The Sustainable Development Goals (SDGs), adopted by all United Nations (UN) member states in 2015, established a set of bold and ambitious health-related targets to achieve by 2030. Understanding China’s progress toward these targets is critical to improving population health for its 1.4 billion people. We used estimates from the Global Burden of Disease (GBD) Study 2016, national surveys and surveillance data from China, and qualitative data. Twenty-eight of the 37 indicators included in the GBD Study 2016 were analyzed. We developed an attainment index of health-related SDGs, a scale of 0–100 based on the values of indicators. The projection model is adjusted based on the one developed by the GBD Study 2016 SDG collaborators. We found that China has achieved several health-related SDG targets, including decreasing neonatal and under-5 mortality rates and the maternal mortality ratios and reducing wasting and stunting for children. However, China may only achieve 12 out of the 28 health-related SDG targets by 2030. The number of target indicators achieved varies among provinces and municipalities. In 2016, among the seven measured health domains, China performed best in child nutrition and maternal and child health and reproductive health, with the attainment index scores of 93.0 and 91.8, respectively, followed by noncommunicable diseases (NCDs) (69.4), road injuries (63.6), infectious diseases (63.0), environmental health (62.9), and universal health coverage (UHC) (54.4). There are daunting challenges to achieve the targets for child overweight, infectious diseases, NCD risk factors, and environmental exposure factors. China will also have a formidable challenge in achieving UHC, particularly in ensuring access to essential healthcare for all and providing adequate financial protection. The attainment index of child nutrition is projected to drop to 80.5 by 2025 because of worsening child overweight. The index of NCD risk factors is projected to drop to 38.8 by 2025. Regional disparities are substantial, with eastern provinces generally performing better than central and western provinces. Sex disparities are clear, with men at higher risk of excess mortality than women. The primary limitations of this study are the limited data availability and quality for several indicators and the adoption of "business-as-usual" projection methods. The study found that China has made good progress in improving population health, but challenges lie ahead. China has substantially improved the health of children and women and will continue to make good progress, although geographic disparities remain a great challenge. Meanwhile, China faced challenges in NCDs, mental health, and some infectious diseases. Poor control of health risk factors and worsening environmental threats have posed difficulties in further health improvement. Meanwhile, an inefficient health system is a barrier to tackling these challenges among such a rapidly aging population. The eastern provinces are predicted to perform better than the central and western provinces, and women are predicted to be more likely than men to achieve these targets by 2030. In order to make good progress, China must take a series of concerted actions, including more investments in public goods and services for health and redressing the intracountry inequities.

China has the highest number of hepatitis B and C cases globally. Despite remarkable achievements, China faces daunting challenges in achieving international targets for hepatitis elimination. As part of a large-scale project assessing China’s progress in achieving health-related Sustainable Development Goals using quantitative, qualitative data and mathematical modelling, this paper summarises the achievements, gaps and challenges, and proposes options for actions for hepatitis B and C control. China has made substantial progress in controlling chronic viral hepatitis. The four most successful strategies have been: (1) hepatitis B virus childhood immunisation; (2) prevention of mother-to-child transmission; (3) full coverage of nucleic acid amplification testing in blood stations and (4) effective financing strategies to support treatment. However, the total number of deaths due to hepatitis B and C is estimated to increase from 434 724 in 2017 to 527 829 in 2030 if there is no implementation of tailored interventions. Many health system barriers, including a fragmented governance system, insufficient funding, inadequate service coverage, unstandardised treatment and flawed information systems, have compromised the effective control of hepatitis B and C in China. We suggest five strategic priority actions to help eliminate hepatitis B and C in China: (1) restructure the viral hepatitis control governance system; (2) optimise health resource allocation and improve funding efficiency; (3) improve access to and the quality of the health benefits package, especially for high-risk groups; (4) strengthen information systems to obtain high-quality hepatitis epidemiological data; (5) increase investment in viral hepatitis research and development.

Aim: Many governments in East and Southeast Asia responded promptly and effectively at the onset of the COVID-19 pandemic. Synthesizing and analyzing these responses is vital for disease control evidence-based policymaking. Methods: An extensive review of COVID-19 control measures was conducted in selected Asian countries and subregions, including Mainland China, Hong Kong, Taiwan, South Korea, Singapore, Japan, and Vietnam from 1 January to 30 May 2020. Control measures were categorized into administrative, public health, and health system measures. To evaluate the stringency and timeliness of responses, we developed two indices: the Initial Response Index (IRI) and the Modified Stringency Index (MSI), which builds on the Oxford COVID-19 Government Response Tracker (OxCGRT). Results: Comprehensive administrative, public health, and health system control measures were implemented at the onset of the outbreak. Despite variations in package components, the stringency of control measures across the study sites increased with the acceleration of the outbreak, with public health control measures implemented the most stringently. Variations in daily average MSI scores are observed, with Mainland China scoring the highest (74.2), followed by Singapore (67.4), Vietnam (66.8), Hong Kong (66.2), South Korea (62.3), Taiwan (52.1), and Japan (50.3). Variations in IRI scores depicting timeliness were higher: Hong Kong, Taiwan, Vietnam, and Singapore acted faster (IRI > 50.0), while Japan (42.4) and Mainland China (4.2) followed. Conclusions: Timely setting of stringency of the control measures, especially public health measures, at dynamically high levels is key to optimally controlling outbreaks.

Background: The Sustainable Development Goals (SDGs) articulate an ambitious global agenda and set of targets to achieve by 2030. Among the health-related SDGs, many formidable challenges remain in settings like the Association of Southeast Asian Nations (ASEAN) which face wide-ranging social, economic and health inequalities. In advance of the 2030 horizon, charting the trajectory of the health SDGs is critical for informing policy and programmatic course corrections to advance health and well-being among ASEAN’s 10 member countries with its 667 million people. Methods and findings: We used estimates from the Global Burden of Disease (GBD) Study 2021 and surveillance data to identify 27 health-related SDG indicators. The indicators were classified into 7 thematic areas: (i) nutrition, (ii) maternal, child and reproductive health (MCH), (iii) infectious diseases, (iv) non-communicable diseases (NCDs), (v) environmental health, (vi) universal health coverage (UHC), and (vii) road injuries. We developed an attainment index ranging from 0 to 100 for each SDG indicator by referencing the SDG targets and projected their progress to 2030. We find an overall positive progress towards the health-related SDG targets in ASEAN from 1990 to 2030. At the aggregate level by 2030, 2 member countries, Singapore and Brunei, are projected to achieve their targets (attainment score ≥ 90). At a wider regional level, ASEAN is projected to make substantial progress in nutrition, MCH, and UHC, with a majority of countries projected to come close to or achieve their targets. However, progress is projected to be slower in the areas of reducing the incidence of infectious disease (i.e., HIV and AIDs, hepatitis B, TB, and neglected tropical diseases), NCD-related mortality and its risk factors (i.e., harmful alcohol use and smoking), environment-related mortality and its risk factors (i.e., unsafe water and poor hygiene, and air pollution), and road injuries. Substantial disparities are identified in the region, with Singapore, Brunei, Malaysia and Thailand generally performing better than elsewhere. A limitation of our study was its reliance on historical trends which may not fully capture future political, social, or technological changes. Conclusions: As a regional bloc, ASEAN faces persistent challenges in achieving health-related SDG targets by 2030, with unequal progress between countries. Moreover, epidemiological transitions and worsening environmental threats further compound potential gains. At the country level, efforts to enhance health system financing, quality and equity will need to be coupled with wider approaches that address structural drivers of disease. Furthermore, coordinated regional efforts will be essential to effectively respond to emerging threats posed by pollution and environmental risks.

Vaccines are cornerstones of public health, yet equitable access remains a major global challenge. While China has achieved sustained high coverage of National Immunization Program (NIP) vaccines, some WHO-recommended cost-effective non-NIP vaccines, such as Hib, pneumococcal conjugate (PCV), rotavirus, and human papillomavirus vaccines (HPV) are not universally accessible and often require out-of-pocket payment. This study examines geographic and urban–rural disparities in the availability of these four vaccines across China using data from a nationally representative China’s National Health Accounts survey in 2022, covering 355 district- and county-level disease control centers and 2,609 public primary health facilities across 27 provinces. Availability was defined as the presence of at least one dose delivered or administered. Inequality was assessed using Slope Index of Inequality (SII) and the Erreygers-corrected Concentration Index (CI), based on provincial GDP per capita. We found significant disparities in vaccine availability across economic development levels and urban–rural settings in China. Overall, HPV vaccines were most available (96.9%) and PCV13 the least (86.5%) at the district/county level. Urban areas had markedly higher availability than rural areas, particularly for PCV13 (94.2% vs. 79.1%). At the clinic level, over 70% of urban clinics provided all four vaccine types, compared to just 40% in rural areas. The vaccines with the highest inequality were DTaP-IPV-Hib (CI: 0.408), PCV13 (CI: 0.362), and RV5 (CI: 0.343), indicating strong pro-rich distribution. In contrast, the Hib vaccine demonstrated the lowest inequality (CI: 0.209). These findings highlight significant inequities in the availability of WHO-recommended non-NIP vaccines across China, particularly affecting rural and economically disadvantaged regions underscoring the need of expanding vaccine provision in underserved areas, strengthening rural service capacity, and considering the inclusion of these vaccines in the NIP.

The Sustainable Development Goals (SDGs), adopted by all United Nations (UN) member states in 2015, established a set of bold and ambitious health-related targets to achieve by 2030. Understanding China’s progress toward these targets is critical to improving population health for its 1.4 billion people. We used estimates from the Global Burden of Disease (GBD) Study 2016, national surveys and surveillance data from China, and qualitative data. Twenty-eight of the 37 indicators included in the GBD Study 2016 were analyzed. We developed an attainment index of health-related SDGs, a scale of 0–100 based on the values of indicators. The projection model is adjusted based on the one developed by the GBD Study 2016 SDG collaborators. We found that China has achieved several health-related SDG targets, including decreasing neonatal and under-5 mortality rates and the maternal mortality ratios and reducing wasting and stunting for children. However, China may only achieve 12 out of the 28 health-related SDG targets by 2030. The number of target indicators achieved varies among provinces and municipalities. In 2016, among the seven measured health domains, China performed best in child nutrition and maternal and child health and reproductive health, with the attainment index scores of 93.0 and 91.8, respectively, followed by noncommunicable diseases (NCDs) (69.4), road injuries (63.6), infectious diseases (63.0), environmental health (62.9), and universal health coverage (UHC) (54.4). There are daunting challenges to achieve the targets for child overweight, infectious diseases, NCD risk factors, and environmental exposure factors. China will also have a formidable challenge in achieving UHC, particularly in ensuring access to essential healthcare for all and providing adequate financial protection. The attainment index of child nutrition is projected to drop to 80.5 by 2025 because of worsening child overweight. The index of NCD risk factors is projected to drop to 38.8 by 2025. Regional disparities are substantial, with eastern provinces generally performing better than central and western provinces. Sex disparities are clear, with men at higher risk of excess mortality than women. The primary limitations of this study are the limited data availability and quality for several indicators and the adoption of “businessas-usual” projection methods. The study found that China has made good progress in improving population health, but challenges lie ahead. China has substantially improved the health of children and women and will continue to make good progress, although geographic disparities remain a great challenge. Meanwhile, China faced challenges in NCDs, mental health, and some infectious diseases. Poor control of health risk factors and worsening environmental threats have posed difficulties in further health improvement. Meanwhile, an inefficient health system is a barrier to tackling these challenges among such a rapidly aging population. The eastern provinces are predicted to perform better than the central and western provinces, and women are predicted to be more likely than men to achieve these targets by 2030. In order to make good progress, China must take a series of concerted actions, including more investments in public goods and services for health and redressing the intracountry inequities.