China seen as model for African health

Lower Under-5 mortality rate shows country's great strides, expert says

China has an impressive record in delivering public health services and could play an important role in helping prevent disease in Africa, a health expert says.

Ray Yip, director of the China Program of the Bill & Melinda Gates Foundation, says China's approach would help African countries strengthen their ability to prevent disease through better services and better delivery.

"We've seen tremendous progress in reducing under-5 mortality in China mostly due to effective preventive services such as childhood immunization," Yip says. "But the challenge in Africa is that even if we have the vaccines, we cannot deliver them to the people who need them most. The Center for Disease Control and Prevention in China ensures that diseases are monitored and necessary services are delivered."

The under-5 mortality rate is one of the most important indicators of progress in health services, he says, and in China the rate fell from 48 deaths per 1,000 live births in 1993 to 9 per 1,000 live births last year.

"But the number of children dying before the age of five is still high, so we need to sustain this important progress. We can do so by looking at some of the highest causes of under-5 deaths, such as pneumonia, diarrhea, and malaria, which are now completely preventable through vaccines."

But in some of the more remote areas of China the under-5 mortality figure can be three to four times that of coastal areas, something that China needs to tackle, Yip says.

But generally China's experience in reducing epidemic diseases and improving public health provides invaluable lessons for Africa, one of these being about accessible health products, Yip says.

"Our foundation has active programs in China to leverage China's capacity to develop better health products that are accessible to those who need them globally. China has the potential to develop and manufacture useful products at international standards at a significantly lower cost."

China has foreign medical aid programs in countries including in Africa, but the foundation sees China's strength in making products such as vaccines or drugs that can save more lives, he says.

The Gates Foundation has set up an office in Beijing that aims to support China's expanding role as a development partner for the rest of the world, and to help the country deal with domestic health and development issues. To develop partnerships to make the most of China's research and development resources and low-cost manufacturing for Africa and elsewhere, the foundation focuses on quality-control and regulatory issues.

Yip says examples of high-value Chinese products include Sino-implant, a four-year-long acting contraceptive often preferred by African women, and family planning products now available at significantly lower prices than in other countries, and Shang Ring, which is used in male circumcision and known to reduce HIV infection by 40 to 60 percent.

These are important, potentially game-changing products that either are unavailable or are relatively expensive in Africa, Yip says, and the foundation is confident China can be used to improve health in Africa.

One challenge is that the foundation is looking at China's assistance only from a foreign aid perspective and in doing so, "we overlook a large part of China's private sector which is already producing quality medical supplies and equipment that can improve health service delivery systems in Africa".

However, a lack of awareness, expertise, and connections prevent most manufacturers and other businesses from entering Africa, Yip says. "If those health products were able to enter the African market, it would reduce healthcare costs and improve services from an investment point of view."

The government should not be viewed as the answer to all of the problems, but as a partner, with the private sector and business, he says.

"Beyond the traditional foreign aid which China has been providing for the past 60 years, the greater opportunity lies in the private sector. There are many valuable Chinese products that can improve livelihood or health that are relatively expensive or unavailable in Africa."

This is likely to be a sustainable approach for African countries' health services, he says. It will also generate goodwill for China in those countries.

lilianxing@chinadaily.com.cn

( China Daily Africa 07/05/2013 page7)