Construction of Science and Technology Support System for Public Health Emergencies in China

Mingsui Li , Zhuoran Wang , Yue Wu , Huili Jiang , Juntao Yang , Depei Liu

Strategic Study of CAE ›› 2021, Vol. 23 ›› Issue (6) : 139 -146.

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Strategic Study of CAE ›› 2021, Vol. 23 ›› Issue (6) :139 -146. DOI: 10.15302/J-SSCAE-2021.06.013
Engineering Management
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Construction of Science and Technology Support System for Public Health Emergencies in China

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Abstract

China’s science and technology support system has played a significant role in fighting public health emergencies. In this study, we summarize the construction status of China’s science and technology support system for emergencies from the aspects of (1) layout of scientific research bases and platforms, (2) application of big data technology, (3) science and technology investment in public health, and (4) transformation of scientific and technological achievements. Subsequently, we analyze the challenges for the construction of the support system in China in comparison with developed countries that are advanced regarding medical science and technology. To solve the problems of weak foundation of basic medical research and lack of key core technologies, we suggest to strengthen the synergy of universities, medical institutions, and science and technology enterprises. This will improve China’s basic medical research ability and promote the research and development of original pharmaceutical products and diagnostic reagents. In view of the lack of bases and platform facilities in China, we suggest to strengthen the construction of national biological resource sample centers and build self-supported data and information sharing platforms. As for insufficient investment in public health and an imperfect personnel system, we suggest to enhance the leading role of the National Academy of Medical Sciences, increase the input of public health, and improve the personnel evaluation, reserve, and training mechanisms.

Keywords

突发公共卫生事件 / 卫生健康 / 科技支撑 / public health emergencies / health / scientific and technological support

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Mingsui Li, Zhuoran Wang, Yue Wu, Huili Jiang, Juntao Yang, Depei Liu. Construction of Science and Technology Support System for Public Health Emergencies in China. Strategic Study of CAE, 2021, 23(6): 139-146 DOI:10.15302/J-SSCAE-2021.06.013

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1 Introduction

Public health emergencies refer to major infectious disease epidemics, mass unexplained diseases, major food and occupational poisoning, and other events that seriously affect public health, which occur suddenly and may cause serious damage to the health of the public [1]. Since the beginning of the new century, there have been frequent outbreaks of new infectious diseases, mainly caused by respiratory viruses, such as severe acute respiratory syndrome (SARS) in 2003, H1N1 influenza A in 2009, Ebola in 2014, and Zika in 2015. The novel coronavirus pneumonia (COVID-19) in late 2019 was defined by the World Health Organization (WHO) as a public health emergency of international concern, representing a severe test of world economic development and social stability and a major test of China’s prevention and control system for public health emergencies.

After several major public health emergencies, China has developed its science and technology support system for public health emergencies through the synergy of multiple forces covering clinical treatment, virus traceability, animal model construction, and research and development (R&D) of drugs, vaccines, testing technologies and products. However, China has relatively weak basic R&D of new technologies. In the field of biosafety, for example, the localization rate of key and core technical products and medical instruments remains low [2]. The country’s drug innovation capacity and industrial development are still far from the advanced international level, with drug R&D equipment and raw materials relying heavily on imports. Pharmaceutical R&D investment is large, high-risk, and long-term, making it difficult for a single R&D institution or enterprise to undertake it [3]. In its efforts to respond to public health emergencies, China also needs to further enhance its capabilities in the R&D of drugs and vaccines, diagnostic reagent production, protective equipment stockpiling, and medical equipment supplies [4]. Compared to the United States of America (USA), China has evident gaps and shortcomings in developing research infrastructure, such as data resource centers and biosafety laboratories [5]. To strengthen scientific and technological support for the public health system and enhance its ability to address public health security, China needs to focus on meeting the demand for scientific and technological talents in public health and explore and improve the mechanism for training talents. There is a need to strengthen basic research in medical sciences, explore research on disease etiology, pathogenesis, diagnosis, and treatment mechanisms, and facilitate original innovation [6]. It is necessary to gain insight into the response capabilities of public health emergencies, identify key aspects from basic biological experimental techniques, protective facilities of high biosafety level laboratories, and important medical treatment and testing equipment, and determine the main direction of research. The development of rapid response technology platforms and biological resource information-sharing platforms should also be emphasized [7].

Overall, existing studies in China have focused on the role of science and technology support in preventing and controlling the COVID-19 pandemic. The analysis perspective lies in establishing a public health system for emergency management, improving early warning mechanisms for epidemic prevention and control, and enhancing biosafety governance capacity. However, there is a shortage of comprehensive analyses and systematic research on science and technology support systems for public health emergencies. However, some research conclusions lack solid theoretical data. This study highlights the supporting role of China’s science and technology innovation system and capacity in public health emergencies and analyzes the shortcomings and gaps in science and technology capacity building. It also puts forward targeted suggestions for key issues, such as weak basic medical research, lack of key and core technologies, inadequate platform facilities, insufficient overall research investment, and imperfect talent systems based on useful international experiences.

2 Current development of China’s science and technology support system for public health emergencies

2.1 Improvements in research bases and platforms

As of August 2020, China has built 986 biotech bases and platforms, including 74 national key laboratories (five developed by multiple institutes across provinces) in the biomedical field, 31 national key laboratories co-built by provinces and ministries, 31 national key laboratories built mainly by enterprises, and 50 national clinical medical research centers built mainly by hospitals [8]. The country has made arrangements for common and frequently occurring diseases, major chronic diseases, prevention, control, and treatment of infectious diseases, new drug research, and traditional Chinese medicine. The country has built Asia’s largest drug compound library and optimized national sharing platforms for science and technology resources in the health sector, including the National Human Disease Animal Model Resource Center.

Amid the COVID-19 pandemic, China relied on the Detection Technology Platform for Emergency Response to Major Infectious Diseases and Infectious Disease Surveillance Technology Platform supported by the project on infectious diseases to confirm the novel coronavirus (SARS-CoV-2) as the pathogen of this unexplained pneumonia within five days, isolated the SARS-CoV-2 strain, and spliced the full genome sequence of the virus, which was highly applauded by WHO as “screening the pathogen in record short time.” The country is the first in the world to establish mouse, Rhesus macaque and Cynomolgus macaque models to address the COVID-19 pandemic based on the National Human Disease Animal Model Resource Center, which has been designated as the national platform for vaccine and drug evaluation. Seven of the first eight vaccines were evaluated, and hundreds of drugs were screened and evaluated. This provided strong support for the development of vaccines and drugs.

2.2 Big data technology for epidemic monitoring and scientific research

To prevent, control, and monitor the COVID-19 pandemic, a special big data task force was set up under the State Council’s joint prevention and control mechanism for the COVID-19 pandemic. The scientific research group established an information technology task force to conduct virus tracing, a transmission chain analysis, epidemic surveillance, and a risk assessment based on the number of confirmed patients, suspected cases, close contacts, foreign inflow population, geospatial information, and remote sensing monitoring data offered by multiple ministries [9]. In unifying health information codes across the country, the national integrated government service platform launched the Health Code for Epidemic Control”, which has been applied nearly 900 million times and used over 40 billion times [8].

2.3 Growing investment in public health science and technology

China’s research on public health emergencies is primarily funded by the National Natural Science Foundation of China (NSFC), and by the National Major Science and Technology Project and the National Key Research and Development Program launched by China’s Ministry of Science and Technology. In 2009, the NSFC launched a major research program on the “management of unconventional emergencies,” which funded 120-plus projects with a total funding of 120 million CNY [3].

Fig. 1. Number of drugs and vaccines developed by the USA, EU and China (based on the Cortellis database, as of September 2021).

3.1.2 R&D capability of testing devices and diagnostic reagents

High-performance detection products, medical instruments, and other prevention and control products provide important scientific and technological support in responding to public health emergencies. However, testing devices and diagnostic reagents related to China’s public health are still more dependent on imports, and innovation of principle is particularly insufficient. Based on the website data of the National Medical Products Administration and the US Food and Drug Administration, there were 70 products developed by China in the past five years for testing devices and pathogenic diagnostic reagents for major infectious diseases (Fig. 2, including COVID-19, influenza, and Zika), and the corresponding number in the USA was 291. In 2020, China had 58 COVID-19-related testing devices and diagnostic reagents on the market, while the USA had 274. It can be seen that the R&D investment and industrial scale of China’s testing devices and diagnostic reagents still need to be further expanded. Crossdisciplinary fields involving the R&D of antiviral drugs, vaccines, antibodies, instruments, and equipment still need to be improved. Prospective, practical, and exploratory research on unknown infectious diseases needs to be strengthened.

Fig. 2. Number of testing devices and diagnostic reagents involved in public health emergencies in China and the USA (2016– 2020).

3.2 Science and technology resource bases and platforms for public health need to be strengthened

3.2.1 Development of public health resource platform

China needs to improve its national laboratory system for public health. The country needs to strengthen its national platforms for the storage, management, and sharing of biomedical data and national biological sample resource platforms for bacteria and virus species, cell strains, experimental animals, literature resources, and population cohorts [5], but only a dozen of them are actually put into use. Geographically, they are concentrated in Beijing, Guangzhou, Shanghai, Wuhan, and other cities. From an industry perspective, they are mainly distributed in customs, inspection and quarantine, and centers for disease control. Almost all high-level medical schools and universities in the USA are equipped with BSL-3 laboratories. In 2011, the USA built 1495 BSL-3 laboratories. By December 2017, 54 BSL-4 laboratories were built and under construction in 23 countries worldwide. Of these, there are 12, 5, and 3 in the USA, the United Kingdom (UK), and China, respectively [7].

China needs to improve the deployment of high-BSL and national laboratories. According to the regional population density, pathogen detection, and research needs, it is necessary to increase the fixed BSL-3 and 4 laboratories according to local conditions, which are to be supplemented by small mobile BSL-3 and 4 laboratories to meet the needs of responding to public health emergencies. It is necessary to strengthen the development of national key laboratories for public health and give full play to the industry-leading role of national medical centers and national clinical medical research centers.

4.3 Improving public health security system to build up comprehensive capacity to respond to public health emergencies

China needs to pool more scientists and engineers who specialize in public health. It is necessary to improve the evaluation system of public health and clinical medical talent and break the assessment methods in which only papers and impact factors matter. Scientific collaboration must be motivated by the need to identify the lead and corresponding authors. China needs to improve the system of talent selection, recruitment, training, reserve, and incentive and attract high-caliber interdisciplinary public health talents with international vision. Therefore, it is necessary to establish national and local emergency response teams and conduct regular emergency prevention and control drills.

China needs to give full play to the Chinese Academy of Medical Sciences’ role as coordinator and leader. The country needs to strengthen the development of national labs for medicine and health, establish a real national academy of medical sciences [21], draw on the experiences of NIH, INSERM, MRC, and other institutions, and fully play the role of coordinating medical science and technology innovation resources and leading medical science and technology innovation. It needs to focus on the life and health of the population and carry out continuous scientific research to implement major strategies for medical science and technology innovation and meet the needs of prevention and control of public health emergencies. It is necessary to integrate advantageous science and technology resources and research forces; coordinate the arrangements of scientific research in population health and biosafety; and strengthen basic, cutting-edge, and non-profit research on the innovation of health science and technology.

China must increase its investment in science and technology for public health. It is suggested that a special medical research fund be established, in addition to the existing five major science and technology programs (special projects and funds), to independently manage science and technology resources in health care [21]. China needs to steadily sustain basic research in life sciences and medical and healthcare key and core technologies and strengthen strategic technological forces in epidemics, disease prevention and control, and public health as soon as possible.

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