•We’ll do better if WHO opens doors for us –Hsueh, health minister
By Emma Emeozor
The East Asia island of Taiwan has distinguished itself as one of the first-class global health care providers following the achievements of the Taipei Veteran General Hospital and the National Health Insurance Scheme, respectively. The Veteran Hospital is a first class hospital and a teaching hospital.
Taiwan’s health policy is in line with the World Health Organisation’s (WHO) guideline. WHO says: “health care should be safe, effective, patient-centered, timely, efficient, and equitable.”
The Minister of Health and Welfare, Jui-Yuan Hsueh believes that Taiwan could hit the sky in the area of health care delivery if WHO and the United Nations (UN) will open a window for us to participate in its activities even as observers.
Addressing international journalists in his office, he said: “Due to our inability to join WHO, we are not able to contribute to global health policies the way we want. Taiwan and its ideas and policies on health matters are being isolated. The policy of WHO and UN is not to leave anyone out.
“But now, we see they have put aside Taiwan with its 23 million people. For example, this year, Taiwan did not receive any invitation to attend WHO summit even as we continue to try to send a delegation.
“Why Taiwan not being a member of WHO is dangerous is obvious. If something happens, how does Taiwan access first hand information, etc? Besides, there are many lessons and knowledge on health matters that we can share with other countries.”
The Superintendent of Taipei Veterans General Hospital, Professor Wei-Ming Chen explained what makes the hospital and the island’s National Health Insurance Scheme unique. He spoke through his Vice President, Dr Wui-Chiang Lee.
Heavy ion therapy centre for cancer
Cancer is one of the deadly diseases ravaging the world. According to WHO, “cancer is a leading cause of death worldwide, accounting for nearly 10 million deaths in 2020, or nearly one in six deaths.” In many regions, particularly in the developing countries, health institutions lack qualified personnel and modern equipment for cancer treatment. This explains why the disease has remained a global concern.
The Taipei Veteran General Hospital has become the pride of Taiwan because of its Heavy Ion Therapy Centre for Cancer. It is “one of the safe and promising cancer treatment modalities” across the globe.
Physical characteristics of heavy ions
But what makes the Centre unique? Lee said Heavy Ion therapy has “much stronger effect than traditional radiotherapy.” Precisely, the Centre was established because of the physical characteristics of heavy ions: “Heavy ion therapy is an advanced form of radiation therapy. It is distinguished by its unique depth dose curve as the “Bragg Peak,” the hospital explained.
Explaining further the physical characteristics of the process, it said, “When heavy ions penetrate the human body, the deposition of energy remains relatively little in the shallow region of the track, and peaks as the ions come to a stop.
“This superior characteristic reduces normal tissue dose and further treatment-related side effects. He explained that the Centre, which is under the hospital’s Oncology department, provides “ a comprehensive and precise treatment approach combining chemotherapy, radiotherapy, target therapy, immunotherapy and antibody-drug conjugate, with sophisticated biomarker and genetic tests.”
The Professor was confident when he gave a breakdown of the Oncology department’s activities. He said it has “accumulated sufficient experience and are capable of treating all types of cancer, from common cancer types, such as head-neck cancer, lung cancer, breast cancer, and colon cancer, to rare cancer types, such as osteosarcoma, glioblastoma, salivary gland cancer, and neuroendocrine carcinoma.”
Advantages of heavy ions
On the advantages of heavy ions compared to photon- and proton-based therapies, the authorities said “carbon ion causes more prominent DNA double-strand breaks, making it difficult for cancer cells to repair.
Heavy ions “results in higher relative biological effect (stronger cytotoxic effect.)” Also, “carbon ion-induced DNA damage is less dependent on oxygen than protons, which need the formation of superoxide to cause DNA damage. Therefore, carbon ion is more effective against hypoxic cancer cells that are usually more aggressive and resistant to conventional radiotherapy and chemotherapy.”
Thus ion therapy has three major advantages: “It is highly precise in the delivery of radiation to the target volume while sparing surrounding normal tissues; it has higher biological effectiveness for tumors resistant to conventional radiotherapy; and it has shorter treatment course which reduce hospital visits for patients and improve their quality of life.”
Summarily put, the benefits of heavy ions are: It is non-invasive and pain-free; it has sharp dose distribution and minimal side effects and it has fewer treatment sessions and shorter courses. It must be mentioned that it “reduces the risk of secondary cancer occurrence.
Types of cancer
The hospital has grouped cancer treatment into two: The first group is cancers listed as standard treatment: Spinal cord tumors; Salivary gland adenoid cystic carcinoma of head and neck; Sinus melanoma and Non-resectazzzble bone and soft tissue sarcomas.
The second group is cancers with consistent literature-supported effectiveness: Pancreatic cancer; Stage I – IIA non-small cell lung cancer; non-resectable liver cancer; non-resectable meningioma; specific blioblastomas; well-differentiated, slow-growing cancers that cannot be removed and prostate cancer.
The team
One of the calamities that have made many health institutions to fail is the lack of adequate and qualified medical personnel. The hospital authorities were conscious of this fact and have therefore ensured that the hospital’s departments are well staffed.
It, therefore, has multidisciplinary care for cancer patients with 21 multi-disciplinary teams covering surgeons, medical oncologists, radiation oncologists, pathologists, radiologists, nuclear medicine specialists and cancer case managers.
Similarly, its interprofessional collaborative care include: physicians, nursing specialists, social workers, psychologists, pharmacologists, physical therapists, traditional medicine specialists and dieticians.
National Health Insurance Scheme
Lee listed seven factors that earned the scheme global praise: They are: Coverage – Compulsory enrollment for all citizens and legal residents, Administration – Single-payer system run by the government, Financing – Premium-based, Benefits – Uniform package, copayment required but low, Providers – About 93 per cent of healthcare providers contracted with NHI, Payment – Plural payment programmes under global budget payment systems and Privileges – Premium subsidies and copayment waivers for the disadvantaged.
Enrollment for the National Health Insurance Scheme is compulsory for all citizens and legal residents. The beneficiaries enjoy it without constraints.
