Bridging policy and practice: implementation of emerging infectious disease risk assessment in China from a One...

Risk assessment of emerging infectious diseases (EIDs) enables the early identification of potential threats and informs timely public health responses. A One Health perspective may enhance its comprehensiveness by integrating human, animal, and environmental factors. However, current understanding of the policy implementation of EID risk assessment in China remains limited. This study examines the implementation of related policies in China to identify gaps between policy design and practice from a One Health perspective.

Semi-structured interviews were performed in Hainan Province and Jiangxi Province during March and June in 2024. Purposive sampling was used to recruit stakeholders from human, animal, environment, and other administrative sectors. All interviews were conducted in Chinese with each lasting 40-60 min. Grounded theory methodology was used to guide thematic analysis. Open coding and axial coding were conducted to allow themes and subthemes from the data.

A total of 54 experts from human (25.9%), animal (24.1%), environment (22.2%) and other (27.8%) sectors participated in the interview. Overall, China advanced risk assessment of EIDs across multiple dimensions, including governance system, cross-sectoral coordination, technology, workforce capacity, and financial investment. The results revealed barriers in implementing of risk assessment, including: (1) minimal surveillance of unknown diseases, (2) minimal surveillance of aquatic and wild animals, (3) insufficient staffing size and weak professional competence, and (4) inadequate cross-sectoral collaboration. It is recommended to improve legal provisions concerning sector responsibilities, develop a minimum data set to facilitate cross-sectoral collaboration, enhance work force capacity through training, and strengthen scientific research cooperation between academic communities and sectors.

Persistent gaps in the local implementation of policies on EID risk assessment in China were identified. The findings highlighted the need to strengthen risk surveillance and facilitate data sharing across multiple sectors from One Health perspective, which may contribute to China's capacities to cope with EIDs.