In the past, like many developing countries, Taiwan suffered from rampant infectious diseases due to poor public health and widespread malnutrition. In the 1950s and 1960s, infectious diseases were the major cause of death in Taiwan, but with the rapid development of the economy subsequent advances in medical technology, as well as better public health conditions, the overall death rate has plunged in the last decade or two.
Rates of occurrence and death from infectious diseases have dropped, and the diseases posing the greatest threat to human life have gradually shifted from acute infectious diseases, transmitted by viruses or bacteria, to chronic diseases and degenerative diseases, influenced primarily by the environment, heredity, lifestyle and diet. In 1982, malignant tumors for the first time surpassed acute cranial vascular disease as the leading cause of death in Taiwan and have remained the number one killer for the past 18 years.
Apart from chronic diseases, a number of infectious diseases such as AIDS, dengue fever, enterovirus, and certain diseases that spread between people and livestock have threatened Taiwan in recent years. Furthermore, the large number of foreign laborers imported to meet the demands of the job market has resulted in certain problems pertaining to the prevention of parasites and tuberculosis. In the coming decade, the important medical and public health problems in Taiwan will be similar to those in other developed countries around the world. They will center around degenerative diseases affecting the elderly, chronic diseases and hereditary diseases. Moreover, certain intermittently arising local or alien infectious diseases will be difficult to avoid because of frequent worldwide travel.
The rapidly spreading and menacing SARS epidemic, which has caused panic around the world, is one example of such an alien infectious disease. According to World Health Organization statistics, by April 5, 2003 a total of 2,416 cases had been reported in 19 countries, and among the six regions where local chains of transmission have appeared, only Taiwan has not yet reported a fatal case. This unique record in the medical world, a veritable "Taiwan miracle," is not just the government's pride. To an even greater extent, it is a testament to the diligent work of National Taiwan University's medical team because, to give the most meaningful indicator of success, the most critically ill patients were stabilized and ultimately cured under round-the-clock care of our medical team.
While demonstrating the capability of the policymaking mechanism at National Taiwan University Hospital to work quickly and effectively, our unique record also shows the importance of medical research, because the cultivation of clinical experience and accurate diagnostic skills is certainly not the result of just riding on a reputation established over the course of the last century. The real behind-the-scenes force that made success possible is the solid research conducted one step at a time, day after day, in the vast field of medicine.
Medical research requires the support of the government and the society. The level of support medical research has received in Taiwan can be judged by data in the 2001 ROC Yearbook of Science and Technology, which indicates that funding for medical research at Academia Sinica and the National Science Council was about NT$2.37 billion that year. This was well behind the NT$7.63 billion in funding for science and engineering and on a par with the NT$2.23 billion allotted to fund the humanities. Neither the Bureau of National Health Insurance nor the Ministry of Education list medical research as a priority item to support.
Because of a sudden increase in the number of colleges that has put pressure on the Ministry of Education and because of financial pressure at the Bureau of National Health Insurance, these two organs are investing less and less of their budgets in medical education and research. At present, 95 percent of the budget at National Taiwan University Hospital comes from earnings painstakingly brought in by individual medical personnel.
Under such circumstances, doctors in the nation's medical centers still faithfully discharge their duties and maintain their unwavering passion for teaching and research. Day and night they stand on the front lines, receiving the most dangerous patients and practicing medicine to the best of their ability. We are extremely worried that if this poor environment doesn't improve, it will create a nightmare for the people of Taiwan. I'm afraid we can't expect the government or our elected representatives to do anything.
Unlike Taiwan, other nations have many public interest groups and charities which make selfless donations to support university medical research. The establishment of many well-known medical centers and research institutions is the generous work of great philanthropists or the wider public.
Given the damage done to the overall Asian economy by the current SARS outbreak, a figure likely to exceed US$100 billion, we should also be concerned about the future repercussions of the current problem. We have long emphasized that medical research is intimately related to the development of the biotech industry and the success or failure of the knowledge economy. The economic effectiveness of the biotech industry, and especially the biomedical industry, can't be evaluated in purely monetary terms.
These industries indirectly improve the quality of human life, advance health, defend us from the threat of disease and bring physical well-being to people as well as peace and harmony to society. The value of this contribution can't be quantified. Thus, the government should naturally invest in the biomedical industry to create a bright future for the public. The development of the biomedical industry is rooted in high quality, in-depth medical research and the industry flourishes in an environment conducive to creativity. Its developmental model naturally cannot follow that of traditional science parks. Nor can the seeds of this industry be cultivated in an industrial park.
I frequently see reports about certain charitable people and their good deeds in newspapers and magazines or on television and they move me deeply. This kind of virtue breathes freshness and vitality into our society and culture. Such warmth proves that love, hope and light still exist. But I often think that we can still differentiate between different gradations when considering this kind of selfless love.
In Records of Welfare Fields (
He was exceedingly frugal in his personal life, using his generous government salary instead to ensure that no one in his father's clan travelled without carriages, none of his mother's clan lacked food or clothing and none of his wife's clan suffered from cold or hunger. At the same time, he enabled over 300 members of the gentry in Qi to support their families. But although Qian considered Yan a virtuous man, he noted that Yan's good works came to an end with his death and therefore in their efficacy they fell far short of Fan's welfare fields, which not only were broad in scope but also remained effective over time.
Every doctor engaging in medical research at National Taiwan University Hospital holds the following aspirations: that bodhisattvas long live among us, that all people's illness and suffering should be dispelled, that all people's health should be maintained and that all people's lives should be safeguarded.
With just a little bit of concern and encouragement from the government, society or compassionate individuals, with just an iota of charitable assistance, the facilities, equipment and environment in our medical centers could be improved. Then more talented people could be attracted to engage in medical research, the morale of researchers could be lifted, the quality of research could be improved and the scope of research could be broadened. Moreover, our merit will help preserve all education, culture, religion and belief. It will keep all the lights of life and love burning. It is said that, "worldly people fear consequences [of their bad karma] while bodhisattvas sow the seeds [of good]." Just think what seeds we could plant. Let us get started!
Hsu Shih-ming is vice president of National Taiwan University Hospital.
Translated by Ethan Harkness
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