Remaining Firmly Committed to the Path of Health Development with Chinese Characteristics

On March 6, 2026, General Secretary Xi Jinping delivered important remarks at a joint group meeting of members of the Chinese Peasants and Workers Democratic Party, the Jiusan Society, the medicine and health sector, and the social welfare and social security sector during the fourth session of the 14th National Committee of the Chinese People’s Political Consultative Conference. He stressed the need to stay firmly committed to the path of health development with Chinese characteristics and make decisive strides in advancing the Healthy China Initiative during the 15th Five-Year Plan period (2026-2030). He also outlined important plans for improving the public health system, building a high-quality and efficient medical service system, promoting healthy and wholesome lifestyles, improving relevant working mechanisms, and refining the policies and institutions for health promotion.

I. How this path has taken shape

Models of health governance vary widely among countries around the world due to differences in history, culture, development stages, and social systems. For China, a developing country with a vast population, the question is: what path of health development can truly protect the health and wellbeing of its entire people? The path a country takes determines the nature, direction, and effectiveness of its health endeavors. It is therefore essential to remain clear-headed about this fundamental issue and maintain strategic resolve.

The path of health development with Chinese characteristics did not emerge from thin air, nor was it a copy of any foreign model. Rather, it was paved step by step through years of relentless efforts by the Chinese people under the leadership of the Communist Party of China (CPC), in response to China’s particular conditions and the demands of the times. In old China, people generally suffered from poor health as the country was torn apart, ravaged by recurrent wars, plagued by rampant epidemics, and short of doctors and medicines. Indeed, the Chinese nation came to be branded even as the “sick man of East Asia.”

When it was founded in 1921, the CPC viewed the protection of public health as integral to the struggle for national independence and the people’s liberation, so much so that its program pledged to protect workers’ health and wellbeing. During the revolutionary war (1921-1949), CPC-led medical institutions and staff, enduring extremely harsh conditions, did everything they could to care for sick and wounded soldiers and provide care for civilians. Public health campaigns were also carried out in the CPC’s base areas. These efforts played an important role in protecting the health of soldiers and civilians and building up the strength of revolutionary forces.

After the founding of the People’s Republic of China (PRC) in 1949, the CPC maintained a strong focus on rural medical and health care. It established a primary healthcare system consisting of a three-tier medical and preventive care network in both urban and rural areas, a rural cooperative medical scheme, and a “barefoot doctor” program. The strengths of traditional Chinese medicine, such as the use of acupuncture and herbs, were also leveraged to provide quick diagnosis and convenient, effective, and affordable treatment. All this reduced the financial burden on people seeking medical treatment. The CPC also vigorously developed medical technologies, carried out patriotic public health campaigns, and promoted participation in sports and exercise.

After the launch of reform and opening up in 1978, the CPC addressed difficulties in accessing medical services by making clear that basic medical and health services should be provided as a public good for the whole population. Setting the goal of ensuring access to basic medical and health services for all, it worked to build a basic medical security system covering both urban and rural residents. This laid a solid institutional foundation for the long-term development of the public health sector.

Since the 18th CPC National Congress in 2012, the CPC Central Committee with Xi Jinping at its core has made ensuring the people’s health a strategic priority in China’s development. It has set the Party’s guiding principles for health in the new era and comprehensively advanced the Healthy China Initiative. Building on past experience, it has successfully embarked on a path of health development with distinctive Chinese characteristics.

Doctors on site are monitoring a fourth-generation surgical robot performing surgery on an elderly patient at the Affiliated People’s Hospital of Ningbo University, Zhejiang Province, May 7, 2026. PEOPLE’S DAILY / PHOTO BY HU XUEJUN

Making all-around progress and achieving major results in health development along this path

Between the founding of the PRC in 1949 and 2025, average life expectancy rose from 35 years to 79.25 years. Over the same period, maternal mortality fell from 1,500 to 13.4 deaths per 100,000 live births, while infant mortality dropped from 200 to 3.8 deaths per 1,000 live births. In terms of key health indicators, China is now among the leading ranks of both upper-middle-income countries and countries with populations of over 100 million. China has eradicated smallpox and successively eliminated the threats posed by major infectious diseases such as malaria and polio. It has also effectively controlled the spread of major diseases such as HIV/AIDS, tuberculosis, schistosomiasis, and hepatitis B.

China has comprehensively upgraded its capacity to deliver medical services and ensure health security, building the largest healthcare service system and medical security system in the world. Basic medical insurance coverage has remained above 95 percent, and over 90 percent of Chinese residents live within a 15-minute journey of their nearest medical facility. The supply of medical resources has expanded dramatically. Over more than seven decades, the number of hospital beds and that of physicians per 1,000 people have increased around 26-fold and 5-fold, respectively. This has provided a solid foundation for protecting the people’s health. Most notably, China has withstood the severe impact of a once-in-a-century pandemic. Its success in overcoming the Covid-19 pandemic as a country with a vast population represents a miraculous achievement in the history of human civilization.

Achieving optimal health outcomes at a relatively low cost thanks to this path

For decades, the prevailing international view was that good health returns could only be achieved through significant inputs. However, by leveraging its institutional strengths, China has optimally allocated its resources to provide health services to nearly 20 percent of the world’s population with just 9 percent of global health expenditure, pursuing a development path that delivers high efficiency at low costs.

The latest data show that China’s total health expenditure accounts for 6.7 percent of its GDP, well below the global average of 9.3 percent and far lower than the 17.2 percent recorded in high-income countries. Indeed, the country has achieved health outcomes close to the Organization for Economic Cooperation and Development (OECD) average while spending just one-seventh of the average per capita expenditure of OECD countries.

In recent years, a growing number of patients from Western countries and China’s neighboring countries have travelled to China for medical treatment, giving rise to a notable new trend of “reverse medical tourism.” What has drawn them to China is its fast, affordable, and high-quality medical services. By “voting with their feet” across national borders, these patients are giving a full endorsement of China’s medical capabilities and providing clear evidence of the success of China’s distinctive health development path.

II. What defines this path?

What China has achieved fully demonstrates that China’s distinctive path of health development is right for our country’s circumstances. It is the sure way to reach the strategic goal of building a Healthy China. This path is defined by the following features.

Meeting the people’s health needs

Who our healthcare programs should serve is a question of fundamental importance. The CPC is dedicated to serving the people wholeheartedly, and China is a socialist country run by its people. Health is a basic right of all people, not a privilege for the few. This means that China’s health-related endeavors must serve all our people, not any particular interest group. The fundamental commitment to benefiting all people reflects the essence of the CPC’s founding mission and fundamental purpose, and it is the source of China’s deep confidence in pursuing this path.

Looking back through history, it is clear that China, regardless of the changing times, has never wavered in putting the people first in its health undertakings, from issuing the call to serve workers, farmers, and soldiers to making the firm commitment to provide primary healthcare access for all, to now ensuring universal access to basic medical and health services.

In contrast, some Western countries, constrained by their social systems and interest group politics, have found it difficult to free their medical and healthcare services from the grip of capital. Their healthcare systems are thus skewed in favor of the wealthy, with quality medical resources disproportionately channeled to those who are affluent, while the health needs of ordinary people often go unmet.

Ensuring that basic medical and health services are oriented toward the public interest

Basic medical and health services form the essential core of the healthcare system and provide a fundamental safety net for people’s health. Should the government assume primary responsibility for the health sector, or should it be left entirely to the market? The answer to this question determines the nature of a country’s health sector. The CPC has made it clear that the government bears primary responsibility for providing basic medical and health services and ensures they are equitably accessible to all people.

In practice, China has reinforced the government’s leading role: it has adopted a combination of measures, including leveraging the principal role of public hospitals and improving the medical insurance network to protect the public-interest nature of basic medical services and guarantee public access to medical care. At the same time, the government has given full play to the market’s role in providing non-basic medical and health services and has encouraged non-government entities to establish non-profit medical institutions to supplement public health care. This two-pronged approach is grounded in the realities of China: a vast population and still considerable disparities between urban and rural areas and among regions. It has not only ensured that basic medical and health services remain oriented toward the public interest, but also effectively increased the supply of medical services across various levels, so as to meet people’s diversified, differentiated, and personalized health needs.

This stands in sharp contrast to many Western countries. Surveys show that in the United States, which spends more on health care than any other country, about 8 to 10 percent of the population has no health insurance, and roughly 40 percent of adults have delayed or forgone necessary medical care due to cost concerns. High medical costs are also a frequent cause of bankruptcy there.

In some developing countries, medical and health services have been commercialized prematurely and to an excessive level, leading to the contraction of public hospitals and profit-driven behavior by private providers. As a result, difficulty in accessing health care and associated high costs have become entrenched social ills.

Putting people’s health first

For every individual, health is the foremost priority—the “1” that comes before all the zeros representing everything we value in life; without it, no matter how many zeros follow, they will ultimately amount to nothing. For a country, public health underpins economic and social development. A healthy population means a stronger nation as a whole and a greater capacity to sustain development. In advancing Chinese modernization, people’s health is both a goal and a pillar of development. It must be understood and pursued not only as an essential part of public wellbeing, but as a priority with overarching, political implications. It is precisely this long-term strategic perspective that has seen the CPC Central Committee led by Xi Jinping make the major decision to implement a health-first strategy, elevating health from its traditional domain to a core position on China’s governance agenda.

At the National Health Conference in 2016, promoting people’s health was declared a strategic priority for the first time. It was then listed as the primary principle in the Outline of the Healthy China 2030 Plan. The Report to the 20th CPC National Congress in 2022 called for improving policies on promoting public health; and at the fourth plenary session of the 20th CPC Central Committee, important arrangements were made for implementing the health-first strategy. These steps reflect CPC’s deepening understanding of the importance of people’s health. What began as a political commitment has been systematically developed into a national strategy and then an institutional framework.

In China, health promotion is not the responsibility of the health sector alone, but a shared undertaking integrated into all areas of public policy. By establishing mechanisms for coordination across government departments and incorporating health indicators into the performance assessment system for economic and social development, China has not only changed how public services are delivered, but also made health a key benchmark for high-quality economic and social development. This fully illustrates how Chinese modernization benefits its people and promotes well-rounded personal development.

Pursuing reform and innovation

Faced with a gap between people’s growing health needs and the supply of medical and healthcare resources, China can only remove institutional barriers and safeguard people’s health through reform and innovation. China’s reform of its medical and healthcare systems has always been problem-focused—tackling tough issues to break new ground and exploring new approaches to realize innovation.

In the early stages of reform, China gave medical institutions greater decision-making power to stimulate the supply of services. In 2009, it launched a new round of reform in the medical and healthcare systems and established three guiding principles: ensuring access to basic medical and health services, strengthening community-level services, and developing sound supporting mechanisms. Since the 18th CPC National Congress, China has pursued systematic, integrated reforms with a focus on five basic medical and healthcare systems. Through this process, we have tackled the global challenge of healthcare reform with approaches suited to China.

Through reform and innovation, China has made a historic break with the old system of financing medical services with revenue from the sale of medicines. With the establishment of a basic medical security network and a tiered diagnosis and treatment framework, it has put in place the essential institutional foundations for basic medical and health care. These reforms have effectively alleviated the difficulties people face in accessing and affording medical care.

China has now entered a new stage of furthering medical reform. A profound transformation is taking place in the way reforms are pursued, shifting from measures in a certain field and local trials to a focus on systematic integration, coordination, and efficiency, and from individual policy fixes and breakthroughs in specific areas to a comprehensive restructuring of institutions and systems. These profound changes have progressed from pilot projects to nationwide implementation and penetrated the surface to address underlying problems. Together with China’s unwavering commitment to continuously identifying problems, finding solutions, and making improvements through innovation, they have demonstrated China’s firm resolve and courage in removing entrenched institutional barriers through reform. Moreover, these changes have greatly boosted our momentum and motivation as we advance along the path of health development with Chinese characteristics.

III. How to stay on this path

Ensuring the people’s health is a systematic endeavor that requires sustained efforts over the long term. As China’s economy and society develop and living standards rise, people are placing greater importance on their quality of life, health, and safety. They also have higher expectations of the government when it comes to ensuring public health and providing basic healthcare services. Meanwhile, industrialization, urbanization, and population aging are changing the patterns of disease. The incidence of some chronic diseases is relatively high, and the prevention and control of infectious diseases remain a serious challenge. Mental and occupational health issues should also not be overlooked.

In response to the new developments, new challenges, and new expectations, the CPC must strengthen its leadership over health work, remain firmly committed to the path of health development with Chinese characteristics, and steadfastly implement the guidelines for health work in the new era. Related policies and measures should be refined in light of evolving dynamics to ensure that the people enjoy steadily improving health.

Prioritizing key areas in advancing the Healthy China Initiative

The CPC Central Committee has made the strategic decision to build a Healthy China by 2035, and the 15th Five-Year Plan period represents a critical window for achieving this goal. At its fourth plenary session, the 20th CPC Central Committee set out major plans for accelerating the building of a Healthy China. The State Council has also recently released a national health plan for the 15th Five-Year Plan period, further defining the path toward achieving this endeavor.

First, the public health system should be improved. A robust public health system is vital for guarding against health risks and ensuring the people’s health. Stronger coordination and integration should be pursued between medical care and disease prevention initiatives, and public participation should also be deepened. Efforts are also needed to improve the disease control system and emergency care capacity, strengthen the prevention and control of major infectious diseases, and enhance mental and psychological health services. Together, these steps will provide stronger safeguards for public health.

Second, a high-quality, efficient medical service system should be established. The architecture of the system should be further refined, and capacity-building projects for community-level health care should be carried out. Steps should be taken to develop close-knit medical consortia, provide greater operational support for county, district, and community-level medical institutions, and improve the tiered diagnosis and treatment system. We should also promote the complementary and coordinated development of traditional Chinese medicine and Western medicine, and expand the provision of health services for the elderly, children, women, and people with chronic diseases, as well as rehabilitative care and palliative care.

Third, healthy and wholesome lifestyles should be promoted. More should be done to raise public health literacy and carry out public fitness initiatives and patriotic health campaigns. We should encourage people to eat a more balanced diet, manage their weight better, and take primary responsibility for their own health.

Continuing the comprehensive reform of medicine and healthcare systems

The aim of this reform is to address the most pressing problems in medical treatment, disease prevention, and health care that are of the greatest and most direct concern to the people; it is focused on providing higher-quality, more efficient health services that are well-integrated, ongoing, equitable, and accessible.

Today, China still faces problems such as the uneven distribution of medical resources, relatively weak service capacity at the community level, and inflexible operation mechanisms in public hospitals. Both longstanding problems that have built up over the years and new challenges can only be addressed through reform.

The reform of public hospitals must be continued to ensure that they better serve the public interest. Targeting deep-seated problems such as poor operation and management, inadequate fiscal input mechanisms, and shortcomings in medical service pricing, this reform should focus on improving the support and operation mechanisms of public hospitals to ensure they prioritize improving public health, thereby steadily enhancing the quality, efficiency, inclusiveness, and accessibility of medical services. A systematic approach is needed to promote coordinated development and governance of medical services, medical insurance, and pharmaceuticals.

At present, the supply structure of medical services remains unbalanced; the role of medical insurance payments as a lever for change in medical practice has yet to be fully realized; and the pricing, supply, use, and regulation of medicines and medical consumables are not well-aligned. Piecemeal adjustments cannot resolve such deep-seated issues. A package of well-coordinated policies is therefore needed to create a new governance framework in which medical services, medical insurance, and pharmaceuticals work in tandem and reinforce one another. To this end, the successful practices of medical reform in Sanming of Fujian Province should be applied more widely in line with local conditions, with coordinated advances made in reforming medical service pricing, medical insurance payment models, and the management of medicine and medical consumables. In this way, we can ensure reforms to medical services, medical insurance, and pharmaceuticals are more closely focused on the goal of improving public health.

Taking solid steps to advance scientific and technological innovation

At present, scientific and technological innovations are reshaping healthcare development models worldwide. In particular, technologies such as AI-assisted diagnosis, innovative medicines, high-end medical devices, and big data-based early warning systems have the potential to substantially improve the accuracy of diagnoses and treatment for complex diseases, and to address weak links in public health emergency response. They can also help further reduce healthcare costs by optimizing the allocation of medical resources.

Medical personnel from Shanghai Municipality and Sanming City of Fujian Province treat patients at the digital joint clinic of Sanming First Hospital, January 15, 2025. The reform experience at the hospital is already being rolled out across the country. SANMING FIRST HOSPITAL / PHOTO BY ZHENG YE

China’s health sector still faces challenges in terms of scientific and technological support, including a lack of synergy between the identification of clinical needs, research on critical issues, and the application of new advances. To firmly retain the initiative in advancing our development agenda, it is important to place equal emphasis on application-oriented development and innovation at the source.

We must tap the strengths of the new system for mobilizing resources nationwide to independently achieve more scientific and technological breakthroughs in key areas, such as high-end medical equipment, innovative vaccines, targeted therapy drugs, and public health testing reagents. Coordination among leading medical institutions, research institutes, and biomedical enterprises should be improved to tackle major challenges in research and development and strengthen China’s capacity to diagnose and treat major epidemic diseases and complex medical conditions.

Furthermore, digital and intelligent technologies should be used to improve public health. We should improve data accessibility and the sharing of medical and health information so as to spare people unnecessary trips when accessing health care. Quality medical resources should be channeled to the community level to ensure advanced technologies are truly used to promote public health.

Strengthening the ranks and competence of healthcare workers

While China’s healthcare workforce is strong overall, we still face problems such as staff shortages, imbalanced workforce composition, difficulties in attracting personnel to community-level roles, and shortcomings in medical ethics and professional conduct. To resolve these issues, healthcare workforce development should be tailored to different levels and categories of personnel. We need to develop top-tier professionals in key areas such as public health, clinical medicine, and disease prevention and management and step up training of urgently needed personnel in key fields like public health, rehabilitation and nursing care, and chronic disease management. The community level should be the main focus in the efforts to strengthen the ranks and competence of healthcare workers.

In addition, the remuneration system should be improved to better recognize the value of medical expertise, and more professional titles and staffing quotas should be allocated to community-level and frontline organizations to address difficulties in retaining staff at the community level. Targeted training and coordinated exchange mechanisms should also be refined. Paired assistance between urban and rural areas and staff rotations across regions should be improved to encourage healthcare professionals to work in counties and villages. This will help to create a more balanced distribution of personnel across different levels of the healthcare system.

Furthermore, ethics and professional conduct must be strengthened across the medicine sector, and efforts should be made to crack down on medical insurance fraud and corruption in the pharmaceutical sector. Healthcare workers should be encouraged to carry forward the great spirit forged in the fight against Covid-19, uphold high standards of professional dedication, and champion sound medical ethics, so as to cultivate a culture of integrity throughout the medical profession.

(Originally appeared in Qiushi Journal, Chinese edition, No. 15, 2026)