Building quality primary health care development in the new era towards universal health coverage: a Beijing initiative.

Primary health care (PHC) is the most effective way to improve people's health and well-being, and primary care services should act as the cornerstone of a resilient health system and the foundation of universal health coverage. To promote high quality development of PHC, an International Symposium on Quality Primary Health Care Development was held on December 4-5, 2023 in Beijing, China, and the participants have proposed and advocated the Beijing Initiative on Quality Primary Health Care Development. The Beijing Initiative calls on all countries to carry out and strengthen 11 actions: fulfill political commitment and accountability; achieve "health in all policies" through multisectoral coordination; establish sustainable financing; empower communities and individuals; provide community-based integrated care; promote the connection and integration of health services and social services through good governance; enhance training, allocation and motivation of health workforce, and medical education; expand application of traditional and alternative medicine for disease prevention and illness healing; empower PHC with digital technology; ensure access to medicinal products and appropriate technologies; and last, strengthen global partnership and international health cooperation. The Initiative will enrich the content of quality development of PHC, build consensus, and put forward policies for quality development of PHC in China in the new era, which are expected to make contributions in accelerating global actions.

Integrated Health Risk Assessment of Heavy Metals in Suxian County, South China.

The purpose of this study was to assess soil heavy metal contamination and the potential risk for local residents in Suxian county of Hunan Province, southern China. Soil, rice and vegetable samples from the areas near the mining industrial districts were sampled and analyzed. The results indicate that the anthropogenic mining activities have caused local agricultural soil contamination with As, Pb, Cu and Cd in the ranges of 8.47-341.33 mg/kg, 19.91-837.52 mg/kg, 8.41-148.73 mg/kg and 0.35-6.47 mg/kg, respectively. GIS-based mapping shows that soil heavy metal concentrations abruptly diminish with increasing distance from the polluting source. The concentrations of As, Pb, Cu and Cd found in rice were in the ranges of 0.02-1.48 mg/kg, 0.66-5.78 mg/kg, 0.09-6.75 mg/kg, and up to 1.39 mg/kg, respectively. Most of these concentrations exceed their maximum permissible levels for contaminants in foods in China. Heavy metals accumulate to significantly different levels between leafy vegetables and non-leafy vegetables. Food consumption and soil ingestion exposure are the two routes that contribute to the average daily intake dose of heavy metals for local adults. Moreover, the total hazard indices of As, Pb and Cd are greater than or close to the safety threshold of 1. Long-term As, Pb and Cd exposure through the regular consumption of the soil, rice and vegetables in the investigated area poses potential health problems to residents in the vicinity of the mining industry.

[Risk assessment of the farmland and water contamination with the livestock manure in Anhui province].

Basing on the data of livestock in 2001-2009 in Anhui province, the farmland pollution loading and water equal standard pollution loading of livestock manure were calculated utilizing the discharge rate of livestock manure. In addition, the risk assessment was evaluated on the livestock pollution in farmland and water bodies in this province. The industrial production of animal manure of this industry in 2008-2009 in Anhui amounted to 0.67 billion tons, and the averaged farmland loading of livestock manure, N, and P were 16.2 t x hm(-2), 83.8 kg x hm(-2), and 34.5 kg x hm(-2), respectively. The overall averaged risk constant of livestock manure loading in farmland was 0.36 (approximately risk level I). As to the water bodies, the averaged equal standard pollution loading was 7.03. However, significant differences were observed for the farmland and water contamination with livestock manure in different areas of Anhui, suggesting that some areas might receive much higher doses than the averaged amounts. The contamination weakened comparing with that in 2001-2002. But there was a trend of increase for P pollution. According to the information in 2008-2009, the farmland and water bodies in the areas of Hefei, Suzhou, and Bengbu still borne the livestock manure contamination. Results of this work provide some useful information for the water and farmland environmental protection in Huaihe river basin in Anhui province.