Optimizing compensation system in China′s Disease Control and Prevention Institutions: historical evolution, current challenges, and reform pathways

Advancing high-quality public health governance necessitates reforming compensation and incentive structures for personnel in China′s CDC system. Historically, CDC remuneration has evolved through four phases: hierarchical position-based salaries, structured salary systems, classified compensation models, and the current performance-linked pay framework. However, persistent structural flaws remain, including stagnant compensation growth, systemic underfunding, uneven "Two Permits" policy implementation (granting autonomy in performance pay and income distribution), ineffective performance-based allocation, and inadequate incentive-driven strategies. To address these issues, this study proposes comprehensive reforms: strengthening fiscal guarantees for stable funding, accelerating "Two Permits" policy adoption, restructuring performance evaluations, and implementing tiered incentive systems.