卫健委崔丽：深化中非卫生健康合作
文 | 崔丽 国家卫生健康委员会副主任
编辑 | 裴安迪
设计 | 姜灵枝
制作 | 黄硕存
导读：中非卫生健康合作，应落实“一带一路”倡议，构建卫生健康领域中非命运共同体，以帮助非洲国家提高卫生体系自主发展能力为目标，在挑战中继续大胆探索、开拓创新。
中国与非洲虽远隔重洋，但联通古老的丝绸之路早在2000多年前就已打开中国和非洲医药交流之门。郑和七下西洋，曾到达非洲东海岸的肯尼亚、科摩罗群岛、塞舌尔群岛，随行的医官不仅开启了中医、针灸对非交流传播的先河，还对非洲当地的流行病和地方性疾病以及动植物资源有了初步的了解，促进了中国和非洲医药文化的交流。
20世纪60年代,为支持发展中国家的卫生事业发展，中国于1963年向阿尔及利亚派出第一批援非医疗队。55年来，中国共向48个非洲国家派出了2.1万人次的援非医疗队员，诊治患者2.2亿人次。2000 年成立的中非合作论坛，搭建了中国和非洲国家集体对话的平台和促进务实合作的机制，也推动中非卫生健康合作进入“快车道”，不仅投入规模增长迅速，援助与合作的内容也更加丰富，参与主体更为多元，合作方式更为多样。2013年，随着“一带一路”倡议的提出，中国和非洲国家的人员、商品、资金和技术流动迅速增加。构建中非健康领域的命运共同体不仅关系着双方人民的健康，更有助于维护中国和非洲的卫生安全。在2015年中非合作论坛约翰内斯堡峰会提出中非的“公共卫生合作计划”的框架下，中非双方卫生健康合作取得了一系列重要进展。
——医疗服务合作成果丰硕。建立18所中非对口医院合作，建成了重症医学中心、心脏中心、微创外科中心、眼科中心等一批医疗示范中心。这些对口医院专科及合作中心，不仅是中非之间医学和医疗技术合作交流、开展本地化教学和培训的基地，还将成为接纳来华进修后回国工作的非洲医护人员施展技能的机构载体，真正实现“授人以渔”。
——卫生创新合作蓬勃发展。2015年以来，国家卫生健康委在佛得角、津巴布韦等7国开展妇幼健康示范项目，帮助非洲国家加强各级妇幼健康机构的基本设施设备建设、人员能力建设和学科建设，扩大高质量的妇幼健康服务在非洲妇女儿童中的覆盖。在博茨瓦纳、摩洛哥等国实施20余次“光明行”义诊手术，帮助5000多名白内障患者重见光明。这些项目活动深受非洲国家民众的欢迎，已经成为中非卫生健康合作的重要品牌。
——公共卫生合作逐渐深入。2014年西非暴发埃博拉疫情，中国派遣近1200名医学专家前往西非三国支持疫情防控，援建了塞拉利昂生物安全三级实验室，利比里亚埃博拉救治中心等。2015年以来，中国支持非洲疾控中心建设，派遣专家参与非洲疾控中心工作，培养非洲公共卫生人才；中国在在科摩罗开展疟疾防控项目，将因疟疾而死亡的人数降到0，发病率下降98%；在坦桑尼亚开展血吸虫病防控项目；中国还派出公共卫生专家组赴安哥拉、马达加斯加、刚果（金）等国协助应对和防控黄热病、鼠疫、埃博拉等传染病；为非洲培训近千名公共卫生人才。
——健康产业合作前景看好。医药贸易是中非卫生合作的亮点，2017年双边贸易额已达到24.32亿美元。近年来，中国制药企业已在埃塞俄比亚、苏丹、马里、南非等多个非洲国家建厂或设立销售点，赴非开展药品本地化生产步伐加快。在非药品市场份额逐步扩大，逐渐成为不少非洲国家药品进口主要来源国，如中国已成为马达加斯加第一大药品进口来源国，占其外来药品30%的市场份额。埃塞俄比亚、乌干达等非洲国家与中国加强在医药领域的合作意愿强烈，拟开展包括医药工业园在内的医药合资合作项目。
2016年，中国政府印发了《“健康中国2030”规划纲要》，提出以“共建共享、全民健康”为战略主题，“把健康置于优先发展的战略地位”，彰显中国积极参与全球健康治理、履行2030年可持续发展议程承诺的坚定决心。联合国2030年可持续发展议程提出要消除各国发展障碍，增进人民福祉，实现经济、社会和环境可持续发展的目标。中非卫生健康合作的主题就是以卫生合作促进健康发展、健康发展促进健康权的实现。我也愿意借此机会，就中非卫生合作提出如下建议：
一是中非卫生健康合作，应落实“一带一路”倡议，构建卫生健康领域中非命运共同体。中非卫生健康合作通过知识经验分享、技术合作和提供各种形式的援助和合作项目，目的是支持非洲国家加强卫生体系建设，促进全民健康覆盖。中非在提升公共卫生体系应急响应能力方面的合作，将能显著减少突发公共事件对经济增长和社会稳定的冲击。中非合作，特别是在全球和区域多边健康治理机制中的合作，将有助于提升发展中国家在全球健康治理议程设定的影响力和话语权。
二是中非卫生健康合作，应以帮助非洲国家提高卫生体系自主发展能力为目标。应非洲国家在后埃博拉时期提出的卫生体系建设与发展的紧迫问题和要求，2015年中非合作论坛约翰内斯堡峰会提出开展中非“公共卫生合作计划”。中国参与非洲公共卫生防控体系和能力建设、对口医院合作、卫生人力资源培养，以及支持中国企业赴非洲开展药品本地化生产等，主要目的都是以支持非洲国家的能力建设为核心，推动中非卫生健康合作已经从的基础设施、物资和派遣医疗队援助转向以技术合作为主，促进非洲国家卫生体系能力提升为核心的发展合作。
三是中非卫生健康合作，应在挑战中继续大胆探索、开拓创新。非洲国家面临双重疾病负担，对中非卫生健康合作需求升级，中国需要在合作的战略统筹、精准对接和保障能力等方面有所提升。未来中国将继续坚持“非洲提出、非洲同意、非洲主导”的原则，通过对口医院、专科培养、短期义诊、公共卫生项目等，持续创新医疗卫生发展援助与合作模式，促进包括中国在内的全球卫生健康资源以更加有效的方式支持非洲国家卫生体系的自主发展，推动构建卫生健康领域中非命运共同体，为维护全球健康安全、促进健康可持续发展做出贡献。
2018年9月，中非合作论坛北京峰会将在中国举办，相信在中非双方的共同努力下，北京峰会必将成为加强中非团结合作的又一历史性盛会。我们期待着与非方共同携手，本着共商共建共享原则，加强卫生健康领域的合作，推动建设中非命运共同体，助力非盟《2063年议程》和联合国2030可持续发展目标的实现，让世界更美好、让中非人民更健康！
⬆60年代，湖北援阿尔及利亚队员到群众家做客（图片提供I湖北省卫生和计划生育委员会）
英文版：
Build a China-Africa community of shared future
Author | Cui Li, Deputy Director of the National Health Commission
Translate | Xu Chengzhi
Design | Jiang Lingzhi
Production | Huang Shuocun
Although China and Africa are far apart from each other, the ancient Silk Road of China has opened the door of Chinese and African medical exchanges since more than 2,000 years ago. Zheng He commanded seven expeditions and his fleet sailed as far as east Africa, arriving in Kenya, the Comoros Islands, and the Seychelles. The accompanying medical officers not only set the precedent of sharing Chinese medicine and acupuncture with Africans, but also gained preliminary understanding about epidemics, endemics, and animal and plant resources in that region.
In the 1960s, in support of the development of health in developing countries, China sent the first aid medical teams to Algeria in 1963. In the past 55 years, China has sent 21,000 medical aid members to 48 African countries, treating 220 million patients. The China-Africa Cooperation Forum, established in 2000, serving as both a platform for collective dialogue between China and African countries and a mechanism to promote pragmatic cooperation, has also brought China-Africa health cooperation into the “fast track”. Now the investment grows fast, assistance and cooperation are diversified, with more diverse participants and more diverse forms of cooperation. In 2013, with the introduction of the “Belt and Road Initiative”, the flow of people, goods, capital and technology between China and African countries has increased rapidly. Building a China-Africa community of shared future in the field of health is not only related to the health of both peoples, but also helps to maintain the safety of China and Africa. Under the framework of the 2015 China-Africa Cooperation Forum Johannesburg Summit on China-Africa's “China-Africa Public Health Plan”, China-Africa health cooperation has made a series of important progress.
The medical service cooperation has achieved fruitful results. China has established cooperation with 18 African counterpart hospitals and built a number of medical demonstration centers such as the Intensive Care Center, Heart Center, Minimal Invasive Surgery Center, and Ophthalmologic Center. These counterpart hospital specialist and cooperation centers are not only the base for cooperation and exchange of medical science and medical technology between China and Africa, but also for localized teaching and training. They are also institutions for the African medical staff who will return to work after coming to China for further study, thus truly realizing the goal of “teaching people how to fish”.
Health innovation cooperation is booming. Since 2015, the National Health Commission has carried out demonstration programs on maternal and child health in seven countries including Cape Verde and Zimbabwe to help African countries improve basic facilities and equipment, personnel capacity building and department building for health institutions at all levels, so as to expand quality service for women and children. In Botswana, Morocco and other countries, China has conducted more than 20 rounds of "Brightness Action" free surgery, helping more than 5,000 cataract patients to see the light. These projects have been well received by the people of African countries and have become an important brand of health cooperation between China and Africa.
Public health cooperation is gradually deepening. In 2014, the Ebola outbreak occurred in West Africa. China dispatched nearly 1,200 medical experts to the West African countries to support the epidemic prevention and control, and assisted in the establishment of the Sierra Leone Biosafety Level 3 (BSL-3) Laboratory and the Ebola Relief Center in Liberia. Since 2015, China has supported the construction of the African CDC, dispatched experts to participate in the African CDC work and cultivate African public health talents; China has launched a malaria prevention and control project in Comoros to reduce the number of deaths from malaria to zero. The incidence rate dropped by 98%; the schistosomiasis prevention and control project was carried out in Tanzania; China also sent public health experts to Angola, Madagascar, Congo (Kinshasa) and other countries to help cope with and prevent yellow fever, plague, Ebola and other infectious diseases. China has since then trained nearly 1,000 public health professionals for Africa.
The prospects for cooperation in the health industry are promising. Pharmaceutical trade is the highlight of China-Africa health cooperation. In 2017, the bilateral trade volume in this sector has reached 2.432 billion US dollars. In recent years, Chinese pharmaceutical companies have set up factories or sales operation in Ethiopia, Sudan, Mali, South Africa and other African countries, and accelerated the pace of localization of drugs in Africa. Chinese companies’ market share has gradually expanded, and they have become a major source of drug imports in many African countries. For example, China has become the largest source of drug imports in Madagascar, accounting for 30% of its market share of imported drugs. African countries such as Ethiopia and Uganda have expressed strong willingness to strengthen cooperation with China in the field of medicine, and they intend to carry out pharmaceutical joint venture projects including pharmaceutical industrial parks.
In 2016, the Chinese government issued the "Outline of the Plan for Healthy China 2030", the theme of which is to involve all citizens in promoting public health and thereby bring health benefits to all. Health has therefore been strategically prioritized in China’s development, which demonstrates the country’s active participation in global health governance and strong commitment to fulfilling the UN 2030 Agenda for Sustainable Development. The UN 2030 Agenda proposes to eliminate barriers to development, enhance people's well-being, and achieve economic, social and environmental sustainability. The essence of China-Africa health cooperation is to promote health development, which in turn advances the right to health. I am also willing to take this opportunity to make the following recommendations on China-Africa health cooperation:
⬆The expert team dispatched by Guangdong Province Hospital for Women and Children Healthcare undertook gynecological and obstetrical surgeries in Ghana in May 2018.（Photo by Health And Family Planning Commission Of Hubei Province）
First, China-Africa health cooperation should put the “Belt and Road Initiative” into practice so as to build a China-Africa community of shared future in the field of health. The China-Africa health cooperation aims to support African countries in strengthening health systems and promoting universal health coverage through knowledge sharing, technical cooperation and various forms of assistance and joint projects. The cooperation between China and Africa in improving the emergency response capability of the public health system will significantly reduce the impact of public emergencies on economic growth and social stability. China-Africa cooperation, especially in global and regional multilateral health governance mechanisms, will help to increase the influence and voice of developing countries on the global health governance agenda.
Second, China-Africa health cooperation should aim at helping African countries improve their ability to develop independently. In response to the urgent problems and demands of African countries in the post-Ebola period of health system building and development, the Johannesburg Summit of the China-Africa Cooperation Forum in 2015 proposed the implementation of the China-Africa Public Health Plan. China is participating in African public health prevention and control systems, counterpart hospitals, human resources training. China encourages local drug production by Chinese companies. The main purpose of these actions is to support the capacity building of African countries. These efforts aim to shift China-Africa health cooperation from infrastructure, material and medical team assistance to technical cooperation with a focus on upgrading African countries' health systems.
Third, China-Africa health cooperation should continue to explore and innovate in a bold manner. African countries are facing a double burden of communicable and non-communicable diseases, and there’s a demand for updating cooperation between China and Africa. China needs to improve its strategic coordination, precision alignment and support capabilities. In the future, by following the principles of cooperation being initiated, agreed and led by Africa, China will continue to innovate in medical and health development assistance and cooperation models through counterpart hospitals, specialist training, short-term clinics, and public health programs. China will continue to promote global resources, including that of China, in more effectively supporting the independent development of health systems in African countries, advance the building a China-Africa community in the field of health, so as to contribute to global health and safety and its sustainable development.
In September 2018, the Beijing Summit of the China-Africa Cooperation Forum will be held in China. I believe that with the joint efforts of China and Africa, the Beijing Summit will surely become another historic event to strengthen China-Africa solidarity and cooperation. We look forward to working with Africa, in line with the principle of wide consultation, joint development and shared benefits, to strengthen cooperation in the field of health, promote the building of a China-Africa community with a shared future, and contribute to the realization of the AU's "2063 Agenda" and the UN 2030 Agenda of Sustainable Development Goals. Let’s make the world a better place and the peoples in China and Africa healthier!
⬆Sudan Uttoman Friendship Hospital — Members of the Chinese medical team and China Investment reporters
