__________________________________________________________________________________________
2012/CTI2/LSIF/012
Agenda Item: IIA
Implementation of the APEC NCD Action Plan –
Chinese Taipei
Purpose: Information
Submitted by: Chinese Taipei
Life Sciences Innovation Forum Planning
Group Meeting
Singapore
31 March 2012
Implementation of the APEC NCD Action Plan
1. Non-communicable disease is the world’s major cause of death, as is Chinese Taipei.
(1)
Table
According to the WHO statistics in 2011, if we were to categorize deaths into
communicable, non-communicable, and injury, non-communicable diseases account for
64% (approx. 2/3) of all mortality. As a major cause of death in Chinese Taipei,
non-communicable disease accounts for 80% of total mortality.
Distribution of causes of deaths around the globe（%）
Global
West-Pacific
Chinese Taipei
Non-communicable
63.50
80.79
80.33
Communicable
27.49
9.85
10.77
Injury
9.02
9.37
8.90
(2)
The WHO has indicated that tobacco use, insufficient physical activity, unhealthy diet,
and harmful use of alcohol are risk factors that increase the risk of contracting
non-communicable diseases. Cancer, diabetes, cardiovascular disease, and COPD,
which are brought about by lifestyle (smoking, alcoholism, betel nuts, lack of exercise,
unhealthy diet etc.) would account for 58.4% of total cause of deaths. In turn, this
means that in 10 deaths, 6 are caused by unhealthy lifestyles.
(3)
Unhealthy behavior compared to the rest of the world
(4)

Most serious: 74% of the population in Chinese Taipei lacks exercise (without
moderate exercise at least 5 times a week, 30 minutes at a time)

Next: Male adults standardized smoking rate is 33.5%, Female adults 4.4%.
Smoking rates are lower than Europe and America. Over half (51.1%) male adults
and over one thirds (35.8%) female adults are either overweight or obese.

Last: Consumption of alcohol by the public is not considered high, however it is
increasing rapidly.

Other unhealthy behavior: There are still 12.5% of males chewing betel nuts.
Economic impact

Smoking: 0.96% loss of GDP is related to smoking related medical expenditure
and productivity loss in people above 35 years of age (2011, Lee YC).

Obesity (lack of exercise, unhealthy diet): The treatment of six types of metabolic
related and cardiovascular conditions account for 2.9% of Domestic Health
Expenditure in direct medical costs.
2. Currently the Bureau of Health Promotion, Department of Health has conducted the following
prevention programs to improve the previously mentioned four risk factors in behavior:
（1）Tobacco hazard prevention
In line with the MPOWER strategy proposed by the World Health Organization (Monitor
tobacco use and prevention policies, Protect people from tobacco use, Offer help to quit
tobacco use, Warn about danger s of tobacco, Enforce bans on tobacco advertising,
promotion and sponsorship, Raise taxes on tobacco), we have promoted a comprehensive
tobacco hazard education, provided accessible and diverse smoking cessation services,
develop international exchange and multilateral cooperation, and adult and teenager tobacco
hazard monitoring and behavior research works. Furthermore, the Bureau proactively
conducts various tobacco hazards prevention law related works such as training tobacco
hazards human resource, enhance local inspection on marketing activities, creating
smoke-free environments with fresh air for the public.
（2）Obesity prevention

Healthy Centenary, Healthy Chinese Taipei, 600 Tons Away Campaign
To combat obesity, Chinese Taipei launched the “Healthy Centenary, Healthy Chinese Taipei”
healthy weight management initiative in 2011, integrating central and local government
supports and from cross-sectoral partners such as work places, schools, NGOs and the mass
media. The initiative called for 600,000 people to “eat smartly, exercise happily and weigh
daily,” in order to achieve a total of 600 tons of healthy weight loss. The factors leading to
obesity will also be identified and transformed into health supporting environments. By
December 31th, 2011, over 720,000 people has joined in the initiative, and has achieved over
1,104 tons of healthy weight loss.

Organize “Healthy Exercise and Diet – Community LOHAS Program:
Public health bureaus from 13 cities/counties, 6,564 community groups and 938 health care
institutes joined together and promoted projects such as “Five Vegetable and Fruits A Day” and
“Exercise to Stay Active,” providing healthy diet and exercise consultations to 794 businesses
and 1,077 community groups, and helped raising public awareness of healthy diet and
exercise and creating supportive environments. To baild up community momentum, 9,508
volunteers were trained to increase community participation. A total 455,609 residents
participated in the “Eat Smartly, Move Happily and Weigh Daily” campaign.
（3）To propose health and welfare surcharge for alcohol
In order to prevent excessive drinking that is damaging the physical and mental health and the
associated social problems, we are drafting an Act to prevent alcohol hazards and levy health
and welfare surcharge for alcohol to reduce the use of alcohol in accordance to the global
strategy to reduce the harmful use of alcohol passed in May 2010 by the World Health
Organization.
Conclusion:
(1) Non-communicable disease is a major health problem in Chinese Taipei. Cancer, diabetes,
cardiovascular and respiratory diseases, of which unhealthy lifestyle such as smoking, betel nut
chewing, lack of exercise, and unhealthy diet are contributing factors, account for almost 60% of total
death. To combat NCDs, we must help our people to change their unhealthy behavior.
(2) The prevention of such problems can only be effectively achieved through the political commitment,
the support of cross-sectoral cooperation and health care system, establishing supportive environment
in communities, monitoring system and evaluation, as well as the cooperation with global partners.
Take cancer prevention as an example we:

Increase the screening rate of four main cancers
Since at least 60%-70% people have had outpatient visits in a year, the government subsides
hospitals to establish a patient-centered screening reminding system, these hospitals will actively
remind qualified patients to receive cancer screening services along with providing rapid service.
Through using IT system, the volume of screening services increased efficiently.
Chinese Taipei began to provide free Pap smear screening in 1973, followed by breast cancer,
colorectal cancer and oral cancer screening services, therefore the ever-screened rate were
greatly improved, and cervical cancer screening was increased from 10%(1995) to 87%(2010),
breast cancer screening from 0.5%(2001) to 34.9%(2011); colorectal cancer screening from
4.8%(2004) to 42.7%(2011), oral cancer screening from 6.7%(2004) to 68.7%(2011). Cervical
cancer screening service has been promoted for 16 years, therefore its ever-screened rate have
reached 87%, the cervical cancer incidence and mortality rate had been dropped down for more
than 50 percent. Except cervical cancer and oral cancer, ever-screened rate of the other 2 cancer
screening services were only about 40 percent, it still takes time to promote these cancer
screening services to reduce the mortality rate.

Use of New screening technology
To promote Mammography, we increased the number of
outreach digital mobile service from 3
to 35 to increase accessibility, number of mammography device were also increased from 87 to
204.
Although cancer mortality has in the past three years reduced from 142.6 per 100,000 population
to 131.6 per 100,000 population, almost 8% rate of reduction, we are determined to further curb
cancer and proposed the “Golden 10 Years” plan, by implementing which we would like to see
cancer mortality to reduce 20%, and halve the adult smoking rate as well as inactivity rate,
Body-Mass Index for both sex to improve 5%.