Pfizer

Executive Summary

The changing demographic structure and rapid aging of Chinese society pose a significant challenge to the country’s economic and social development. The Opinions of the State Council on the Implementation of the Healthy China Initiative clearly stated that the health and happiness of the elderly are important symbols of a civilization’s progress. China has the world’s largest elderly population and one of the fastest rates of population aging. Actively addressing population aging has a significant impact on Chinese society and people’s well-being. It is also a crucial step towards achieving high-quality economic development and safeguarding national security and social stability.

Since the 18th CPC National Congress, China has set “actively addressing population aging” as a national strategy. China has since introduced and implemented medium- and long-term plans to address population aging, resulting in the establishment of a comprehensive top-level design and the implementation of major reforms and measures, which have laid a solid foundation for China’s ability to cope with its aging population. In 2016, China issued the Outline of the Healthy China 2030 Plan, which emphasized that protecting the health of the entire population is the fundamental goal of building a healthy China. The Plan is based on two focal points – the whole population and the entire life cycle – while emphasizing the provision of health services that are equitably accessible and systematically continuous. Addressing the health problems of the elderly, as one of the key population groups, is of great significance to realizing the goal of a higher level of health for all. The Plan puts forward the key task of promoting healthy aging, emphasizing “advancing the construction of a medical and health service system for the elderly, and promoting the extension of medical and health services to communities and families” and “strengthening health guidance and comprehensive interventions for common and chronic diseases in the elderly, and reinforcing health management for the elderly.”

The 14th Five-Year Plan period presents an important window of opportunity for addressing population aging. It is expected that China will become a moderately aging society during this period, and become a significantly aging society by around 2035. During this critical period, China has taken the initiative to more proactively implement national strategy on population aging by issuing the Opinions of the State Council on the Implementation of the Healthy China Initiative. This document proposes the implementation of an “Elderly Health Promotion Action” to help improve the health of the elderly, enhance their quality of life, and achieve healthy aging. Since the launch of the “Elderly Health Promotion Action” under the Healthy China initiative in 2019, the health literacy level among the elderly has continued to improve, with life expectancy rising from 77.3 years in 2019 to 78.6 years in 2023. In the concluding year of the 14th Five-Year Plan period, the 2025 government work report proposes to “strengthen the construction of professional teams in nursing, pediatrics, pathology, general medicine and geriatrics.” This initiative fully reflects China’s long-term planning in healthcare policy, protecting the health of the elderly through high-quality medical care.

Disease prevention, as a vital component of healthy aging, plays a positive and effective role in addressing the prominent health issues of the elderly population. The Healthy China initiative emphasizes prevention as its primary focus by prioritizing it prominent in the overall planning. The Healthy China initiative promotes advancing the line of defense for disease prevention and treatment and adopting effective intervention measures. The National Medium- and Long-Term Plan for Responding Proactively to the Aging Population calls for the establishment and improvement of an integrated and continuous health service system for the elderly that includes health education and preventive health measures.

Vaccination is an important preventive tool for controlling respiratory infectious diseases and improving health of the elderly. Preventive vaccination can protect the whole population throughout a patient’s life cycle. For the elderly, especially those with underlying diseases, vaccination is not only essential but its safety and effectiveness for elderly patients have been validated. Several guidelines on chronic disease prevention and treatment have identified the elderly as a key target group and recommend the elderly population to be vaccinated against common infectious diseases. As a population group that is highly susceptible to respiratory infectious diseases, elderly individuals urgently need preventive measures to safeguard their health. The Healthy China Initiative (2019–2030), issued by the Healthy China Action Promotion Committee in July 2019, recommends that high-risk populations such as the elderly and patients with chronic respiratory diseases proactively receive influenza and pneumococcal vaccines. The General Office of the National Health Commission has issued the Key information for the Prevention of Incapacity in Older Adults, which recommends that the elderly receive pneumococcal and shingles vaccines regularly, and that they receive influenza vaccines under a physician’s guidance before the influenza epidemic season. Taking pneumococcal disease as an example, in China, pneumococcal disease is a common respiratory infection that poses a serious threat to the health of the elderly population. Studies show that Streptococcus pneumoniae bacteria is one of the main pathogens responsible for community-acquired pneumonia (CAP), with the hospital mortality rate for elderly CAP patients reaching 5.7%. China has designated promoting pneumococcal vaccination as a key task in the Healthy China Initiative (2019-2030). However, for the time being, the vaccination rate for the elderly in China is generally low. Vaccination efforts for the elderly face certain “bottlenecks” and constraints.

Accelerating vaccine innovation is not only of significant importance in building a respiratory infectious disease prevention and control system for the elderly, but also meets the people’s demand for high-quality pharmaceutical products, thereby realizing the goal of healthy aging. The accelerated launch of the COVID-19 vaccine provides an important example for the prevention and control of respiratory infectious diseases among the elderly in China. By February 2023, there were 241,688,000 people over the age of 60 who had received the COVID-19 vaccine in China. The National Medical Products Administration (NMPA) and other departments accelerated the vaccine approval process of the COVID-19 vaccine through conditional approval, enabling the COVID-19 vaccine to benefit the general population as quickly as possible and providing a strong guarantee for epidemic prevention and control. The Opinions on Comprehensively Deepening the Regulatory Reform of Drugs and Medical Devices to Promote the High-Quality Development of the Pharmaceutical Industry, issued by the General Office of the State Council, set the goal of building a globally competitive innovation ecosystem to transition China from a big pharmaceutical country to a pharmaceutical powerhouse, better meeting the people’s demand for high-quality drugs and medical devices. With the advancement of Healthy China and the high-quality development of the pharmaceutical industry, China needs to improve the review and approval mechanisms for innovative vaccine products to address the unmet needs of patients regarding respiratory infectious diseases in a timely manner and to control the growth of medical expenses and socio-economic costs.

As a leading global biopharmaceutical company, Pfizer is committed to supporting China in strengthening capacity-building for the prevention and control of respiratory infectious disease and safeguarding the health of the elderly. We are committed to contributing to these efforts and propose the following recommendations for reference in the formulation of future policy actions:

· Actively promote conditional approval to facilitate the introduction of innovative vaccines: Utilize the experience gained from the conditional approval of COVID-19 vaccines to expedite the approval of innovative vaccines for respiratory infectious disease. The introduction of mature and innovative vaccines already approved in other markets can reduce the incidence of respiratory infectious disease among the elderly, reduce the length and frequency of hospitalization for the elderly, and alleviate the socioeconomic burden.

· Optimize infectious disease monitoring system to provide high-quality evidence for vaccine introduction decision-making: National health authorities can leverage existing data monitoring networks to build a nationwide surveillance system for respiratory infectious diseases, particularly for pneumococcal disease. This system should assess vaccination coverage, the disease burden and economic burden of vaccine-preventable diseases. The system should also measure the preventive effect of individual vaccines and their impact on disease incidence, providing solid evidence for the selection and application of effective vaccines.

· Establish diversified payment channels for vaccines covered by immunization programs to improve the affordability of vaccines for respiratory infectious diseases: Introduce multi-payer mechanisms, including commercial health insurance and city-customized affordable medical insurance (e.g., huiminbao), and encourage pilot programs in eligible regions to leverage multi-payer mechanisms to incorporate urgently needed and innovative vaccines into elderly immunization programs.

· Increase the number of vaccination sites for respiratory infectious diseases for key population groups including the elderly to improve the coverage and convenience of vaccination services: Scientifically plan and establish vaccination sites to provide convenient vaccination services for the elderly and high-risk groups.

· Strengthen health education for the public by raising awareness of respiratory infectious disease and vaccination and encourage vaccination: Strengthen public education on respiratory infectious diseases and vaccines, particularly among the elderly and other high-risk groups, to boost vaccine confidence and encourage vaccination.

· Strengthen grass-roots health capacity-building, improve the awareness of primary-level healthcare practitioners regarding the prevention and treatment of respiratory infectious diseases: Comprehensively enhance the capacity of primary-level medical institutions to prevent and control respiratory infectious diseases by increasing financial investment, improving infrastructure, and strengthening personnel training. Establish primary-level training mechanisms, provide regular training to primary-level medical staff on the diagnosis and treatment of respiratory infectious disease and vaccination.

Download the full report：Promoting the Construction of a System for Preventing and Controlling Respiratory Infectious Diseases Among the Elderly, and Improving the Health of the Elderly