From Barefoot Doctors to Biologics: Dr. Ruby Wang on China's Healthcare Revolution

Kaiser Kuo (0:09)

Welcome to Sinica Podcast, a weekly discussion of current affairs in China. In this program, we look at books, ideas, new research, intellectual currents, and cultural trends that can help us better understand what's happening in China's politics, foreign relations, economics, and society. Join me each week for in-depth conversations that shed more light and bring less heat to how we think and talk about China.

I'm Kaiser Kuo coming to you this week from my home in Beijing.

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I've been in and out of China since the 1980s, as many of you know, and then living here for most of the years, since. Of all the transformations I've watched in that time, health care may be the one that's kind of hardest to convey to anyone who wasn't around for the early part of it. If you spent any time in a Chinese hospital, Wobi Tai Yi, in the late 80s, say, or the 90s, you remember. You remember getting there before dawn to queue up for a registration ticket, and you remember the hall fans of the ticket scalpers, who had already bought up all the morning slots, or whichever doctor you actually wanted to see. You remember the cashiers' windows at every single step. Pay here, you take a little slip, you go do your thing, come back, pay again, get another slip. You remember corridors that were really crowded with people who were being seen in them, IV trips for most of them for some reason. For more or less everything, they were handing out antibiotics willy-nilly for even just a head cold and underneath all of it, a kind of low-grade dread, the sense that if something genuinely serious were to happen to you, your outcome was going to depend on whether you knew somebody.

I've been lucky enough to mostly avoid it though, the many trips that I've taken with siblings and girlfriends and friends, and then of course the wife and kids have etched the experience into me rather deeply. The world that I've described has not disappeared completely. I do want to be careful here because I live in Beijing, which is about as good as it gets in this country, and the distance between a Beijing, even like tertiary hospital and a county hospital, say in Guizhou, is still going to be enormous. Nobody should come away from this episode thinking China has Saul's health care. It clearly hasn't, but even allowing for all of that, the change is still pretty hard to overstate. I mean, I book appointments now on my phone, payment and insurance settle inside the same app that you booked on. Test results come back on your phone. Prescriptions get delivered to your door. There are hospitals in this country where a newly diagnosed cancer patient can go from genetic sequencing to a matched therapy inside of a couple of days. There are people listening to this right now who have better digital continuity of care in Hangzhou than I could get from an American health system I've paid into for decades. And the delivery side isn't even the part that I find most striking. It's actually what's happened to the drugs themselves. So last week, if you heard my show last week, in my little preamble, I was talking about how staying relevant to the discourse on China seems now to require unmanageable levels of familiarity with all sorts of different areas of specialization, especially tech, AI and semiconductors, all the ins and outs of trade policy, rare earths, of course, which is what we talked about last week. Add one more to the list, because the next thing is almost certainly going to be pharma and biopharma. Now, I am a complete neophyte to do this, so do bear with me if you are somebody who knows this area much better than I do. For a long time, China's role in the global pharmaceutical business was the unglamorous end of it, active pharmaceutical ingredients, the chemical building blocks that go into other people's medicines. Plus, of course, generics, like India had done for a long time, copies of molecules that were invented somewhere else. That was the reputation, and you know, mostly it was deserved. I remember the work that companies like Wuxi Apptech, which was still back then called Wuxi Pharmatech, when I visited them 20 years ago as a reporter, was this kind of unglamorous work that they were doing. You know, it's the same, I am going to say that sentence again.