Download the 2020 Consensus Agreement (PDF)

 

The National Committee on U.S.-China Relations and the National School of Development at Peking University convened the fifth Track II Dialogue on Healthcare virtually through Zoom on July 13 and 14, 2020 (July 13 and 15, 2020 in China). The dialogue brought together American and Chinese experts (attendee list attached) from academia, think tanks, and industry for off-the-record discussions on healthcare issues pertaining to both countries.

The meeting took place at a time when both countries, and the world, were dealing with the COVID-19 pandemic. This situation led the dialogue participants to focus on public health concerns and how China and the United States can work together to envision, prepare for, and deal with crises similar to the current pandemic.


KEY POINTS DISCUSSED

 

Public Health Reforms and COVID-19 Containment Strategies. China and the United States have now been dealing with the COVID-19 pandemic for several months. Participants recognized that both countries can learn much from the other in developing strategies for containing the virus, diagnosing and managing incidents to prevent the spread of the disease, and researching the course of the disease and potential interventions, and reopening economies in a safe way.

Having dealt with a first wave of the disease, focused mostly in the city of Wuhan and the surrounding areas of Hubei, China has now adapted a proactive defense strategy to prevent new importations of the disease and resurgence in local communities. Examples include daily life practices of mask wearing, social distancing, and regular ventilation and disinfection; disease control protocols (early detection, tracing, reporting, isolation and treatment) and the following vaccination program; and targeted and staged reopening of public places and facilities.

The United States has also adopted many of these policies, however, there has not been a uniform national policy and the United States is seeing significant variations in adoption of best public health practices. The American participants recognized that implementation has been fragmented and much still needs to be done to improve behavioral adherence to new norms and build up testing and contact tracing.

Both sides agreed on the important role of public health systems in dealing with health crises and on the need for both countries to strongly commit to developing an effective domestic public health infrastructure that is global-oriented at the same time. This is a key area for collaboration between our two countries. Strategies that transcend national, political, and cultural bounds are especially needed.

Vaccine and Therapeutic Development. The world is moving swiftly to develop effective COVID-19 vaccines. The urgency of the situation requires a rethink of how the vaccine research and development process is structured, reducing unnecessary pauses between R&D phases without sacrificing scientific assessment and efficacy. On an encouraging note, vaccine targets have been directed at the COVID-19 spike protein and early results of novel vaccines, including mRNA and inactivated vaccines, are promising. At the same time, we must move forward with anticipating manufacturing and deployment needs and dealing with related challenges, even before the most useful vaccine candidates have been identified.

To meet the global demand, nations will need to substantially improve their vaccine development capacity. There are several areas where collaboration and data sharing between the United States and China can help in this effort:

  • Regulatory harmonization: aligning clinical, manufacturing and post market regulation can promote greater efficiency among companies and government agencies working to bring effective vaccines to market.
  • Manufacturing capacities: to meet global demand and ensure that vaccines are brought first to the most vulnerable populations and the most needed groups prioritized, China and the United States should focus on global manufacturing strategies that include all areas of need, such as the manufacture of glass needed to produce vials.
  • Communications: with skepticism among some segments of the public about vaccines and changing scientific information regarding the virus, it is important that both nations work towards consistent communications to reverse the erosion of trust in science and the health community.
  • Transparency of and access to data: greater access to key data (including de-identified patient data) can help further R&D efforts in both nations, for both vaccine development and treatment strategies, and the use of integrated clinical data to support rapid evaluations of telehealth and other components of value-based service models.

COVID-19 Impact on Healthcare Systems. Dealing with the global pandemic has been a major challenge for healthcare providers in both China and the United States and has exposed vulnerabilities in current systems, especially those that rely on traditional fee-for-service (FFS) payment models. As such, the current crisis offers an opportunity for both nations to reconsider how healthcare is delivered and restructured.

The participants agreed on the need to invest more in primary care, which remains weak in both countries. New ways of delivering healthcare outside of the hospital system, through telemedicine and digital health for example, could help provide greater overall healthcare coverage and reduce waste and mitigate risk of disease transmissions. In the United States, at the first stage of the pandemic in the spring of 2020, the majority of primary care in advanced integrated health systems was delivered through telehealth. Providers that have already moved away from FFS models to more value-based healthcare have dealt better with the challenges from the pandemic, and other providers should be encouraged to make the same move. Prospective payment models can more comprehensively support financing for these organizations during pandemics.

In addition to more investment in primary care, it is important for governments to commit to valuing innovation in the healthcare system. R&D unlocks breakthroughs that create healthier and more prosperous societies. These investments include prevention (vaccines, wellness, public health education); treatment of chronic disease with cutting-edge medicines that improve quality of life; and cures, which enable patients’ return to their normal lives. Only through sustained investment in R&D can we ensure that we have answers for current and future health crises.


RECOMMENDATIONS

 

While acknowledging the current tensions between the United States and China, the Dialogue participants believe it is essential that both nations continue to collaborate on efforts to deal with the COVID-19 pandemic and improve their respective healthcare systems for the betterment of both populations. Areas that the participants particularly emphasized include:

  1. Containing COVID-19. Share experiences and best practices in dealing with the current pandemic, including testing, tracking and tracing, isolating, social distancing and lockdown protocols. Support global effort to strengthen mechanism and capacity of virus evolution monitoring and sequence sharing. Be prepared to fight the pandemic for the long haul and mindful of impacts beyond the health realm.
  2. Development of vaccines. Encourage and provide financial assistance to Chinese and American corporations so they can more rapidly develop effective vaccines and bring them to market in a timely manner.
  3. Improved healthcare delivery systems. Build up stronger primary care systems to promote better public health and healthcare in both nations.
  4. Value-based care. Encourage providers to move from FFS to value-based models.
  5. New technology models. Promote joint study of new technology systems, such as telemedicine and digital health and therapeutics, that can bring greater efficiency and cost control to our healthcare systems.
  6. Build an innovative and collaborative ecosystem. Ensure adequate market incentives to foster innovation and expand access to a greater diversity of innovative products, including financing tools that reward innovation. Formulate preferential human resource policies to create a conducive environment for global scientific collaboration. Enhance collaborations among research institutions, health providers, governments and companies and improved intellectual property.

Implementation of these recommendations will require coordination and cooperation among institutions from both nations. To help in this endeavor, the participants recommended to carry out a joint project that can address a specific area of concern on a limited scale with potential broader applications in the future.

CHINESE PARTICIPANTS

CHEN Wen Professor, Health Economics and Director of Center for Pharmacoeconomics Evaluation and Research, Fudan University
CHEN Xi Associate Professor, Health Policy, Global Health and Economics, School of Public Health, Yale University
DING Lieming Founder, Chairman and CEO, Betta Pharmaceuticals Co., Ltd.
FENG Zijian Deputy Director General, Chinese Center for Disease Control and Prevention (China CDC); Senior Researcher in Public Health Epidemiology
GAO Fu Director-General, Chinese Center for Disease Control and Prevention
GONG Peng Professor and Chair, Department of Earth System Science; Dean, School of Sciences, Tsinghua University
GUO Yan Professor, School of Public Health, Peking University
HUO Yong Professor, Peking University First Hospital
LEI Xiaoyan Professor of Economics, National School of Development, Peking University
Gordon G. Liu PKU BOYA Distinguished Professor of Economics, National School of Development; Dean of the PKU Institute for Global Health and Development, Peking University (Co-Organizer of the Dialogue)
LIU Qian Former Vice Minister, Ministry of Health; Vice-Chairman, the Education, Science, Culture & Health Committee of the National People’s Congress; President, Chinese Hospital Association (Head of the China team)
PAN Jie Professor of Health Policy and Economics, Sichuan University; Vice Dean, West China School of Public Health; Vice President, West China Fourth Hospital
SHAO Xiaojun Chief Medical Officer, China Pacific Life Insurance Co.
YAN Lijing Professor, Global Health; Head, Non-Communicable Chronic Diseases (NCDs) Research at the Global Health Research Center, Duke Kunshan University
ZHANG Ligang Chairman and CEO, iKang Healthcare Group, Inc.
ZHAO Kun Director, Division of Health Policy Evaluation and Technology Assessment of the National Health Development Research Center
ZHENG Qiang Director, Center for Pharmaceutical Information and Engineering Research, Peking University

AMERICAN PARTICIPANTS

Lawrence D. Brown Professor, Health Policy and Management, Mailman School of Public Health, Columbia University
Molly J. Coye Executive-in-Residence, AVIA Health Innovation
Margaret Hamburg Foreign Secretary, National Academy of Medicine; President, American Association for the Advancement of Sciences (AAAS)
Harlan M. Krumholz Harold H. Hines, Jr. Professor of Medicine and Epidemiology and Public Health, Yale School of Medicine
Larry Z. Liu Executive Director, Outcomes Research, Merck Center for Observational and Real-world Evidence (CORE)
Mark B. McClellan Director and Robert J. Margolis, M.D., Professor of Business, Medicine and Health Policy, Margolis Center for Health Policy, Duke University (Leader of the U.S. team)
Paul Neureiter Executive Director, International Government Affairs, Amgen
Samuel R. Nussbaum Strategic Consultant, EBG Advisors; Senior Fellow, University of Southern California Schaeffer Center for Health Policy and Economics
Stephen Orlins President, National Committee on U.S.-China Relations (Dialogue Co-Organizer)
David Rind Chief Medical Officer, Institute for Clinical and Economic Review
Julia Spencer Associate Vice President, Global Vaccine Public Policy, Partnerships and Government Affairs, Merck
Winnie Yip Professor of the Practice of International Health Policy and Economics, Harvard University


2020 U.S.-China Track II Dialogue on Healthcare (Zoom)

The National Committee on U.S.-China Relations and the National School of Development at Peking University convened the fifth Track II Dialogue on Healthcare virtually through Zoom on July 13 and 14, 2020 (July 13 and 15, 2020 in China). The dialogue brought together American and Chinese experts from academia, think tanks, and industry for off-the-record discussions on healthcare issues pertaining to both countries.

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