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The State of Health in The People's Republic of China

Indicators of the status of China’s health sector can be found in the nation’s fertility rate of 1.8 children per woman (a 2005 estimate) and an under-five-years-of-age mortality rate of 37 per 1,000 live births (a 2003 estimate). In 2002 China had nearly 1.7 physicians per 1,000 persons and about 2.4 beds per 1,000 persons in 2000. Health expenditures on a purchasing parity power (PPP) basis were US$224 per capita in 2001, or 5.5 percent of gross domestic product (GDP). Some 37.2 percent of public expenditures were devoted to health care in China in 2001. However, about 80 percent of the health and medical care services are concentrated in cities, and timely medical care is not available to more than 100 million people in rural areas. To offset this imbalance, in 2005 China set out a five-year plan to invest 20 billion renminbi (RMB; US$2.4 billion) to rebuild the rural medical service system composed of village clinics and township- and county-level hospitals.

In 2004 health officials announced that China had some 120 million hepatitis B virus carriers. Although not identified until later, China’s first case of a new, highly contagious disease, severe acute respiratory syndrome (SARS), occurred in Guangdong in November 2002, and within three months the Ministry of Health reported 300 SARS cases and five deaths in the province. By May 2003, some 8,000 cases of SARS had been reported worldwide; about 66 percent of the cases and 349 deaths occurred in China alone. By early summer 2003, the SARS epidemic had ceased. A vaccine was developed and first-round testing on human volunteers completed in 2004.

China, similar to other nations with migrant and socially mobile populations, has experienced increased incidences of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). Based on 2003 estimates, China is believed to have a 0.1 percent adult prevalence rate for HIV/AIDS, one of the lowest rates in the world and especially in Asia. However, because of China’s large population, this figure converted in 2003 to some 840,000 cases (more than Russia but fewer than the United States and second in Asia to India), of whom 44,000 died. About 80 percent of those infected live in rural areas. In November 2004, the head of the United Nations AIDS program (UNAIDS) cited China, along with India and Russia, as being on the “tipping point” of having small, localized AIDS epidemics that could turn into major ones capable of hindering the world’s efforts to stop the spread of the disease. In 2004 the Ministry of Health reported that its annual AIDS prevention funding had increased from US$1.8 million in 2001 to US$47.1 by 2003 and that, whereas treatment had been restricted to a few hospitals in major cities, treatment was becoming more widely available. According to the study by the World Health Organization, China’s Ministry of Health, and UNAIDS, China had an estimated 650,000 people who were infected with HIV by the end of 2005.

In the 2000–2002 period, China had one of the highest per capita caloric intakes in Asia, second only to South Korea and higher than countries such as Japan, Malaysia, and Indonesia. By 2002, 92 percent of the urban population and 68 percent of the rural population had access to an improved water supply, and 69 percent of the urban population and 29 percent of the rural population had access to improved sanitation facilities.

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