1.The National Health and Family Planning Commission (NHFPC) officially came into being. On March 10, 2013, the plan on institutional restructuring and functional transformation of the State Council was made open. It was proposed that a national health and family planning commission would be set up by merging the former Ministry of Health and the National Population and Family Planning Commission, integrating the responsibilities of the former and the administration and service-provision responsibilities of the latter. In the institutional restructuring, the functional transformation was highlighted and more attention was paid to the macro-administration, administration in accordance with the law, overall supervision and optimization of resource allocation, and mutual complementation of health services and family planning services. On March 16, the First Session of the 12th National People's Congress appointed Li Bin as the commissioner of the NHFPC. On March 17, the NHFPC held the first staff meeting. Liu Yandong, vice premier of the State Council, delivered an important speech in which she stressed that the Second Plenary Session of the 18th Central Committee of the CPC and the decisions made in the First Session of the 12th National People's Congress must be carried out. All work related to institutional restructuring of the health and family planning sectors had to be done in a down-to-earth manner by focusing on functional transformation.

On June 18, the NHFPC promulgated a document that defined the major responsibilities, internal bodies and staffing of the NHFPC. It removed 10 responsibilities related to administrative approval and appraisal; integrated and strengthened seven responsibilities related to the deepening of health reform; and set up the Department of Health System Reform, which would take over the responsibilities of the Leading Group Office of Deepening Healthcare System Reform previously under the State Council.

2. The Central Committee of the CPC and the State Council developed comprehensive plans for deepening health care reform. On November 12, 2013, the Third Plenary Session of the 18th Central Committee of the Communist Party of China adopted the Decision of the Central Committee of the Communist Party of China on Some Major Issues Concerning Comprehensively Deepening Reform, in which it made clear that efforts should be made to deepen health care reform; to proceed with a comprehensive reform in health insurance, medical care, public health, and the medicine supply and regulatory system; to deepen the comprehensive reform of primary care institutions; to accelerate the reform of public hospitals; to abolish the markup policy of drug sales to make up for the shortage ofhospital funds; to extend the universal coverage of health insurance; and to encourage private funds to flow to medical services.

On June 28, the national video and teleconference on healthcare reform was held, and Premier Li Keqiang gave important instructions that required all local governments and departments concerned to regard the advancement of healthcare reform as one of the most important tasks in guaranteeing and improving people’s livelihood. Among the present was Liu Yandong, committee member of the CPC Central Politburo, vice-premier of the State Council and leader of the Leading Group Office of Deepening Healthcare System Reform at the State Council. Liu stressed that new breakthroughs had to be made in promoting healthcare reform. On December 30, the NHFPC and the State Administration of Traditional Chinese Medicine printed and issued the Several Opinions on Accelerating the Development of Privately-Run Medical Services, which stipulates that the development of privately-run medical services was to be accelerated, the abilities of private medical service providers were to be improved, and supervision of such providers was to be strengthened. Under the leadership of Party committees and the people’s government at all levels, local departments concerned actively promoted all work related to the deepening of health care reform.

In 2013, more than 900 counties in the whole country started comprehensive reform with the key link being abolishment of the markup of drug prices to make up for the shortfall in hospital funds. The Opinions on the Consolidation and Improvement of the System of Essential Drugs and the New Operation Mechanism at the Community Level issued by the State Council General Office were implemented all over the country, and the comprehensive reform focused on the efforts to have a new mechanism by inputting more funding and produced progressive results. The field investigation at grassroots units indicated that 87 percent of patients reported that the high cost of getting medical services at grassroots units had been reduced somewhat, and 80 percent of medical staff at grassroots units reported that their enthusiasm for work had been aroused.

3. While persisting in the basic national policy of family planning, a policy that married couples can have two children if one of the parents is a single child was launched. On November 12, 2013, the Decision of the Central Committee of the Communist Party of China on Some Major Issues Concerning Comprehensively Deepening Reform adopted at the Third Plenary Session of the 18th Central Committee of the Communist Party of China was published in full. It was made clear that “while persisting in the basic national policy of family planning, we will initiate a policy that married couples can have two children if one of the parents is a single child, and gradually adjust and improve the birth policy to promote balanced population growth in the long run.” On December 21, the Central Committee of the CPC and the State Council printed and issued the Opinions on Adjusting and Improving the Birth Policy, in which the great significance of adjusting and improving the birth policy and the general idea for it were made clear. It was required that the basic national policy of family planning should be adhered to and all work should be advanced in a steady, down-to-earth and orderly way. Supplementary measures should also be improved.

On December 23, the Standing Committee of the 12th National People’s Congress held the sixth session and reviewed such bills as the Draft Resolution on the Adjustment and Improvement of the Birth Policy, which had been put before the committee for review by the State Council. Local governments were required to take into account their own actual situation and determine the specific date when the policy of allowing married couples to have two children if one of the parents is a single child would be implemented by revising local regulations on the part of the provincial people’s congress or its standing committees or formulate new regulations for that purpose so that the implementation of this policy would have a legal basis. On December 18, the NHFPC and four other ministries or commissions issued the Circular on Further Improving Assistance for the Neediest Households in Family Planning, which was designed to intensify financial aid to the neediest households in family planning and carry out social care activities on an extensive basis.

4．Public health emergencies such as the epidemic of H7N9 bird flu were appropriately dealt with. Ten years after the great victory in fighting against the epidemic of SARS, the public health emergency preparedness and response system in China is now characterized by the administrative mechanism for public health emergencies at the levels of the central government and local governments, the inter-ministerial synergy led by the NHFPC in public health emergency response and a series of laws and regulations and routine response plans. Efforts were made to accelerate the construction of the Public Health Emergency Command Decision Making System, which was comprehensively upgraded in terms of response speed, site disposal, information management and self-protection. In March 2013, three cases of H7N9 bird flu were reported in Shanghai and Anhui. The Chinese government immediately launched the inter-departmental and inter-regional joint prevention and joint control mechanism and made great efforts to do a good job in epidemic analysis, the control of source of infection, early diagnosis and early treatment, and the tracing of the origin of the epidemic. By sticking to the principle of transparency, the Chinese government released timely precise information on the epidemic and the prevention and control efforts, strengthened international cooperation and effectively kept the epidemic under control, which won the recognition and affirmation of the general public and the international community. The WHO said that “China’s response is good enough to serve as a model.”

A survey indicated that 93.1 percent of the public believed that the government was in a position to control and appropriately deal with the H7N9 bird flu. On September 25, the NHFPC conducted the “National Health Emergency Rehearsal,” in which the health emergency response teams showcased their superb professional skills and excellent mental outlook. After the Lushan earthquake, the NHFPC dispatched seven national health emergency response teams, which headed for the earthquake-stricken area two hours after the earthquake where they provided medical rescue, sanitary and epidemic prevention, and psychological assistance. On November 21, the Chinese government dispatched an emergency response team to the Philippines, where they provided medical emergency relief in the wake of Typhoon Haiyan. In two weeks, they received a total of 2,144 patients and provided medical relief to 200,000 people in the disaster area, thus winning extensive praise from people in all circles both at home and abroad.

5. China expanded cooperation in delivering medical aid to developing countries and observed the 50th anniversary of the first overseas medical aid mission. On August 15, 2013, the National Conference of Overseas Medical Aid & the 50th Anniversary of the First Overseas Medical Aid Mission was held in Beijing. Thirty medical teams and 59 individuals were honored at the ceremony by the NHFPC and the Ministry of Human Resources and Social Security. On the morning of August 16, Xi Jinping, general secretary of the CPC Central Committee, received representatives i who had been honored on the previous day and health ministers from Africa. On the same day, the Ministerial Forum on China-Africa Health Cooperation was held. Liu Yandong, vice-premier of the State Council, attended the opening ceremony and delivered the keynote speech, in which she stressed that efforts should be earnestly made to develop mutually beneficial health cooperation between China and Africa and constantly consolidate and deepen the New Type of China-Africa Strategic Partnership.

In the forum, the Beijing Declaration of the Ministerial Forum of China-Africa Health Development was signed and published. The health officials decided to take a series of measures such as jointly developing human resources for health to promote the in-depth China-Africa health cooperation. The “Beijing Declaration” developed a roadmap for China and Africa to make joint efforts to solve major health problems affecting Africa by establishing a sustainable and long-term cooperation mechanism. Since 1963, 23,000 medical workers have been sent to 66 countries and regions in Asia, Africa, Latin America, Europe and Oceania. The medical staff have been bringing into play the spirit of the Chinese medical team of “defying hardship, making willing contributions, healing the wounded, rescuing the dying and giving boundless love,” thus playing an irreplaceable role in enhancing friendship between the Chinese people and peoples in recipient countries, promoting friendly cooperation between China and recipient countries, and building a good international environment for China’s reform and opening-up to the outside world.

6. Extensive efforts were made to roll out practical activities of Mass Line education among Party members. Substantial results were achieved in the “Health Action to Serve the Masses.” In accordance with the unified plans of the Central Committee of the CPC, the NHFPC launched practical activities of Mass Line education among Party members in July 2013, and started the “grand grassroots survey research.” Ten survey research groups successively went to 100 counties or cities in 25 provinces, where they obtained first-hand materials. Leaders of the NHFPC held 11 lectures for the “Face-to-Face Auditorium.” Efforts were made to solve prominent problems for the masses and initiate the “Health Action to Serve the Masses.” Moreover, the “Nationwide Volunteer Medical Consultation Week,” in which 600,000 medical staff from 23,000 medical institutions took part and 11 million people got diagnosed and treated, was promoted and well-received by the masses at the grassroots level.

The NHFPC joined hands with six other ministerial departments, such as the Ministry of Public Security. It took the “Special Action of Further Rectifying the Medical Treatment Order and Knocking down Medical Practices without Obtaining Relevant Qualifications.” Some cases were dealt with, and criminal activities, including “illegal clinics” and “hospital scalpers,” were severely cracked down, rectifying and standardizing the medical treatment order and guaranteeing the health rights and interests of the general public. For the sake of standardizing medical treatment behavior and building a new spirit in the medical profession, the NHFPC printed and issued the Circular on Implementing the “Nine No’s” to Improve Hospital Ethics and the Circular on Promoting the Practice of Keeping Records of Improper Activities of Commercial Bribery in the Pharmaceutical Sales Fields.

7. There was plenty of public debate about the practice of collecting social compensation fees, and the NHFPC demanded that local departments concerned standardize the management of social compensation fees. On July 11, 2013, some lawyers requested that 31 provincial health and family planning commissions and provincial departments of finance publicize the details on the collection and audit of social compensation fees in 2012, thus drawing the general public’s attention to the issue of social compensation fees. On September 4, the spokesman of the NHFPC made it clear that: the collection of social compensation fees has its legal basis; the management of social compensation fees is part of the budget control of local governments because they are not revenues of the central government or the health and family planning departments; it is not acceptable to tie social compensation fees to expenditures on the work of family planning; and health and family planning departments should, under the guidance and direction of local governments, do a good job in publicizing, in accordance with relevant laws and regulations, information on the collection and management of social compensation fees. On September 18, the National Audit Office published the audit results of social compensation fees collected in some counties in Gansu and eight other provinces (municipalities).

The NHFPC urged local departments concerned to take practical measures to further standardize the collection and management of social compensation fees. On November 1, the NHFPC published the results of the trials of several cases for administrative reconsideration concerning social compensation fees in 14 provinces. In the case of the seven provinces that gave replies after the legal time limit was over, the NHFPC made its decision of the administrative reconsideration, which stated that such practices did not conform to the Regulations of the People’s Republic of China on Open Government Information. In the case of the seven provinces that failed to give an open reply to the request of disclosing government information, the NHFPC made its decision of the administrative reconsideration, which stated that they had to give the replies within a prescribed period of time.

8. Efforts were made to crack down on crimes targeting medical staff and carry out the special action of maintaining medical service order. On October 25, 2013, a vicious incident happened to doctors in the First People's Hospital of Wenling city, Zhejiang province, resulting in the death of one doctor and serious injuries to two doctors. On the morning of October 28, hundreds of medical staff gathered in the First People’s Hospital of Wenling and called for “zero tolerance” of violence against medical staff in order to maintain normal medical service order. On November 7, Liu Yandong, vice-premier of the State Council, chaired a meeting for the purpose of studying and implementing the important instructions of Premier Li Keqiang and discussing such issues as how to maintain normal medical service order and build a harmonious doctor-patient relationship. In the meeting, it was stressed that efforts should be made to firmly stop the frequent and increasing violence against medical workers.

It was decided that a special action would be taken so as to see positive interaction between doctors and patients and prevent medical staff and the masses from being exposed to life-threatening situations. On December 20, the NHFPC, the Office of the Central Committee for Comprehensive Management of Public Security and other departments jointly held the Conference on Building “Safe Hospitals” in China & Maintaining Medical Service Order and Cracking down Crimes against Medical Workers. During the conference, it was decided that a year-long special action would be taken to create a good environment for patients and medical staff and earnestly maintain social harmony and stability.

9. China gave high priority to HIV/AIDS prevention and treatment. Before the 2013 World AIDS Day, Xi Jinping, general secretary of the CPC, commented on a report submitted by the Communist Party of China (CPC) Beijing Municipal Committee on its anti-HIV/AIDS work and gave written instructions in which he stressed legal and scientific prevention and control work as well as the smooth implementation of support policies, calling on the public to jointly eliminate discrimination and help provide timely and effective treatment and support for HIV carriers and AIDS patients. Premier Li Keqiang wrote a letter to Beijing You’an Hospital and extended his greetings and thanks to the medical staff, social organizations and volunteers. He also encouraged AIDS patients to be more confident in fighting the disease.

On December 1, Liu Yandong, vice-premier of the State Council, paid a visit to Beijing You’an Hospital, where she inspected the work of HIV/AIDS prevention and treatment, had cordial conversations with some AIDS patients and received representatives of medical workers. In the plenary session of the State Council AIDS Working Committee on November 29, it was stressed that more input would be made to improve related systems and mechanisms to ensure that the objectives set for HIV/AIDS prevention and control could be realized as planned. On November 30, the NHFPC, the National Development and Reform Commission, the Ministry of Civil Affairs, the Ministry of Finance, the Ministry of Human Resources and Social Security, and the Leading Group Office of Poverty Alleviation and Development of the State Council jointly printed and issued the Circular on Further Advancing the Work of AIDS Prevention and Control, which included clearly defined requirements for further advancing HIV/AIDS prevention and control in China. Local governments made great efforts to publicize and educate the general public, monitor the spread of HIV, provide tests for the general public, deliver comprehensive interventions and ARV treatment, and prevent mother-to-child transmission. As a result, noticeable progress was made in HIV/AIDS prevention and treatment.

10. The General Office of the CPC Central Committee and the General Office of the State Council asked the leading cadres to refrain from smoking in public places. Health literacy of Chinese residents was also enhanced. On December 29, the General Office of the CPC Central Committee and the General Office of the State Council jointly printed and issued the Circular on Matters Related to Leading Cadres’ Taking the Lead in Not Smoking in Public Places. The circular made it clear that leading cadres at all levels should set an example to abide by the smoking ban in public places and must not smoke in public places such as schools and hospitals where smoking is banned; Party and government organizations at all levels must see to it that smoking is banned in the course of carrying out official duties; efforts must be made to build Party and government organizations at all levels into organizations free from smoking; Party and government organizations at all levels must voluntarily subject themselves to the supervision of the masses and the supervision of public opinion. The NHFPC would strengthen the efforts to publicize the smoking ban and provide health education for the public; play an exemplary role to promote smoking bans in the health sector and family planning sector; facilitate the building of smoking-free environments; provide services to help smokers quit; and conduct research on legislation on banning smoking in public places.

On November 10, the NHFPC published a report on the results of monitoring the health literacy of Chinese residents. According to the report, the health literacy rating of urban and rural residents in China in 2012 was 8.8 percent, an increase of 2.32 percentage points over 2008. In order to further improve the health literacy rating of Chinese residents, the central government would go on subsidizing promotion actions taken by local governments to increase health literacy among residents. Efforts would be made to do commonwealth advertising, promote health-related lectures, monitor health literacy and the spread of smoking, build health promoting hospitals, and provide health education on some priority diseases and priority fields. Greater efforts were made to deepen the “China Health Travel and National Action to Improve Health Literacy,” whose theme in 2013 was the “rational administration of drugs.” Efforts were made to strengthen collaboration with media outlets and roll out such activities as: lectures on how to keep and improve health in some cities; the construction of healthy life experiencing zones; bus-based health promotions in communities; publicity events stressing the importance of rational administration of drugs in different types of schools for the purpose of disseminating health knowledge to communities, classrooms and households.