Page 42 - Genomic Medicine in Emerging Economies

Recent Development of Genomics-Related Public Health in China 31

governments. Until 2007 there were about 685 million peasants (about 66%
of the total rural population) who had health insurance. In addition, com-
mercial health insurance (also called “private” health insurance), which is
a kind of health insurance paid for by organizations other than the govern-
ment, is used in both urban and rural areas. It is usually paid by the client’s
employer, by a union, by the client and employer sharing the cost, or by the
client. Commercial health insurance can overcome the deficiencies of the rural
and urban health care system in China. Everyone can choose this insurance
according to his or her health or economic condition. Until now, commercial
insurance schemes accounted for less than 2% of all health schemes in China.

RECENT DEVELOPMENT OF GENOMICS-RELATED
PUBLIC HEALTH IN CHINA
Genomics-Related Public Health Programs
and Services in China
Genomics is the study of the total or a part of the genetic sequence information
of organisms, and attempts to understand the structure and function of these
sequences and downstream biological products, which differs from genetics,
the study of genes, heredity, and variation in living organisms. Genomic medi-
cine involves clinical care that includes diagnostic, therapeutic, and the other
methods for identifying and monitoring diseases by using genomic informa-
tion. There is no nationwide approach to public health genomics in China.
However, the opening of the State Key Laboratory of Medical Genetics in 1991
established the regulations and procedures for public health genomics-related
programs and services. In addition, the National Center for Women’s and
Children’s Health (China WCH) of the China CDC is a state-level professional
organization for women’s and children’s health under the aegis of the China
CDC (Zheng et al., 2010a). The China WCH provides the administrative hub
of the China Women and Children Health Network (http://www.chinawch.
com/) to facilitate coordination of relevant activities, prenatal screening, and
congenital anomalies surveillance. To date—except for Qinghai, Xinjiang,
Ningxia, and Tibet—22 provinces, 2 autonomous regions, and 4 municipali-
ties in mainland China have established their own local websites/networks
providing information on the laws, policies, research counseling, education,
and surveillance relevant to women’s and children’s health care.

Prenatal Screening
The general protocol at present for prenatal screening is predominately
focused on those diseases with relatively high prevalence in China, such as
Down syndrome, open neural tube defect, and also, in some cases, for trisomy
18 by using multiple serum markers. This practice varies and depends on the
specific request of the doctor, generally prompted by the age of the pregnant