australia-china healthcare opportunities this report was authored by kerry brown, professor of chinese politics and director of the china studies centre, university of sydney and simone van nieuwenhuizen, special project officer at the china studies centre.the authors wish to acknowledge the contributions of john knight and the george institute for global health in the drafting of this report.china studies centre the university of sydney nsw 2006 room 313, old teachers' college (a22) manning road tel: 61 2 9114 0837 chinastudies.centre@sydney.edu.au sydney.edu.au/china_studies_centrenational australia bank healthcare & ageingaustralia level 18 nab house, 255 george street, sydney, nsw 2000 tel: 61 (2) 9237 9427 laura.c.sampson@nab.com.auasia level 27 one pacific place 88 queensway, hong kong tel: 852 2822 9830 michael.ball@nabasia.comwww.nab.com.authe george institute for global health level 10, king george v building royal prince alfred hospital missenden rd camperdown nsw 2050 australia po box m201, missenden road, sydney, nsw 2050 tel: 61 2 9993 4500 info@georgeinstitute.org www.georgeinstitute.org a key challenge will be to achieve a good, all round living standard for its population. even in the space of a few years, chinese people will be wealthier, have higher expectations for public goods, and will increasingly live in cities and work in the service sector. keeping this all-important emerging middle class – which could amount to 750 million people by the end of this decade – happy and healthy will be politically and economically crucial for the government and country as a whole.nevertheless, china faces some formidable challenges over this period. health and wellbeing are among the largest of these. firstly, despite increasing investment in the healthcare sector and rising longevity, it also has the largest number of smokers in the world, as well as rising levels of obesity due to dietary and lifestyle changes. secondly, as demographer and national people’s congress (npc) standing committee member cai fang has noted, china runs the risk of growing old before it gets rich due to its ageing population.1 thirdly, serious environmental problems, which are intimately linked to public health, will need to be addressed.this paper sets out the opportunities for australia to collaborate with chinese organisations as china works towards fulfilling one of the key aspects of its project of modernity: a universal, affordable healthcare system for the largest population in history. china has an immense interest in australian experience, intellectual resources and inventions, and with the china australia free trade agreement (chafta) signed in 2015, there is a pathway for australian companies to engage with the opportunities in the healthcare sector.through this report, the national australia bank, the university of sydney’s china studies centre and the george institute for global health aim to start a conversation in the context of china’s recent healthcare reforms and chafta. these organisations represent different areas of specialisation within the sector, allowing both australian and chinese businesses to consider the opportunities from different perspectives. their recommendations include: examining healthcare opportunities presented by chafta; enhancing dialogue between chinese and australian experts; careful consideration of the location of business operations in china; concentrating in areas of strength, and exploring enhanced collaboration in the field of traditional chinese medicine.while this report is comprehensive in many respects, it does not explore legal or regulatory matters, and it is recommended that businesses consult with specialists on specific issues related to chafta and its implementation.executive summaryone of china’s two millennial goals, which mark the hundredth anniversary of the establishment of the communist party, is to complete a transition to what it calls a ‘middle income’ country by 2020-21.1 ‘china will grow old before it gets rich’, macrobusiness, 24 july 2012, http://www.macrobusiness.com.au/2012/07/china-will-grow-old-before-it-gets-rich/, viewed 1 september 2015. china’s health challengesince the founding of the people’s republic of china (prc) in 1949, the country has experienced dramatic change and immense achievements in its healthcare system. in 1949, the average life expectancy in china was 32 years, and the system was not equipped to deal with the health problems of its large population. however, with the start of the reform and opening up period in 1978, china’s development path changed and the country saw the dramatic improvement of many indicat