生院，提高了县级医院和乡镇卫生院医疗技术水平和管理能力。转变基层医疗服务模式，在乡镇卫生院开展巡回医疗服务，在市辖区推行社区全科医生团队、家庭签约医生制度，实行防治结合，保障居民看病就医的基本需求，使常见病、多发病等绝大多数疾病的诊疗在基层可以得到解决。经过努力，基层医疗卫生服务体系不断强化，农村和偏远地区医疗服务设施落后、服务能力薄弱的状况明显改变，基层卫生人才队伍的数量、学历、知识结构出现向好趋势。2011年，全国基层医疗卫生机构达到91.8万个，包括社区卫生服务机构2.6万个、乡镇卫生院3.8万所、村卫生室66.3万个，床位123.4万张。微博@高斋翻硕 公众号:高斋翻译学堂
Urban and rural grass-roots level medical and health services have been further improved. The government has invested more to ensure the funding for grass-roots medical and healthcare institutions. From 2009 to 2011, the central government invested 47.15 billion yuan to support the building and development of grass-roots level medical institutions. Diverse forms have been adopted to strengthen the ranks of healthcare workers at the grass-roots level, and preferential policies have been made to train and introduce competent personnel for rural and community healthcare. A system of general practitioners (medical workers with sufficient knowledge in all branches of medicine) has been established, under which general practitioners are trained in the regular way; grass-roots medical and healthcare workers are enrolled in training courses for upgrading them to general practitioners; and medical students are specially trained for the needs of central and western urban areas, for which they do not have to pay their tuition fees. A project, known as “ten thousand doctors extending support to rural medical care,” has been launched. From 2009 to 2011, over 1,100 Grade-III urban hospitals extended support to 955 rural county-level hospitals every year, and urban medical institutions above Grade II in central and western China granted aid to over 3,600 township hospitals every year, thus helping improve the overall technological level and management of the county and township hospitals. Meanwhile, the mode of medical services has been changed. Touring medical services have been provided in township hospitals; and in the urban districts ranks of general practitioners have been formed and a system of family doctors has been set up. Prevention has been combined with the treatment, measures have been taken to ensure basic needs of the residents to see doctors and make it possible that the diagnosis and treatment of most commonly seen and frequently occurring diseases are performed at the community level. After years of effort, community-level medical and healthcare system has been strengthened; marked changes have taken place to the situation of backward facilities and poor services in rural and remote areas; community-level medical workers have increased in number, and their educational background and knowledge have improved. In 2011, the number of grass-roots medical and healthcare institutions across the country reached 918,000, including 26,000 urban community service centers, 38,000 township hospitals and 663,000 village clinics, and the number of hospital beds reached 1,234,000.
——基本公共卫生服务均等化水平明显提高。国家免费向全体居民提供国家基本公共卫生服务包，包括建立居民健康档案、健康教育、预防接种、0—6岁儿童健康管理、孕产妇健康管理、老年人健康管理、高血压和II型糖尿病患者健康管理、重性精神疾病患者管理、传染病及突发公共卫生事件报告和处理、卫生监督协管等10类41项服务。针对特殊疾病、重点人群和特殊地区，国家实施重大公共卫生服务项目，对农村孕产妇住院分娩补助、15岁以下人群补种乙肝疫苗、消除燃煤型氟中毒危害、农村妇女孕前和孕早期补服叶酸、无害化卫生厕所建设、贫困白内障患者复明、农村适龄妇女宫颈癌和乳腺癌检查、预防艾滋病母婴传播等，由政府组织进行直接干预。2011年，国家免疫规划疫苗接种率总体达到90%以上，全国住院分娩率达到98.7%，其中农村住院分娩率达到98.1%，农村孕产妇死亡率呈逐步下降趋势。农村自来水普及率和卫生厕所普及率分别达到72.1%和69.2%。2009年启动“百万贫困白内障患者复明工程”，截至2011年，由政府提供补助为109万多名贫困白内障患者实施了复明手术。微博@高斋翻硕 公众号:高斋翻译学堂
Access to basic public health services has become more equitable. The state provides all residents with a free package of 41 basic public health services in ten categories, including health record, health education, preventive inoculation, healthcare for children under six, healthcare for pregnant and lying-in women, healthcare for elderly people, treatment for hypertension and type II diabetes patients, healthcare for severe psychosis patients, reporting and handling of infectious diseases and public health emergencies, and healthcare supervision and coordination. Targeting special diseases, key groups and special areas, the state has launched key public health service programs, including subsidizing rural pregnant women for hospitalized childbirth, re-vaccinating people under 15 against hepatitis B, eliminating fluorosis caused by coal burning, supplementary taking of folic acid by rural women before pregnancy and in the early stage of pregnancy, building sanitary toilets, cataract removal for poor patients, cervical and breast cancer tests for rural women within eligible age, and preventing mother-to-child transmission of AIDS. In 2011, the inoculation rate of the National Immunization Program (NIP) exceeded 90%; the rate of hospitalized childbirth nationwide reached 98.7% (98.1% in rural areas); and the maternity mortality rate in rural areas kept going down. In the rural areas, 72.1% of the population had access to tap water and 69.2% had access to sanitary toilets. In 2009, the government launched a program to provide cataract operations for a million poor patients, and by 2011 more than 1.09 million such people had had such operations with government subsidies.
——公立医院改革有序推进。从2010年起，在17个国家联系试点城市和37个省级试点地区开展公立医院改革试点，在完善服务体系、创新体制机制、加强内部管理、加快形成多元化办医格局等方面取得积极进展。2012年，全面启动县级公立医院综合改革试点工作，以县级医院为龙头，带动农村医疗卫生服务体系能力提升，力争使县域内就诊率提高到90%左右，目前已有18个省（自治区、直辖市）的600多个县参与试点。完善医疗服务体系，优化资源配置，加强薄弱区域和薄弱领域能力建设。区域医学中心临床重点专科和县级医院服务能力提升，公立医院与基层医疗卫生机构之间的分工协作机制正在探索形成。多元化办医格局加快推进，鼓励和引导社会资本举办营利性和非营利医疗机构。截至2011年，全国社会资本共举办医疗机构16.5万个，其中民营医院8437个，占全国医院总数的38%。在全国普遍推行预约诊疗、分时段就诊、优质护理等便民惠民措施。医药费用过快上涨的势头得到控制，按可比价格计算，在过去三年间，公立医院门诊次均医药费用和住院人均医药费用增长率逐年下降，2011年比2009年均下降了8个百分点，公立医院费用控制初见成效。
The reform of public hospitals has been carried on in an orderly way. In 2010, the Chinese government started pilot reforms of public hospitals in 17 state-designated cities and 37 province-level districts; and positive progress has been witnessed in improving services, innovating institutions and mechanisms, strengthening internal management and speeding up the creation of a situation in which hospitals are established and run in diversified forms. In 2012, the government launched a pilot comprehensive reform of county-level public hospitals, aiming to improve rural system of medical services with the county hospitals playing the leading role, and enabling 90% of the population in a county to see doctors. So far, over 600 counties in 18 provinces, autonomous regions and municipalities directly under the central government have been included in this reform. The government has worked hard to improve medical services, optimize the allocation of medical resources, and enhance the medical capabilities of weak areas and weak fields. The capabilities of key clinical specialties in regional medical centers and county-level hospitals to deliver medical services have been enhanced, and the mechanism of division of responsibilities and cooperation between public hospitals and community-level medical institutions is being studied and formed. The government has intensified efforts in the creation of a situation of establishing and running hospitals in diversified forms, encouraging and guiding non-governmental funds to establish both for-profit and non-profit medical institutions. By 2011, there were 165,000 medical institutions established with non-governmental investment, including 8,437 private hospitals, accounting for 38% of the national total. Doctor-appointment service, time-phased outpatient service and high-quality nursing service that bring benefits and convenience to the people have been introduced nationwide. The fast price growth of medicine has been contained. In comparable prices, the growth rates of average outpatient and inpatient costs in public hospitals has decreased year by year in the past three years, and that of 2011 went down by eight percentage points from that of 2009, reaping initial results in expense control for public hospitals.
新一轮医改给中国城乡居民带来了很大实惠。基本公共卫生服务的公平性显著提高，城乡和地区间卫生发展差距逐步缩小，农村和偏远地区医疗服务设施落后、服务能力薄弱的状况明显改善，公众反映较为强烈的“看病难”、“看病贵”的问题得到缓解，“因病致贫”、“因病返贫”的现象逐步减少。
The new round of medical reform has brought substantial benefits to both urban and rural residents. Access to basic public health services has become much more equitable; the gap between urban and rural areas and between regions has been narrowed in medical development; medical services in rural and remote areas with backward facilities and weak capabilities have been remarkably improved; medical services have become more affordable and accessible; and fewer and fewer people are becoming poor or return to poverty because of illness.
三、传染病防治与卫生应急
III. Infectious Disease Prevention and Treatment, and Health Emergency Management
新中国成立以来，中国政府坚持“预防为主，防治结合”方针，不断加大传染病防治力度，通过开展预防接种和爱国卫生运动等防控措施，降低了传染病发病率，有效控制了传染病的流行和蔓延。自20世纪50年代起，基本控制了鼠疫、霍乱、黑热病、麻风病等疾病的流行。2011年甲类和乙类传染病发病率控制在241.4/10万的较低水平，有力保障了广大居民的身体健康和生命安全。
Since the founding of New China, the Chinese government has persisted in the principle of “prevention first and integrating prevention with treatment” and continuously intensified efforts in the prevention and treatment of infectious diseases. By preventive inoculation, patriotic health campaigns and other prevention and control measures, China has succeeded in bringing down the morbidity of infectious diseases and brought their spread under control. China has basically brought under control the epidemics of such diseases as plague, cholera, kala-azar and leprosy since the 1950s. In 2011, the morbidity of Class A and B infectious diseases was kept at a low level - 241.4 per 100,000 people. All these measures help to safeguard the Chinese people’s health and life.
实施国家免疫规划。免疫规划工作是中国卫生事业成效最为显著、影响最为广泛的工作之一。20世纪60年代初，中国通过接种牛痘消灭了天花，较世界卫生组织1980年宣布全球根除天花早了十几年。2000年，中国实现了无脊髓灰质炎目标。2002年，中国决定将新生儿乙肝疫苗纳入国家免疫规划，国家免疫规划由接种4种疫苗预防6种传染病，扩大到接种5种疫苗预防7种传染病。2007年，国家决定实施扩大国家免疫规划，国家免疫规划疫苗增加到14种，预防15种传染病，免疫规划人群也从儿童扩展到成人。新一轮医改启动以来，国家免疫规划内容不断扩大，对于减少传染病发生、保护公众身体健康起到了积极作用，目前多数疫苗可预防传染病的发病已降至历史最低水平。微博@高斋翻硕 公众号:高斋翻译学堂
National immunization program has been implemented. The national immunization program represents one of the most notable and influential undertakings of China’s healthcare work. In the early 1960s, China eliminated smallpox through vaccine inoculation, a dozen years ahead before the World Health Organization (WHO) announced the eradication of the disease in 1980. China attained the goal of eliminating poliomyelitis in 2000. In 2002, the Chinese government decided to include hepatitis B vaccination for the newborn in the national immunization program, increasing the number of four vaccines against six infectious diseases to five vaccines against seven infectious diseases. In 2007, China decided to further expand the scope of the program, increasing the number of vaccines to 14 to prevent 15 infectious diseases and extending the scope of vaccination from children to including adults. Since the launch of the new round of medical reform, the scope of the national immunization program has kept expanding, and it has played a positive role in reducing the morbidity of infectious diseases and improving the health of the public. Already, the morbidity of most infectious diseases that can be prevented by vaccination has fallen to the lowest level in history.
重点传染病地方病得到有效控制。艾滋病、结核病、血吸虫病、包虫病、麻风病、疟疾等重大及重点传染病患者获得免费药物治疗。截至2011年，中国存活艾滋病病毒感染者和病人约为78万人，远低于将艾滋病病毒感染人数控制在150万以内的目标。传染性肺结核患病率降至66/10万，提前实现了联合国千年发展目标确定的结核病控制指标。所有血吸虫病流行县实现疫情控制目标，血吸虫病病人控制在32.6万。率先在全球83个丝虫病流行国家和地区中消除了丝虫病。提升以监测为核心的流感防控能力，2010年，中国疾病预防控制中心国家流感中心被正式命名为全球第五个流感参比和研究中心。稳步推进地方病防治工作，在国家层面实现消除碘缺乏病目标，大骨节病、克山病和氟中毒等病情得到有效控制，发病患者显著减少。微博@高斋翻硕 公众号:高斋翻译学堂
Major infectious and endemic diseases have been brought under effective control. Patients of many major infectious diseases, such as AIDS, tuberculosis, snail fever, hydatid disease, leprosy and malaria, are provided medicines and treatment free of charge. In 2011, China’s living HIV-infected persons and AIDS patients were estimated at 780,000, far below China’s goal of controlling the HIV-infected population within 1.5 million. The morbidity of infectious tuberculosis has fallen to only 66 per 100,000 people, attaining the goal defined in the UN Millennium Development Goals ahead of time. All counties where epidemics of snail fever used to break out have attained the goal of bringing under control such epidemics, limiting the number of snail fever patients to 326,000. China took the lead in eradicating filariasis among the 83 countries where epidemics of filariasis hit. China keeps improving its capabilities of influenza control and prevention, taking monitoring at the major task. In 2010, the National Influenza Center of the Chinese Center for Disease Control and Prevention was officially nominated the fifth WHO Collaboration Center for Reference and Research on Influenza. China steadily promotes endemic disease prevention and treatment. It has eradicated the diseases caused by iodine deficiency at the national level, and brought under effective control of Kashin-Beck disease, Keshan disease and fluorine poisoning, notably reducing the incidence of these diseases.
爱国卫生运动卓有成效。爱国卫生运动是中国公众广泛参与、与公众健康密切相关的社会公益事业，迄今已开展60年。爱国卫生运动坚持预防为主的方针，通过开展除害灭病、健康教育和健康促进、农村改水改厕、国家卫生城镇创建、城乡环境卫生整治等，降低了传染病危害，提高了居民健康水平，形成了爱国卫生人人参与、健康生活人人共享的良好局面。截至目前，中国累计命名153个国家卫生城市、32个国家卫生区和456个国家卫生镇（县城），并在此基础上探索国家健康城市（镇）创建工作。
Patriotic health campaign has gained fruitful results. Patriotic health campaign, an invention of China that has been in existence for 60 years so far, is a social welfare undertaking featuring massive public participation and a close relationship with the public health. Following the principle of taking prevention first, the campaign has reduced the hazards of infectious diseases and promoted the public health through a series of measures, such as exterminating pests, health education and promotion, improving rural water supply and sanitation, building “healthy cities and towns,” and improving the environmental hygiene in both urban and rural areas. A wholesome atmosphere is taking shape, with everyone participating in the campaign and enjoying a healthy lifestyle. Now, China is exploring a better working mechanism for building “healthy cities and towns,” based on the 153 cities, 32 districts and 456 towns (counties) that have been nominated “healthy” for their wholesome surroundings.
卫生应急水平全面提高。颁布突发事件应对法、突发公共卫生事件应急条例等法律法规，修订传染病防治法，推动卫生应急工作走上法制化和规范化轨道。以疾病预防控制体系、卫生监督体系和医疗体系为基础，初步建成统一指挥、布局合理、反应灵敏、运转高效、保障有力的突发公共事件卫生应急体系。建立完善卫生应急预案体系，覆盖突发急性传染病、不明原因疾病、中毒事件等突发公共卫生事件防控以及自然灾害、事故灾难、恐怖事件的医疗卫生救援和重大活动医疗卫生保障。建立国家、省（自治区、直辖市）、地（市）、县四级应急管理体制。建立卫生应急能力评估指标体系。国家组建了传染病控制、医疗救援、中毒处置、核和放射处置等4类27支国家级卫生应急队伍，地方也组建了各级突发公共事件卫生应急专业队伍。国家医药储备制度日趋完善，保障了应对突发公共卫生事件所需的医药产品。近年来，中国有效处置了传染性非典型肺炎、甲型H1N1流感、鼠疫、人禽流感等突发公共卫生事件，及时开展四川汶川特大地震、青海玉树地震、甘肃舟曲特大山洪泥石流灾害的紧急医学救援，顺利完成北京奥运会、上海世博会等大型活动的医疗卫生保障任务。
Health emergency management capability has been enhanced. China is striving to make its health emergency management more standard and law-based by issuing the Law on Emergency Management and the Regulations on Preparedness for and Response to Public Health Emergencies, and amending the Law on the Prevention and Treatment of Infectious Diseases. Based on the disease prevention and control system, the public health monitoring system and the medical service system, China has basically set up a response system for public health emergencies featuring unified leadership, reasonable distribution, quick response, efficient operation and powerful logistics. China has established and improved health emergency plans, which cover the prevention and control of such public health emergencies as acute infectious disease emergencies, diseases with unknown causes and poisoning incidents, medical rescue in case of natural disasters, disastrous accidents and terrorist attacks, and medical services for important events. A four-level emergency management system has been established that covers the national, provincial, city and county levels. Also has been established is the public health emergency response ability assessment system. The central government has organized 27 teams for health emergencies to respond to four categories of incidents, namely, infectious disease control, medical rescue, poisoning treatment, and nuclear and radiation accident handling. Local governments have also set up professional teams to handle health emergencies at their respective levels. China’s medicine reserve system keeps improving, ensuring sufficient supply of medicines for health emergencies. In the past few years, China has successfully dealt with many public health emergencies, especially pandemic threats of infectious diseases, including SARS, H1N1, plague and avian influenza, carried out urgent medical rescues for the 2008 Wenchuan earthquake in Sichuan Province, 2010 Yushu earthquake in Qinghai Province and 2010 Zhouqu mudslide in Gansu Province, and provided medical services for the 2008 Beijing Olympic Games and 2010 Shanghai Expo.
法定传染病和突发公共卫生事件实现网络直报。2004年，中国启用传染病和突发公共卫生事件网络直报系统，实现对39种法定传染病病例个案信息和突发公共卫生事件的实时、在线监测。截至2011年，全国100%的疾病预防控制机构、98%的县级及以上医疗机构和94%的乡镇卫生院实现了法定传染病网络直报。微博@高斋翻硕 公众号:高斋翻译学堂
Online direct report system has been enforced for notifiable infectious diseases and public health emergencies. The online direct report system, which puts the 39 infectious diseases defined by law and public health emergencies under real-time and online surveillance, was not available in China until 2004. By 2011, the online direct reporting of infectious diseases had been extended to all disease prevention and control institutes, 98% of medical institutions at and above the county level, and 94% of township clinics in China.
四、慢性非传染性疾病防治
IV. Prevention and Treatment of Chronic Non-communicable Disorders
伴随中国工业化、城镇化、老龄化进程的加快，居民慢性病患病、死亡呈现持续快速增长趋势。中国现有确诊慢性病患者2.6亿人，慢性病导致的死亡占中国总死亡的85%，导致的疾病负担占总疾病负担的70%。
Accelerated industrialization, urbanization and ageing of the population have brought about a trend of a continuous and rapid increase in the incidence of chronic diseases and mortality caused by such diseases. At present, about 260 million Chinese have been diagnosed to have contracted chronic diseases that have caused 85% of total deaths in China and incurred 70% of total medical costs.
中国政府把防治慢性病作为增进公众健康、改善民生的重要任务，逐步建立起覆盖全国的慢性病防治服务体系，对主要慢性病进行分级管理，实施综合防控策略，全面提高慢性病综合防治能力，努力降低人群慢性病危险因素水平，减少慢性病发病率、致残率和死亡率。
The Chinese government regards chronic disease prevention and treatment as an important task in improving the people’s health and well-being. It has established step by step a nationwide prevention and treatment service for chronic diseases, adopted level-by-level management over certain major chronic diseases, implemented a comprehensive control strategy, enhanced the overall prevention and treatment capacity over chronic diseases, made efforts to reduce factors that cause chronic diseases and bring down the morbidity and mortality of chronic diseases as well as disability caused by them.
促进慢性病防治结合。2002年以来，慢性病防控策略逐步实现由重治疗向防治结合方向的转变。国家级层面形成了以中国疾控中心、国家癌症中心和国家心血管病中心为主要技术支撑的慢性病防控格局。各地逐步形成了由疾控机构、基层医疗卫生机构、医院和专业防治机构共同构筑的慢性病防控工作网络。提出早诊断、早治疗，降低发病率、病死率和病残率的慢性病防治目标，面向一般人群、高危人群和患病人群，对心脑血管病、恶性肿瘤、糖尿病和慢性阻塞性肺病等主要慢性病，血压升高、血糖升高、胆固醇升高和超重/肥胖等主要生物危险因素，以及烟草使用、不健康饮食、缺少体力活动和过量饮酒等主要行为危险因素，实施有效干预。微博@高斋翻硕 公众号:高斋翻译学堂
Integration has been promoted between prevention and treatment of chronic diseases. Since 2002, China’s strategy for prevention and control of chronic diseases has gradually shifted to placing equal emphasis on prevention and treatment from laying stress on treatment alone. At the state level, a chronic disease prevention and control system, which takes as its technical support the China Center for Disease Control, the National Cancer Center of China and the National Center for Cardiovascular Diseases of China, has gradually taken shape. In the localities, networks of chronic disease prevention and control have gradually been formed, comprising the local disease control institutions, grass-roots medical and healthcare institutions, hospitals as well as professional prevention and treatment organizations. The principle of early diagnosis and early treatment was proposed, in a bid to realize the targets of reducing the rate of morbidity, mortality and disability in the prevention and treatment of chronic diseases. Primary attention has been directed at the general public, the high-risk population and people with diseases. For major chronic diseases such as cardiovascular diseases, malignant tumors, diabetes and chronic obstructive lung diseases, effective medical interventions should be taken to reduce biological risk factors, like high blood pressure, hyperglycemia, high cholesterol in blood and overweight/obesity, and behavioral risk factors, such as smoking, unhealthy diet, lack of physical exercises and excessive drinking.
制定慢性病防控措施。出台《中国慢性病防治工作规划（2012～2015年）》等一系列慢性病防控政策性文件和慢性病防治指南。从2005年开始，实施癌症早诊早治等慢性病防治重大专项。2007年，在全国启动全民健康生活方式行动，多途径、多形式、多角度推动健康生活方式行为养成。2009年，将高血压、糖尿病、老年人健康管理纳入医改基本公共卫生服务项目内容。2010年启动国家级慢性病综合防控示范区建设工作，提高慢性病综合防控能力。大力开展儿童口腔疾病综合干预，预防儿童龋齿。微博@高斋翻硕 公众号:高斋翻译学堂
Measures for chronic disease control and prevention have been worked out. China has issued the “National Program for Chronic Disease Control and Prevention (2012-2015)” and other relevant policy documents and guidelines. Starting in 2005, such major special programs as that for early diagnosis and early treatment of cancer have been put into implementation. In 2007, a nationwide movement of healthy lifestyle was launched in the general public, employing various measures and channels to encourage the people to cultivate a healthy lifestyle. In 2009, the government included hypertension, diabetes and elders’ health management in the basic public health services amidst medical reform. In 2010, China set out to build state-level demonstration areas in chronic disease prevention and control capacity, aiming at enhancing the comprehensive prevention and control capability against chronic diseases. Comprehensive intervention has been vigorously carried out for early-childhood oral disorders to prevent dental caries among children.
建立慢性病信息管理系统。实施慢性病综合监测，开展慢性病危险因素监测、慢性病患病监测、死因监测、营养健康状态监测、恶性肿瘤随访登记，建立和逐步完善覆盖全生命周期的围绕慢性病及其危险因素流行情况的慢性病信息系统，为国家开展慢性病防控工作提供科学的基础数据。
Information management system of chronic diseases has been established. China enforces comprehensive surveillance of chronic diseases, monitors the risk factors of such diseases, the incidence, the causes of death, and nutrition and health conditions of people suffering from these diseases, and has established cancer registries, thereby establishing and gradually improving an information system that centers around chronic diseases and the prevalence of their risk factors, so as to provide scientific basic data for the state’s chronic disease prevention and control efforts.
开展健康教育和健康促进活动。持续开展“全国亿万农民健康促进行动”、“相约健康社区行”、“健康素养促进行动”等。逐步建立健康教育体系，初步形成多部门合作、全社会参与的健康教育格局。居民健康素养基本知识和技能日益普及，自我保健意识和能力不断提高。加大控烟宣传力度，提高公众对烟草危害的认识，逐步形成全社会支持控烟的氛围。世界卫生组织《烟草控制框架公约》2006年1月在中国生效以来，各地积极推动公共场所控烟立法，建设无烟环境。微博@高斋翻硕 公众号:高斋翻译学堂
Health education and promotion movements have been carried out. China will continue to promote the “national health-promotion campaign for farmers,” “healthy community campaign,” “healthy manners promotion campaign,” and other health-promotion campaigns. Efforts will be made to gradually build a health education system featuring cooperation among multiple departments and the whole-society participation. Knowledge of and skills related to health will become increasingly widespread among the Chinese people, and their awareness of good health and ability to keep healthy are being constantly enhanced. Publicity has been intensified for tobacco control to enhance the public’s awareness of the hazards of smoking, and eventually creating the atmosphere that the whole society support tobacco control. Since China joined theWHO Framework Convention of Tobacco Control in January 2006, the various localities in China have made proactive efforts to legalize control of smoking in public places for a smoking-free environment.
重视维护公众的精神健康。颁布精神卫生法，通过立法规范精神卫生服务，保护精神障碍患者的权益。完善重性精神疾病防治网络，加强精神卫生医疗机构救治急重性精神疾病能力建设，建立医院与社区相互支持和配合的重性精神疾病防治工作机制。把精神卫生专业人员列入“十二五”时期急需紧缺的人才类别，加强人才培养工作。规范患者服务管理，启用国家重性精神疾病基本数据收集分析系统，实现病人信息电子化管理。目前，在城市社区和农村居家接受规范管理的重性精神疾病患者有302.6万人。
Maintenance of people’s mental health has been valued. China issued the Mental Health Law to regulate the mental health services and protect the rights and interests of people with mental disorders. The Chinese government strives to improve the prevention and treatment network of severe mental illnesses, enhance the ability of mental healthcare institutions to treat and cure acute or severe mental illnesses, and has established a working mechanism for severe mental illness prevention and treatment in which psychiatric hospitals and communities support and cooperate with each other. China has included professionals in mental health services as the urgently needed task during the 12th Five-Year Plan, and has intensified their training. It has standardized patient services and management, launched a basic data collection and analysis system for severe mental illnesses, and digitized data on patients. At present, there are 3.026 million people with serious mental disorders in China’s urban and rural areas who are receiving standard management at their homes.
五、妇女儿童健康权益保护
V. Protecting Women and Children’s Right to Health
中国现有8.6亿妇女儿童，约占总人口的三分之二。中国政府将男女平等作为一项基本国策，一贯高度重视妇女儿童的生存和健康状况，完善妇幼卫生法制与政策，签署多项保护妇女儿童的国际公约，健全妇幼卫生服务体系，实施妇幼公共卫生服务项目，着力提高妇幼卫生服务的公平性和可及性，促使广大妇女儿童健康权益得到有效保护。微博@高斋翻硕 公众号:高斋翻译学堂
Currently, China has 860 million women and children, accounting for two thirds of the nation’s total population. The Chinese government has established gender equality as a basic national policy, and has always attached great importance to the life and health of women and children. The state strives to improve the legal regime and related policies regarding women and children’s healthcare, and has signed many international conventions committed to the protection of women and children. China has improved its health services for women and children, and implemented public health service programs for them, focusing on making these services more equitable and accessible so as to effectively protect women and children’s right to health.
完善妇幼卫生法制和政策。1994年10月全国人大常委会审议通过母婴保健法，标志着妇幼卫生工作进入法制化管理阶段。20世纪90年代以来，中国政府制定实施《中国妇女发展纲要（1995～2000年）》、《中国妇女发展纲要（2001～2010年）》、《中国妇女发展纲要（2011～2020年）》和《九十年代中国儿童发展规划纲要》、《中国儿童发展纲要（2001～2010年）》、《中国儿童发展纲要（2011～2020年）》，把妇女儿童健康纳入国民经济和社会发展规划，作为优先发展的领域之一。
The legal regime and related policies regarding women and children’s healthcare have been improved. In October 1994, the Standing Committee of the National People’s Congress reviewed and passed the Law on Healthcare for Mothers and Infants, which signaled that China’s management of women and children’s affairs had entered a law-based stage. Since the 1990s, the Chinese government has enacted the Program for the Development of Chinese Women (1995-2000),Program for the Development of Chinese Women (2001-2010), Program for the Development of Chinese Women (2011-2020), Program for the Development of Chinese Children in the 1990s, Program for the Development of Chinese Children (2001-2010) and Program for the Development of Chinese Children (2011-2020), giving priority to women and children’s health in national programs of economic and social development.
健全妇幼卫生服务体系。中国妇幼卫生体系以妇幼保健专业机构为核心，以城乡基层医疗卫生机构为基础，以大中型综合医疗机构和相关科研教学机构为技术支持，为妇女儿童提供全方位的医疗保健服务。建立妇幼卫生年报系统和世界上规模最大的妇幼卫生监测网络，实施出生缺陷监测、孕产妇死亡监测、5岁以下儿童死亡监测、危重孕产妇监测和儿童营养健康监测。妇幼卫生信息为各级政府制定卫生政策特别是妇幼卫生政策提供了科学依据。
The health service system for women and children has been improved. China’s healthcare system for women and children takes professional women and children’s health organizations as its core and is based on community-level urban and rural healthcare services. With technical support from large and medium-sized general hospitals and relevant research and training institutions, the state provides all-round healthcare services for women and children. The country publishes annual reports on women and children’s healthcare progress and has developed the world’s largest monitoring network in this regard, keeping track of cases of birth defects, deaths of pregnant and lying-in women, deaths of children under five years of age, and complicated cases of pregnant and lying-in women, as well as children’s nutrition and health. The information collected on women and children’s health has provided a solid statistical basis for governments at all levels to formulate healthcare policies, especially policies on women and children’s health.
开展妇女生殖保健服务。积极推广婚前和孕前保健，普及优生优育、生殖健康科学知识，深入开展孕产期保健，形成包括产前检查、产前筛查与诊断、高危孕产妇筛查与管理、住院分娩、新生儿保健和产后访视在内的一整套孕产期保健服务。2011年全国孕产妇产前检查率、产后访视率和系统管理率分别为93.7%、91.0%和85.2%，比2000年分别提高4.81%、5.57%和10.36%，高危孕产妇管理率达到了99.6%。开展“降低孕产妇死亡率、消除新生儿破伤风”项目，消除了孕产妇及新生儿破伤风。2011年，全国孕产妇死亡率为26.1/10万，比1990年和2000年下降了72.4%和50.8%。开展妇女病普查普治、青春期保健和更老年期保健等，为广大妇女提供全生命周期服务。微博@高斋翻硕 公众号:高斋翻译学堂
The reproductive health services for women are provided. China has proactively promoted premarital and pre-pregnancy healthcare, and has been publicizing knowledge on prenatal and postnatal care, and reproductive health. Intensive healthcare services for pregnant and lying-in women are available, and a complete array of services for pregnant and lying-in women has been developed, covering prenatal examination, prenatal defect screening and diagnosis, screening and management of high-risk pregnant and lying-in women, hospitalized delivery, infant healthcare and postnatal home visits. In 2011, a total of 93.7%, 91.0% and 85.2% of pregnant and lying-in women, respectively, received prenatal examinations, postnatal home visits and other medical management services in China, 4.81%, 5.57% and 10.36% higher than the statistics of 2000. The percentage of high-risk pregnant and lying-in women included in the medical management program has reached 99.6%. China has carried out a program to "lower the maternal mortality and eliminate neonatal tetanus," which achieved the desired effects. The maternal mortality rate in 2011 was 26.1 per 100,000, dropping 72.4% and 50.8% as compared to 1990 and 2000, respectively. The state also provides medical services for the screening and treatment of gynecological diseases, adolescence health, and climacteric and old-age health, offering services that cover the whole life cycle of Chinese women.
开展儿童保健服务。加强新生儿保健，规范新生儿访视服务。开展婴幼儿及学龄前儿童保健，实施7岁以下儿童保健管理和3岁以下儿童系统管理。2011年全国3岁以下儿童系统管理率和7岁以下儿童保健管理率分别达到84.6%和85.8%。儿童生长发育水平不断提高，儿童营养不良状况持续减少。努力控制出生缺陷，提高出生人口素质，开展新生儿疾病筛查、0～3岁儿童早期综合发展、发育偏离儿童的康复训练、高危儿早期干预、食物过敏的早期干预、睡眠问题干预、环境污染对儿童健康损害的早期干预以及青春期保健等。关注和重视留守儿童、流动儿童、伤残儿童等特殊儿童群体的身心健康。
The healthcare services for children are provided. China has strengthened healthcare for newborns and regularized home-visiting service for newborns. The state offers healthcare services for infants, young children and pre-school children, and exercises health management of children under seven years of age and comprehensive management of children under three years of age. In 2011, some 84.6% of children under three years of age and 85.8% of children under seven years of age received comprehensive health management and medical management services. Chinese children are growing healthier and faster physically, and cases of malnutrition keep declining. The state strives to control birth defects and improve the quality of newborn babies, and has conducted disease screenings for newborns, early development programs for children under three years old, rehabilitation training for children with growth deviation, early-stage intervention for high-risk children, early-stage intervention in cases of food allergy, assistance with sleep problems, early-stage help in case of damage to children’s health caused by environmental pollution, and adolescence healthcare, among others. Children whose parents seek employment away from home, children who live with their migrant-worker parents, disabled children and other special groups of children also receive attention and help from the state both physically and mentally.
六、中医药发展
VI. Development of Traditional Chinese Medicine
中医药在中国有着悠久的历史，是中华民族在生产生活实践以及治疗疾病过程中形成和发展的医学科学，是中华民族智慧的结晶，为中华民族繁衍昌盛作出了重要贡献。中医药在治疗常见病、多发病和疑难病等方面独具特色和优势，在治疗传染性疾病方面也有良好效果，并以其费用低、疗效好、副作用小等特点，深受中国公众喜爱，在医疗卫生保健中发挥着不可替代的重要作用。中国政府一贯积极扶持和促进中医药事业的发展。
Traditional Chinese Medicine (TCM) has a long history in China, and is a medical science formed and developed by the Chinese people in their daily work and life as well as attempts to treat diseases. TCM is the crystallization of the wisdom of the Chinese people, and has made important contributions to the continuance and thriving of the Chinese nation. Known for its unique characteristics and advantages in curing common diseases, frequently occurring diseases and complicated diseases, TCM has also proved effective in treating infectious diseases and is very popular among the Chinese public for its low cost, satisfactory curative action and mild side effects. TCM plays an irreplaceable role in China’s medical and healthcare endeavors, and the Chinese government has always supported and promoted its development.
建立覆盖城乡的中医医疗服务体系。在城市，形成了以中医医院、民族医医院、中西医结合医院、中医专科医院、综合医院中医科、社区卫生服务机构及中医门诊部和中医诊所为主的城市中医药服务网络。在农村，形成了由县级中医医院、乡镇卫生院中医科和村卫生室为主的农村中医药服务网络。目前，75.6%的社区卫生服务中心、51.6%的社区卫生服务站、66.5%的乡镇卫生院、57.5%的村卫生室能够提供中医药服务。微博@高斋翻硕 公众号:高斋翻译学堂
Networks of TCM medical services have been established to cover both urban and rural areas. Networks of TCM medical services now cover Chinese cities, providing services for urban residents through TCM hospitals, ethnic-medicine hospitals, hospitals of integrated traditional Chinese and Western medicine, specialized TCM hospitals, TCM departments of general hospitals, community health services, TCM outpatient departments and TCM clinics. In the rural areas, TCM service networks have also been developed to serve rural residents through county-level TCM hospitals, and TCM departments or sections of township hospitals and village clinics. Currently, 75.6% of community health service centers, 51.6% of community health service stations, 66.5% of village and township hospitals and 57.5% of village clinics can provide TCM services.
形成独具特色的中医药人才培养体系。国家把人才培养作为中医药事业发展的根本，加强名老中医药专家学术思想和经验继承工作以及优秀中医临床人才培养，加强社区、农村基层中医药人才的培养，基本形成了院校教育、师承教育、继续教育多形式、多层次、多途径的中医药教育体系，初步建立起社区、农村基层中医药人才培养机制。截至2011年，全国共有高等中医药、民族医药院校46所，高等教育中医药类在校生人数55.3万人，卫生机构中医类别执业（助理）医师29.4万人，中药师（士）9.7万人。
A unique training system for qualified TCM professionals has been developed. The state takes the cultivation of qualified professionals as the cornerstone for the development of TCM. China has enhanced its efforts to pass down the academic achievements and experience of renowned and senior TCM experts as well as the training of high-caliber professionals in clinical practice. An education system for TCM personnel has been basically developed in the forms of academic education, master-apprentice tutorials and continued education at different levels and through different channels. By 2011, China had a total of 46 institutions of higher learning specializing in TCM and ethnic medicine, with 553,000 undergraduate students of TCM on campus, as well as 294,000 practitioners and assistant doctors of TCM, in addition to 97,000 licensed and assistant pharmacists in TCM.
推进中医药现代化。积极利用现代科学技术，推进中医药的理论和技术创新，在中医基础理论、临床诊疗、中药技术等领域取得重要成果。推进中药产业化和现代化，中药产业规模、技术水平大幅提高。目前，全国中药生产企业近1500家。中药产品种类、数量、生产工艺水平有了很大提高。重视和保护中医药的文化价值，41项中医药项目列入国家非物质文化遗产名录。
A modernization drive for TCM has been initiated. The state has proactively promoted theoretical and technical innovations in TCM through the application of modern science and technology, and has gained important achievements in basic TCM theory, clinical diagnosis and treatment, TCM technology and other related areas. China promotes the industrialization and modernization of TCM, and as a result the industrial scale and technical level of TCM has increased markedly. Currently, there are about 1,500 manufacturers of TCM pharmaceuticals in China, and the variety, quantity and processing technique of TCM pharmaceuticals have improved by a wide margin. The state attaches importance to the protection of TCM’s cultural values, and 41 TCM programs have been included on the nation’s intangible heritage list.
积极开展国际交流合作。目前，已有70多个国家与中国签订了包含中医药内容的政府协议或专门的中医药合作协议，中医药对外医疗、教育、科技合作不断扩大，已传播到世界上160多个国家和地区。“中医针灸”列入人类非物质文化遗产代表作名录，《黄帝内经》、《本草纲目》等中医药典籍列入《世界记忆遗产名录》。国际标准化组织（ISO)成立了中医药技术委员会，并将这一委员会的秘书处设在中国。微博@高斋翻硕 公众号:高斋翻译学堂
International exchanges and cooperation have been actively promoted. China has signed treaties with TCM contents or special TCM cooperation agreements with over 70 countries, and cooperation in TCM application in foreign countries, and TCM education and technical cooperation has steadily expanded. Now, over 160 countries and regions around the world have access to TCM. TCM acupuncture and moxibustion has been recognized as a masterpiece of the intangible heritage of mankind, and the Huangdi Neijing (Inner Canon of the Yellow Emperor), Bencao Gangmu (Compendium of Materia Medica) and other TCM treatises have been included in the UNESCO Memory of the World. The International Standardization Organization (ISO) has set up a TCM technical committee and located its secretariat in China.
七、卫生国际合作
VII. International Medical and Healthcare Cooperation
长期以来，中国积极参与全球卫生事务，广泛开展卫生领域的政府间和民间的多边、双边合作交流，积极参加国际社会、国际组织倡导的重大卫生行动。高度重视卫生国际援助，先后为许多发展中国家援建医院、培训卫生人才、开展疾病防控等工作，为受援国医疗卫生事业发展发挥了巨大作用。微博@高斋翻硕 公众号:高斋翻译学堂
For a long period of time, China has been actively participating in international health affairs, and has carried out extensive inter-government and non-governmental multilateral and bilateral cooperation and exchanges. China has also proactively taken part in major health programs of the international community and international organizations. The state pays great attention to international health assistance programs, and has played a huge role in improving the medical and health conditions in many developing countries by building hospitals, training medical and healthcare professionals and carrying out disease control there.
支持世界卫生组织等国际组织工作。积极参与全球卫生议题讨论，分享经验。20世纪70年代，中国总结和贡献卫生实践经验，为推动1978年《阿拉木图宣言》实施初级卫生保健发挥了重要作用。近年来，在《国际卫生条例（2005）》框架下，与世界卫生组织及各国保持及时、密切、畅通联系，为全球疾病防控作出贡献。中国政府每年向世界卫生组织、联合国艾滋病规划署以及全球抗击艾滋病、结核病和疟疾基金等国际组织提供捐款。大力支持国际社会在慢性病、人禽流感、控烟、应急等技术领域的工作。
Support has been rendered to the work of the World Health Organization and other international organizations. China has been taking an active role in international discussions on health issues and sharing experiences in this regard. In the 1970s, China summarized its practices in healthcare and played an important part in the signing of the Declaration of Alma-Ata in 1978 on primary healthcare by contributing its medical experience. In recent years, China has been efficiently maintaining timely and close contact with the World Health Organization and various countries under the framework of theInternational Health Regulations (2005), making its due contribution to disease control on a global scale. The Chinese government makes annual donations to the World Health Organization, the Joint United Nations Program on HIV and AIDS (UNAIDS), the Global Fund to fight AIDS, tuberculosis and malaria, and other international efforts. China also vigorously supports international work to combat chronic diseases and human avian influenza, as well as in tobacco control, emergency medical responses and other related technical fields.
加强区域卫生合作。2003年以来，以中国—东盟传染病防控领域的合作为开端，加快推进区域卫生合作进程。目前，中国已在大湄公河次区域、中亚区域经济合作、中国—东盟、东盟与中日韩、中日韩、亚太经济合作组织和上海合作组织等7个区域性合作机制下，开展与周边国家和本区域的卫生合作和国际援助。从2005年起，中国与缅甸、越南、老挝合作，在边境地区开展疟疾、艾滋病联防联控项目，还开展了结核病、登革热防治等跨境合作项目。
Regional health cooperation has been strengthened. In 2003, China initiated cooperation in the field of infectious disease control with ASEAN, and has quickened its steps to promote regional health cooperation since then. Currently, China is carrying out health cooperation with peripheral countries and regional international aid programs within seven regional cooperation mechanisms, namely, those of the Greater Mekong Sub-region, Central Asia Region, China-ASEAN, ASEAN and China, Japan and Korea, Inter-China-Japan-Korea, Asia-Pacific, and Shanghai Cooperation Organization. Since 2005, China has been cooperating with Myanmar, Vietnam and Laos to carry out joint prevention and control programs of malaria and AIDS, as well as cross-border cooperation programs on the prevention and treatment of tuberculosis and dengue fever.
派遣援外医疗队。援外医疗队是中国履行国际义务，按政府双边协议向受援国派遣医务人员团队，在发展中国家开展医疗卫生服务的无偿援助项目。1963年，中国政府向阿尔及利亚派出第一支援外医疗队。截至2011年，中国政府已先后向73个国家派遣了医疗队。目前，有56支医疗队分布在阿尔及利亚、坦桑尼亚、摩洛哥、津巴布韦等53个国家，为当地特别是贫困地区人民提供免费医疗服务，并为受援国引入大批先进医疗技术。50年来，中国援外医疗队共诊疗患者约2.6亿人次。医疗队的工作获得当地民众的高度赞扬，受到受援国政府的充分肯定，迄今约有900名中国医疗队员获得受援国颁发的勋章等各种荣誉。在此期间，有50名中国援外医疗队员牺牲在异国他乡。
Medical teams have been sent to developing countries to improve medical conditions there. The medical teams China dispatches to developing countries to improve the medical and health conditions there are a regular aid program between the Chinese government and the recipient countries in accordance with bilateral agreements. In 1963, the Chinese government sent its first medical team abroad, to Algeria, and by 2011, China had sent medical teams to 73 countries. Currently, there are 56 Chinese medical teams in Algeria, Tanzania, Morocco, Zimbabwe and 49 other countries. The medical teams provide free medical services for local people there, especially people in poverty-stricken areas, as well as introducing advanced medical technology into the recipient countries. For 50 years, the Chinese medical teams have diagnosed and treated a total of 260 million cases, and their work has been much appreciated by the people and fully recognized by the governments of the recipient countries. So far, about 900 Chinese medical team members have been awarded honors by the recipient countries, and 50 members died during their service abroad.
援建医疗机构。从1970年开始，中国支援非洲等地区的发展中国家建设医疗机构，致力于改善受援国医疗设施条件。截至2011年底，中国共帮助52个国家建成100所医院和医疗中心，为解决当地民众看病就医困难作出了积极贡献。中国为援建医院提供大量成套医疗设备和药品，仅2011年中国就提供了34批医疗设备和药品。截至2011年11月，还有28个国家的31个援建项目在建。
Medical institutions have been built in developing countries with aid from China. Since 1970, China has been committed to helping developing countries in Africa and other areas to build medical institutions and improve their medical conditions. By the end of 2011, China had helped a total of 52 countries, and built 100 hospitals and medical centers for them, improving medical conditions and providing medical services for local people. China equipped the hospitals with a large number of complete sets of medical equipment and medicines, and in 2011 alone it shipped 34 batches of medical equipment and medicines to the recipient countries. By November 2011, 31 new projects in this regard were still under construction in 28 countries.
培训卫生人力资源。中国援外医疗队通过带教、讲座、培训等方式，将医疗技术传授给当地医护人员，提高受援国卫生技术水平。中国政府支持卫生技术机构在华为发展中国家举办卫生技术研修和培训，截至2011年，共举办培训班400多期，培训15000余人，涉及卫生管理、紧急救援管理、食品卫生、传统医药、传染病防控、实验室检测、卫生检疫和护理技术等。为帮助发展中国家培养高层次医学卫生人才，中国政府还向在华学习医学和中医药学的发展中国家学生提供政府奖学金。
Health professionals have been trained by China for developing countries. The Chinese medical teams pass their medical knowledge and technology to local medics through personal tutorials, lectures and training courses, improving the medical technology of the recipient countries. The Chinese government supports health technology institutions to hold related study and training programs for developing countries in China. By 2011, China had held over 400 training courses for 15,000 persons on health management, emergency management, food hygiene, traditional medicine, infectious disease prevention and control, laboratory testing, health quarantine, nursing skills and other areas. To help developing countries train medical and health professionals of high caliber, China also offers government scholarships for students from developing countries studying medicine and TCM in China.
开展国际紧急救援。2004年，印度洋地震和海啸在东南亚和南亚地区造成重大人员伤亡，中国及时派出卫生救援队赴泰国、斯里兰卡、印度尼西亚开展救援，并通过世界卫生组织向受灾国家捐助医疗仪器设备和美元现汇。近五年来，中国政府累计开展卫生紧急救援近200次，包括向发生疫情、自然灾害的几内亚比绍、马达加斯加、巴基斯坦、印度尼西亚、海地等国家派遣卫生救援队、提供物资或现汇紧急援助等。中国还派出救援队赴黎巴嫩、刚果(金)等国际维和任务区实施人道主义医学援助，派遣“和平方舟号”医院船赴亚非五国、拉美四国开展巡回医疗服务。微博@高斋翻硕 公众号:高斋翻译学堂
International emergency rescue has been undertaken. In 2004, Southeast Asia and South Asia suffered great casualties due to an earthquake in the Indian Ocean and the following tsunami. China promptly responded to the emergency by sending medical rescue teams to Thailand, Sri Lanka and Indonesia to help relief efforts there, and donated medical equipment and cash in US dollar to the affected countries through the World Health Organization. Over the past five years, the Chinese government has responded to about 200 health emergencies, sending medical rescue teams to Guinea-Bissau, Madagascar, Pakistan, Indonesia, Haiti and other countries stricken by epidemics or natural disasters, as well as providing relief supplies and cash to those countries. China has also dispatched rescue teams to Lebanon, the Democratic Republic of the Congo and other international peacekeeping mission areas to offer humanitarian medical aid there, and its Peace Arkhospital ship sailed to five Asian and African and four Latin-American nations to provide medical services to the people there.
结束语
Conclusion
@高斋翻译TransElegant的翻译讲解：
随着中国工业化、城市化进程和人口老龄化趋势的加快，居民健康面临着传染病和慢性病的双重威胁，公众对医疗卫生服务的需求日益提高。与此同时，中国卫生资源特别是优质资源短缺、分布不均衡的矛盾依然存在，医疗卫生事业改革与发展的任务十分艰巨。
With the quickened pace of the country’s industrialization and urbanization, as well as its increasingly aging population, the Chinese people are facing the dual health threats of infectious and chronic diseases, and the public needs better medical and health services. In the meantime, problems still exist regarding China’s health resources, especially the shortage of high-quality resources and the unbalanced distribution of those resources. China has arduous tasks ahead for reforming and developing its medical and health services.
中国政府提出，到2020年建立健全覆盖城乡居民的基本医疗卫生制度，实现人人享有基本医疗卫生服务。为此，中国将继续深入推进改革，全面发展医疗卫生事业，更好地维护、保障和增进全体居民的健康。中国也将继续积极参与全球卫生事务，与各方共同携手，为改善全球健康作出更大努力。微博@高斋翻硕 公众号:高斋翻译学堂
The Chinese government has announced that it will establish a sound basic medical and health system covering both urban and rural residents by 2020, so as to ensure that everyone enjoys access to basic medical and health services. For this goal, China will continue to reform and develop its medical and health services, and better maintain, ensure and enhance the health of its people. China will also continue its active role in international health affairs and work together with different parties to make greater effort to improve the health of mankind.
