第76屆世界衛生大會部長專文
後疫情時代之永續健康發展
薛瑞元部長
衛生福利部
中華民國(臺灣)
前言
新冠肺炎(COVID-19)疫情至今已邁入第4年，全球疫情趨緩，各國邊境逐步開放，全球衛生治理的重點已從對抗大流行，轉向疫情後之復甦，為加速實現聯合國永續發展目標(Sustainable Development Goals, SDGs)，達成全人健康福祉(Health and well-being)，各國已加速努力推動因受疫情影響的各項健康永續發展目標。
臺灣支持WHO「三個十億」目標和永續發展目標，建構更具韌性與平等的衛生服務供應鏈，落實包容與公平的全民健康覆蓋體系，從初級衛生照護體系提供民眾疾病預防、管理與照護。臺灣能在建構跨部門、整合性、創新、以全人健康為核心的全球衛生工作中，分享我們的經驗，協助全球加速落實永續發展目標之健康福祉。
本次COVID-19疫情臺灣因具有完善的公衛體系及訓練有素的防疫人員，透過完善疾病監測、調查、分析等系統，竭力減緩各類傳染病疫情發生及擴散速度，於疫情發生時因超前部署、及早應變，建立完整應變模式，包括邊境嚴管、精準疫調、醫療資源配置、病患後送機制、防疫物資整備等，以等待疫苗及藥物之研發上市。加上臺灣民眾互助配合政策戴口罩、保持安全社交距離、減少出入人潮聚集處、隔離檢疫規定及接種疫苗等。臺灣本次COVID-19每百萬人口累積確診死亡率及致死率與38個OECD國家及新加坡相較排名第6位、至少接種一劑COVID-19疫苗的覆蓋率排名第4、每百人口疫苗追加劑接種數排名第3。
健康促進，全民均健(Health For All)
WHO積極推動的「5P」優先項目 ，即健康促進（Promoting）、提供成果（Providing）、衛生安全（Protecting）、賦權（Powering）與強化WHO表現（Performing），其中健康促進是最為首要的工作。而在WHO之「落實健康福祉全球框架」中，也展示了其對於推動健康促進的決心。
臺灣自1995年起，推動全民健康保險制度，並為不同人生階段之國人持續推動增進健康(Promotion)與預防疾病(Prevention)等健康促進及照護，使所有人民獲得應有健康權益。在孕產婦及新生兒護理方面，我國提供產前檢查，妊娠糖尿病篩檢、貧血檢驗與3次超音波檢查服務，減少妊娠風險及促進母嬰健康。為支持與協助不孕症生育願望並減輕進行試管嬰兒之經濟負擔，持續擴大不孕症治療補助方案；亦推廣母乳哺育，建構友善母乳哺育環境，並提供兒童預防保健及衛教指導。
非傳染性疾病預防及控制方面，臺灣推動代謝症候群防治計畫，針對特定族群民眾採行生活型態介入，提供健康飲食及規律運動指導、戒菸及戒檳榔等促進健康服務，幫助民眾主動改善生活型態，降低後續三高慢性病的發生；我國亦支持全球癌症防治行動計畫的實現，以達到WHO在2025年降低25％癌症死亡率之目標，期對全球癌症防治工作貢獻更多的心力，為達成WHO於2030年消除子宮頸癌目標，臺灣補助子宮頸抹片檢查，並提供公費接種人類乳突病毒(HPV)疫苗，將疫苗納入國家疫苗接種計畫，於2018年12月起提供國中女生HPV疫苗接種服務，2022年接種率為92.1%。
創新技術與全民健康覆蓋
臺灣全民健康保險是一個實現全民健康覆蓋的成功範例，COVID-19疫情使國際社會認識到區域合作和醫療數位化的重要性，而臺灣致力於促進數位健康和創新以強化醫療服務的可及性和品質，包括開發「跨時代的次世代醫療資訊系統升級計畫」，幫助醫療體系升級，也與國際接軌，支持導入各項新型態醫療照護模式、透過遠距醫療提供偏鄉離島民眾即時地取得健康服務、AI和其他新興技術的應用。臺灣於疫情期間核發13張「臺灣清冠一號」（NRICM101）外銷專用藥品許可證，幫助疫情影響嚴重的區域國家，亦積極採取多項措施強化疫情後國內關鍵藥品或原料藥的自產能力，以確保取得所需原料藥，避免藥品短缺。
此外，體認到全球衛生合作的重要性，臺灣將持續與國際網絡合作交流，分享我國創新技術及實施全民健保的經驗及實現全民健康覆蓋的最佳運作方式。
臺灣能幫忙，臺灣正在幫忙
自2017年起，臺灣已多年未受邀出席世界衛生大會，而在COVID-19大流行即將落幕、全球加速強化衛生體系的各項討論中，臺灣能夠幫忙，臺灣不應該被遺漏，臺灣的參與，將能使世界更為健康、更為永續、更為平等。
我們籲請WHO 及相關各方堅定支持將臺灣納入 WHO ，讓臺灣完整參與 WHO 各項會議、機制及活動，與世界各國攜手，共同落實 WHO 憲章「健康是基本人權」及聯合國永續發展目標「不遺漏任何人」之願景。
Sustainable health development in the postpandemic era
Dr. Hsueh Jui-yuan
Minister of Health and Welfare
Republic of China (Taiwan)
As the world enters the fourth year of the COVID-19 pandemic, the situation is gradually improving. Most border restrictions have been lifted and global health governance has shifted from pandemic response to postpandemic recovery. Countries worldwide have stepped up efforts to achieve health and well-being for all and further the realization of United Nations Sustainable Development Goals (SDGs) whose progress was impacted by the pandemic.
Taiwan fully supports health-related SDGs and the World Health Organization’s triple billion targets. Indeed, Taiwan is committed to building a more resilient and equitable health service supply chain, maintaining an inclusive and equitable universal health coverage system, and providing disease prevention and management through a robust primary healthcare system. Taiwan is willing and able to share its experience in creating a cross-sectoral, innovative, and people-centered health approach to help the international community work toward the realization of the SDGs related to health and well-being.
During the COVID-19 pandemic, Taiwan effectively mitigated the spread of the disease, leveraging its comprehensive public healthcare system, well-trained antipandemic personnel, and epidemiological surveillance, investigation, and analysis systems. Taiwan’s antipandemic response model included advance deployment and rapid response mechanisms. Other measures included border control policies, coordinated distribution of medical resources, and a patient transfer system to prevent and contain the pandemic at a time when vaccines and antiviral drugs were unavailable.
The Taiwanese people have played a pivotal role in the success of Taiwan’s antipandemic model by wearing masks, practicing social distancing, avoiding crowded areas, following quarantine regulations, and getting vaccinated. When compared with the 38 Organisation for Economic Co-operation and Development member states and Singapore, Taiwan ranks sixth-lowest in COVID-19 mortality and case-fatality rates. Taiwan also ranks fourth-highest for coverage rates of at least one COVID-19 vaccine dose and third-highest in terms of vaccine boosters administered.
Promoting health for all
Last year, WHO’s Director-General outlined five priorities for the subsequent five years, which are promoting health, providing health services, protecting health, powering progress, and performing. Moreover, WHO’s Achieving well-being: A draft global framework for integrating well-being into public health utilizing a health promotion approach further demonstrates its commitment to health for all.
Taiwan established a universal healthcare insurance system in 1995. Since that time, the government has continued to provide disease prevention and healthcare services so that people of all ages can enjoy the right to health. Taiwan provides prenatal checkups, gestational diabetes screening, anemia testing, and three ultrasound examinations to reduce pregnancy risks and promote maternal and infant health. To assist infertile couples and reduce the financial burdens of in-vitro fertilization, the government has continued to expand subsidized infertility treatment programs. Taiwan also aims to create a breastfeeding-friendly environment and provide preventive pediatric healthcare and health education.
What’s more, Taiwan has established a number of prevention and management programs for noncommunicable diseases. For instance, programs targeting chronic metabolic diseases assist at-risk groups, providing services such as diet and exercise guidance as well as smoking and betel nut cessation information to empower people to take control of their own health. Such initiatives improve lives and reduce the prevalence of high blood pressure, high cholesterol, and high blood sugar, which often lead to chronic disease. Taiwan also supports the global fight against cancer and WHO’s goal of reducing cancer mortality 25 percent by 2025. In line with WHO’s Cervical Cancer Elimination Initiative, Taiwan subsidizes cervical screenings and human papillomavirus vaccinations. HPV vaccines have been administered to female students aged 12 to 15 since 2018. By December 2022, a coverage rate of 92.1 percent had been achieved.
Innovative technology and universal health coverage
Taiwan’s National Health Insurance (NHI) is a prime example of universal health coverage, offering financial protection and access to a wide range of essential services. The COVID-19 pandemic helped the international community recognize the importance of regional cooperation and digitization in healthcare. Taiwan is committed to promoting digital health and innovation to enhance the accessibility and quality of healthcare services, including plans for a next-generation NHI program. Taiwan has introduced innovative healthcare services, utilizing real-time telehealth consultations for patients residing in remote areas and outlying islands, and is exploring applications for artificial intelligence and other emerging technologies. During the pandemic, Taiwan issued 13 export licenses for its herbal formula NRICM101 (Taiwan Chingguan Yihau) to help countries in the region combat the pandemic. Taiwan is currently implementing preventive measures for the postpandemic era, such as strengthening the domestic production of critical drugs and active pharmaceutical ingredients to avert future drug shortages. Understanding how important it is to work with the international community, Taiwan will further share innovative technologies and best practices with partners around the world to advance universal health coverage.
Taiwan can help, and Taiwan is helping
Taiwan has not been invited to the World Health Assembly since 2017. Now that the COVID-19 pandemic is abating and dialogue on strengthening health systems worldwide is accelerating, Taiwan should not be left out. Taiwan can help, and Taiwan’s inclusion would make the world healthier, more sustainable, and more equitable.
Taiwan urges WHO and all relevant stakeholders to support Taiwan’s inclusion in the World Health Assembly as an observer, as well as Taiwan’s full participation in WHO meetings, mechanisms, and activities. Taiwan will continue to work with the world to help ensure the fundamental right to health enshrined in the WHO Constitution. In the spirit of the SDGs, no country should be left behind—especially not Taiwan, which has made significant contributions to global public health.