Sun, Aug 12, 2007 - Page 8 News List

Healthy Taiwan a wealthy Taiwan

By David Bloom

On July 27, President Chen Shui-bian (陳水扁) proposed a major advance in Taiwan's health policy. He announced that he would seek a large increase in the central government's vaccination budget in order to expand the range of vaccines covered by the national health insurance system and to accelerate their introduction. This is good news. An expanded vaccination program will contribute to the population's health and longevity, and it represents a far-sighted investment in the nation's economic prosperity.

Taiwan is one of the major participants in the so-called "East Asian miracle." The nation experienced -- and benefited from -- very rapid economic growth over a sustained period, despite starting from a point where few thought such an advance likely. This "miracle" growth clearly resulted from the convergence of multiple factors, one of which was a deep and early commitment to improving health. Indeed, one lesson that Taiwan's experience has emphasized to the world is that "healthier means wealthier."

There is strong evidence that health improvements promote income growth via higher labor productivity, educational attainment and cognitive function, savings and investment. In addition, health improvements have led to lower birth rates and a subsequent increase in the relative size of the working-age population, from which economic benefits can also flow.

Taiwan has an amazing record in health achievements. With life expectancy at 77 years and infant mortality at five per 1,000 live births, it shines as an example of what a determined, once-poor country can accomplish. This success stemmed from an early focus on improving health via better treatments, new antibiotics and better prevention through safe water, sanitation and vaccines.

Of these various public health measures, Taiwan's vaccination record is particularly notable. Children have been receiving free vaccines since the 1980s, and more than 90 percent of the population has been immunized by basic vaccines. Taiwan provides influenza vaccinations for infants, children, and the elderly.

Taiwan was the first country to implement a hepatitis B vaccination program nationally. And vaccination has contributed to the elimination of certain diseases -- in 1991, polio was eradicated, and measles (except for a few sporadic cases) is also gone.

Yet as Chen implicitly acknowledged in his announcement this week, in the years since these successes vaccination policy has stagnated.The national vaccination program has been slow to take advantage of new vaccines, including protection against pneumococcal disease, rotavirus Hib, and the human papilloma virus.

The nation spends about NT$300 million (US$9 million) to NT$400 million each year on vaccines -- an amount that has not grown in recent years. The new vaccines are considerably more expensive than existing vaccinations, such as those against DPT and measles. Making the new vaccines universal could quadruple spending.

Yet an increase in this budget is warranted. Funding these vaccinations holds the promise of conferring multiple benefits. Children obviously gain, because they get sick less often, die in fewer numbers and avoid the sometimes debilitating long-term effects that diseases can leave. When they go to school, they are more attentive and have fewer cognitive deficits, so they learn more.

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