Tuesday news: The US health model best for China | Food and drug police | SARS victims forgotten | HIV medication non-compliance | Womens' wrinkles vary by region

US healthcare model is the answer to China's problems
The answer to China's health problems is to follow the American model and encourage growth of the private health insurance industry, says an American academic. Harvard's Professor Martin Feldstein, a former economics adviser to Ronald Reagan, says China could boost the growth of private health companies by creating tax breaks for employers and people who pay into them. Expansion of health insurance would also lead to an increase in the provision of hospital services as private insurers will enter the market, Professor Feldstein told Jewish Business News. By encouraging the purchase of health insurance by individuals or employers, the Chinese government could reduce the current trend for household saving to pay for medical bills and free up funds to increase consumer spending, he said.

'Health police' to be set up to catch drug and food crooks
"Watch it, here come the health police ..." - may soon become reality in China.  The Ministry of Public Security is planning to set up a new police division to deal with "food and drug safety crimes" in conjunction with the China Food and Drug Administration (CFDA). At present those who break food and drug regulations are supposed to be dealt with by the CFDA, but  the agency has weak powers and not enough staff to deal with the numerous cases of drug and food violations. The new food and drug police would have more powers, but some people are warning that it will lead to duplication and will not deter back street drug factories or sub-standard food manufacturers.

SARS victims abandoned to ill health
Many of the 5000 people in China who were infected with SARS a decade ago are struggling today under a burden of severe long term complications, clinicians say. SARS victims feel forgotten and abandoned, with may having debilitating lung problems that stop them from working and earning a living, according to an article by Professor Xiang Yutao and colleagues of Capital Medical University in Beijing. Many people who had SARS  developed long term problems and disabilities due to the high dose steroid therapy they were given, according to Professor Xiang. However there is no social or financial support for the many people who need ongoing medical treatment, he says.

HIV patients stop taking their medicines
Antiretroviral medicines are provided free of charge to HIV positive people in China but despite this, many stop taking them, leading to high rates of treatment failure. A new study from Guangzhou of 813 HIV-infected adult 19% had recently missed taking their medication and 7% had had stopped their antiretrovirals for at least a month in the past year). Those most likely to stop tended to be male, living alone, poorly educated and to drink alcohol.

The women with the best skin in China live in ...
If you want beautiful skin, go live near the Yangtze - that's the conclusion of a study of women's skin quality in different areas of China. Dermatologists found that skin quality and appearance depended on the local climate - in the cold, dry smoggy climate of Beijing womens' skin tended to be dry and wrinkled, whereas in the hotter sub-tropical humidity Guangzhou women had finer wrinkles - but more greasy skin due to higher sebum content.  Cities such as Shanghai and Wuhan had a combination of high moisture and moderate temperatures and women's skin had more elasticity.

Armed with SARS lessons, China fights H7N9 influenza

by Shannon Tiezzi
10 years after SARS, China is fighting another viral outbreak – and seems to be winning.
Hong Kong reported its second case of the avian flu strand known as H7N9 today, showing that the virus which first appeared in mainland China back in February continues to spread. To date, H7N9 has infected 138 in total. Of those, 45 have died.
According to reports, the first reported H7N9 case in Hong Kong was a 36 year old Indonesian domestic helper, while the latest case was an 80 year old man from Shenzhen. The Indonesian had also recently traveled to Shenzhen, leading Dr. Leung Ting-hung, Hong Kong’s controller of the Centre for Health Protection, to believe that both cases were contracted in the mainland city.
H7N9 has not been shown to spread easily from person to person, meaning the risk of a large-scale epidemic is fairly low. Still, Hong Kong is taking no changes. The city has increased its border checks and the government isolated 17 people who had been in close contact with the first H7N9 victim. To date, none of the quarantined group had tested positive for the virus.

Beijing doctor claims to have cure for bone necrosis caused by corticosteroids

Most people think about the respiratory system when they think about SARS. Chen Weiheng knows it can also affect the pelvis.
The 50-year-old doctor and director of the China Academy of the Chinese Medical Sciences' Wangjing Hospital has spent the past decade treating patients with pelvic bone necrosis caused by the hormone therapies used to treat SARS and the necrosis often causes the affected pelvis to collapse.
Chen had focused on avascular necrosis of the femoral head (ANFH) since 1991. ANFH occurs when bone tissue dies and the bone often collapses due to a lack of blood flow to the top of the femur. This has happened to many SARS survivors who received hormonal treatments.
The doctor has used a myriad of treatments and much research to slow the cellular death of his patients' hips. He has employed surgery, intravenous infusions of traditional Chinese medicine, arterial injections, Western drips, DNA analyses - anything he can to maintain skeletal integrity.
He has saved hundreds of patients from losing their joints to metal replacements.
Source: China Daily

SARS was a watershed for China public health domestically but not globally

by Chan Lai-Ha
In 2002, SARS not only exposed a fundamental shortcoming of China's public health surveillance system as well as its single-minded pursuit of economic growth since the late 1970s, but also forced China to realise that, in the era of globalisation, public health is no longer a domestic, social issue that can be isolated from foreign-policy concern.
Its ailing health care system, its aspiration to be seen as a “responsible state,” and international demands for health cooperation have compelled China to be more proactive in the global health domain. There are signs that China is now using public health as a means to strengthen its diplomatic relations with the developing world, in particular the African continent. While China has embraced multilateral cooperation in a wide array of global health issues, its engagement remains “state centric” and therefore leaders attach primary significance to intergovernmental organisations, particularly the UN agencies.
Following the Chinese government's acknowledgement of a SARS outbreak in the country, it began to acknowledge the importance of public health to national development and to accordingly strengthen its multilateral cooperation in combating contagious diseases inside and beyond its borders. For example, in the midst of the recent global economic downturn, the Chinese government announced in 2009 an injection of 850 billion yuan (US$125 billion) into its health care system to improve its operation. Since the SARS outbreak, it has not only deepened its engagement with other nations and international organisations, and cooperated with a variety of actors in dealing with its own fledgling health care system including the problem of HIV/AIDS, but China has also developed a vision for global health diplomacy. A ground-breaking implication of the SARS outbreak for China is that it was struck to realise that public health is not simply a domestic, social issue that can be isolated from foreign-policy and security concerns. In a globalising world, the Chinese government appears to have learned that its health policy will be scrutinised by the world, and hence, it has become more open to and actively participates in global health governance. The government is now learning from such European countries as the UK, France, and Switzerland in the provision of the global public goods for health. Its substantial health assistance to sub-Saharan Africa in building hospitals and training health practitioners forms part of its health diplomacy and contribution to global health governance. It has also been proactively engaging with both regional and global health institutions since 2003 and set up different health surveillance networks with its ASEAN partners as well as other intergovernmental organisations, such as the Asia-Pacific Economic Cooperation (APEC) forum .
Despite its increasing engagement with global health governance since the SARS outbreak, China's approach remains, however, fundamentally state-centric, contrary to the essence of global health diplomacy and governance. With grave concern about the loss of national sovereignty to external or nongovernmental actors, Chinese senior leaders have therefore attached primary significance to intergovernmental organisations, particularly the UN agencies. In evaluating the impact of SARS, Andrew Price-Smith has put the same point succinctly: “while the SARS epidemic may have generated moderate institutional change at the domestic level …, it resulted in only ephemeral change at the level of global governance”. In other words, national sovereignty is still of paramount importance for the Chinese leadership. Because of its sensitivity to foreign interference into its internal affairs, the Chinese government has not yet formally or officially endorsed the notion of “human security.” Under the umbrella concept of national security, “human safety,” instead of “human security,” is discussed throughout all of China's five white papers on national defence since 2000 (i.e., 2000, 2002, 2004, 2006, and 2008). Taiwan's participation in the World Health Assembly is predicated on the condition that it is considered part of China, not an independent entity. Having no tolerance in ceding its supreme authority, the central government has adopted a multi-faceted attitude towards its civil society organisations. While Beijing shows its willingness to cooperate with a wide array of actors inside China, it refuses to let its domestic NGOs and activists establish direct links with their counterparts overseas.
It is still uncertain whether this sovereign concern will trump the provision of global public good for health. Nevertheless, in a highly globalizing world, infectious diseases know no border. While China is seeking to adhere as much as possible to the underlying norms and rules of global health governance (and sometimes even applies them to their extremes), as evidenced by its handling of the recent swine flu outbreak, the major step forward is perhaps to reframe health as a global public good that is available to each and every individual of the world, rather than merely as an issue of concern to nation-states.
Source: PLOS Medicine

SARS ten years later - The Peking Duck

Incredibly enough, it’s now nearly ten years since SARS became an international crisis and turned much of China inside out.
SARS affected my impressions of China more than any other issue and shaped the tone of this blog for years. Below are my recollections of this turbulent time.

Life and
It was the winter of 2002 and I was having a difficult time in Beijing. I was wondering whether I wanted to live there at all. On my first night in my new apartment I lay down on the bed and it collapsed onto the floor with a crash. As it got colder my central heating only worked about half the time. Sometimes I slept in an overcoat. I had to send part of my salary back to the US to pay for my mortgage and soon learned the bank simply wouldn’t let me. The government wanted to keep all the renminbi in China. And I wasn’t quite prepared for the culture shock of rampant line-cutting, drivers who saw pedestrians as moving targets, questionable sanitation practices and worse.
Read more: Peking Duck

Beijing on new SARS alert after five coronavirus deaths in Middle East

Beijing hospitals are monitoring for severe respiratory infections after five deaths caused by a novel coronavirus

translation by Michael Woodhead
The Beijing Municipal Centre for Disease Control (CDC) says the city has started monitor in city hospitals for a new coronavirus infection that has caused five deaths in the Middle East.
The WHO recently confirmed laboratory reports that a novel coronavirus infection has caused nine cases of serious infection, including five deaths increased. There are now concerns that this will trigger a new"atypical pneumonia (SARS) epidemic. To date, WHO has received nine new coronavirus infection confirmed cases, five cases (including three deaths) from Saudi Arabia , two cases from Qatar , the other two cases (all deaths) from Jordan. 　　
WHO has called on all members to continue to monitor for severe acute respiratory infections, and to consider the novel coronavirus as a possible cause of any unexplained pulmonary infections in patients. The WHO stressed that monitoring should take place worldwide and any countries or regions that see any cluster of severe acute respiratory infection should conduct a thorough investigation. 　　
In response, the director of the Beijing CDC Dr Ying Rendeng said the city has already begun to monitor for coronavirus, with a careful history taken of unexplained pneumonia cases required at all medical institutions at all levels. This aims to be a 'dragnet' for monitoring suspected cases of coronavirus. All emergency doctors have received training in coronavirus characteristics and patient symptoms. Meanwhile, laboratory tests have also been prepared, so that if cases do occur, doctors and laboratories will be able to detect and diagnose them rapidly. Currently, the city has no case reports of any novel coronavirus infection.
WHO says that it is best not to assume that the new coronavirus spread is limited to the above-mentioned Middle Eastern countries. No matter which country a cluster of severe acute respiratory infection is seen, or if these infections occur among health workers, there should be a thorough investigation. 　　The reason why the new virus has caused great concern is because "atypical pneumonia" (SARS) virus that killed hundreds in 2003 was due to coronavirus. However, genetic analysis shows the closest match to the novel coronavirus is a bat coronavirus found in the Netherlands in 2008, rather than the SARS virus of 2003. The cause of the novel coronavirus infections is unclear, with most infected people having severe acute respiratory syndrome associated with acute renal failure.
Source: Hexun