China's One Health governance system: the framework and its application

Trends and burden of cardiovascular diseases among children and adolescents in China from 1990 to 2021

BACKGROUND AND AIM

There are currently no reports on the burden and trends of cardiovascular disease among children and adolescents in China. This study aims to investigate the burden and epidemiological characteristics of Cardiovascular Diseases (CVD) within the Chinese population by analyzing the trends and burden of CVD among children and adolescents of different genders and age groups in China from 1990 to 2021.

METHODS AND RESULTS

Utilizing data from the Global Burden of Diseases Study 2021, we estimated the incidence, mortality, and disability-adjusted life years (DALYs) associated with CVD among children and adolescents aged 0-19 years in China from 1990 to 2021. During this period, both the rate of death and exhibited a declining trend, while incidence rate showed a slowly declining trend. The incidence rate of CVD increased with age, especially in the population aged ≥5years. Various diseases demonstrated different the estimated annual percent change (EAPC) during 1990-2021 and almost all diseases had a decreasing trend. The ranking of incident cases, deaths and DALYs of CVD and changes indicated that stroke, rheumatic heart disease were the most important diseases.

CONCLUSIONS

Despite a consistent decline in the incidence, mortality, and DALY rates of CVD over the past three decades, children and adolescents in China continue to face substantial cardiovascular health challenges. We need to focus on CVD in children and adolescents continuously and develop health policies and practical strategies based on the current trends to address this health challenge.

Global, regional, and national burden of Visceral leishmaniasis, 1990-2021: findings from the global burden of disease study 2021

BACKGROUND

Leishmaniasis is a vector-borne parasitic disease caused by protozoa of the Leishmania genus; it is transmitted through the bites of infected phlebotomine sandflies. Clinically, it manifests in three primary forms: cutaneous, mucocutaneous, and visceral leishmaniasis (VL). Among these, VL represents the most severe form, characterized by high morbidity and mortality, and poses a considerable public health burden, particularly in endemic regions. This study utilizes data from the Global Burden of Disease (GBD) study 2021 to conduct a comprehensive analysis of the global epidemiological trends and burden of VL from 1990 to 2021, aiming to generate evidence-based insights to inform prevention and control strategies.

METHODS

Using GBD 2021 data, this study examined trends in the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of VL across 204 countries and territories, stratified by age, sex, and sociodemographic index (SDI) levels. Average annual percent change (AAPC) was calculated to describe trends in age-standardized rates and indicator counts from 1990 to 2021.

RESULTS

From 1990 to 2021, the global age-standardized incidence rate (ASIR; AAPC = -0.25, 95% confidence interval (CI) -0.25, -0.24), age-standardized prevalence rate (ASPR; AAPC = -0.06, 95% CI -0.06, -0.05), age-standardized mortality rate (ASMR; AAPC = -0.03, 95% CI -0.04, -0.02), and DALY rate (AAPC = -2.38, 95% CI -2.44, -2.33) for VL all showed a declining trend. The ASMR was highest among children under 5 years old and decreased progressively with age. VL remains a critical and under-recognized tropical disease in Latin America, the Middle East, Africa, and South Asia.

CONCLUSIONS

VL disproportionately affects males and presents the highest risk in children under 5 years. Enhanced global collaboration in infectious disease control, with a focus on regions such as Latin America, Africa, the Middle East, and South Asia, is essential to further reduce the burden of VL.

Mismatched online public concern and tick-borne disease risk in China

Introduction

Ticks and tick-borne diseases are increasing public health concerns in China. This study examines public awareness and concern using data from the People Cloud, a national public opinion data platform.

Methods

We analyzed 358,862 posts related to ticks, tick bites, Lyme disease, and tick-borne encephalitis from October 2022 to November 2023. Temporal trends and geographic distribution were assessed to identify patterns of public interest.

Results

Public concern peaked in April, coinciding with tick season, with "ticks" being the most mentioned term, particularly on social media platforms, such as WeChat. High search activity was concentrated in southeastern and northern provinces, especially Zhejiang, Guangdong, and Jiangsu. Lyme disease posts were more dispersed, while tick-borne encephalitis posts clustered in southern areas.

Conclusion

Public interest in ticks follows seasonal and regional trends, reflecting tick activity but not always matching disease risk or tick distribution. Monitoring public opinion data can guide targeted health interventions and improve disease prevention efforts.

Strategy and mechanism of One Health governance: case study of China

Background

Strategy and mechanism are crucial components of One Health governance in China, designed to address the interconnected health issues between humans, animals, and the environment. This study aims to evaluate China's current One Health governance framework, identify key strengths and gaps, and provide recommendations for establishing a more integrated and effective system.

Methods

A qualitative approach was employed, including in-depth interviews, policy analysis, and a review of existing literature, to evaluate the strengths and gaps in China's One Health framework.

Results

The analysis identified progress and challenges in six key areas: (1) political commitment: strong national support exists, but lacks a unified strategy; (2) legislation and regulation: notable legislative efforts are in place, yet they remain fragmented; (3) leadership building: effective leadership structures have been established during crises but are not institutionalized; (4) strategic planning: initial regional planning is underway, but a comprehensive national focus is needed; (5) coordination and communication: mechanisms exist but require formalized, consistent information-sharing channels; (6) stakeholder engagement: public and academic awareness is growing, yet local community involvement needs strengthening.

Conclusion

To advance its One Health governance, China must focus on creating a unified strategy, enhancing interdepartmental coordination, and deepening stakeholder engagement, ensuring its alignment with international standards and improving public health outcomes.

Power of One Health: the first year of Science in One Health

The international journal Science in One Health (SOH), launched a year ago, is a platform to disseminate research achievements and practical lessons in the field of One Health globally and to achieve the United Nations Sustainable Development Goals by systematic thinking with multi-disciplinary approach to solve complex health problems. This paper reviews the efforts that SOH editorial board made in the first year to promote a multi-disciplinary teamwork, create a platform for exchanges of ideas, and initiate a community for One Health. SOH has received manuscripts from six continents and published 24 articles (5 in press) in the first year. SOH is devoted to providing more and more high-quality articles in One Health disciplines including One Health database, antimicrobial resistance, zoonotic diseases, food security, One Health governance and climate changes with their impacts. This editorial illustrated the power of Science in One Health.