U.S. Dept. of State - IIP: The United States and China

First Lady Hillary Rodham Clinton
at the signing of an agreement between
Beijing Medical University and the Centers for Disease Control and Prevention

Held at Beijing Medical University

Neural tube defects occur more frequently in China than anywhere else in the world, up to ten times as often as in the United States. We estimate that more than 50,000 Chinese women have a pregnancy affected by neural tube defects every year.

In 1993, Beijing Medical University began to work on an ambitious community intervention program. The aim was to enroll women into the program at the time they registered for marriage so they could begin to take pills before they became pregnant and then to follow these women throughout pregnancy to the birth of their child. One component of this program was the development of a birth defects surveillance system that established the means to determine the rates of neural tube defects. At this time, more than 600,000 births have been documented since 1992, identifying more than 12,000 cases of birth defects, 850 of which were neural tube defects.

Efforts to promote folic acid consumption in China have met with exceptional success. You抳e just heard from President Wang about that. These high rates of participation and high compliance with folic acid use in China mean that many babies who would have been born with a serious birth defect have now been born healthy. As a result of these outstanding achievements, the Ministry of Health of China established a national prevention program in October, 1995 recommending that all women who are getting married should take folic acid to prevent neural tube defects.

Similar prevention efforts are being implemented in many countries thoughout the world. In the United States, for example, the Public Health Service recommends that all women of child-bearing age consume 0.4 milligrams of folic acid daily in the form of fortified grain products or pill supplementation. In the future, we need to work very hard to educate women and health workers about the benefits of folic acid. We also need to develop and implement effective folic acid prevention programs around the world. Folic acid represents an economical and humane intervention that is effective in preventing lifelong disability and suffering and, in many cases, death.

Our signing of this document this day establishes our intention to continue scientific collaboration beneficial to the United States and to China, and ultimately to all the countries of the world, in the prevention of birth defects, disabilities and health hazards due to environmental factors. In the area of birth defects, some of our continuing effort will include evaluating the role of folic acid and other vitamins in the prevention of congenital heart disease and other birth defects. In the area of environmental health, we will collaborate to identify sources of exposure to radiation and lead and to help develop programs to control these exposures.

We also plan to work together to assess the health impacts of asthma and other respiratory diseases and their relationship to environmental factors. We at the Centers for Disease Control and Prevention look forward to working with our colleagues at Beijing Medical University and the Ministry of Health to insure that all of our children have the best chance of being born healthy and the opportunity to live full and productive lives. Xie xie da jia.

Now I have the very great honor to introduce to you the Honorable Minister of Health Jiang Wen Kang.

MRS. CLINTON: Thank you again. Thank you very much, Mr. Minister. And I am honored to be here at this very renowned University. Beijing Medical University is, I was told and confirmed, the largest medical university in the world. (applause) And I抦 delighted to be here. Thank you, Dr. Jiang, for that kind introduction. Thank you, Dr. Berry of the Centers for Disease Control and Prevention. Thank you, Dr. Wang and all of you who are here today with us to witness the signing of a new agreement to expand U.S.-China cooperation in the areas of medical and scientific research.

It is very important that we continue the cooperation that has existed between this great university and the Centers for Disease Control for a number of years. And today, we reaffirm our joint commitment to tackle the neural birth defects that rob too many children of their health and their lives.

I was pleased to meet the young mother and her baby girl because I know that, as a mother of a girl, how important we cherish every child, and I know that this young mother understands the benefits of taking folic acid during the early months of pregnancy. This is a message and a lesson that is being transmitted to millions of women around the world. Because we have seen, all too often, how spina bifida and other neural tube defects affect hundreds of thousands of pregnancies around the world and more than 50,000 here in China alone.

We know, and thanks to the research that you have done here, that we can do much to prevent this leading cause of death of infants in the first weeks of life and to prevent the defects that many children endure. If we take this research that you have done and be sure that we spread the message as you are doing, then women will be more aware of what they themselves can do to prevent defects and deaths.

It is also significant that you are discovering that there may be another benefit of folic acid, mainly a marked decrease in congenital heart defects in newborns. We look forward to working together to learn more about this possible new research.

Today, the CDC and the Beijing Medical University come together again to announce a new and expanded framework for collaboration that will build on the progress we have already made together. The signing of this declaration of intent calls for collaboration on prevention of birth defects, disabilities and health defects resulting from environmental factors, such as exposure to lead, radiation and water pollution. This is one of the most significant areas for medical research that we should be pursuing throughout the world.

We are learning more in my own country about the environmental causes of various diseases, particularly in infants and children. We are learning to great extent how different children are from adults. If one thinks about it, they are not little adults, they actually breathe in more air, they roll around in the dirt, they are exposed to more of the environment than adults are. So it is critical that we learn more about the environmental effects that do affect women during pregnancy and babies and children.

So, we are very excited about this collaboration. And as we see and witness the signing of the declaration, I hope that we re-double our efforts to be partners and collaborators, on behalf of women, children, men -- everyone who seeks the expertise that can come from a great university such as this. From the doctors whom you train and the research that you do so that we can better promote the health of all of our people.

This unique partnership goes beyond making positive changes to public health practices in the United States, China and around the world. It also strengthens goodwill and scientific collaboration between our two countries. I want to commend all of you here at Beijing Medical University. And I want to commend the CDC for all the hard work that has brought us to this point. And I wish to commend you on your future collaboration. By working together, we will make progress.

And, perhaps in the 21st century, our grandchildren will have to look in history books, not medical books, to learn about diseases like spina bifida. We have that progress within our grasp. If we work together, we make the necessary research breakthroughs, and then we take the knowledge that you derive at a great university such as this and disseminate it to women like the young woman we saw throughout your country, my country and the world, paying particular attention to rural women and poor women, whether in urban or rural areas.

And if we do that, we will all together see great progress in improving public health in the years to come. And that will mean that we will see more happy mothers and babies like the one we saw today. Thank you very much.