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Development of China's Public Health as an Essential Element of Human Rights
中国健康事业的发展与人权进步
【法宝引证码】

Development of China's Public Health as an Essential Element of Human Rights

 

中国健康事业的发展与人权进步

(State Council Information Office of the People's Republic of China, September 2017) (中华人民共和国国务院新闻办公室 2017年9月)

Contents 目录
Preface 前言
I. Ensuring People's Right to Health Based on China's Conditions 一、符合国情的健康权保障模式
II. Continuous Improvement of Health Environment and Conditions 二、健康环境与条件持续改善
III. Public Health Service Capability Improving Steadily 三、公共卫生服务能力稳步提升
IV. Great Improvement in the Quality of Medical and Health Services 四、医疗卫生服务质量大幅提高
V. Improvement of the National Medical Security System 五、全民医疗保障体系逐步健全
VI. Significant Improvement in the Health of Special Groups 六、特定群体的健康水平显著进步
VII. Active Participation in Global Health Governance and International Medical Assistance 七、积极参与全球健康治理和国际医疗援助
Conclusion 结束语
Preface 前言
Health is a precondition for the survival of humanity and the development of human society. The right to health is a basic human right rich in connotations. It is the guarantee for a life with dignity. Everyone is entitled to the highest standard of health, equally available and accessible 健康是人类生存和社会发展的基本条件。健康权是一项包容广泛的基本人权,是人类有尊严地生活的基本保证,人人有权享有公平可及的最高健康标准。
The Communist Party of China (CPC) and the Chinese government have always focused on the people's needs while seeking the development of the nation. Putting the people first, the Party and the government work to fulfill the people's aspiration for a better life, and strive to enhance the people's well-being and all-round development. China has always put the people's health at the top of its policy agenda, working hard to improve the people's health and fitness, and making universal health and fitness a primary goal of development. With years of strenuous effort, marked progress has been achieved in making the Chinese people healthier - China is no longer the "sick man of East Asia." China has made continued improvement in boosting the overall strength of its public health and medical services, and in enhancing the physical fitness and health conditions of its people. China has been hailed as a "role model for developing countries" by the World Health Organization (WHO) in recognition of its achievements. 中国共产党和中国政府始终坚持以人民为中心的发展思想,奉行人民至上的价值取向,牢牢把握人民群众对美好生活的向往,把增进人民福祉、促进人的全面发展作为发展的出发点和落脚点。多年来,中国坚持为人民健康服务,把提高人民的健康水平、实现人人得享健康作为发展的重要目标。经过长期不懈奋斗,中国显著提高了人民健康水平,不仅摘掉了“东亚病夫”的耻辱帽子,而且公共卫生整体实力、医疗服务和保障能力不断提升,全民身体素质、健康素养持续增强,被世界卫生组织誉为“发展中国家的典范”。
Prosperity for all is impossible without health for all. Health for all is a solemn promise to the people by the CPC and the Chinese government. Since the Party's 18th National Congress in November 2012, under the firm leadership of the CPC Central Committee with Xi Jinping at the core, China has given top priority to improving the people's health, incorporating the development philosophy of innovation, coordination, green development, opening up and shared benefits into the promotion and protection of the people's right to health. Focusing on promoting healthy lifestyles, improving health services, enhancing medical security, building a healthy environment and developing the health industry, China is striving to enhance public health and fitness, providing full-life-cycle medical and health services to its people. With improvement in the Chinese people's right to health, China's human rights have also seen profound progress. 没有全民健康,就没有全面小康,实现全民健康是中国共产党和中国政府对人民的郑重承诺。党的十八大以来,在以习近平同志为核心的党中央坚强领导下,中国把人民健康放在优先发展的战略地位,把创新、协调、绿色、开放、共享的发展理念贯穿于健康权的促进与保护中,以普及健康生活、优化健康服务、完善健康保障、建设健康环境、发展健康产业为重点,加快推进健康中国建设,努力为人民群众提供全生命周期的卫生与健康服务,提升了中国的健康权保障水平,使中国人权事业得到长足发展。
I. Ensuring People's Right to Health Based on China's Conditions 

一、符合国情的健康权保障模式

China is a large developing country with 1.3 billion people. The CPC and the Chinese government have always attached great importance to developing the medical and health services, to transforming the development model of the health sector, and to respecting and protecting citizens' right to health. A mechanism based on China's conditions to ensure the people's right to health has been put in place. 中国是一个有着13亿多人口的发展中大国。中国共产党和中国政府始终高度重视发展卫生与健康事业,加快转变健康领域的发展方式,切实尊重和保障公民的健康权,形成了符合国情的健康权保障模式。
When the People's Republic of China was founded in 1949, China had a weak medical and health system due to low levels of development in its economy and society. The nation had only 3,670 medical and health institutions, 541,000 health workers and 85,000 beds at health institutions. The average life expectancy was 35 years. To change this situation, the government devoted great efforts to developing the medical and health services, and implemented guidelines which stipulated that the health services were to serve vast majority of the people, that prevention should be stressed, that both Western medicine and Traditional Chinese Medicine (TCM) should be utilized, and that health promotion and people's involvement should be incorporated. The people were mobilized to carry out health promotion programs, and basic knowledge about healthcare was widely spread. All this greatly enhanced the people's health, and major breakthroughs were made in medical sciences. Chlamydia trachomatis was identified for the first time by Chinese scientists; Chinese doctors performed the world's first replantation of a severed limb; and artemisinin, an effective cure for malaria, was extracted in a Chinese laboratory. 1949年新中国成立时,经济社会发展水平相对落后,医疗卫生体系十分薄弱,全国仅有医疗卫生机构3670个,卫生人员54.1万人,卫生机构床位数8.5万张,人均预期寿命仅有35岁。为尽快改变这种状况,国家大力发展医药卫生事业,制定实施“面向工农兵、预防为主、团结中西医、卫生工作与群众运动相结合”的工作方针,广泛开展群众性爱国卫生运动,普及初级卫生保健,人民健康状况得到了很大改善,医疗技术取得重大突破,首次分离了沙眼衣原体,进行了世界第一例断肢再植手术,成功研制出抗疟新药青蒿素等,取得了举世瞩目的伟大成绩。
Following the introduction of the reform and opening-up drive in 1978, to address problems such as a severe shortage of medical and health resources and a lack of service capability and low efficiency, the government allowed multi-channel financing for the medical industry, and encouraged medical development in various forms, by increasing resource supply, opening up the pharmaceuticals manufacturing and circulation market, developing the pharmaceutical industry, and promoting TCM. Economic incentives were adopted to encourage medical personnel to enhance their performance. At the First National Health Service Meeting in 1996, a decision was made on implementing the guiding principles for health services in the new era, namely, "focusing on the rural areas, prioritizing prevention, equal emphasis on Western medicine and TCM, relying on science and education, encouraging public participation, promoting public health, and serving socialist modernization." In 1998, China began to form a social medical insurance system to cover the basic medical needs of workers. In 2000, it set the goal of establishing an urban medical and healthcare system in line with the socialist market economy, so that the people could enjoy reasonably priced, high-quality medical services, and thus become healthier. In 2002, the government released the Decision on Further Enhancing Health Services in Rural Areas. Taking into consideration the levels of economic and social development in rural areas, the government decided to drive health services reform to a deeper level, and put in more funding to rural areas, to provide different levels of medical services to rural residents. 1978年改革开放以后,国家针对当时存在的医疗卫生资源严重短缺、服务能力不足、服务效率较低等问题,实行多渠道筹资,鼓励多种形式办医,增加资源供给,逐步放开药品生产流通市场,发展医药产业,注重发挥中医药的作用,采取一定的经济激励措施,调动医务人员积极性,增强内部活力。1996年,第一次全国卫生工作会议明确了“以农村为重点,预防为主,中西医并重,依靠科技与教育,动员全社会参与,为人民健康服务,为社会主义现代化建设服务”的新时期卫生工作方针。1998年,国家开始建立保障职工基本医疗需求的社会医疗保险制度。2000年,国家提出建立适应社会主义市场经济要求的城镇医药卫生体制,让群众享有价格合理、质量优良的医疗服务,提高人民健康水平的改革目标。2002年,国家发布《关于进一步加强农村卫生工作的决定》,从农村经济社会发展实际出发,深化农村卫生体制机制改革,将卫生投入重点向农村倾斜,满足农民群众不同层次的医疗卫生需求。
In 2003, under the firm leadership of the Party and the government, the Chinese people, united as one, won a decisive victory in their combat against the severe acute respiratory syndrome (SARS) pandemic. Learning a lesson from this experience, the government took comprehensive measures to improve public health services, and the prevention and control of serious diseases. Marked progress was made in the prevention and control system for serious diseases, in the response mechanism for public health emergencies, in the development of community healthcare services in rural and urban areas, and in the new-type rural cooperative medical care and basic medical insurance for urban residents. 2003年,在党和政府的坚强领导下,全国人民万众一心,取得了抗击“非典”的重大胜利。在总结经验的基础上,国家全面加强了公共卫生服务和重大疾病防控工作,重大疾病防治体系不断完善,突发公共卫生事件应急机制逐步健全,农村和城市社区医疗卫生发展步伐加快,新型农村合作医疗和城镇居民基本医疗保险取得突破性进展。
In 2009, China launched a new round of reform of the medical and healthcare system. With the release of the Opinions on Deepening Reform of the Medical and Healthcare System, the government delivered a message that the basic medical and healthcare system should be available to all citizens as a public product. The nonprofit nature of public medical and healthcare was made clear. In the document it was proposed that China would develop the "four systems" of public health, medical services, medical security and drug supply and the "eight supporting mechanisms" of medical and healthcare management, operation, investment, pricing, supervision, technology and personnel, information, and law-based development, in an effort to form a basic medical and healthcare system and promote the all-round, balanced, and sustainable development of the health sector. Soon after that, China issued the Plan for Reforming Key Areas of the Medical and Healthcare System (2009-2011) and Plan for Deepening Reform of the Medical and Healthcare System during the 12th Five-Year Plan Period (2011-2015). In these two documents, the government set the goals of the reform, which were accelerating the basic medical security system, improving community-level medical and healthcare services, and promoting equal access to basic public health services. 2009年,国家启动实施新一轮医药卫生体制改革,颁布了《关于深化医药卫生体制改革的意见》,确立把基本医疗卫生制度作为公共产品向全民提供的核心理念,进一步明确公共医疗卫生的公益性质,提出建立公共卫生、医疗服务、医疗保障、药品供应“四大体系”和医药卫生管理、运行、投入、价格、监管、科技和人才、信息、法制“八项支撑”,加快基本医疗卫生制度建设,推动卫生事业全面协调可持续发展。随后,国家又颁布了《医药卫生体制改革近期重点实施方案(2009-2011年)》和《“十二五”期间深化医药卫生体制改革规划暨实施方案》,提出加快推进基本医疗保障制度建设,健全基层医疗卫生服务体系,促进基本公共卫生服务逐步均等化等改革任务。
Since 2012 China has redoubled its effort to reform the medical and healthcare system; it has accelerated the comprehensive reform of public hospitals and the price reform of drugs and medical service; it has also implemented serious illness insurance policies covering both urban and rural residents, adopted a multi-layer diagnosis and treatment mechanism, and improved the policies regarding the production, distribution and use of drugs. On October 29, 2015, enhancing public health and fitness was formally introduced in the communique of the Fifth Plenary Session of the 18th CPC Central Committee. In August 2016, at the National Health and Fitness Conference, it was stated that the government will "follow the correct guidelines for promoting health and fitness services, focus on lower-level medical institutions, strive to reform and make innovations in the medical sector, prioritize disease prevention, lay equal emphasis on Western medicine and TCM, incorporate health promotion in all policies, and involve all citizens in promoting public health and thereby bring health benefits to all." In October 2016, the state issued "Healthy China 2030" Planning Outline, a guiding document on promoting public health and fitness, with plans to make the Chinese people healthier. 2012年以来,中国不断加大医药卫生体制改革力度,加快推进公立医院综合改革,推进药品和医疗服务价格改革,全面实施城乡居民大病保险,积极建设分级诊疗制度,优化完善药品生产流通使用政策。2015年10月29日,健康中国建设正式写入党的十八届五中全会公报。2016年8月,全国卫生与健康大会提出:“要坚持正确的卫生与健康工作方针,以基层为重点,以改革创新为动力,预防为主,中西医并重,将健康融入所有政策,人民共建共享。”2016年10月,国家颁布《“健康中国2030”规划纲要》,为推进健康中国建设,提高人民健康水平做出了战略部署。
The development in the field of health services has brought concrete benefits to the Chinese people. The average life expectancy of the Chinese rose to 76.5 years in 2016 from 67.9 years in 1981; maternal mortality dropped from 88.9 per 100,000 persons in 1990 to 19.9 per 100,000 persons in 2016; and infant mortality declined from 34.7 per 1,000 in 1981 to 7.5 per 1,000 in 2016. The main health indicators of the Chinese are generally better than the average level of middle- and high-income countries, and China has achieved the UN's Millennium Goals in this regard ahead of schedule. Furthermore, China has established a complete medical and health system that is guided by the Constitution, based on civil laws and regulations, laws and administrative regulations on health, and local regulations, and directed by the outlines, programs, and plans of the health sector. The system has proved effective in maintaining sound doctor-patient relations, addressing medical disputes with impartiality, and ensuring citizens' right to health. 健康事业的发展给人民群众带来实实在在的健康福祉,中国人均预期寿命从1981年的67.9岁提高到2016年的76.5岁,孕产妇死亡率从1990年的88.9/10万下降到2016年的19.9/10万,婴儿死亡率从1981年的34.7‰下降到2016年的7.5‰,居民的主要健康指标总体上优于中高收入国家平均水平,提前实现联合国千年发展目标。同时,中国已形成了以宪法为总领,以民事法律法规、卫生行政法律法规、地方性法规等为实施基础,以健康领域各种纲要、纲领、计划为行动指南的健康制度体系,有效平衡医患关系,公正化解医疗纠纷,切实实现公民健康权。
The reform of the medical sector has produced noticeable results. Within a short period of time, China was able to achieve the following: developing the world's largest basic medical insurance network that covers all citizens, providing insurance for patients of serious diseases, enabling patients to receive emergency medical services, and improving medical assistance. All this has provided institutional guarantee that patients have access to medical services. The state has gained effective control over serious infectious diseases, has kept the spread of AIDS at a low level, has achieved the tuberculosis control target of the UN's Millennium Goals ahead of schedule, has reduced the number of schistosome infections to the lowest level in history, and became a polio-free country in 2000. China set up the world's largest online direct reporting system of notifiable epidemics and public health emergencies in 2015, and the average reporting time has been shortened to four hours from five days before the introduction of the system. 深化医改效果持续彰显,在较短时间内织起了全世界最大的全民基本医疗保障网,建立大病保险制度、疾病应急救助制度,健全医疗救助制度,为实现病有所医提供了制度保障。重大传染病得到有力控制,艾滋病整体疫情控制在低流行水平,联合国千年发展目标确定的结核病控制指标提前实现,血吸虫病疫情降至历史最低水平,2000年实现无脊髓灰质炎目标。2015年,建成了全球最大的法定传染病疫情和突发公共卫生事件网络直报系统,平均报告时间由直报前的5天缩短为4个小时。
Significant progress has been made in developing a system of medical and healthcare services. A basic medical services network covering both urban and rural areas has been put in place, with 980,000 medical and health institutions at all levels, 11 million health workers, and seven million beds at medical institutions. The state has increased its efforts to foster more medical professionals. A standardization training system for resident doctors is being established, and outstanding figures such as Nobel Prize laureate in Physiology or Medicine Tu Youyou have made significant contributions to society. As more social resources flow into the medical sector, private hospitals now account for over 57 percent of all hospitals, making medical services more diverse. China's medical and health emergency rescue capability is among the world's best. It stood the severe test of the Ebola epidemic, blocking all infectious sources from outside its territory and achieved zero infection while Chinese medical teams went on assistance missions in Africa. 医疗卫生服务体系建设取得重大进展,基本建成了覆盖城乡的基层医疗卫生服务网络,各级各类医疗卫生机构超过98万个,卫生人员超过1100万人,卫生机构床位数超过700万张。人才队伍建设加快推进,住院医师规范化培训制度逐步建立,涌现出了诺贝尔生理学或医学奖得主屠呦呦等一批杰出医务工作者。社会办医加速发展,民营医院占医院总数的比重超过57%,多元办医格局初步形成。医疗卫生应急救援能力走在国际前列,经受住了防控埃博拉出血热特大传染病疫情的严峻考验,实现了国内“严防控、零输入”和援非抗疫“打胜仗、零感染”双重胜利。
After many years of hard work, a new stage has been reached in China's medical and health services. This has not only made the Chinese people healthier, but has also created a model suited to the country's prevailing conditions that is able to ensure people's right to health. This model has the following features: 经过长期努力,中国卫生与健康事业发展跨上了崭新台阶,不仅显著提高了人民的健康水平,而且形成了符合本国国情的健康权保障模式,其主要特点是:
-- Prioritizing health and fitness. The government places people's health at the forefront of its development strategies, based on China's prevailing reality, incorporates the awareness of maintaining and improving people's health into the decision-making process of policies and the formulation and implementation of laws and regulations, and strives to achieve sound and coordinated development between healthy lifestyles, working conditions, the natural environment, and the economy and society. --健康优先,把健康置于优先发展的战略地位,立足国情,将维护和提升健康的理念融入政策、法律、法规制定实施的全过程,实现健康的生活方式、生产条件和生态环境与经济社会良性协调发展。
-- Focusing on prevention. The focus on healthcare has been shifted from treating illnesses to enhancing people's health. Equal emphasis is put on disease prevention and treatment, and the well-being of both mind and body. Western medicine and TCM have been made complementary to each other. More efforts have been focused on the prevention and control of chronic, endemic and occupational diseases. In order to reduce the occurrences of illnesses, China's medical sector is striving to learn more about the patterns and development of health-related issues, emphasizing early diagnosis, treatment and recovery. --预防为主,把以治病为中心转变为以人民健康为中心,坚持防治结合、身心并重、中西医互补,注重慢性病、地方病、职业病防控,减少疾病发生,把握健康领域的发展规律,强化早诊断、早治疗、早康复。
-- Nonprofit services. The basic medical and healthcare services will continue to be basically nonprofit, and made available to all citizens as a public product. Public hospitals are the pillar of the medical service system, and steps will be taken to ensure universal access to public-health services. --公益主导,坚持基本医疗卫生事业的公益性,把基本医疗卫生制度作为公共产品向全民提供,将公立医院作为医疗服务体系的主体,逐步实现全民享有公共健康服务。
-- Equality and benefit for all. The state will continue to ensure full coverage of health and medical services. Focusing on rural areas and communities, the gaps in health conditions between urban and rural areas, between different localities and between different groups will be gradually narrowed, so that everyone has equal access to basic health services. --公平普惠,坚持卫生服务和医疗保障覆盖全民,以农村和基层为重点,逐步缩小城乡、地区、不同人群间健康水平的差异,保证健康领域基本公共服务均等化。
-- Universal participation and sharing of benefits. The government will continue to assume the leading role, while private organizations and individuals are encouraged to participate. The goal is to involve all citizens in the building and development of the medical care system, with the benefits jointly shared by all. The government will appropriately handle its relationship with the market, so that the former can play its due role in the basic medical and healthcare sector and that the market can provide more choices in the non-basic medical care sector. --共建共享,坚持政府主导与调动社会、个人的积极性相结合,推动人人参与、人人尽力、人人享有,正确处理政府与市场的关系,政府在基本医疗卫生服务领域有所作为,市场在非基本医疗卫生服务领域发挥活力。
Graphics shows main health indicators in selected years written in the "Development of China's Public Health as an Essential Element of Human Rights" white paper, issued by the State Council Information Office. (Xinhua/Ma Yan) 
II. Continuous Improvement of Health Environment and Conditions 

二、健康环境与条件持续改善

China is keen to promote a healthy lifestyle, national fitness and health education, protect food and drinking water safety, and improve the environment for production, people's life, ecology and society in order to better guarantee the Chinese people's right to health. 中国积极推广健康生活方式,开展全民健身运动,推进全民健康教育,保障食品和饮用水安全,改善生产、生活、生态和社会环境,为促进公民健康权提供了良好条件。
Developing a healthy lifestyle. In 2007, China launched the Healthy Lifestyle for All campaign, calling on the Chinese people to develop a healthy diet and engage in physical exercises, advocating healthy lifestyle ideas, creating a supporting environment for a healthy lifestyle, and enhancing the people's awareness and behavioral abilities to develop a healthy lifestyle. By the end of 2016, the campaign had covered 81.87 percent of counties (districts) across the country. China published the Chinese Dietary Guidelines (2016) that provides healthy dietary guidance to the Chinese people in general, and to children and the elderly in particular to help them develop a balanced diet and nutrition absorption; the government has intensified monitoring of the Chinese people's nutritional status and health conditions while keeping track of, and issue information about chronic diseases and the people's nutritional status; it urges the Chinese people to reduce their salt intake, and publicizes information on how to prevent and control high blood pressure; it has adopted measures to improve the nutritional status of key populations and instituted a nutritional improvement plan for compulsory education students in rural areas as well as nutritional improvement programs for children in poverty-stricken areas; the government is continuing to tighten control on the use of tobacco and implement the WHO Framework Convention on Tobacco Control. In 2014, Shenzhen began to activate the Regulations of the Shenzhen Special Economic Zone on Smoking Control; in 2015, Beijing implemented the Beijing Regulation on Smoking Control; in 2017, Shanghai enacted revised Regulations of Shanghai Municipality on Smoking Control in Public Places, banning indoor smoking in public areas. By the end of 2016, 18 cities had adopted regulations on a smoke-free environment, covering one tenth of the population. 健康生活方式全面推行。2007年,国家启动全民健康生活方式行动,倡导居民合理饮食和适量运动,传播健康生活方式理念,创造健康的支持环境,提高全民健康意识和健康行为能力。截至2016年底,全国已有81.87%的县(区)开展了此项行动。发布《中国居民膳食指南(2016)》,对一般人群及儿童、老年人等特定群体进行科学合理膳食指导,引导居民做到平衡膳食、均衡营养。推进居民营养与健康状况监测,以及慢性病与营养监测和发布。推行全民减盐倡议,向居民传授减盐防控高血压等健康知识。实施重点人群营养改善措施,开展农村义务教育学生营养改善计划和贫困地区儿童营养改善项目。持续加大控烟力度,履行世界卫生组织《烟草控制框架公约》规定。2014年深圳市实施《深圳经济特区控制吸烟条例》,2015年北京市实施《北京市控制吸烟条例》,2017年上海市实施《上海市公共场所控制吸烟条例》修正案,落实室内全面禁烟的要求。截至2016年底,全国已有18个城市制定了地方性无烟环境法规、规章,覆盖总人口的十分之一。
Giving full play to national physical fitness. Physical fitness has become a national strategy, and the work regarding people's physical fitness has been included in economic and social development plans, fiscal budgets and annual work reports of governments at all levels. A development trajectory of nationwide physical fitness "led by the government, coordinated among relevant sectors and participated by all" has taken shape. Since the National Fitness Regulations were promulgated in 2009, 16 provinces and ten major cities have worked out local regulations on fitness for all, and all of the country's 31 provinces, autonomous regions and municipalities directly under the central government have worked out provincial-level fitness-for-all programs. Since 2009, August 8 has become National Fitness Day in China. From 2011 to 2014, 3,405 fitness centers, 9,447 community multipurpose sports playgrounds, 2,366 sports parks, 24,879 fitness squares and 878 outdoor camps were established nationwide, with 1.69 million outdoor fitness facilities installed. Physical fitness venues and facilities can be found in communities (administrative villages), sub-districts (towns and townships), counties (districts) and cities (prefectures). By the end of 2015, up to 33.9 percent of the whole population engaged in physical exercises on a regular basis; the per capita sports venue area reached 1.57 square meters; the coverage rate of sports associations at county level and above was 72 percent; the number of various kinds of juvenile sports clubs was 7,147; every ten thousand people shared three fitness centers on average, and thus a popular national fitness network was basically formed. 全民健身运动蓬勃开展。将全民健身事业提升为国家战略,把全民健身工作纳入各级政府国民经济和社会发展规划、财政预算及年度工作报告。“政府主导、部门协同、全社会共同参与”的全民健身事业发展格局初步形成。自2009年颁行《全民健身条例》以来,全国已有16个省份和10个较大市制定了全民健身地方性法规,31个省(区、市)全部制定完成省级《全民健身实施计划》。从2009年起,国家将每年的8月8日定为“全民健身日”。2011年至2014年,全国已建成全民健身活动中心3405个,社区多功能运动场9447个,体育公园2366个,健身广场24879个,户外营地878个,室外健身器材169万件。各市(地)、县(区)、街道(乡、镇)、社区(行政村)普遍建有体育场地,配有健身设施。截至2015年底,全国经常参加体育锻炼的人数比例达到33.9%,人均体育场地面积达到1.57平方米,县级及以上地区体育总会平均覆盖率达到72%,各级各类青少年体育俱乐部达到7147个,全民健身站点平均达到每万人3个,社会化全民健身组织网络基本形成。
Promoting national health education. Publicity media, such as newspapers, television, radio, the Internet and other forms of new media are utilized for public health publicity, education and consultation to help people develop a self-tailored and self-disciplined healthy lifestyle. China celebrates National Environment and Health Publicity Week every year; it has promulgated the Environment and Health Literacy of the Chinese Citizens (Trial) and a code of conduct for Chinese citizens with the slogan "Breathe the same air and get it done together" to improve air quality and intensify publicity and education through basic public health services and health education, health literacy promotion campaigns, the "Healthy Chinese" and "TCM in China" initiatives, and major theme-day public health publicity. Health awareness in both urban and rural areas rose to 10.25 percent in 2015 from 6.48 percent in 2008. 全民健康教育持续推进。充分利用报刊、电视、广播、互联网及新媒体等宣传媒介开展公众健康宣传教育咨询,引导居民形成自主自律的健康生活方式。国家每年举办“中国环境与健康宣传周”活动。发布《中国公民环境与健康素养(试行)》《“同呼吸、共奋斗”公民行为准则》。通过基本公共卫生服务健康教育、健康素养促进行动、健康中国行、中医中药中国行、重大卫生主题宣传日等项目和活动,开展健康宣传教育。城乡居民健康素养水平由2008年的6.48%上升至2015年的10.25%。
Vigorously pursuing environmental improvement. Joint pollution prevention and control between different regions has been enhanced; air quality monitoring facilities at county and district levels in the Beijing-Tianjin-Hebei region, the Yangtze River Delta and the Pearl River Delta function as a network; a network monitoring particle matter (PM) and photochemical pollutants in the Beijing-Tianjin-Hebei region and neighboring areas is in full operation. From 2011 to 2015, the nationwide chemical oxygen demand, emissions of ammonia nitrogen, sulfur dioxide, and nitrogen oxide decreased by 12.9 percent, 13 percent, 18 percent and 18.6 percent, respectively. In 2016, the PM 2.5 average concentration dropped by 6.0 percent year on year and the number of days with excellent and good air quality increased by 2.1 percentage points year on year in 338 cities at the prefectural level and above. In 2013, China enacted the Air Pollution Prevention and Control Action Plan; from 2014 to 2016, about 16 million heavily-polluting vehicles and old vehicles that couldn't meet the environmental protection standards were eliminated; all coal-fired generators have realized desulfurization and denitrification; ultra-low emissions have been encouraged, and by March 2017 coal-fired generators of about 500 million kw had been improved to achieve ultra-low emissions; the Action Plan for the Prevention and Control of Soil Pollution has been enacted, and a comprehensive survey of soil pollution has been launched; the Rules on Environmental Management of the Soil of Contaminated Sites (Trial) have been promulgated. A fund for soil pollution prevention and control has been set up, and from 2016 to 2017, RMB15 billion was earmarked by the government for this purpose. A national soil environment network has been primarily established, with 22,000 basic monitoring spots and about 15,000 risk-monitoring stations; the Action Plan for the Prevention and Control of Water Pollution has been promoted and completely implemented; the comprehensive management of the environment surrounding the river valleys has been enhanced; the environmental protection of the Yangtze River Economic Belt has been pursued, and the investigation of black and odorous water bodies in urban areas has been carried out; in 2016, according to the state-controlled monitoring bodies of surface water, the proportion of such spots of Grades I-III reached 67.8 percent, while that of inferior water bodies of Grade V dropped to 8.6 percent. 环境治理深入开展。加强区域联防联控,实现京津冀、长三角、珠三角县区级空气质量监测站点联网,京津冀及周边区域颗粒物组分和光化学监测网全面建成。2011年至2015年,全国化学需氧量和氨氮、二氧化硫、氮氧化物排放总量分别下降12.9%、13%、18%、18.6%。2016年,全国338个地级及以上城市细颗粒物(PM2.5)平均浓度同比下降6.0%,优良天数同比提高2.1个百分点。2013年,国家颁布实施《大气污染防治行动计划》。2014年至2016年,累计淘汰黄标车和老旧车辆1600余万辆。燃煤火电机组基本实现脱硫脱硝全覆盖。超低排放加快推进,截至2017年3月,完成煤电机组超低排放改造约5亿千瓦。实施《土壤污染防治行动计划》,全面启动土壤污染状况详查。颁布《污染地块土壤环境管理办法(试行)》,设立土壤污染防治专项资金。2016年和2017年,国家共下达专项资金约150亿元。初步建成国家土壤环境网,完成2.2万个基础点位布设,建成约1.5万个风险监控点。全面推动落实《水污染防治行动计划》。加强流域水环境综合治理。落实长江经济带大保护工作,组织排查城市黑臭水体。2016年,全国地表水国控监测断面Ⅰ-Ⅲ类水体比例达67.8%,劣V类水体比例降至8.6%。
Progress in comprehensive management of environmental hygiene in urban and rural areas. The China Healthy Cities and Towns Initiative is being pursued to largely improve living conditions in urban and rural areas. According to a survey in 2012, since the initiative was introduced, the proportion of standardized fairs and markets had risen to 60.6 percent from 35.2 percent, and the percent of residents who are satisfied with urban amenities and the environment increased from 30 percent to 98 percent, with 98 percent of them satisfied with the effect of the initiative. By the end of 2015, the sewage treatment rate in urban areas had increased to 92 percent while the pollution-free treatment rate of household garbage in urban built-up areas had reached 94.1 percent. Comprehensive environmental improvement had been carried out in 78,000 villages, benefiting over 140 million people in rural areas; waste treatment and resource utilization facilities had been installed in 61,000 large-scale livestock and poultry farms. By the end of 2016, the treatment rate of household garbage in rural areas was around 60 percent, and the proportion of administrative villages with sewage treatment had reached 22 percent. In 2016, 80.4 percent of rural households use toilets while the rate was 71.7 percent in 2012; in some provinces in the more developed eastern areas the figure was 90 percent or higher. 城乡环境卫生综合整治成效明显。开展卫生城镇创建活动,显著提升城乡人居环境质量。根据2012年调查显示,卫生城镇创建后与创建前相比,规范集贸市场比例由35.2%提高到60.6%,居民对市容环境的满意率由30%提高到98%,对创卫效果的满意率达到98%。截至2015年底,全国城市污水处理率提高到92%,城市建成区生活垃圾无害化处理率达到94.1%。实施7.8万个村庄的环境综合整治,1.4亿多农村人口直接受益。6.1万家规模化养殖场(小区)建成废弃物处理和资源化利用设施。截至2016年底,全国农村生活垃圾处理率在60%左右,处理污水的行政村比例达到22%。农村卫生厕所普及率从2012年的71.7%提高到2016年的80.4%,东部一些省份达90%以上。
Drinking water safety issues in rural areas basically solved. From 2006 to 2010, the investment in safe drinking water projects in rural areas reached RMB105.3 billion, providing safe drinking water to 212 million rural residents in 190,000 administrative villages. From 2011 to 2015, RMB121.5 billion from the central government and over RMB60 billion from local governments were appropriated for safe drinking water projects in rural areas. By the end of 2016, the safe drinking water monitoring covered over 85 percent of rural villages, and up to 82 percent of rural residents enjoy centralized water supply. The state has allocated funds to areas with particular difficulties, and raised the subsidy standards, such as by appropriating RMB495 million to provide safe drinking water to over 1,400 monasteries, 32,300 monks and nuns and 60,000 other residents with temporary needs in the Tibet Autonomous Region. 农村饮用水安全问题基本解决。2006年至2010年,农村饮水安全工程建设总投资1053亿元,解决了19万个行政村、2.12亿农村人口的饮水安全问题。2011年至2015年,国家共安排农村饮水安全建设工程资金1215亿元,地方配套资金600多亿元。截至2016年底,全国农村饮水安全卫生监测乡镇覆盖率达85%以上,农村集中式供水覆盖人口比例提高到82%。国家针对个别地区的特殊困难安排专项资金,提高补助标准,安排4.95亿元资金解决西藏自治区1400多座寺庙、3.23万僧尼和6万多临时供水人口的饮水安全问题。
Enhancing occupational health management. In 2011, China revised the Law of the People's Republic of China on Prevention and Control of Occupational Diseases. Campaigns were launched to control and reduce the hazards associated with fine dust and toxic stuff during production processes in particular sectors, such as quartz sand processing, asbestos mining and asbestos-product manufacturing, gold mining, cement manufacturing, stone-material processing, ceramics and refractory-material production. Corporations are urged to increase investment to improve production processes and protection measures for employees. Operational environment and conditions at workplaces have been primarily improved. By the end of 2016, the government, in accordance with the law, had punished the corporations that refused or failed to improve their occupational health management, demanding 1,524 corporations to suspend production for rectification, shutting down 1,576 corporations in response to public demand, and eliminating 426 illegal enterprises. The government has intensified supervision and inspection on occupational health management of employers. From 2013 to 2016, the number of corporations nationwide that had been brought under government supervision and inspection increased from 229,000 to 395,000, up by 72.5 percent.
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 职业健康管理不断加强。2011年,国家修订《中华人民共和国职业病防治法》,大力开展重点领域尘毒危害专项治理,对粉尘危害严重的石英砂加工、石棉开采及制品制造、金矿开采、水泥制造、石材加工、陶瓷生产和耐火材料制造等行业领域组织开展集中整治,督促企业加大投入力度,改进生产工艺,完善防护设施,加强个体防护。工作场所作业环境和条件得到初步改善。截至2016年底,国家依法处罚了一批拒不治理或治理不力的企业,共责令停产整顿1524家,提请关闭1576家,取缔非法企业426家。加大对用人单位职业卫生监督检查力度。2013年至2016年,全国各地区监督检查企业数量从22.9万家增加到39.5万家,增长72.5%。
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