Health Ministers of Indonesia, Papua New Guinea, the Philippines, and Chinese Taipei; the Vice Health Minister of Vietnam; the Deputy Finance Minister of the Philippines; the Deputy Science and Technology Minister of Chinese Taipei; senior officials; academic and industry leaders; non-health sectors; representatives of non-governmental and international organizations met in Cebu, Republic of the Philippines on 30-31 August 2015 for the Fifth APEC High Level Meeting on Health and the Economy (HLM5) to discuss the Critical Success Factors (CSFs) that will help APEC member economies achieve the goals set forth in the “Healthy Asia Pacific 2020 Initiative.”

The APEC 2015 theme, “Building Inclusive Economies, Building a Better World”, underscores the significance of promoting economic cooperation and advancing inclusive growth in the Asia-Pacific region to attain productivity and enhance the quality of life of populations across the region. In this regard, APEC has long recognized the importance of health and life sciences to economic development. APEC recognizes the changing landscape of global health challenges, and the “triple burden”[1] of disease resulting from social, economic, and health threats across the region; notably, 1) the continuing high incidence of infectious diseases, such as influenza, malaria, HIV/AIDS and tuberculosis, and the rapid spread of emerging and re-emerging infectious disease such as Ebola virus disease, Middle East respiratory syndrome coronavirus (MERS-CoV) and dengue fever; 2) an epidemic of non-communicable diseases, including mental health; and 3) rapidly aging populations.

The endorsement during the Fourth APEC High Level Meeting on Health & the Economy (HLM4) of the “Healthy Asia Pacific 2020 Initiative” was timely in providing guidance for actions to develop sustainable and high performing health systems to address the social and economic burden of disease. Member economies were encouraged to adopt or adapt, as appropriate to their domestic context, “health in all policies” and holistic approaches, namely “whole-of-government”, “whole-of-society”, and “whole-of-region”[2] approaches.

HLM5 agreed that the Roadmap for the “Healthy Asia Pacific 2020 Initiative”, developed jointly by the Health Working Group (HWG) and the Life Sciences Innovation Forum (LSIF), cover five Critical Success Factors and relevant Key Actions to ensure that the Initiative is implemented in a meaningful, sustainable, and cost-effective way. Implementation of the Roadmap aims to mitigate threats to the region’s people, trade, and economic security and should be adapted as appropriate by each member economy. Critical Success Factors in the Roadmap are: 1) government commitment to health; 2) platforms for policy dialogue and stakeholder engagement; 3) promoting prevention, control, and awareness; 4) innovation; and, 5) inter-sectoral and cross-border collaboration.[3]

The implementation of “Healthy Asia Pacific 2020 Initiative” by member economies will set the region apart globally in terms of the partnerships, collaborations, and innovations adopted to promote and secure better health.

Preparedness, prevention and response to public health emergencies, including disasters and infectious diseases

Improving health emergency preparedness, surveillance, response and recovery systems for public health events, such as disasters and the emergence or re-emergence of infectious diseases, is crucial for the health security of all APEC economies. Recent global and regional experience has demonstrated the need for increased investment in health and improved capacities of health systems in this area.

HLM5 commended the Philippines on its response to recent disasters, such as Tropical Storm Haiyan, and encouraged APEC economies to learn from this experience to enhance their response to disasters.

HLM5 welcomed the focus on combating infectious diseases and encouraged APEC economies to continue to implement the World Health Organization’s International Health Regulations (2005) to establish core capacities for prevention, detection and control of infectious diseases. HLM5 commended Korea’s actions to curb the spread of MERS-CoV and, recommended that the protocols used by Korea be shared with other economies. HLM5 also encouraged greater research collaboration with other countries most impacted by the MERS-CoV threat to better understand and control its spread.

HLM5 encouraged the growth of efficient mechanisms for international collaboration and partnerships to prepare for future health challenges, and welcomed research and development to address these needs. HLM5 welcomed industry initiatives to develop innovative preventive mechanisms, and roll out models, such as the new dengue vaccine. It is also necessary to fulfill the availability and the distribution of a qualified health workforce.

HLM5 recognized the important role of the health hotline in responding to health emergencies by providing public risk communication and rumors surveillance. HLM5 welcomed the Working Manual of Health Hotline Responding to Public Health Emergencies.

HLM5 observed that the incidence of health care-associated infections and anti-microbial resistance (AMR) continues to rise in the region. HLM5 called for a renewed, comprehensive, multi-sector effort to strengthen the infection control infrastructure through government and institutional-level improvements in core infection prevention knowledge and skills, including hand hygiene compliance among health care workers, antibiotic stewardship, laboratory capacity, and healthcare-associated infections (HAI) surveillance and public reporting. Accordingly, HLM5 welcomed the upcoming APEC - Global Health Security Agenda (GHSA) Policy Forum in Seoul, Korea on 7-8 September 2015. 

To ensure sustainable access to safe blood across the APEC region, HLM5 endorsed the APEC Blood Supply Chain 2020 Roadmap and welcomed the establishment of the Blood Supply Chain Partnership Training Network to support the Roadmap’s implementation.

Preventing and Controlling Chronic Disease

The productivity of our work forces, competitiveness of our businesses, and ultimately growth of our economies, are significantly affected by the challenges posed by chronic diseases. To help mitigate the growing cost to the economy from the rise in chronic disease, the HLM5 suggested APEC economies take a multi-sector approach to examine the social, economic, and fiscal effects of chronic disease. In addition, HWG and LSIF are encouraged to collaborate with Senior Finance Officials (SFOM) on a cross-fora policy dialogue on this matter in 2016 to examine the models formed and initial outcomes.

HLM5 also welcomed the commitment of APEC Business Advisory Council (ABAC) to encourage employers to promote voluntary prevention and wellness programs for employees as well as for the communities.

As disease patterns grow increasingly complex in the Asia-Pacific region, new approaches and models are needed for research, development, and commercialization.[4] APEC economies are encouraged to improve and strengthen health systems and economies through inclusive innovation and multi-sector collaboration, and to invest in public-private partnerships with the aim of providing sustainable access to health innovations.

Increasing Awareness of Mental Health

Mental health is a timely topic of discussion in the region with challenges and successes in the implementation of mental health programs in APEC economies. Mental illness accounts for one-third of all chronic disease burden; hence, it is a key element of socio-economic concern. In this context, HLM5 welcomed the progress of the Task Force on Mental Health in implementing the APEC Roadmap to Promote Mental Wellness in a Healthy Asia-Pacific. HLM5 further encouraged APEC members to complete their Strategic Needs Assessment on Mental Health and looks forward to the establishment of technical working groups in areas identified as of common concern, and the launch of a digital hub as an interactive resource to facilitate the establishment of partnerships to implement the Roadmap.

Improving Women’s Health in the Workplace

HLM5 commended APEC initiatives to secure better participation by women in the economy. HLM5 welcomed the Policy Toolkit on Healthy Women, Healthy Economies. This Policy Toolkit includes a set of strategies and practices that may serve as a reference for policymakers, companies, and non-profit organizations seeking to improve female labor force participation through better health. Further, HLM5 urged volunteer economies to join the Philippines to participate in the implementation of model pilot projects and noted that results will be reviewed in 2016.

Safe Medicines and the Health Value Chain

HLM5 welcomed the recommendations directed at reducing and eliminating barriers to trade in healthcare products as called for by HLM4 and the Healthy Asia Pacific 2020 initiative. The study conducted on barriers to trade in healthcare products, and subsequent discussions at the SME meeting in June 2015 in Atlanta, showed that, in addition to lowering costs along the supply chain and increasing patient access, SMEs would benefit most from a reduction in these barriers, allowing them to access secure supply chains with their innovative products.

The barriers identified in the study are: 1) lack of common data standards for product verification and serialization; 2) complex regulatory approval procedures; 3) unnecessarily high tariffs; and 4) presence of illegal internet pharmacies. In this regard, HLM5 welcomed the launch of a pilot project testing the efficiency of the use of a common data standard for product verification in the pharmaceutical supply chain and recommended that officials consult on ways of addressing the high tariffs encountered in the supply chain. 

HLM5 endorsed work underway in APEC to ensure the quality and integrity of the health value chain and suggest that officials strengthen the capacity in combating substandard/spurious/falsely labelled/falsified and counterfeit (SSFFC) medical products and the use of illegal internet pharmacies in order to improve access to safe, effective and good quality medical products and services.

HLM5 observed that APEC would continue advancing regulatory convergence for medical products by 2020. With this, HLM5 welcomed the progress in 2015 to establish an APEC Regulatory Sciences Center of Excellence (CoE) on multi-regional clinical trials to promote global drug development as well as a training curriculum on good clinical practices. HLM5 noted that a CoE for bio-therapeutics is next in line.

RECOMMENDATIONS

Recognizing the critical role of health in economic development, HLM5 recommends that Ministers and Leaders:

  • Endorse the Healthy Asia-Pacific 2020 Roadmap. Implementation of “Healthy Asia Pacific 2020 Initiative” will result in sustainable and high performing health systems to promote population health and well-being through their whole life course by means of whole-of-government, whole-of-society and whole-of-region approach to promote the health security, growth and development of Asia-Pacific region.

  • Support health’s increasing prominence on APEC’s agenda and the continuation of partnerships and engagement with academia, civil society, and the private sector as well as robust participation of officials responsible for trade, finance, and health policy to ensure that health continues to have a role in promoting economic cooperation and inclusive growth in the region.

  • Welcome the upcoming APEC - Global Health Security Agenda (GHSA) Policy Forum to support implementation of the WHO IHR core capacities at the economy level in order to prevent, detect, and respond to global infectious disease threats. Welcome the work underway in this initiative to strengthen the infection control infrastructure through government and institutional-level improvements in core infection prevention knowledge and skills, antibiotic stewardship, hand hygiene, laboratory capacity, and HAI surveillance and public reporting.

  • Encourage public-private partnerships to provide sustainable access to health innovations by APEC economies. Encourage research and development and innovative prevention and roll out models to address current and emerging infectious diseases, as exemplified by the development of the new dengue vaccine.

  • Endorse the APEC Blood Supply Chain 2020 Roadmap and welcomed the establishment of the Blood Supply Chain Partnership Training Network to support the Roadmap’s implementation.

  • Suggest APEC economies take a multi-sector approach to examine the social, economic, and fiscal effects of chronic disease. In addition, HWG and LSIF are encouraged to collaborate with Senior Finance Officials (SFOM) on a cross-fora policy dialogue on this matter in 2016.

  • Encourage ABAC to promote voluntary prevention and wellness programs for employees as well as for the communities.

  • Encourage APEC members to complete their Strategic Needs Assessment on Mental Health and establish technical working groups in areas identified as of common concern, and welcome the launch of a digital hub as an interactive resource to facilitate the establishment of partnerships to implement the APEC Roadmap to Promote Mental Wellness in a Healthy Asia-Pacific.

  • Endorse work underway in APEC to ensure the quality and integrity of the health value chain and suggest that officials strengthen the capacity in combating SSFFC medical products and the use of illegal internet pharmacies in order to improve access to safe, effective and good quality medical products and services.