Noncommunicable Diseases

Prevention and treatment of hypertension

According to MOHW statistics for 2016, heart disease, cerebrovascular disease and hypertensive disease—all related to hypertension—were ranked as the second, fourth and eighth leading causes of death in Taiwan, respectively. One in every 4.5 deaths is caused by hypertensive diseases. Since hypertension has no obvious symptoms, it is known as the silent killer. On May 17, 2017, World Hypertension Day, themed Know Your Numbers, called on governments across the world to stress the importance of blood pressure measurement. To raise awareness of the issue and encourage people to check their blood pressure, the MOHW’s Health Promotion Administration organized a monthlong campaign in cooperation with the Taiwan Hypertension Society, Taiwan Pharmacist Association and Taiwan Millennium Health Foundation. Over 1,500 blood pressure measurement spots were set up nationwide in locations like convenience stores, cosmetics retail outlets and pharmacies. An estimated 60,000 people checked their blood pressure and consulted with pharmacists through the campaign.

Prevention and treatment of high blood sugar

Diabetes was the fifth leading cause of death in Taiwan in 2016. Working in collaboration with clinics, local foundations and public health and welfare organizations, 22 cities and counties in Taiwan have launched community care networks for diabetes patients since 2003. The networks have helped enhance care quality, develop training and accreditation systems for medical professionals and set up interdisciplinary medical teams. Under the networks, 255 health care facilities have been accredited as diabetes health promotion centers by the HPA. The NHI has also established a pay-for-performance scheme targeting the disease, providing financial incentives to medical institutions that achieve diabetes treatment standards and goals. In 2016, the proportion of diabetes patients covered by the NHI’s pay-for-performance program reached 46 percent. These measures have led to significant improvements in outcomes.

To strengthen public awareness of diabetes prevention, the HPA has also published a series of brochures containing clear information about the disease. Each year on World Diabetes Day, the HPA also collaborates with local government health departments and relevant associations to organize news conferences, lantern ceremonies, hiking events and festivals to boost understanding of diabetes prevention. Taiwan’s standardized diabetes mortality rate dropped from 37.1 per 100,000 people in 2012 to 24.5 per 100,000 people in 2016, a decline of 34 percent. This demonstrates the effectiveness of the nation’s integrated care networks.

Cervical cancer screening

In line with WHO recommendations, Taiwan offers subsidized screenings for four kinds of cancer: breast, cervical, colorectal and oral. Research shows that cervical screenings can lower the incidence and mortality rates for cervical cancer by between 60 percent and 90 percent. Since 1995, Taiwan health authorities have encouraged women aged 30 and over to undergo cervical cancer screenings every three years. Women aged 30 and over with an NHI Card and National Identification Card can receive free examinations at NHI-contracted clinics and hospitals. As of the end of 2017, a total of 2.16 million women had undergone screenings, resulting in 3,900 cervical cancer diagnoses. In addition, precancerous lesions were identified in some 9,600 patients. The standardized mortality rate for cervical cancer in Taiwan dropped by about 70 percent from 1995 to 2016.

Tobacco control

Since the Tobacco Hazards Prevention Act took effect in 1997, the HPA has launched various programs in line with the WHO’s MPOWER measures. Under the initiative, the WHO urges countries to monitor tobacco use; protect people from tobacco use; offer help to quit tobacco use; warn about the dangers of tobacco; enforce bans on tobacco advertising and promotion; and raise taxes on tobacco products. The measures unveiled in Taiwan include expanding smoke-free areas; launching new packaging warning labels; prohibiting tobacco advertising; increasing taxes on tobacco products; and strengthening cessation services. The percentage of smokers in Taiwan decreased from 20 percent in 2009 to 15.3 percent in 2016. In addition, the proportion of local high school students smoking dropped from 14.8 percent in 2009 to 9.3 percent in 2016, while the percentage of junior high students smoking declined from 7.8 percent in 2008 to 3.7 percent in 2016. Consistent annual declines underscore the country’s progress toward the goal of a 30 percent reduction in the prevalence of tobacco use, as set by the WHO’s Noncommunicable Diseases Global Monitoring Framework. The proportion of junior high school students who smoke in Taiwan is lower than the WHO figures for Malaysia, 26.1 percent; Italy, 20.6 percent; South Africa, 15 percent; South Korea, 9.6 percent; Australia, 5.4 percent; and the U.S., 4.2 percent, as reported in the Global Youth Tobacco Survey released in 2016.