CDC in China

With a population of nearly 1.4 billion and 50% of the world’s livestock, China’s ecology poses a risk for emerging, re-emerging, and novel diseases that could threaten China, the U.S., and the rest of the world. Moreover, the world’s growing network of air travel routes dramatically increases the risk for infections to rapidly spread, and for potential pandemics that can cause illness, death, and costly disruption to global trade. Through modeling best practices in public health, CDC supports China’s development of efficient public health systems that can detect, respond to, and prevent disease outbreaks before they become pandemics. In addition, as China’s domestic public health capacity has grown, CDC is now also helping the Chinese Center for Disease Control, known as China CDC, develop its own global public health capacity for work in Africa and elsewhere, which further improves global health security.

CDC works closely with countries to establish Field Epidemiology Training Programs (FETPs) that train a workforce of field epidemiologists —or disease detectives— to identify and contain outbreaks close to the source. In China, CDC is the primary technical partner for the Chinese FETP. Using classroom and hands-on experience, this program has graduated 279 epidemiologists who conducted more than 2,000 outbreak investigations as part of their training. Specialized training tracks are now being established in non-communicable diseases and tuberculosis.  With technical guidance from CDC, 71 graduates completed training for the new Western FETP that supports 13 under-served provinces of China–remote areas more vulnerable to novel infections and with increasing transport corridors.

CDC has supported China CDC’s  national influenza laboratory for more than 20 years. CDC works in close partnership with the China CDC’s National Influenza Epidemiology, Virology, and Pandemic Preparedness Centers, China’s provincial and local CDCs, hospitals, and academic institutions. CDC supports Chinese partners in monitoring seasonal and novel influenza viruses, as well as enhancing efforts to detect and respond to seasonal, avian, and other novel influenza viruses with pandemic potential. With the establishment of the Chinese National Influenza Surveillance Network, China now has advanced capabilities to monitor and assess the risk of influenza viruses circulating in China,  to collect evidence about influenza disease burden and vaccine effectiveness, and to share data with the international community.

CDC’s key supporting activities include:

• Strengthening influenza surveillance for seasonal and novel influenza viruses
• Conducting research to estimate disease burden and vaccine effectiveness among populations at greatest risk (including young children, older adults and pregnant women)
• Promoting influenza vaccination policy development and coverage
• Supporting novel virus risk assessments
• Establishing pandemic influenza preparedness in China
• Maintaining close ties between U.S. and China influenza experts

Enhancing China’s ability to contain infectious disease outbreaks before they spread globally is a shared priority of the U.S. and China. CDC collaborates with China CDC to improve its ability to detect and respond to emerging infectious diseases, including through surveillance sites in health care facilities. Increased collaboration with human and animal health sectors has furthered the “one health” concept of recognizing that the health of people is connected to the health of animals and the environment, this approach aims to reduce human disease burden due to rabies, brucellosis, and other zoonotic diseases.

China has the second highest tuberculosis (TB) burden after India. Around 900,000 people were diagnosed with TB in 2017. To address this public health problem of global significance, CDC and local partners work to:

• Improve TB surveillance
• Strengthen infection control practices at health care facilities
• Increase treatment completion rates among TB patients
• Address multi-drug resistant TB

CDC provides technical assistance to strengthen the laboratory network to rapidly detect emerging pathogens. These efforts include:

• Supporting the implementation of international quality control and assurance practices, such as the CDC-developed Strengthening Laboratory Management Toward Accreditation (SLMTA) program that aligns the quality management of laboratories with international standards
• Supporting training on worker safety and risk reduction

As China’s public health capacity has strengthened, in part due to long-term CDC support, it is also beginning to develop a global public health presence. China successfully supported the 2014-2016 West Africa Ebola outbreak. CDC’s partnership with China CDC has been effective coordinating activities in support of Africa CDC, like building informatics capacity. Strengthening China’s ability to play an effective global health leadership role can further promote global health security.