The 2024 APEC Health Working Group (HWG) Meeting was convened in Peru on August 16 and 17. Deputy Minister Ching-Yi Lin of the Ministry of Health and Welfare (MOHW) led Taiwan's delegation. Director General Chung-Liang Shih of the National Health Insurance Administration (NHIA) shared Taiwan's experience in achieving "Beyond Universal Health Coverage", highlighting how Taiwan has improved the accessibility and quality of healthcare through careful arrangements of different measures. Taiwan has also overcome obstacles posed by economic disadvantages, geographic limitations, physical disabilities, and uneven distribution of medical resources. In addition, Taiwan delegation was invited to participate in a policy dialogue on lung cancer prevention and control hosted by the U.S. Department of State. Director General Shih presented Taiwan's experience in improving the survival rate of lung cancer patients by implementing low-dose CT lung cancer screening test program and the NHI precision medicine coverage program; multiple member economies were highly impressed with Taiwan's achievement. In the future, the NHIA shall continue to contribute to APEC's One Health initiatives via the APEC collaboration platform to ensure regional peace and population health.

Taiwan's NHI program has been implemented for over 29 years since 1995 and has achieved universal coverage for healthcare. The theme of this APEC HWG meeting was Beyond Universal Health Coverage and discussions were held on further expanding the universal health care. To address health inequality, Director General Shih of the NHIA shared four main aspects of Taiwan's execution strategies. First, financial aid is provided to patients with economic disadvantages to prevent the vicious cycle of poverty and illnesses. Second, medical teams are sent to remote areas to provide mobile healthcare, including the mountains and offshore islands. In recent years, telemedicine has been introduced to offer remote specialty consults. Over 85% of townships and health centers in remote areas are able to provide services incorporating virtual appointments and relevant medical equipment onsite such as digital diagnosis scope set and ultrasound device. Statistics showed that in these areas, the provision of ophthalmologist services increased by 7-folds, the provision of otolaryngologist services increased by 5-folds, and the overall satisfaction rate reached 95%. In addition, to provide human-centered holistic medical care, the Holistic Integrated Care trial project has been implemented in remote areas. The project incorporates preventive care, health promotion, healthcare services, and long-term care services, creating an integrated service that significantly improves the health of local residents and the healthcare quality in remote areas. Third, for patients with physical disabilities that hinder their mobilities, an integrated home care service has been implemented. Moreover, the Acute Hospital Care at Home Trial Project implemented this July, allows patients with acute mild infections such as pneumonia, urinary tract infection, and soft tissue infection to receive treatments at home or in a care institution instead of being admitted to a hospital care. At the same time, telemedicine technologies and remote monitoring equipment enable patients to receive treatments at home with ease. The NHI program further covers bedside exams and tests to enhance home healthcare services. Lastly, in terms of issues related to the uneven distribution of medical resources, starting this year, the NHIA encourages all medical facilities to establish "zone defense" and ensure timely medical services for acute patients through an efficient referral system to save precious lives.

On August 17, the U.S. Department of State hosted an APEC member economies policy dialogue on Accelerating Progress for Lung Cancer Prevention, Diagnosis, and Treatment: Learnings from APEC Collaboration on Cancer Control. Taiwan delegation was invited to share their experiences on successfully reducing lung cancer mortality rate. Deputy Minister Lin of the MOHW attended the session while Director General Shih of the NHIA gave a speech about Taiwan's complete prevention and control strategies for lung cancer. Key measures of these strategies include the Tobacco Control Project initiated in 1997; a nation-wide low-dose CT lung cancer screening test program for heavy smokers and patients with family history implemented in July 2022; and the Cancer Screening Positive Follow-up Project implemented in 2023 by the NHIA, which aims to achieve the goal of early detection, early diagnosis, and early treatment.  Additionally, the NHIA has included the next generation sequencing in the NHI payment package in May 2024 and introduced several reforms such as the parallel review procedure, conditional listing, and flexible reimbursement of the Cancer Fund. The NHIA has also accelerated the inclusion of new drugs in the NHI package and implemented the precision medicine agenda for cancer. Besides sharing Taiwan's experiences, the delegation noticed differences in lung cancer onset for Asians and Westerners; for example, gene mutation types differ, the percentage of female non-smoker patients is higher in Asia, and the patients' age are 5 to 10 years younger when first diagnosed with lung cancer. Such findings indicated that lung cancer prevention and control projects must be adapted to local conditions in the APEC region. The Cancer Screening Positive Follow-up Project has successfully achieved early diagnosis, with 83.2% participants diagnosed at an early-stage cancer (stage 0 or stage 1). The project is estimated to reduce lung cancer mortality rate by 55% and significantly increase the survival rate.

Through the APEC collaboration platform, Taiwan can share nearly three decades of experience with its NHI program with other member economies. At the same time, Taiwan is looking forward to contributing to the health of everyone in the Asia-Pacific region through relevant collaboration mechanisms.