Written by Tsung-Mei Cheng. Chronic financial instability and the difficulty the government has with raising the premium rate to balance the budget aside, the NHI faces myriad other challenges, including rising patient-consumer expectations and demands for ever more and better health care, the high cost of new medical technology and its coverage, provider payment reform, health care workforce shortages, ageing of the population, building long term care, etc.
Written by JhuCin Rita Jhang, Ph.D. The possibilities to study tongzhi/LGBTQ+ health are endless. Tongzhi/LGBTQ+ issues are a chance to reexamine existing power structures, assumptions, beliefs, and biases and challenge exclusive and even oppressive systems. Suppose Taiwan pledges to adhere to international human rights standards and aspires to be the leader in tongzhi/LGBTQs rights in Asia. In that case, we cannot afford to ignore tongzhi/LGBTQ+ (nor anyone else) in health, medicine, and social policies.
Written by Po-Han Lee. The ethical imperative of the human rights-based approach to public health requires the ‘acceptability’ (including cultural appropriateness) of health policymaking, impact assessment, and care services. In this context, Cultural competence in public health practices is concerned with ‘health for all’ through ‘safety for all’. That is, the principle of cultural safety, along with awareness of intersectional marginalisation, is to eliminate health inequities due to systemic racism and eventually decolonise public and global health practices.
Written by Chunhuei Chi. Beyond the pandemic, our healthcare system will face more future challenges, from chronic diseases of the ageing population and emerging new infectious diseases to the health impacts of climate change. We need a strengthened healthcare system that is innovative, adaptable, trusted, and governed by the people to face these challenges.
Written by Jens Damm. With the outbreak and global spread of COVID-19, reports of the stigmatisation of Asian-looking people have been accumulating in Germany and worldwide. Therefore, for a small research project, I chose to conduct qualitative semi-structured interviews with Taiwanese who spent the time of the pandemic in Berlin. I focused on their personal experiences as transnational actors. I asked in particular about personal experiences of discrimination and economic hardships during the pandemic and their evaluation of the different COVID-19 measures in Germany and in Taiwan.
Written by Yu-Chuan “Daniel” Lin. Although PrEP medication solves the HIV epidemic, research has found an inadequate number of MSM receiving it. For example, a 2015 U.S. CDC report has indicated that at least one of four gay men should be taking PrEP daily to effectively avoid more extensive HIV transmission, requiring the participation of roughly 1,200,000 MSM nationwide. However, its data showed that no more than 50,000 MSM are doing so, which translates into a poor execution rate (around 3%) of the government’s PrEP project designated to combat the HIV epidemic.
Written by Geng-Hui Lin. Compared to HIV risk, which is assessed through responses to a CDC survey, age is a relatively inflexible criterion for MSM’s who want to obtain PrEP through Taiwan’s PrEP program. There are ways to be categorised as an elevated risk for HIV infection depending on your answers to the CDC’s HIV risk assessment. As a result of these criteria, although some MSM’s over thirty-five have been enrolled in the program, access and availability remain mostly limited to those under this age. This leaves older MSM’s as outsiders to the program, unable to enter.
Written by Tsung-Mei Cheng. Time will tell how quickly Taiwan can bring the Covid surge under control. However, the fundamentals that worked so well for Taiwan before the surge—preparedness (a national plan), universal health coverage, advanced IT and communications infrastructure, and a cooperating public—should continue to serve Taiwan well in the fight against the current surge. Moreover, it will hopefully also defend us against future variants of the Covid-19 coronavirus to come.
Written by Chunhuei Chi. Taiwan’s repeated successes in controlling domestic outbreaks, including successfully controlling the new outbreak in May of 2021 by mid-July, ironically contributed to Taiwan’s challenge to move into the transitional phase. This success enabled Taiwanese residents to enjoy a normal life with a low tolerance for domestic outbreaks and caused a unique form of vaccine hesitancy, especially among the elderly. When there is little to no risk of infection, many people associate vaccination with risks and few potential benefits.
Written by Brian Hioe. Now, Taiwan faces the challenge of transitioning from its COVID-zero approach toward what the Central Epidemic Command Centre (CECC), which coordinates Taiwan’s COVID-19 response, has referred to as a “zero severe COVID” approach. Namely, as Taiwan transitions to a COVID-management strategy, attempts are made to avoid serious cases of COVID-19.
Written by Yunaw Sili and Besu Piyas. The story began in 2006. That year, the Council of Indigenous Peoples in Taiwan issued a guideline stating that if Indigenous students need preferential treatment for college admission, they must pass the national Indigenous language certification test. As a result, many parents were worried that their children’s access to higher education would become more difficult. Because of this issue, we started our grassroots organising work in Hanxi Village, Datong Township of Yilan County. That was the first time we engaged and coordinated with the community people on local concerns. On April 19th, 2006, we demonstrated in front of the Council of Indigenous Peoples, fighting for our youth’s college rights.
Written by Wasiq Silan. Despite the varying colonial histories with Indigenous peoples in other parts of the world, Indigenous people in Taiwan have one disturbing issue in common: poor health. Among other indicators (such as maternal mortality, birthweight, malnutrition, obesity and so on), Indigenous peoples in Taiwan die almost a decade sooner than the general population. Why this disparity? We are taught to believe the argument that blames Indigenous peoples for their own high-risk behavioural choice, lack of awareness, low educational attainment, and dysfunctional families; closer examination shows that we need to look beyond the individual level.
Taiwan Insight 