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Public Health and Medicine

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Global Challenges and Opportunities

The following challenges facing public health are adapted from the World Health Organization’s (WHO) Engaging for Health: Eleventh General Programme of Work 2006-15: A Global Health Agenda.

  • Chronic Non-communicable Diseases (NCDs)

Chronic NCDs already represent 60 percent of global diseases and the mortality rate for NCDs in developing countries is rapidly increasing due to, among other things, unhealthy diets and physical inactivity. In some cases, such diseases may be due to certain lifestyle choices. In other cases, however, such diseases may be due to other factors: In small island developing states, for example, a lack of agricultural development and the unavailability of fresh, locally grown produce can encourage such nations to import canned goods and processed foods.

  • Child and Maternal Mortality

Further resources and efforts need to be given over to child and maternal mortality to ensure that targets for the UN’s Millennium Development Goals (MDG) are met by 2015:

Few developing countries are currently on track to meet the [MDG] target for reducing child mortality, despite this being largely due to common conditions for which knowledge and effective interventions exist. Neonatal deaths have not declined as much as other infant and child deaths. Although the maternal mortality ration has declined in countries with lower levels of mortality, those with high maternal mortality rates are experiencing stagnation or even higher death rates. Gaps in mortality rates within countries are still large.

  • Poor Public Health Systems and Health Care-related Human Resources

Many health care systems in developing countries do not offer universal access to services, while private health care services may be too expensive for those with the greatest need of such services. Public health care systems may lack basic infrastructure, equipment and technologies. Furthermore, there is often a lack of health care-related human resources and know-how in developing countries, for which reason governments may need to provide incentives that halt the “brain drain” of qualified medics from developing countries moving to developed countries. Health care-related management and administrative capacity also need to be improved.

  • Rural vs. Urban Health Care

Certain groups and communities in rural areas cannot gain access to crucial public health resources and services, even if they are known to be cheap and efficient. This is because a disproportionate amount of resources are allocated to urban areas, and because “hi-tech” medical services and equipment tend only to be available in larger urban centers. Pilot projects and “islands of excellence” often prove not to be as useful as initially expected, because they are not scaled up to expand the coverage of health care into areas which lack such services.

  • Health Systems in Times of Crisis

Health systems in developing countries are often insufficiently advanced, or have insufficient resources, to cope with the increased burden in times of crisis, or when natural disasters occur. The pressure upon such systems continues to have a “knock-on” effect after the immediate danger has passed, for example due to the depletion of stockpiles of medicines and medical materials.

  • Rapid Urbanization without Pro-poor Improvements to Health and Living Conditions

Inadequate water supplies, the spread of water-borne diseases, poor housing, overcrowding and unhealthy working conditions are particularly important public health challenges due to increases in rates of urbanization and the growth of urban slums.

Given the challenges described above, the WHO’s Eleventh General Programme of Work identifies seven priority areas of work:

1. Investing in health to reduce poverty;
2. Building individual and global health security;
3. Promoting universal coverage, gender equality and health-related human rights;
4. Tackling the determinants of health;
5. Strengthening health systems and equitable access;
6. Harnessing knowledge, science and technology;
7. Strengthening governance, leadership and accountability.

Taiwan’s Strengths and Resources

Taiwan’s public health and medical systems – such as public policy development, public health promotion, community health care and epidemic monitoring and management systems, as well as other areas – embody a wealth of successful experiences that partner countries can learn from.

  • World-renowned Medical Technologies

Taiwan’s medical technologies and the quality of the sector is impressive, attracting international attention. Taiwan was the fourth country in the world – and the first in Asia – to establish an evaluation system for its national health service. The first child liver transplant and the first kidney transplant in Asia were both performed here, while Taiwan was also the first country in Southeast Asia to establish a craniofacial center, which has achieved a 100 percent success rate in the treatment of cleft palate and lip. Taiwanese medical teams are also involved in research into rare diseases.

  • Sound Health Care Systems

Taiwan’s outstanding achievements extend beyond medical and health care: The country is an important global base for ICT-related research and development, applications and production. Taiwan has already built a telecare system whose many applications combine modern ICT and medical diagnosis to provide patients with real-time monitoring services via wireless technology (WiMAX). The system provides patients with 24-hour control over their health, using radio-frequency identification (RFID) technology to trace medication securely and track identities, thereby offering patients greater security.

  • Prevention and Treatment of Infectious Diseases

Taiwan has also proved to be effective actor in the prevention and treatment of various infectious diseases, with malaria, smallpox and rabies having all been eradicated. The effectiveness of Taiwan’s tuberculosis controls also surpasses standards set by the WHO. In addition, the management and surveillance of diseases throughout the country has seen the Department of Health’s Center for Disease Control establish a comprehensive, Internet-enabled network that allows various epidemic prevention units to access the information they require in the shortest possible time, so that prevention work can take place as efficiently and quickly as possible.

TaiwanICDF’s Objectives and Methods

At present, the two strongest trends in global health care are the globalization of health care-related humanitarian assistance and environment-oriented improvements to international health care. Firm efforts are also being made to achieve the MDGs. The TaiwanICDF’s operations in public health and medicine will integrate Taiwan’s 50 years of experience in implementing foreign aid projects – such as those involving epidemic prevention and the implementation of medical and public health systems – by focusing on four core areas: public health programs, training for partner countries’ medical personnel, donations of used medical equipment, and medical cooperation. The methods we will employ to assist partner countries to strengthen public health and medicine are described in further detail below.

  • Integrate Taiwan’s Medical Resources; Improve the Effectiveness of Foreign Aid

We are integrating the strengths of various Taiwanese medical institutions through projects such as our Donation and Training of Used Medical Equipment Program, which collects and collates used medical equipment. Donating equipment enhances standards and medical equipment in partner countries’ medical institutions and provides citizens in such countries with better medical services. The project also includes components that support the maintenance and operation of equipment, together with education and training, thereby building the capacity of medics assigned to operate such equipment. Nurturing human resources is actively assisting medical professionals in partner countries to enhance their knowledge, skills and experience, and realizing our development objective of enhancing the quality of medical services in these countries.

  • Build the Capacity to Develop Partner Countries’ Health Care Systems

To harmonize our efforts with the health care-related MDG targets of partner governments, we will strengthen cooperation with other countries, supporting visits and on-the-job training to enhance the competencies of government officials working in medical administration and management, so as to improve the skills of health practitioners and primary health care services. For example, our Workshop on Healthcare Management, organized for participants from the South Pacific and Africa, covers the management of human resources and the development of medical management policies and practices, which cultivates talent in medical management amongst such partner countries and promotes international health care affairs through associated exchanges.

  • Draw on Resources from Taiwan’s Public and Private Health Care Systems; Enhance Partners’ Health Care Systems

In order to integrate the professional expertise and experience of Taiwanese medical institutions we are working with such institutions to tie together the government’s health care-related foreign aid policies, jointly assist our partners to upgrade the quality of their medical services and the international humanitarian assistance skills of Taiwanese medics, and generate opportunities for working with international organizations. To do these things, we have established the International Health Care Strategic Alliance (IHCSA) with 37 private medical institutes, so as to recruit more expertise from the private sector.

Supported by the abundant medical and human resources of this medical community, we are assisting medics from IHCSA institutions to visit partner countries, where they enhance the quality and depth of local medical work by providing clinical demonstrations and training. And our Healthcare Personnel Training Program, for example, involves the cooperation of dozens of medical institutes, with whom we have jointly developed workshops to share the strengths of Taiwan’s health care system. This provides participants with a rich clinical experience that they can share, as “seed” teachers, upon returning to their home countries.

Recently, we have been contributing assistance toward plans to station medics in Pacific partner countries on a permanent basis. The next step is to assist partner countries to research their most pressing needs in terms of medical cooperation, and to allocate the proper resources needed for cooperation in the field of international health care. Transferring projects involving clinical technologies as successfully as possible requires that we integrate and deepen the resources involved in public health projects.

Sources

  1. Engaging for Health: Eleventh General Programme of Work 2006-15: A Global Health Agenda. World Health Organization.

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