Implementation of Healthy China Initiative: Joint Interpretation by National Health Commission, Ministry of Education, and General Administration of Sport

On July 15, the State Council Information Office held a regular policy briefing of the State Council to introduce the relevant details of the “Opinions on Implementing the Healthy China Initiative” and the “Notice on Issuing the Plan for Organizational Implementation and Assessment of the Healthy China Initiative,” both issued on the same day.

Yu Xuejun, Deputy Director of the National Health Commission; Mao Qunan, Director of the Department of Planning and Information under the National Health Commission; Wang Dengfeng, Director of the Department of Physical, Health and Arts Education under the Ministry of Education; and Lang Wei, Director of the Department of Mass Sports under the General Administration of Sport attended the event and provided introductions to their respective areas related to the Healthy China Initiative.

Through unremitting efforts, China’s health sector has achieved substantial development, and the population’s health status has continued to improve. In 2018, the average life expectancy in China rose to 77.0 years, with major health indicators for residents generally surpassing the average levels of upper-middle-income countries, thereby laying a solid health foundation for building a moderately prosperous society in all respects. However, as industrialization, urbanization, and population aging accelerate, the disease profile of Chinese residents is changing, presenting new problems and challenges to public health.

On one hand, issues such as hepatitis, tuberculosis, occupational health, and endemic diseases cannot be ignored, and the situation regarding the prevention and control of major infectious diseases like AIDS remains severe. On the other hand, due to the low rate of health knowledge awareness among residents, unhealthy lifestyles such as smoking, excessive alcohol consumption, lack of exercise, and unreasonable dietary habits are quite common, leading to increasingly prominent disease problems. In particular, chronic diseases represented by cardiovascular and cerebrovascular diseases, cancer, chronic respiratory diseases, and diabetes have caused deaths accounting for 88% of total deaths, with the resulting disease burden comprising over 70% of the total disease burden, posing a serious threat to public health. The key figures here are 88% and over 70%.

Unhealthy lifestyles, such as smoking, excessive alcohol consumption, physical inactivity, and unreasonable dietary habits, are modifiable; major health risk factors are preventable and controllable. To actively and effectively address current prominent health issues, we are transforming our approaches and methodologies. While continuing to deepen healthcare reform and resolving the difficulties and high costs associated with accessing medical care, we must vigorously promote a shift from a “disease-treatment-centered” model to a “people’s health-centered” model. We strive to provide comprehensive, full-cycle health protection for the public, implement the policy priority of prevention first, and empower every individual to assume primary responsibility for their own health. Through the joint participation of individuals, families, society, and the government, we will integrate health into all policies and foster a framework of collaborative construction and shared benefits.

The key terms here are the two priorities and one shift in health and healthcare work.Two key priorities are to continue addressing the difficulties and high costs of accessing medical care, while one major shift is to transition from a disease-centered approach to a people’s health-centered approach.

Since June last year, the State Council has established a working group led by the National Health Commission, in collaboration with more than 30 departments including the Ministry of Education and the General Administration of Sport. This group has organized experts and scholars from relevant fields to jointly formulate documents related to the Healthy China Initiative. The State Council issued the “Opinions on Implementing the Healthy China Initiative,” which concisely summarizes the core content of the initiative, clarifies its guiding ideology, basic principles, and overall objectives, proposes the implementation of 15 specific actions across three areas—addressing health determinants, safeguarding health throughout the life course, and preventing and controlling major diseases—and deploys measures for organizational implementation.

Meanwhile, to ensure the effective implementation of the Healthy China Initiative, the General Office of the State Council concurrently issued the Notice on Printing and Distributing the Implementation Organization and Assessment Plan for the Healthy China Initiative, established the Healthy China Initiative Promotion Committee, and released the Healthy China Action (2019–2030). Therefore, the key components here are three documents: the State Council’s “Opinions,” the General Office’s “Plan,” and the “Action Plan.”

The "Opinions on Implementing the Healthy China Action" issued by the State Council, along with related supporting documents, proposeThe Healthy China Action outlines overall goals for 2022 and 2030, specifying the implementation of 15 special initiatives., divided into three major sections. The first section comprises six initiatives that implement comprehensive measures across health knowledge dissemination, balanced diets, nationwide fitness, tobacco control, mental health, and healthy environments to comprehensively address health determinants. The second section includes four initiatives focused on key populations—women and children, primary and secondary school students, workers, and the elderly—to safeguard health throughout the life course. The third section consists of five initiatives aimed at strengthening the prevention and control of major diseases, targeting four categories of chronic diseases (cardiovascular and cerebrovascular diseases, cancer, chronic respiratory diseases, and diabetes) as well as infectious and endemic diseases. Therefore, the keywords here are “three sections” and “15 initiatives.”

Each special campaign features clear objectives, indicators, and implementation pathways. It encompasses not only specific governmental tasks but also health recommendations for society and the public. By presenting information in an accessible and easy-to-understand manner, it integrates the concepts and requirements of the Healthy China Strategy into all aspects of people’s daily production and life. This approach provides an effective mechanism for individuals, families, society, and the government to participate in the Healthy China Action, facilitating the transition from a “disease-centered” model to a “health-centered” model.

In summary, implementing the Healthy China Initiative is a major decision and deployment made by the CPC Central Committee and the State Council. In the short term, it aims to secure happiness and health for the people; in the long run, it seeks to achieve the rejuvenation of the Chinese nation.

Yu Xuejun pointed out that, unlike previous efforts, the implementation of the Healthy China Initiative involves not only health promotion and advocacy but also focuses on the major health issues and influencing factors currently faced by the public through 15 special campaigns. In other words, it entails not just publicity and mobilization, but also practical actions driven by coordinated efforts across multiple levels, including individuals, families, society, and the government. Specifically, its characteristics can be summarized as achieving “four shifts”:

First, in terms of positioning, there is a shift from being disease-centered to health-centered.Comprehensively focus on the key factors affecting people's health, including lifestyle behaviors, living and working environments, and healthcare services; provide clear recommendations and make systematic arrangements to address prominent health issues faced by key diseases, priority populations, and across different life stages.

Second, in terms of strategy, there is a shift from focusing on “treating existing diseases” to emphasizing “preventive care.”Emphasize targeted health promotion and education tailored to the characteristics of different population groups. Through practical implementation, strive to ensure that everyone acquires essential core health knowledge and skills, effectively put into practice the concept that “each individual is the primary person responsible for their own health,” foster autonomous and self-disciplined healthy lifestyles, and make concerted efforts to help the public avoid illness, reduce disease incidence, and delay disease onset, thereby improving quality of life.

Third, in terms of the main actors, shift from relying solely on the health system to fostering society-wide coordinated action.Uphold the concept of “comprehensive health and well-being,” and exert efforts from both the supply and demand sides. Each initiative has specific objectives, with clearly defined tasks for individuals, families, society, and the government. The aim is to strengthen interdepartmental collaboration, “integrate health into all policies,” mobilize the enthusiasm and creativity of the entire society, and ignite a surge in the construction of Healthy China, striving to realize a practical framework for Healthy China characterized by “government leadership, societal participation, family support, and individual responsibility.”

Fourth, in terms of action, strive to shift from publicity and advocacy to nationwide participation and individual action.The “Healthy China Action” targets the general public, focusing on key health risk factors, major diseases, and priority populations. It not only advocates for shared health responsibilities among the government, society, families, and individuals, but also mobilizes nationwide action to achieve universal participation, shared responsibility, and equitable access to health benefits. In my view, akin to the measures adopted by the Patriotic Health Campaign for the prevention and control of infectious diseases, we should now launch a new-era, mass-based health revolution targeting chronic diseases and major infectious diseases.

On how to advance the implementation of documents related to the Healthy China Action, Yu Xuejun proposed:

First, establish an organizational structure to advance the initiative, clearly defining who is responsible for driving it forward.The implementation and assessment plan is clearly defined. At the national level, the Healthy China Action Promotion Committee shall be established under the auspices of the National Patriotic Health Campaign Committee to be responsible for formulating and issuing the “Healthy China Action (2019–2030),” and for coordinating the organization, implementation, monitoring, and evaluation of related work. The Director of the Promotion Committee shall be a State Council leader in charge of this area. The Office of the Promotion Committee shall be housed within the National Health Commission. The Promotion Committee shall also establish an Expert Advisory Committee and set up working groups for each special action. Relevant departments are required to actively study major issues concerning the implementation of the Healthy China Strategy, promptly formulate and implement specific policies and measures for the Healthy China Action, propose annual task recommendations, and ensure effective implementation in accordance with the deployed arrangements. This outlines the entities responsible for advancing the initiative.

Second, the promotion of actions is guided by specific indicators, which essentially define what is to be advanced.The “Healthy China Action (2019–2030)” proposes key indicators to be addressed by individuals, families, society, and the government, including outcome-based indicators, advocacy-oriented indicators, government performance indicators, and mandatory indicators. Relevant local authorities, departments, and experts have fully demonstrated the scientific validity and feasibility of these indicators, thereby clarifying the specific objectives to be advanced.

Third, the implementation of actions must be supported by monitoring and statistics to determine how to proceed.Monitoring and evaluation shall be conducted under the overall leadership of the Steering Committee, with each special action working group responsible for specific organization and implementation. Based on existing statistical data and leveraging internet and big data technologies, monitoring shall be carried out on key indicators and the progress of priority tasks. The Office of the Steering Committee shall compile a comprehensive monitoring and evaluation report, which, after review and approval by the Steering Committee, shall be submitted to the State Council. Upon approval by the State Council, the report shall be released annually. Fourth, performance assessment and evaluation must be incorporated into the promotion of actions, ensuring that there is a clear account of how effectively the initiatives are being advanced.

In alignment with the primary objectives and requirements for building a Healthy China, it is essential to establish a relatively stable evaluation framework. Key health indicators must be incorporated into the performance assessment metrics of Party committees and governments at all levels. The comprehensive evaluation results, upon review and approval by the Promotion Committee, shall be publicly announced to enable localities and departments to understand and monitor the implementation and progress in relevant fields and tasks. Therefore, through this series of measures, the primary aim is to ensure the effective implementation of the Healthy China Action (2019–2030) and to guarantee that the general public derives tangible benefits.

The Opinions on Implementing the Healthy China Initiative were promulgated in the name of the State Council, the Notice on Issuing the Implementation Organization and Assessment Plan for the Healthy China Initiative was released in the name of the General Office of the State Council, and the Healthy China Initiative (2019–2030) will be issued in the name of the Steering Committee for the Healthy China Initiative. These three documents constitute the overarching series of policy documents for the Healthy China Initiative.

It can be said that the State Council’s “Opinions on Implementing the Healthy China Action” serve as the core of these three documents. They clearly outline the guiding ideology, main principles, key content, and requirements for organization and implementation of this initiative. The “Notice on Issuing the Plan for Organizing, Implementing, and Assessing the Healthy China Action” is designed to ensure the further organizational implementation of the “Opinions.” Meanwhile, the “Healthy China Action (2019–2030),” released by the Healthy China Action Promotion Committee, comprises 15 specific actions. In essence, it details 15 special initiatives targeting the three key aspects identified in the “Opinions”: major health risk factors, priority populations, and major diseases. These special initiatives clarify the focus of each action and specify how they should be advanced, enabling government, society, families, and individuals to work in concert—like a “combination punch”—to achieve effective implementation.

To understand the “Healthy China Action (2019–2030),” it is essential to revisit the “Outline of the ‘Healthy China 2030’ Plan.” As is well known, in 2016, the Central Committee of the Communist Party of China and the State Council released the “Outline of the ‘Healthy China 2030’ Plan,” marking the nation’s first medium- to long-term plan in the health sector. This Outline sets forth a grand blueprint and action program for China’s healthcare and public health efforts. With the goals of co-construction, shared benefits, and health for all, it prioritizes the popularization of healthy lifestyles, optimization of health services, improvement of health security, creation of health-supportive environments, and development of the health industry, aiming to safeguard and promote people’s health comprehensively and across the entire life course. Since the implementation of the Outline, societal awareness of broad-based hygiene and holistic health has continued to strengthen, as has the public’s awareness of self-care and health preservation.

If the Outline of the Healthy China Plan serves as the overarching framework, then the “Healthy China Action (2019–2030)” currently being implemented functions as both a roadmap and a detailed blueprint for advancing the construction of a Healthy China. It outlines how to effectively translate the strategic plans into concrete actions. The document on the “Healthy China Action (2019–2030)” incorporates relevant content from the Outline of the Healthy China Plan, such as special plans addressing chronic diseases and health promotion, thereby achieving alignment and integration with other related planning documents. To fully comprehend the Healthy China Action, it is essential to further study the provisions set forth in the strategic plan and outline for building a Healthy China. Meanwhile, through the initiatives designed under this action, society-wide mobilization is aimed at achieving the goal of joint participation, co-construction, and shared benefits in realizing a Healthy China for all.

Following the issuance of the “Implementation Plan for Comprehensive Prevention and Control of Myopia in Children and Adolescents” by the Ministry of Education and seven other departments, efforts have been made in the following three areas:

First, establish and improve leadership mechanisms to concretely assign responsibility for myopia prevention and control to each province, autonomous region, and municipality. The Ministry of Education and the National Health Commission have signed responsibility agreements with provincial-level people's governments on the prevention and control of myopia among children and adolescents. These agreements stipulate that each province, autonomous region, and municipality should strive to reduce the myopia rate among children and adolescents by 0.5 to 1 percentage point annually. Provinces with high prevalence of myopia should aim for a 1-percentage-point reduction within one year, while other provinces should achieve a reduction of more than 0.5 percentage points. This represents the most significant effort undertaken in recent years in the areas of physical health and myopia prevention and control among children and adolescents.

By December this year, every province, autonomous region, and municipality will be required to “submit their accounts” for evaluation, assessing the effectiveness of myopia prevention and control efforts among children and adolescents over the past year, and determining whether the myopia rate has genuinely decreased by 0.5 to 1 percentage point.

Second, efforts to prevent and control myopia among children and adolescents primarily focus on changing unhealthy lifestyles, strengthening physical exercise, and further reducing academic burdens. These are also the core components of the responsibility agreements signed between the Ministry of Education, the National Health Commission, and provincial-level people’s governments. In this regard, we must further advance reforms in school physical education to ensure that schools effectively help children and adolescents acquire health knowledge and master basic motor skills during physical education classes, while promoting regular practice and frequent competitions—that is, consistent participation in physical exercise and competitive events. Through such concrete measures, we aim to encourage more children and adolescents to spend time outdoors in the sunlight and on the playground, thereby transforming unhealthy lifestyles.

Before the end of this year, the Ministry of Education will also issue guidelines on strengthening school-based physical education and aesthetic education in the new era. The guidelines explicitly state that reforms in school physical education should center on three key concepts: “effective instruction,” “regular practice,” and “frequent competition.” If these three concepts are effectively implemented, they can help transform unhealthy lifestyles, enable children and adolescents to acquire health knowledge and master one or two sports skills, and encourage their regular participation in physical exercise and sports competitions. This represents a crucial step in preventing and controlling myopia among children and adolescents and improving their overall physical health.

Meanwhile, conditions must be created to ensure more effective protection of vision in children and adolescents. This includes continuously improving classroom lighting, adjusting the height of desks and chairs according to students’ stature, strengthening eye exercises, and enhancing the promotion and dissemination of health and hygiene knowledge, thereby enabling children to acquire essential knowledge and skills for protecting their eyesight as well as their physical and mental well-being.

Third, from the perspective of the joint efforts promoted by the Ministry of Education and eight other departments, a series of measures have been adopted, including the establishment of special funds for myopia prevention and control, and the formation of lecture teams to conduct nationwide awareness campaigns. Meanwhile, the National Health Commission and relevant departments have taken a series of actions, including annual screening of myopia among children and adolescents, establishing health records, and tracking changes in each student’s visual acuity. These efforts have achieved phased results to date. Responsibility statements have been signed by all provinces, and lecture teams as well as expert committees have been established and have already begun conducting nationwide outreach. The various actions and plans outlined in the local responsibility statements are being steadily advanced. As it is now mid-July, with five months remaining until the end of the year, we hope that through this year’s efforts, the myopia prevention and control targets set for the first year following the issuance of the Implementation Plan will be achieved.

The National Fitness Program has been elevated to a national strategy, and the Outline of the “Healthy China 2030” Planning also incorporates content on national fitness, underscoring the high priority attached to this initiative. The National Fitness Program comprises two key components: first, addressing where people can engage in physical activity, and second, guiding how they should exercise.

First, we must have places to work out; otherwise, there is no basis for discussing how to exercise. In recent years, the General Administration of Sport of China has taken measures to address where people can exercise, with its direct investment reaching nearly RMB 15 billion. In particular, since the 18th National Congress of the Communist Party of China, the General Administration of Sport has continuously increased its investment.

First, the "Rural Farmers' Sports and Fitness Project" targeting rural areas.Rural areas suffer from a severe shortage of sports facilities. Currently, the “one court and two tables” initiative has been implemented in 570,000 administrative villages, with the final push underway to cover the remaining 50,000 to 60,000 villages.

Second, the General Administration of Sport of China has implemented the “Snow Charcoal Project” to build fitness centers in communities.

3. Develop “National Fitness Trails”, governments at all levels and sports authorities at all levels have used lottery public welfare funds to build fitness trails in communities.

Fourth, in collaboration with the Ministry of Finance, we will promote the free and low-cost opening of public sports venues to the public.The list of sports venues now open to the public is intended to provide free or low-cost services to residents. Admission is free during regular working hours, while a low fee (not a high fee) is charged on evenings during holidays.

5. Construction of Sports Parks, featuring basic sports facilities, including fitness trails and a multi-purpose sports field. The stadium can be used not only for soccer and track and field events but also as a versatile venue for activities such as square dancing and volleyball.

The General Administration of Sport of China must continue to intensify its efforts in these five areas, with substantial support also provided by the State Council.

Since 2014, nationwide censuses conducted in accordance with the methodology of the National Bureau of Statistics have shown that the per capita sports venue area has increased by 0.2 square meters. This corresponds to a total increase of 280 million square meters, equivalent to more than 40,000 standard football pitches. Through coordinated efforts by the state and government, sports authorities at all levels, and various ministries and commissions, the construction of sports venues and facilities has been actively promoted, resulting in a substantial increase.