The decision made by the 20th Central Committee of the Communist Party of China on further comprehensively deepening reforms and promoting Chinese-style modernization (hereinafter referred to as the "Decision") has made important deployments for deepening the reform of the medical and health system. This is an important measure to improve the health level of the people, safeguard and improve people's livelihood, and is also an inevitable requirement for building a healthy China and laying a solid health foundation for Chinese-style modernization. To study and implement the spirit of the 20th Central Committee of the Communist Party of China, and further deepen the reform in the field of health and wellness, the most critical and fundamental thing is to adhere to Xi Jinping's Thought on Socialism with Chinese Characteristics for a New Era as the guiding ideology. We must deeply study and implement the recently published "Excerpts from Xi Jinping's Discourses on Healthy China" and profoundly understandthe decisive significance of the "two establishments", resolutely achieve the "two safeguards", adhere to the Party's comprehensive leadership over health and wellness work, closely focus on the Party's health and wellness work guidelines in the new era, which emphasize "focusing on grassroots, driving reform and innovation, prioritizing prevention, balancing traditional Chinese and Western medicine, integrating health into all policies, and co-building and sharing by the people", continuously promote the shift from a disease-centered approach to a people-centered health approach, accelerate the realization of equalization of basic public health services, homogenization of basic medical services, and balanced regional allocation of high-quality medical and health resources, providing the people with high-quality, efficient, convenient, and affordable health services, and safeguarding and promoting the national health level.

Focus on grassroots and accelerate the construction of a hierarchical diagnosis and treatment system.

The Party's governance foundation lies at the grassroots level. Focusing on grassroots is an important embodiment of our Party's people-centered development philosophy in the field of health and wellness. It guides the shift of the focus of medical and health work downwards and the sinking of resources, putting healthThe establishment of the "gatekeeper" system is a fundamental strategy to meet the people's demand for medical treatment. The "Decision" clearly requires to "strengthen grassroots medical and health services". According to the goal proposed by General Secretary Xi Jinping of "serious illnesses not leaving the province, general illnesses solved at the city and county level, and routine illnesses handled at the grassroots level", we should focus on grassroots to examine and optimize the medical and health service system, service models, medical treatment concepts, and order, implement a strong foundation project for medical and health services, further promote the expansion and sinking of high-quality medical resources and their balanced regional layout, further promote high-quality medical resources to extend to the central and western regions, northeast regions, and densely populated areas within provinces, further promote high-quality medical resources to sink to county-level and urban-rural grassroots, further promote the sharing and mutual recognition of medical and health services within regions, actively carry out mobile medical services and support work for urban and rural grassroots, enhance the service capacity of grassroots medical and health services, and provide the people with fair, accessible, convenient, and continuous health services.

Actively promote the construction of national medical centers and national and provincial regional medical centers. Fully leverage their roles as critical centers for the referral and consultation of severe cases, emergency medical rescue dispatch centers for sudden incidents, support centers for grassroots medical and health institutions, preferred centers for medical staff training, reform centers for implementing deepening medical reform tasks, centers for integrating prevention at different levels, technology innovation centers oriented towards health needs, demonstration centers for maintaining public welfare and compliance, and centers for undertaking directive tasks, driving the overall improvement of regional medical service levels. Newly established national and provincial regional medical centers should be tilted towards populous cities outside provincial capitals.

Comprehensively promote the construction of closely-knit medical alliances. The focus is on promoting the sinking of personnel and services, with each grassroots medical and health institution having physicians dispatched from higher-level hospitals.The "distributed examination and centralized diagnosis" service model allows the public to enjoy high-quality medical services conveniently and nearby. Continuously solidify the grassroots network, classify and optimize the layout of grassroots medical and health institutions, achieve full coverage of services in towns, communities, and administrative villages, implement the inclusion of college student village doctors into the staffing management, and dynamically include village clinics into the designated medical insurance points, and promote family doctor contract services. Comprehensively promote the continuous support of urban medical and health resources for county-level medical and health services, providing year-round guidance in medical, pharmaceutical, nursing, and management areas, enhancing the service capacity of grassroots diagnosis and treatment. Improve the referral mechanism, focus on solving the accessibility of medications at the grassroots level within closely-knit medical alliances, gradually promote mutual recognition of examination and inspection results, make systematic arrangements for upward and downward referrals and continuity of services, and effectively alleviate the worries of the public regarding medical treatment.

Driven by reform and innovation, comprehensively enhance the public welfare nature of public hospitals.

Reform and innovation are the fundamental driving forces for high-quality development. Hospitals are the main force of our country's medical and health services, and the effectiveness of their reform directly relates to the public's sense of access to medical treatment, and is closely related to the stability of economic and social development. We must adapt to the development of the times, further deepen the reform of the medical and health system, promote theoretical innovation, institutional innovation, management innovation, and technological innovation, and maintain the sustainable development of public hospitals.

Enhancing vitality and driving force for the development of public hospitals with a public welfare orientation. Currently, there are still some issues in the economic operation of hospitals in our country, with some medical institutions in a state of debt, some price adjustments not adapting to the rapidly developing medical and health service changes, and a considerable proportion of medical staff not included in staffing management. We need to promote the digestion of existing staffing and dynamic increases, ensuring that qualified, capable, and ethically sound health professionals gradually receive staffing guarantees. Establish a charging mechanism dominated by medical services, timely reflecting cost and technological changes, promptly incorporating mature new technologies verified in clinical practice into medical insurance, regularly evaluating, dynamically adjusting, and making small, rapid progress.Implement the "two allowances" (allowing medical and health institutions to exceed the current salary control level for public institutions, allowing medical service income to deduct costs and primarily use the remaining funds for personnel rewards), dynamically narrow the income gap between different levels of medical institutions and different departments, dynamically reduce the proportion of performance-based rewards, better reflect public welfare, and promote balanced and coordinated development. Improve and perfect the health investment mechanism that aligns with economic and social development, fiscal conditions, and health needs, and promote the implementation of government subsidies for public hospitals. Adhere to the principle of doing what we can and acting within our means, gradually providing policy arrangements for the basic salaries of medical staff, especially in pediatrics, psychiatry, and traditional Chinese medicine, and providing subsidies for the operating expenses of infectious disease hospitals, psychiatric hospitals, and occupational disease prevention hospitals, steadily resolving long-term debt issues, especially during the COVID-19 pandemic, covering expenses for equipment purchases and nucleic acid testing, and alleviating the economic operational pressure on public hospitals.

Improve and perfect the health technology innovation mechanism oriented towards health needs. Without high-level health technology, it is difficult to support the health of the entire population. We need to focus on key issues in the prevention and treatment of common and frequently occurring diseases that affect public health, focus on key technologies, equipment, and standard systems, focus on the forefront of global technology and suitable technologies for grassroots in our country, leverage the advantages of the new national system, and establish a collaborative work pattern among central and local governments, different departments, and various innovation entities, promoting the research and development of drugs, vaccines, medical devices, and consumables, and facilitating the transformation of results into practical applications.

Improve and perfect the comprehensive regulatory mechanism for the entire industry. Adhere to the dual emphasis on development and regulation, strictly control the disorderly expansion of public hospitals, and for oversized construction projects, study the implementation of an upgraded approval system to enhance the rigidity of regional health planning execution. Develop special medical services in an orderly manner, guide and standardize the development of private hospitals, pilot the promotion of high-level opening up in the medical field in key cities, moderately develop Sino-foreign joint ventures and wholly foreign-owned hospitals, adapt to the diverse medical needs of residents, and connect with the development of commercial health insurance. Promote the normalization of governance against misconduct in the pharmaceutical field, consolidate a strict tone, strict measures, and a strict atmosphere, innovate regulatory methods, and comprehensively utilize hospital inspections, surprise checks, abnormal expense case reviews, audits, statistics, and complaint handling, strengthen institutional regulation, behavioral regulation, functional regulation, penetrating regulation, and continuous regulation, vigorously develop smart regulation, and further enhance regulatory effectiveness. Continuously improve the fundamental strategies to eliminate the soil and conditions for corruption in the pharmaceutical field, providing the public with safe, effective, convenient, and affordable medical and health services.

Prioritize prevention and improve the public health system.

Prevention is the most economical and effective health strategy. The health and wellness undertakings led by the Party always focus on the actual national conditions and adhere to the work policy of prioritizing prevention. Currently, our country is still in the primary stage of socialism, and we must strive to maintain people's health with limited resources, allowing the public to get sick less, get sick later, and avoid major illnesses as much as possible. The "Decision" proposes,"Improve the public health system, promote social co-governance, medical prevention collaboration, and medical prevention integration." We need to promote early intervention, adhere to joint prevention and control, group prevention and control, innovate medical prevention collaboration and integration mechanisms, and shift from a disease-centered approach to a people-centered health approach.

Comprehensively strengthen the prevention and control of key infectious diseases. The situation of infectious disease prevention and control in our country remains severe, with a certain number of new HIV infections each year, a prominent burden of tuberculosis, a large number of chronic hepatitis B virus carriers, and human papillomavirus (HPV) infections posing serious threats to women's health and family happiness, and the risk of cross-border transmission of newly emerging infectious diseases always exists. We must optimize prevention and treatment strategies, adhere to targeted measures based on diseases, multi-disease prevention, and comprehensive prevention and treatment, continuously reducing the prevalence of key infectious diseases. We should vigorously promote the inclusion of vaccine-preventable diseases in the immunization program, actively promote the research and application of combination vaccines, and strive to reduce the disease burden. We must continue to carry out health knowledge dissemination and education, improve the health literacy of the population, and cultivate healthy lifestyles, making everyone truly the first responsible person for their own health.

Comprehensively strengthen early screening, early diagnosis, and early treatment of major chronic diseases. As the aging population deepens, the number of chronic disease cases continues to increase. Currently, the number of people with hypertension in our country is about245 million, with more than 125 million diabetes patients, and the number of new cases and deaths from malignant tumors continues to rise. We need to focus on major chronic diseases affecting people's health and promote suitable technologies for early screening, early diagnosis, and early treatment. We should strengthen basic public health services, highlight service orientation, enhance service equity and accessibility, fully leverage the role of general practitioners, and strengthen health management services for chronic disease patients.

Comprehensively strengthen the core capability construction to respond to newly emerging infectious diseases. Systematically summarize the experiences and practices in combating the COVID-19 pandemic, and solidify"Four Responsibilities," ensuring effective practices such as the emergency command system's transition between emergency and routine, regional medical resource coordination, collaborative information sharing, and establishing public health committees in villages (communities). Continuously strengthen core capabilities in monitoring and early warning, testing and inspection, epidemiological investigation, emergency response, comprehensive treatment, and emergency expansion of medical capacity. Vigorously cultivate interdisciplinary strategic talents who understand clinical medicine, prevention, and social governance to serve disease prevention and government scientific decision-making, effectively responding to the threats and challenges of unknown newly emerging infectious diseases.

Balance between traditional Chinese medicine and Western medicine, planning a grand framework for the inheritance and innovation of traditional Chinese medicine.

Balancing traditional Chinese medicine and Western medicine, promoting mutual supplementation and coordinated development, is a significant advantage of our country's health and wellness undertakings. The "Decision" proposes,"Improve the mechanism for the inheritance and innovation of traditional Chinese medicine." We should promote the combination and mutual promotion of traditional Chinese medicine and modern science, encourage mutual supplementation and coordinated development of traditional Chinese and Western medicine, and fully leverage the unique advantages and roles of traditional Chinese medicine in preventing diseases, treating major illnesses, and rehabilitating patients.

We must place the development of traditional Chinese medicine within the overall health and wellness framework, planning and implementing all work in an integrated manner. We should tilt resource allocation, policy systems, and project arrangements towards traditional Chinese medicine, promoting its better development within the broader health and wellness framework. Strengthen mutual learning and collaborative research between traditional Chinese and Western medicine. With a more open perspective and a more scientific attitude, we should promote mutual learning, integration, and innovation between traditional Chinese and Western medicine. Strengthen the construction of disciplines that combine traditional Chinese and Western medicine, promote the combined medical model, incorporate traditional Chinese medicine into multidisciplinary consultation systems, and formulate and implement"Combined treatment plans of 'traditional when appropriate, Western when appropriate' for major difficult diseases, infectious diseases, chronic diseases, etc. Implement major projects for Western medicine to learn from traditional Chinese medicine, inherit and promote the essence of traditional Chinese medicine, and vigorously cultivate talents in traditional Chinese medicine who are well-versed in both ancient and modern knowledge.

We need to plan well for the great article of inheritance and innovation, implementing"The New Era Shennong Tasting Hundred Herbs" action, exploring new medicinal plant resources and authentic medicinal materials globally, jointly developing and utilizing them under the guidance of traditional Chinese medicine theory, enriching the treatment methods of traditional Chinese medicine, and serving human health and well-being. When dispatching foreign medical teams, increase the number of traditional Chinese medicine personnel, expand the overseas development of traditional Chinese medicine, and showcase the great charm and role of traditional Chinese medicine and excellent traditional Chinese culture.

Integrate health into all policies, implementing a health priority development strategy.

Ensuring people's health is a systematic project that must start from the broad, social, and holistic nature of health impact factors, fully leveraging the advantages of socialism in concentrating efforts to accomplish major tasks, and comprehensively strengthening overall coordination. The "Decision" proposes,"Implement a health priority development strategy." We must deeply understand the essential requirements of prioritizing health development, making the guarantee and improvement of health a priority goal of high-quality economic and social development, ensuring that development planning is prioritized, funding resources are prioritized, governance systems are optimized and coordinated, policies and regulations are fully integrated, and element combinations are prioritized to guarantee the construction of a modern health and wellness system.

Promote the highlighting of health goals in economic and social development planning. Incorporate major health indicators into national and local"14th Five-Year Plan," promoting relevant departments to include the guarantee and improvement of people's health as an important content in special planning and public policies. Establish and improve monitoring, investigation, and risk assessment systems for diseases and health risk factors, and organize research on major health risk factors to formulate and implement comprehensive prevention and control measures.

Promote the improvement of governance mechanisms that support health priority development. Deeply implement the Healthy China initiative, strengthen the assessment weight of key health indicators affecting the health of the public, and implement the main responsibility of local party committees and governments in promoting the construction of a Healthy China. Local party committees should strengthen leadership, clarify divisions of labor, and promote coordination; local governments should have a designated leader in charge of medical, health insurance, and pharmaceutical work, enhancing overall coordination. Using cities as units, adaptively promote the experience of Sanming medical reform, establishing a unified and efficient"Three Medical" policy coordination, information connectivity, and regulatory linkage mechanisms to promote the coordinated development and governance of medical care, health insurance, and pharmaceuticals.

Promote the improvement of the legal system for health and wellness. Advance the implementation of the Basic Medical and Health Promotion Law, accelerate the revision process of the Infectious Disease Prevention and Control Law, the Emergency Response Law for Public Health Emergencies, and explore the legislative path for health impact assessment systems, clearly integrating health into all policies and regulations, and continuously strengthening the legal promotion and implementation in the health and wellness field to ensure the implementation of the health priority development strategy with a sound legal system.

People's co-construction and sharing, forming a strong synergy for building a Healthy China.

People's co-construction and sharing is a concrete manifestation of the Party's mass line in the health and wellness field, and it is the logical starting point and value aim of building a Healthy China. The "Decision" proposes,"Adhere to a people-centered approach, respect the primary position and innovative spirit of the people, respond to the people's calls with reforms, and ensure that reforms are for the people, rely on the people, and share the results of reforms with the people." We must wholeheartedly serve the health of the people, implement a number of practical projects for the people each year, mobilize the whole nation to participate in health promotion, encourage everyone to become the primary responsible person for health, and promote health work that is more in line with the people's hearts, public opinion, and benefits their lives.

Deepen the patriotic health movement. Fully leverage the organizational advantages and mass mobilization advantages of the patriotic health movement, expand work from aspects such as living environment, health literacy, social mental health, and public health facilities, innovate methods, and strive to control major health impact factors and significant diseases that harm human health. Promote the construction of healthy villages, using the creation of healthy towns, healthy cities, and healthy cells as entry points to enhance the overall level of health governance in society.

Popularize healthy lifestyles. Carry out health knowledge popularization, advocate for civilized, healthy, and environmentally friendly lifestyles. Strengthen interventions in healthy lifestyles for families and high-risk individuals, and carry out special actions for healthy weight, oral health, and bone health. Conduct good work in popularizing mental health knowledge and mental illness, strengthen the reporting, registration, and treatment of severe mental disorder patients. Every healthcare worker should actively participate in health education, allowing more health knowledge to "fly into the homes of ordinary people," enabling the public to master more health skills.Widely promote national fitness activities, promote the deep integration of national fitness and health, and popularize scientific fitness knowledge and methods. Encourage healthcare workers to prescribe non-drug prescriptions based on the situation, guiding the public to adjust their lifestyles to improve physical health, and promote a healthy lifestyle where everyone participates, takes responsibility, and enjoys the benefits.

We must deeply understand the current situation of declining birth rates, aging population, and regional population fluctuations in our country, analyze the background and causes of population negative growth, and dynamically optimize and improve population fertility policies in a targeted manner. This includes establishing a correct view of marriage and childbirth, ensuring reproductive rights, optimizing reproductive services, reducing the costs of childbirth, upbringing, and education, expanding inclusive childcare services, enhancing public services for women and children, and safeguarding legal rights and interests, actively building a fertility-friendly society to support high-quality population development for Chinese-style modernization.