Reforming China’s Rural Health System
China as % OECD average
Figure 1.1
Declining Poverty and Rising Living Standards, 1980–2007
16%
900
14%
800 700
12%
600
10%
500 8% 400 6%
300
4%
200
2% 0% 1980
no. poor (millions)
2
100 0 1985
1990
1995
2000
2005
GDP per capita at PPP (LHS) air transport, passengers carried per 1000 pop (LHS) poverty (RHS) Sources: Gross domestic product (GDP) and air transport data are from World Development Indicators; poverty data are from Chen and Ravallion (2008). Note: LHS refers to left-hand vertical axis; RHS refers to right-hand vertical axis.
Bank’s new international $1.25-a-day poverty line (Figure 1.1). In China at the start of the economic reforms, air travel was rare: just 3 people per thousand population boarded a commercial flight in 1980, less than onehalf of 1 percent of the OECD rate.4 By 2006, the figure in China had risen to 120 per thousand, about 8 percent of the OECD rate. Also striking is the recentness of these changes. Between 1981 and 1990, China lifted people above the international poverty line at the rate of 16 million per year. Over the following nine years, the rate of poverty reduction was 27 million per year. From 1999 to 2005, the rate was 41 million per year. It might be assumed that China’s successes in economic growth, poverty reduction, and living standards have been matched by a parallel success in health. Certainly, there have been successes. China’s strides in health during the early days of the People’s Republic are indeed legendary. Its malaria control program, launched in 1955, brought malaria mortality down from 5,528 deaths in 1955 to just 24 deaths in 1998. In the case of maternal mortality, the rate declined from