The original article “Mortality, morbidity, and risk factors in China and its provinces, 1990–2017: a systematic analysis for the Global Burden of Disease (GBD) Study 2017”, draws the conclusion that “China has made substantial progress in reducing the burden of many diseases”.1 We have several criticisms of the study from methodological and ethical standpoints. The article asserts the reduction of disease burden through Chinese health policy, yet the study includes “Taiwan, Province of China” as data analyzed to support its conclusion, which is strongly flawed methodologically. Taiwan exists as an independent state, and its democratic government and health care policies are not under the jurisdiction of the People's Republic of China (PRC). For example, Taiwan launched the world's first universal hepatitis B vaccination program in 1984.2 China did not implement its own program nearly two decades later until 2005. It is inappropriate to compare the contribution of vaccination to declines in liver cancer. In addition, in 1995, Taiwan started its National Health Insurance Program and reached 99% coverage in 2004, with no such program in the PRC.
Date:
2020-01
Relation:
Journal of the Formosan Medical Association = Taiwan yi zhi. 2020 Jan;119(1),Part 1:1-2.
