China’s sick healthcare system breeding antibiotic-resistant "superbugs"

Photo from University of Arizona

Ever notice the tendency for medical clinics and hospitals to over-prescribe medications here in Shanghai (even for things like simple colds and sore throats)? This bottle of pills is for the inflammation, take three times a day. Take one of these twice day, it’ll help reduce the pain. Oh, those ones? We’re not quite sure, but trust us, you need ‘em. Turns out the practice isn’t just dangerous for your wallet, it’s also breeding strains of bugs that are becoming antibiotic-resistant. Uh oh.

Some leading scientists say that the reckless use of antibiotics in the Chinese healthcare system is unleashing an explosion of drug resistant superbugs that could be a medical cocktail for a global disaster. How over-prescribed is China? Says Professor Xiao Yonghong of the Institute of Clinical Pharmacology at Beijing University, “In Chinese hospitals our data shows that 60 per cent of in-patients are being prescribed antibiotics compared with the WHO guideline of 30 per cent.”

Throw twice as many antibiotics at a person as needed and, according to the studies, you get a rapid rise in antibiotic-resistant bacteria such as staphylococcus aureus (MRSA). And with the relative ease of international air travel today, these new strains of superbugs could depart Shanghai in the morning and arrive in Toronto the same day.

According to Dr Andreas Heddini of the Swedish Institute for Infectious Disease Control:

“We have a lot of data from Chinese hospitals and it shows a very frightening picture of high-level antibiotic resistance. Doctors are daily finding there is nothing they can do, even third and fourth-line antibiotics are not working. There is a real risk that globally we will return to a pre-antibiotic era of medicine, where we face a situation where a number of medical treatment options would no longer be there. What happens in China matters for the rest of the world.”

But why do so many Chinese doctors feel the need to over medicate their patients?

While it’s possible the doctors are just overeager to care for their patients’ well being, a more convincing argument points to the underlying systematic deficiencies of the ailing Chinese health care system.

Public health experts have pointed out that China has an underfunded health system where medical centers take up to half of their operating income from selling drugs, a haphazard solution to the semi-privatization of the entire industry.

Or as Drew Thompson, Director of China Studies at the Nixon Center in the U.S, explains:

[With the] widespread dismantling of the public sector in China and growth in the private sector, health care was heavily affected. Factories, state-owned enterprises, no longer were running their own health care clinics; public hospitals increasingly began to operate like private hospitals; government funding was reduced for the public health care system. The result was the health care system became heavily dependent on fees.”

When you add that to the fact that all medical professionals are treated – and paid – like public officials (which, incidentally has caused a shortage of doctors here since long gruelling years of study don’t translate to much more money), it’s no wonder the doctors become pushers. And as the doctors become pushier, Chinese people become more suspicious. Says Helen Ye, a Beijing resident, “”We go to clinics for colds, but we don’t trust the doctors because they are all being paid by the drug companies and so they over-prescribe.”

China is not turning a blind eye to these huge problems. In March 2009, it announced a $123 billion health care reform plan. Under the plan, 90% of China’s citizens will be covered by a universal health care system and health care facilities will be upgraded, including construction of 30,000 hospitals, clinics, and care centers across the country.

The State Council says that by 2020, the world’s most populous country will have a basic health-care system that can provide safe, effective, convenient and affordable health services to urban and rural residents. Of course, as with any huge reform plan, it will be some time before the effects trickle down (and, as with any huge reform plan in China, a lot will most likely “disappear” through intermediaries).

But until then, make sure you ask what’s in the anonymously marked box of drugs that you apparently “need”.