任明辉博士, 现任中国卫生部国际合作司司长。1987年7月毕业于西安医科大学医疗系，获医学学士学位；1993年6月毕业于美国哈佛大学公共卫生学院，获公共卫生硕士学位； 2008年6月北京大学医学部卫生政策与管理学系博士毕业，获社会医学与卫生事业管理专业医学博士学位。自1987起在卫生部工作。曾担任卫生部政策法规司政策研究处、医疗保险处副处长、卫生部办公厅部长秘书。 2001年1月起，担任卫生部国际合作司副司长；2008年4月起，任国际合作司司长。任世界卫生组织执委会 (Executive Committee) 委员、世界卫生组织结核病策略和技术顾问小组(Strategic and Technical Advisory Group for TB, STAG-TB) 成员、联合国艾滋病规划署加速实现全面可及全球指导委员会 (Global Steering Committee on Scaling Up Towards Universal Access) 等委员会委员、全球抗击艾滋病、结核病和疟疾基金理事代表、财务与审计委员会副主席、政策与战略委员会委员，以及中美、中加、中法、中澳等国政府间卫生合作委员会、克林顿基金会、盖茨基金会、生物梅里埃基金会艾滋病、结核病等合作项目管理机制中方主席等职。
Dr. REN is the Director-General of the Department of International Cooperation at the Ministry of Health (MOH) of the People’s Republic of China. Throughout his career, Dr. REN has been involved in numerous health policy research projects including the “Health care systems research in rural China” (MOH), “Financing and organization of health care services in poverty areas of China” (World Bank), “The pilot study of health insurance reform in urban China” (Chinese State Council) and the “Experiment in community health protection-policy exploration, training and demonstration program” (UNDP). In recent years, as a senior representative of the Chinese government, he served as a leading board member in a number of international organizations including WHO, UNAIDS, and the Global Fund to Fight AIDS, TB and Malaria. He is also the point of contact for many Chinese bilateral cooperation mechanisms in health. Dr. REN received his MD, MPH and PHD from Xi’an Medical University in 1987, Harvard School of Public Health in 1993 and Peking University in 2008, respectively.
Dr. Lingling Zhang initiated this interview when she met with Dr. REN at the Harvard America-China Health Summit organized by the Harvard School of Public Health China Initiative. Dr. REN was one of the invited guests of honor at the Summit. Dr. REN responded to Dr. Zhang’s questions in writing after he returned to China.
1. 重返哈佛 (Revisiting Harvard)
Lingling: As an alumnus of the Harvard School of Public Health (HSPH), what is your strongest feeling coming back here again?
Dr. REN: Although my return visit was short, I was very impressed with what I experienced during this visit. I was most touched and impressed by the Harvard community with its great attention and support for China’s health policy and health system reform, as well as the depth of related research. In addition, I am happy to see the development of HSPH in the recent years and would like to congratulate on its achievements.
2、中美医疗改革 (Health Reform in China and the United States)
Lingling: As you are an official from the Department of International Cooperation with the Ministry of Health of China, what positive impacts do you think China’s health care reform have on the relationship between China and the US?
Dr. REN: Generally, Sino-American relations have been strengthened in recent years but dissonance also exists. Pursuit of health is the ultimate goal of human beings as well as the common interest of both China and the US. The exchange and collaboration between the two countries on their health care systems, especially health care reform, will bring benefits and positive impacts to their relationship, which has global significance. Therefore, collaboration and cooperation on health care and medical science has become one of the most stable areas between the two countries, and has been growing stronger and closer with the involvement of multi-stakeholders from the governments and civil societies, bilateral collaboration and multilateral coordination in many areas, including policy exchange, research collaboration, and workforce training.
Lingling: Do you think it is a coincidence that China and the United States are undertaking their health care reform at the same time?
Dr. REN: No, it’s not a coincidence. Both China and the United States have large populations, yet the two countries are very different and are at different stages of their economic and social development. That’s why their health care reforms have drawn great attention worldwide. As a matter of fact, many countries are undertaking their health care reform currently to adjust their health care delivery and financing. These countries include the UK, France, Australia, the Netherlands, Mexico, among others. This is inevitable and results from the demand of global socio-economic development on health needs and health care delivery. This represents the global development agenda in the 21st century.
3. 中国医疗改革 (Healthcare Reform in China)
Lingling: In your opinion, which countries’ healthcare systems has China’s healthcare reform drawn the most lessons from?
Dr. REN: China’s health care reform plan has widely drawn lessons from other countries’ experiences including both successes and weaknesses, with thorough considerations of China’s own domestic characteristics and health systems. Therefore, it’s hard to calculate which specific country has offered the most experience to China. The health care system is a component of a country’s social and political system. Its formulation and development, as well as constant adjustment and reform have to be embedded in the political and economic system, social environment, and culture evolution at certain historical times. Hence, China’s health care reform cannot simply replicate what other countries have done. We need to understand the core value of other reforms and to analyze whether they are compatible with China’s system. Then a proper health care development can be creatively implemented within China. China’s health care reform has seized universal principles of equity in health care services and used essential health care services and financing as a breakthrough. From this standpoint, China’s health care reform has its unique “intellectual property”.
Lingling: From your perspective, what is the toughest issue in China’s health care reform? How would you propose to solve it?
Dr. REN: Among five major fields in the reform, public hospital reform is the most difficult one. Other reforms, i.e., improvement of essential health insurance system, establishment of essential medicine system, and equalization of essential public health services, are all greatly dependent on the services provided by public hospitals. If public hospital reform was not well implemented, the overall health care reform and its sustainability would face difficulties. However, the scope of public hospital reform goes far beyond the internal management of hospitals. It encompasses finance input, price control, regulation and other government functions, while ensuring public hospital’s “public” nature. I think it is critical for public hospitals to have clear micro functions and macro scales. Also, governments at all levels should have a clear role and responsibility in managing public hospitals, especially in terms of tax, health insurance, and pricing policies, as well as regulatory actions and their formats.
Lingling: What are the advantages and disadvantages of the current health care reform in China?
Dr. REN: The current health care reform is a widely accepted political will throughout the Central Government, all levels of local governments, and the society. Based on the general reform plan, the work was divided among various departments/ministries in central government, the accountability contract was signed by the central government agencies and local governments, and the monitoring and evaluation indicators were clarified for every stakeholder. All the above reasons ensure that health care reforms can progress smoothly on the schedule. However, the reform has not solved the fundamental, systematic and structural problems, for instance the systematic increase of fiscal investments at all government levels, and the establishment of a coherent, efficient, and coordinated health administration system. These emerging problems will need to be studied and solved gradually in the future.
Lingling: From the perspective of health care reform implementation, what is the best the Ministry of Health has done and in which areas we need to devote more efforts?
Dr. REN: Health care reform has involved multiple government agencies and ministries, including the National Development and Reform Commission, the Ministry of Finance, and the Ministry of Human Resources and Social Security. The Ministry of Health (MoH) is a major decision maker, participant, and practitioner. In order to implement the health care reform, the MoH set up a system to periodically collect, analyze, and report surveillance indicators. MoH leadership, major operating departments, and local health bureaus have all signed an “accountability contract”. This accountability mechanism is a prominent characteristic of the current health care reform. More efforts are needed in strengthening general coordination through all levels of governments, improving communication with the public, and creating a more favorable environment for health care reform.
Lingling: What are the positive experiences from China’s health care reform that are worth learning for other countries?
Dr. REN: China’s health care system puts prevention as a main focus, strengthens public health, and emphasizes on maternal and child health, and aims at local essential health services delivery. It has been proved that this is the appropriate way forward for China’s health care development, which can also offer a good reference to other countries.
Lingling: What do you think is the key factor for a successful health care reform in China?
Dr. REN: The determined political decision and strong implementation, and execution capacity are critical for the success of China’s health care reform.
4. 寄语中国卫生政策与管理学会（Words to CHPAMS）
Lingling: What would you like to share with CHPAMS members and China Health Review readers?
Dr. REN: China’s health care reform is a long march. Even though the basic principle and goals are already set, there are many problems that still need to be continuously explored, studied and resolved which requires continuing learning from international experiences. Based on the discussions at the Harvard America-China Health Summit, I think we need to put more efforts in micro data collection and analysis to better serve policy-making decisions. I hope all CHPAMS members will continue watching and supporting China’s health care reform, and more actively get involved in and advocate for China’s health care reform.
By Lingling Zhang, ScD, Harvard University
Note: This article was translated from the original responses in Chinese by Lingling Zhang, ScD, and edited by Zheng (Jane) Li, PhD. In case of ambiguities in the English translation, please refer to the original Chinese version.