Zhu Chen / Illustration by Wesley Allsbrook
Inspiring Lives: Zhu Chen
China's barefoot minister of healthZhu Chen never expected to be the public face of the world’s largest health system.
A vocal critic of China’s failings in public health who had never joined the Communist Party, Chen was hardly a natural choice for the role. But in 2007, the molecular biologist and leukemia expert received a surprising invitation from the government. “I didn’t even realize that there was a chance to become the Minister of Health,” Chen chuckles, “I was not prepared.”
His three years in office have repeatedly put Chen on the front lines of China’s most pressing public health problems: the Sichuan earthquake, the swine flu outbreak, and the tainted milk controversy. But his focus is firmly on the future, where Chen intends to reduce healthcare inequities, train new medical professionals in rural areas, and increase emphasis on prevention of non-communicable diseases, such as diabetes and heart disease through his Healthy 2020 program. “We are very encouraged to have a scientist like Minister Chen at the helm of the Ministry,” says Henk Bekedam, a development director at the WHO’s regional office in the Philippines.
Chen’s start in public health began at the age of 16, when he became a “barefoot” doctor. Without formal training, he set off to the rural Jiang Xi province—or “profound China” as he calls it—some 1,200 kilometers from the skyscrapers of Shanghai. For eight years during the Cultural Revolution, Chen treated common diseases such as childhood diarrhea and provided vaccinations for polio while learning the basics of traditional medicine techniques that he still embraces, such as acupuncture. “That experience helped me understand the situation in rural China,” he explains. As he helplessly watched a well-respected farmer develop cirrhosis and liver cancer, he first learned of the scourge of hepatitis B. “That was unforgettable for me,” he says. Indeed, last year he launched a campaign to vaccinate all children under 15 against the disease.
Chen’s parents were themselves doctors trained in endocrinology, and in 1978, Chen returned to Shanghai and began his study of hematology. Obtaining a medical internship in Paris before pursuing a Ph.D., his research would eventually earn him a place in the U.S. National Academy of Sciences in 2003. But Chen’s rise to prominence in the policy realm began as he took charge of the biology section of the Chinese Academy of Sciences, where he would oversee 25 research institutes.
During that period, he hardly held back his criticism of the beleaguered Health Ministry. In November 2002, a farmer from the Guangdong Province in southern China came into a hospital with pneumonia-like symptoms. The patient ultimately died, and soon after China had a mysterious new epidemic on its hands: severe acute respiratory syndrome, or SARS. China failed to notify the WHO and the Health Ministry promulgated the incorrect theory that the disease was simply caused by a Chlamydia bacterium. Indeed, scientists in Beijing who first identified a virus never before seen in humans kept mum about their findings, slowing down the international community’s attempts to track the deadly disease. When asked about the Ministry’s role in suppressing information on SARS, Chen did not mince his words: “They prevented others from expressing their views,” he told the journal Science in 2003. Today, Chen says the Chinese government has come a long way in terms of transparency. “When doctors or public health professionals find something abnormal, they report it to the Chinese Center for Disease Control.”
Chen’s own tenure as Minister of Health has not been free from criticism. In May 2009, at the start of the H1N1 outbreak, he advocated aggressively quarantining thousands of patients thought to be carrying the virus, including 21 U,S, teenage students who were unlucky enough to share a flight to China with a sick passenger. Chen argues that he had no choice during the first weeks of the outbreak. “The first information we received from the WHO was that mortality was over 10%, and we had a little over half a million doses of Tamiflu stockpiled,” he says. The country reported only 800 H1N1 deaths and Bekedam calls Chen’s handling of the situation “excellent.”
The biggest public health challenges for China, in Chen’s view, date back to the same problems he saw in his days as a barefoot doctor: The massive rural population lacks the same access to healthcare as those in urban centers. Meanwhile, public hospitals have drifted from their stated mission of providing quality services to all and have become profit centers. Although China failed to pass a sweeping healthcare reform bill last year, in March the Premier Wen Jiabao announced that the government will cover major diseases in children, including leukemia, as Chen had advised. “The Minister of Health is not a very strong minister,” Chen says. “But I think science can play a major role in supporting evidence-based policies.”
Photo: Zhu Chen / Illustration by Wesley Allsbrook
