Health & Life Sciences Update: January 15, 2020

Health & Life Sciences | January 15, 2020
Authors: Sunita Kapoor, Hai Pham, Nguyen Thi Phuong Thao and J-Ren Ong
 
LOOKING AHEAD
 
 
  • January 21, 2020: Health & Life Sciences 2020 Workplan Discussion Call

  • March 5-6, 2020: Health & Life Sciences Industry Mission to Vietnam

  • Between March 16-19, 2020: Health & Life Sciences Committee Meeting with Leslie Mancuso, Co-Chair of Health and Life Sciences Committee; President and CEO of Jhpiego

  • April 21-22, 2020: Health & Life Sciences Industry Mission to Indonesia

  • 1st Half of 2020: Joint Antimicrobial Resistance Program in ASEAN (inaugural collaboration between Council’s Food & Agriculture and Health & Life Sciences committees)

  • 1st Half of 2020: Regional HLS Presidents Luncheon and Potentially Regional HLS Presidents Industry Mission to Thailand

 
THE COUNCIL'S TAKE
 
 

UHC implementation in ASEAN, looking forward

Universal Healthcare Coverage (UHC) is an objective that is backed by all ASEAN Member States. Many governments in the region are looking to expand healthcare coverage systems to their citizens, as part of their commitments towards achieving the UN Sustainable Development Goals (SDG) by 2030. However, ASEAN’s economic diversity also poses challenges to the obtainment of UHC regionally as the different member states are at varying levels of economic development. The provision of healthcare insurance options, both private and public, can increase access to medical services without placing direct financial strain on citizens and are critical in establishing robust UHC systems. In ASEAN, three broad categories outline the medical insurance coverage within the ten member states.

The first category are countries such as Brunei, Malaysia, Singapore and Thailand that have successfully established national government based universal health systems alongside private sector healthcare systems which cover their entire populations and which include both public and private healthcare insurance schemes respectively. The second, group are countries such as Indonesia, the Philippines and Vietnam, whose governments have passed laws guaranteeing universal healthcare access alongside private healthcare systems, but sufficient insurance programs to cover every citizen have yet to be developed. The last group are those who currently lack the financial capital to adequately implement UHC laws, such as Cambodia, Laos and Myanmar.

From a strategic lens, nations like Vietnam and Thailand are emerging as potential regional models on how middle-income countries can make impressive progress towards achieving UHC. For example, Vietnam has 87.7% of its population covered by health insurance, while 97% of Vietnamese children receive standard immunizations despite having a modest per capita health expenditure of U.S.$122.8 as of 2016. Furthermore, progressive policies and investments made by the Ministry of Health, which emphasize the development of primary healthcare have been crucial to the countries success. In comparison, Thailand which already has a well-developed public healthcare system has implemented UHC oriented initiatives since 2002 and has allocated large fiscal spending on for improving the nation’s health infrastructure. It has also rapidly expanded the construction of hospitals in every district and encouraging the number of rural doctors. Successive parties have also stayed committed to achieving UHC by increasing its benefits.

 

The Philippines government determined to cut prices of over 120 medicines by more than 50%

President Duterte has affirmed that he plans to sign the draft Executive Order (EO) to slash the prices of 122 drugs by more than 50%, despite the pharmaceutical industry’s offer to voluntarily cut the cost of their medicines. The Department of Health (DOH) proposed expanding the list of drugs covered by the Maximum Drug Retail Price (MDRP) in September 2019 but is yet to confirm a list of new medicines that will face price caps. Additionally, the DOH specified that MDRP would cover drugs that treat conditions such as hypertension, cardiovascular disease, chronic lung diseases, neonatal diseases and cancers. MDRP will also cover high-cost treatments for chronic conditions such as kidney disease, psoriasis and rheumatoid arthritis.

However, there is concern that the proposed price caps might not lead to lower drug prices, as the implementation of MDRP does not account for pharmacy mark-ups. Furthermore, MDRP might dissuade pharmaceutical companies from introducing new treatments and drugs to the Philippines and may even withdraw existing products sold, inadvertently hurting patient access to medicines.

The DOH’s MDRP efforts are part of the 2008 Universally Accessible Cheaper and Quality Medicines Act (Republic Act No.9502) which allows the President ‒ on recommendation from the Health Secretary ‒ to set maximum retail prices on all medicines that treat chronic illnesses and life-threatening conditions. The pharmaceutical industry could challenge the EO in the Supreme Court, which could temporarily order an injunction preventing the immediate execution of MDRP.


Philippine Senate approves bill on alcohol and e-cigarette excise tax hike

On December 18, 2019, Philippine congress ratified Bill No.1074, which will increase the excise tax rates imposed on alcohol, heated tobacco and electronic cigarettes ‒ inclusive of electronically heated tobacco and vape products. It also aims to impose stricter regulations on the sale of e-cigarettes and increase import tariffs on vape products. The bill is currently awaiting President Duterte’s signature.

Under the new tax hikes, fermented liquors will be subject to a specific tax rate of P35 per litre in 2020 and increasing to P43 in 2024 with a 6% annual increase after that. Distilled spirits will receive a 22% ad valorem tax, with an additional specific tax rate of P42 in 2020 climbing to P66 in 2024 with a 6% indexation. Sparking and still, wines will incur a specific tax rate of P50 in 2020, with a 6% increase after that. Heated tobacco products will be subject to a specific tax rate of P25 in 2020, increasing to P32.50 in 2023 with a 5% increase annually after 2023. Nicotine salts will be subject to a specific tax rate of P37 per millilitre in 2020 climbing to P52 by 2023, with a 5% indexation after that. Freebase nicotine will receive a specific tax rate of P45 per millilitre, increasing to P60 in 2023, with a 5% increase after that.

The Department of Finance has estimated that the proposed bill will generate an additional P22.2 billion (U.S.$439 million) in its first year, and as much as P356.9 billion (U.S.$7.053 billion) by the 5th year of implementation. The department plans to allocate most of the tax revenue to support fiscal spending for investments in the implementation of the UHC law and strengthening the nation’s health infrastructure. 60% of the tax revenue generated will be used to support the UHC law and another 20% funnelled towards the Health Facilities Enhancement Program. The remaining 20% will assist the Philippines in achieving its Sustainable Development Goals.

Myanmar’s Ministry of Health and Sports identifies national critical health issues in 2020

Health and Sports Minister U Myint Htwe has identified patient safety, public and private health facilities, hospital information systems, health literacy and school health as the crucial health issues that the Government of Myanmar will prioritize in 2020. The Minister also emphasized developing national medical supply chain management and medical staff training as areas where additional resources will be invested. Other plans the ministry will pursue in 2020 include: Non-communicable disease surveillance and control; medical ethics in research and public health; adopting e-health systems; budget management and promoting a healthy lifestyle campaign called “exercise is medicine”.

The Government of Myanmar has budgeted approximately K1.2 trillion (U.S.$812.3 million) to the Ministry of Health and Sport for 2019-2020, a 9% increase from last year. Additionally, the Minister plans to update the National Health Policy to identify more comprehensive and agile strategies that match Myanmar’s shifting conditions. The Ministry is also hopes revise its standard operating procedures and guidelines for all its clinical and public health programs. Finally, Myanmar is looking to increase cooperation with supranational organizations like the UN’s WHO and various other development partners like ADB to meet its commitments towards Sustainable Development Goals (SDG). In 2020, the Council will continue to look for opportunities to expand private sector cooperation with the Ministry in any of the above areas of mutual interest to members.

 
ADVOCACY UPDATE
 
 

Malaysia Price Control Mechanisms on Pharmaceuticals Call

On January 7, 2020, the Council's Health & Life Sciences Pharmaceuticals Sub Committee engaged in a call to discuss the Malaysian Ministry of Health's (MOH) plan to pass External Reference Pricing (ERP) on drugs. The call strategized how the HLS Committee could assist the advocacy efforts of member companies and collaborate closely with the Pharmaceutical Association of Malaysia (PhAMA).

The following are the recommendations and action items agreed upon during the meeting:

  • USABC to request PhAMA to share talking points outlining the organization's approach and position on Price Control Mechanisms
  • USABC to review talking points and organize engagement points between the pharmaceutical industry and government
    • eg. Round table discussions between Council and various government ministries such as the Ministry of Finance, Ministry of International Trade and Industry, and related industries.
  • USABC to Identify and reach out to crucial advocates within Malaysian government that can be engaged on the drug pricing issue.
  • USABC will continue gathering, collating and sharing information and intelligence on the topic.

For queries please contact Sunita Kapoor (skapoor@usasean.org) or Ngyuyen Thi Phuong Thao (tnguyen@usasean.org).


Meeting with Philippine Senator Bong Go on MDRP Issue

The Department Of Health (DOH) has drafted an Executive Order (EO) that will expand the MDRP to cover 122 drugs. The DOH is pursuing MDRP under the Universally Accessible Cheaper and Quality Medicines Act of 2008. As of January 13, 2020, the EO has been submitted to the Office of the President and is awaiting signature by Duterte. The Council has requested a meeting with Senator Christopher Lawrence "Bong" Tesoro Go to provide U.S. private sector perspectives on the MDRP, and also explore potential collaborations in the area of Antimicrobial Resistance.

For more information contact Sunita Kapoor (skapoor@usasean.org), or Nguyen Thi Phuong Thao (tnguyen@usasean.org).

 
IN THIS UPDATE
 
 
ASEAN
An obese ASEAN
Asia's hardest year for dengue fever
ASEAN aiming to develop Universal Healthcare Coverage for all member states

Brunei
Brunei free from viral pneumonia
Clearing the air on Metformin medicine

Cambodia
Transcending dental medication
Calls for faster import, export of medicines | Phnom Penh Post
Ministries tackle drug resistance | Phnom Penh Post
In sickness and in debt: Medical expenses linked to informal borrowing
IOM, Cambodia Launch New Project to Detect, Manage TB among Migrants on Thai-Cambodian Border - Cambodia
Canadia Bank signs MoU to provide healthcare packages

Indonesia
BPJS Kesehatan goes digital to address complaints over long waiting times
No more funds available to cover BPJS deficit, says Sri Mulyani
Public participation crucial in sustaining universal health services
Almost 35 percent informal sector workers have no health insurance
Govt vows to cover blue-collar workers who can’t pay higher health insurance premiums

Laos
Over 5,600 malaria cases recorded in Laos in 2019
Laos steps up fight against antimicrobial resistance

Malaysia
Future of healthcare is already in Malaysia
Withdrawal of incentive will hurt health services, say 5 medical associations
Cheaper ringgit may boost Malaysia’s medical tourism volume
QFFD Humanitarian Clinic for refugees in Malaysia
Malaysia reports first case of polio since 1992

Myanmar
Myanmar govt to provide better health care in all prisons by 2025
Myanmar intensifies screening of travellers over China pneumonia outbreak
Ministry details plan to address important health issues in 2020
Myanmar seeks migrant-worker protections in Malaysia and Thailand

Philippines
I will sign medicine price cap EO ‘twice over’ –Duterte
Higher 2020 budget seen supporting healthcare market growth
FDA gets high rating from ASEAN states
Senate Oks bill on alcohol, e-cigarette excise tax hike
DOH on alert over ‘mystery’ disease in China | Claudeth Mocon-Ciriaco
Rody open to reviewing Kaliwa dam deal
DOH shuns big pharma firms’ warning vs price cuts

Singapore
Second suspected case of Wuhan virus in Singapore tests negative
Big jump in dengue clusters over just two days
Healthcare Services Bill: MOH can temporarily take over operations of healthcare services in financial trouble
Wuhan pneumonia: First suspected case reported in Singapore
The war on diabetes goes digital

Thailand
Chinese woman with mystery virus quarantined in Thailand
Thailand launches full-time clinics dispensing cannabis oil
Govt rolls out cannabis clinic based on traditional medicine
Anutin calls for calm over viral outbreak
Health insurance extended

Vietnam
Central database to connect all patients' records by 2025
E-prescriptions to replace written versions in Vietnam
Pollution kills over 71,300 in Vietnam in a year - VnExpress International
Vietnam wants WHO’s support to better healthcare system: Deputy PM
Fostering medical tourism on the agenda of health ministry conference
 
ARTICLE CLIPS
 
 
ASEAN

An obese ASEAN The ASEAN Post 6th Jan 2020
There is a growing trend in ASEAN that is not so welcomed – obesity. The prevalence of obesity and being overweight among ASEAN’s citizens is increasing due to rising incomes, and urbanisation. It is also placing a strain on the region’s healthcare systems and government budgets. An obese person can be measured by his or her Body Mass Index (BMI) which measures a person’s weight in relation to their height. An obese person would have a BMI higher than 30, whereas a normal BMI is between 18.5 and 24.9. According to a report on obesity from Fitch Solutions Macro Research, Vietnam, Thailand, Singapore, the Philippines, Malaysia and Indonesia have seen a rise in the number of obese adults. The report recorded Vietnam as having the highest growth for obesity in ASEAN between 2010 and 2014 but still had the lowest number of obese persons in 2014. In the period of five-years, Vietnam’s obesity rate increased to 38 percent, whereas Indonesia and Malaysia were at 33 percent and 27 percent, respectively.  Based on a 2019 statistic from the World Population Review, Vietnam still has the lowest share of obese persons at 2.1 percent, far below Malaysia’s 15.6 percent and Brunei’s 14.1 percent. Yet, a study by Vietnam’s National Institute of Nutrition based on 5,028 students, discovered that 42 percent of children in Vietnam’s urban areas are overweight and/or obese, compared to 35 percent in rural areas. 

Asia's hardest year for dengue fever the Guardian 30th Dec 2019
More than a million dengue cases were in south-east Asia, hitting the poorest households hard and stretching health services. The epidemic is exacerbated by poor infrastructure and lack of access to healthcare, with struggling health services overwhelmed by outbreaks. In the Philippines, there have been more than 1,000 deaths and 403,000 cases were reported this year – a 98% increase on 2018. In Thailand 110 people died from dengue between January and October, with 106,000 cases reported. For the same period last year there were just 50,000. From Bangladesh to Singapore, hospitals have struggled to cope with the unusually high number of patients. Since May the Angkor hospital for children in Siem Reap, north-west Cambodia, which treats more than 500 children a day free of charge, has launched several appeals for emergency donations. This year also saw a massive outbreak of chikungunya, another mosquito-borne disease, along the Thai-Myanmar border. The strain has never been recorded in Mae Sot before and is believed to have travelled north from the deep south of Thailand on the Malay border.

ASEAN aiming to develop Universal Healthcare Coverage for all member states The Thaiger 28th Dec 2019
Promoting universal healthcare coverage for citizens is now a common goal of ASEAN member states. The aim is to grant people access to healthcare without barriers to improve nations’ health and wellbeing of all citizens. Universal healthcare is a hallmark of civilised governments around the world with the UN describing UHC as a right of all citizens. Deputy Permanent Secretary of Public Health Ministry Dr Supakit Sirilak says the ASEAN Bloc hopes to assist some member states lift the standard of their medical services to provide full universal healthcare, understanding that each nation is at a different stage of economic development. Achieving UHC is one of the main targets in the Sustainable Development Goals (SDGs) and the United Nations is strongly encouraging the leaders of every country to introduce UHC for the good health and wellbeing of their citizens.

Brunei

Brunei free from viral pneumonia Borneo Bulletin Online 8th Jan 2020
Amid global concerns of an unknown viral pneumonia in Wuhan, Hubei Province of China, the Ministry of Health (MoH) has issued a statement, reassuring that Brunei Darussalam presently has no cases of severe acute respiratory infection linked to the events in Wuhan. On January 3, Chinese health authorities reported that 44 individuals had come down with fever, shortness of breath and other symptoms consistent with a respiratory infection known as pneumonia, the cause of which is still unknown. As a precautionary measure, members of the public are advised to avoid contact with sick animals, including poultry and birds; don’t consume raw or undercooked meats; avoiding close contact with people who are unwell or showing symptoms of illness; and to observe good personal hygiene and frequent hand-washing with soap, particularly before handling food or eating, after going to toilet, and after coughing or sneezing.

Clearing the air on Metformin medicine Borneo Bulletin Online 12th Dec 2019
The Ministry of Health (MoH) has cleared the air regarding the recent information from the Health Sciences Authority, Singapore on December 4, regarding three Metformin brands that have been recalled. The following recalled products were found to contain the impurity, N-nitrosodimethylamine (NDMA) that was above internationally accepted levels.....

Cambodia

Transcending dental medication Khmer Times 10th Jan 2020
Dental tourism in Asia has seen a steady growth in the last decade with countries such as Thailand and Vietnam becoming the hub for foreign patients seeking dental care. Taking into account  political stability and affordability of healthcare, the likes of Singapore, Thailand and Taiwan have become a magnet for dental tourism in the region. Cambodians are known to opt for neighbouring countries to seek healthcare because of the lack of faith in the existing medical sector in the country, but confidence in Khmer dentistry tells a different story.  With Thailand and Malaysia ramping up efforts to promote themselves as a more attractive option for medical treatment seekers, Cambodia’s dental sector has been enjoying a healthy number of what are now known as health tourists. Cambodia boasts low rates of dental fees and established clinics, including the likes of Pachem Dental and Roomchang, which have begun attracting patients from other countries such as the US and Australia. Pachem dental clinic sees a majority of their international clients coming from places like Australia, the United States, China, England, Canada, Japan, Russia, Germany, France, Ireland, Poland, New Zealand and South Korea. Pachem Chief Executive Officer Nary Keuk says many Cambodians go abroad for health checkups and medical treatment. However, when it comes to dental care, most are aware and even proud of the quality of dentistry available in the country.

Calls for faster import, export of medicines | Phnom Penh Post The Phnom Penh Post 2nd Jan 2020
Privately owned pharmaceutical companies have asked the Ministry of Health to simplify the process of importing and exporting pharmaceutical products to ensure sustainability and further promote the industry in the Kingdom. Minister of Health Mam Bun Heng on Tuesday led a working group to a second joint meeting with nearly 50 members of the private healthcare sector to determine the challenges faced by pharmaceutical companies. The meeting tackled issues such as the application process to obtain pharmaceutical drugs trade licences, import tariff rates, importing raw materials for manufacturing medicines, and drug registration. The prakas also states that pharmaceuticals, preventive medicines such as vaccines, and reactive medicines with less than 18 months before expiry are only valid for use for at least two-thirds of duration on arrival in Cambodia.

Ministries tackle drug resistance | Phnom Penh Post The Phnom Penh Post 24th Dec 2019
In a move to safeguard the lives of hundreds of thousands of people every year, the ministries of Health; Agriculture, Forestry and Fisheries, and Environment have launched a joint multi-sectoral action plan to combat antimicrobial resistance (AMR). Despite much progress, AMR continues to pose a threat to Cambodia’s population and development, the action plan states. The UN World Health Organisation describes AMR as the ability of micro-organisms, such as bacteria, viruses and some parasites, to stop antimicrobials – including antibiotics, antivirals and antimalarials – from working against them. If AMR is not prevented, more than 700,000 people could die every year, according to a document prepared by the three ministries in May last year. The action plan – to run from this year to 2023 and include seven priority strategies to fight AMR in Cambodia – was launched on Monday in Phnom Penh by officials from the three ministries. A recent report by the World Bank and the UN’s Food and Agriculture Organisation said if no solution was found to AMR, low-income countries could lose more than five per cent of gross domestic product due to expenses in healthcare and losses in agricultural production.

In sickness and in debt: Medical expenses linked to informal borrowing Khmer Times 20th Dec 2019
Last month a study conducted by the University of New South Wales (UNSW) in Australia painted a bleak picture for Cambodia’s ailing healthcare system. While acknowledging progress made in the field of delivering quality healthcare and the government’s apparent commitment to its universal access, the study notes that Cambodia’s rural poor are most at risk. In fact, 28.1 percent of the 5,000 households studied were found to borrow money in order to pay for it. Despite being published in November this year, the study itself was conducted in 2016, says Dr Ir – although he notes that there is still work to be done. More than half of those borrowing to pay medical bills – 55 percent to be precise – were subjected to distress financing, whereby they either borrowed with interest or sold assets in order to cover the costs of being treated. The study claims this creates cyclical poverty, adding that 22 percent of people across 40 low- to middle-income countries borrow to pay for healthcare. The nature of the loan, along with the size of the household and its collective wealth were found as key determinants of the impact of healthcare bills in Cambodia. It noted that interest rates had become more prevalent and played a major role in the sustained cycle of poverty, particularly in rural communities.

IOM, Cambodia Launch New Project to Detect, Manage TB among Migrants on Thai-Cambodian Border - Cambodia ReliefWeb 20th Dec 2019
IOM and the Cambodian National Centre for Tuberculosis and Leprosy Control (CENAT) have launched a new collaboration to diagnose tuberculosis (TB) among Cambodian migrants returning from Thailand. The project, which is funded by the Global Fund for AIDS, TB and Malaria, will provide TB screening, diagnosis, health education, and referral support to over 100,000 migrants over the next three years. The Poipet border between Thailand and Cambodia, in Cambodia’s Banteay Meachey province, is the main crossing point for Cambodian irregular migrants returned by the Thai immigration authorities. According to Poipet officials, over 70,000 were returned through the Poipet in 2017. As irregular migrants working in Thailand, many suffered from poor working and living conditions and had limited access to healthcare, making them especially vulnerable to TB. Under the new project, IOM and CENAT will collaborate to offer TB screening at the Poipet Migrant Transit Centre, through providing health education, onsite digital X-ray services, referral support for TB suspect cases to get rapid diagnosis through molecular diagnosis, and follow up to ensure that diagnosed patients get access treatment through Cambodia’s national TB programme at their final destination. Poipet currently has very limited capacity for TB diagnosis and treatment. The project, which is part of a regional Global Fund grant implemented across Greater Mekong Sub-region countries to address TB in migrants and mobile populations, will also offer services to the local community, where many people are mobile and work on both sides of the border.

Canadia Bank signs MoU to provide healthcare packages Khmer Times 13th Dec 2019
The Malaysian Healthcare Travel Council (MHTC) has signed a memorandum of understanding (MoU) with one of the Kingdom’s largest banks, Canadia Bank. The signing, which took place in Rosewood Phnom Penh, will provide Canadia Bank’s customers with a healthcare package tailor-made by MHTC. Chief commercial officer of MHTC, Nik Yazmin Nik Azman says the signing between both organisations will allow customers of the bank to experience a unique offering if they choose Malaysia as a destination for medical treatment. The package will include both medical screenings as well as tours. The package is expected to be rolled out sometime in January because details to tailor the package are underway.

Indonesia

BPJS Kesehatan goes digital to address complaints over long waiting times The Jakarta Post 11th Jan 2020
Scenes of patients lining up since dawn, some even using their sandals or helmets to keep their place in line, are commonly seen at community health centers and hospitals partnering with the Health Care and Social Security Agency (BPJS Kesehatan), which manages the JKN scheme. The agency has acknowledged this problem, noting that it was among the most common complaints filed by JKN participants as shown in a recent study, BPJS Kesehatan deputy for health treatment reference Budi Muhammad Arief said. Some had also complained of being rejected by hospitals due to unavailability of hospital wards, he said, raising suspicions among participants that hospitals had been unfair toward them as compared to those paying on their own or using private insurance. The Indonesian Consumers Foundation (YLKI) and Indonesia Corruption Watch (ICW) have also raised concerns about the service received by participants. As of November 2019, the agency has partnered with 2,200 hospitals across the country. It has encouraged these hospitals to adopt digital queue systems as well as applications to display ward availability to patients to accelerate and improve services, targeting that at least 75 percent of the hospitals had adopted these systems by 2019. This target has been reached. By 2019, the BPJS Kesehatan claimed that 80.36 percent of its partnering hospitals, or 1,784 of them had adopted the electronic queue system, while 78.33 percent or 1,739 had presented patients with information on ward availability on their mobile applications. Budi of BPJS Kesehatan said the agency had targeted that all the hospitals would adopt the digital initiatives this year.

No more funds available to cover BPJS deficit, says Sri Mulyani The Jakarta Post 8th Jan 2020
The government plans to no longer provide cash injections to cover the Healthcare and Social Security Agency's (BPJS Kesehatan) deficit this year following a hike in the insurance premiums. "We are sure that BPJS Kesehatan would not need additional funds in 2020 following a hike in the insurance premiums.  BPJS  has also promised to keep their finances in check," Finance Minister Sri Mulyani Indrawati said during a press briefing on the 2019 state budget in Jakarta on Tuesday. The year 2020 marks a new phase for Indonesia's universal healthcare program, National Health Insurance (JKN), as the government raised its premiums for the first time since it started operations in 2014. Beginning in January, the government raised the premiums for first-class service by 100 percent to Rp 160,000 (US$11.40) per month per person, while more than doubling the cost for the second-class service from Rp 51,000 to Rp 110,000. The government also hiked the premiums for the third-class service by 64 percent from 25,500 per person per month to Rp 42,000. BPJS Kesehatan has suffered a huge financial deficit since its establishment as its premium income was far from enough to pay for insurance claims. BPJS Watch estimates that the increase in the premiums is expected to reduce its deficit to Rp 18 trillion from the initial estimate of Rp 32.89 trillion at the end of 2019. Speaking during the same briefing, the Finance Ministry's budgeting director-general, Askolani, told reporters that the government would still allocate Rp 20 trillion to subsidize the premium payments of low-income participants.

Public participation crucial in sustaining universal health services The Jakarta Post 28th Dec 2019
The government needs to enforce the mandatory status of the National Health Insurance (JKN) in a bid to maintain public participation in the service and improve health facilities’ readiness as the insurance program sees its premiums rise next month. “We lack doctors, especially medical specialists, and hospitals are not ready to meet the public’s needs from the JKN program,” University of Indonesia (UI) public health expert Hasbullah Thabrany told The Jakarta Post on Dec. 27. While shortages in medical supplies are relatively easy to replenish, Hasbullah said, the lack of specialists in Indonesia could potentially hamper the JKN program. He also urged the Health Care and Social Security Agency (BPJS Kesehatan) to be more flexible in its bureaucracy to better serve the public.

Almost 35 percent informal sector workers have no health insurance Antara News 21st Dec 2019
Almost 35 percent of the 1,800 household heads employed in the informal sector in Indonesia's six provinces have no health insurance, according to the result of a research by the Indonesian Institute of Sciences (LIPI). The household heads employed in the informal sector legally have clear work relations and are exempt from tax, LIPI senior researcher Dewi Harfina stated at an event held to disseminate details on the research result and media briefing on social insurance in the informal sector in Jakarta on Friday. On the economic side, LIPI found two percent of them were living in poverty and eight percent are prone to poverty, while the other 25 percent are not in a state of being impoverished, she noted. Although 25 percent of them do not live in poverty, several of them do not hold health insurance, she remarked. The survey also indicated that each of the six provinces had different health coverage under the National Health Insurance (JKN).

Govt vows to cover blue-collar workers who can’t pay higher health insurance premiums The Jakarta Post 8th Jan 2020
Adinda, a 26-year-old waitress at a restaurant in South Jakarta, is in a dilemma. As her monthly expenses have increased this month along with the newly hiked national health insurance (JKN) premium, she now has to decide whether she will continue or opt out of the state insurance scheme. She is currently covered under the JKN third-class service, for which the monthly premium has increased from Rp 25,500 (around US$2) to Rp 42,000 per person since Jan. 1. She said it would not be expensive if she only had to pay for herself, but it has become a financial burden since she also pays for her parents and three younger siblings.

Laos

Over 5,600 malaria cases recorded in Laos in 2019 Xinhua 17th Dec 2019
There has been over 5,600 of malaria cases so far this year in Laos, loca media reported Tuesday. According to local daily Vientiane Times report, the update was reported at the meeting to summarize the work of Lao Ministry of Health over the past year and discuss the plans for 2020 in Vangvieng district, Vientiane province from Monday to Friday. Lao Deputy Minister of Health Phouthone Muongpak, Director General of the Department of Communicable Disease Control under Lao Ministry of Health Lattanaxay Phetsouvanh, and Viengxay Vanisaveth, acting director of the Center of Malariology, Parasitology and Entomology, are attending the meeting along with health officials and representatives of international organizations. So far this year, no deaths have been reported from malaria infection due largely to the national strategy to eradicate malaria by 2030, according to the Ministry of Health. In 2018, there were 8,084 malaria cases nationwide, resulting in six deaths. In 2019, there have been 5,600 infections, a reduction of 30.73 percent compared to 2018 and no reported deaths, said the report. Malaria prevention and control is a priority of the Ministry of Health with a substantial budget allocated to undertake control activities against mosquitos that spread the fever.

Laos steps up fight against antimicrobial resistance Xinhua 1st Jan 2020
The Lao government is stepping up its fight against the emergence of so-called "super-bugs": infections that do not respond to commonly used antibiotics. Backed by international partners, the Lao Ministry of Health and Lao Ministry of Agriculture and Forestry launched on Tuesday the National Strategic Plan against Antimicrobial Resistance 2019-2023, Lao News Agency (KPL) reported on Thursday.

Malaysia

Future of healthcare is already in Malaysia The ASEAN Post 6th Jan 2020
Malaysia is on the verge of fully entering the Fourth Industrial Revolution (4IR) as embodied by digitalisation alongside adopting the 5G technology pioneered by Huawei. The country’s Minister of Communication and Multimedia Gobind Singh Deo has never tired of expressing the government’s commitment and determination that the country would not be left behind in the global digitalisation wave and revolution. The boundaries between the two are already blurred as could be seen in the emergence of the Internet of Bodies (IoB). IOB is simply the extension of the Internet of Things (IOT) to the realm of the organic (human, animal) body – so as to be manipulated, controlled, experimented, monitored, etc. remotely. Here, the body itself is subject to the process of digitalisation and external programming, and this eminently illustrated in none other than the domain of healthcare. In Malaysia, this can be seen in the case of neurobotics technology such as the concomitant of Hybrid Assistive Limb (HAL) as cybernic treatment. Neurobotics has to do with the interface between the central nervous system and artificial intelligence (AI) with the aim of, for example, decoding brainwaves or neural signals so as to simulate and reconstruct the interaction externally. Neurobotics leverages on the pre-existing technology of electroencephalography (EEG). Cybernic treatment is simply applied neurobotics that aims to restore and improve the connection between the patient’s muscles and the neural system via algorithm-based artificial or biomechatronic body parts attached to the patient to improve mobility. 

Withdrawal of incentive will hurt health services, say 5 medical associations Free Malaysia Today 28th Dec 2019
Five associations of medical professionals have called on the government to not only retain the critical service incentive for new appointees from Jan 1 but also improve their benefits to retain talent in the civil service. In a joint statement, the Malaysian Medical Association, Malaysian Dental Association, Malaysian Pharmaceutical Association, Malaysian Association of Medical Assistants and the Malaysian Nurses Association welcomed the government’s announcement that it has postponed the removal of the incentive, or BIPK, pending further discussion by the Cabinet. The associations said they support the government’s measures to be fiscally responsible and to demonstrate good financial governance. While acknowledging that the BIPK is not a permanent allocation, they said they are disappointed that the 2019 review determined that 33 service categories no longer fulfill the talent attraction criteria, including the five largest categories of staff in the health ministry. In the short-term, the associations said morale and stature of the health professions could be negatively affected.

Cheaper ringgit may boost Malaysia’s medical tourism volume Borneo Post Online 27th Dec 2019
A cheaper ringgit might boost Malaysia’s medical tourism volume. AmInvestment Bank highlighted that private healthcare operators in Malaysia may be negatively impacted by a weaker ringgit versus the US dollar as costs of key inputs such as drugs, medical supplies and medical equipment are affected by the US dollar. On the other hand, a cheaper ringgit might boost Malaysia’s medical tourism volume the research firm said. On the global front, AmInvestment Bank noted that the growth prospects for the sector are positive over the long term, underpinned by an aging population, rising affluence and increasing life expectancy. However, the research firm anticipated new hospitals to be hit by gestational costs in the near term as well as the impending drug pricing control (DPC). AmInvestment Bank estimated sales of drugs to be circa 20 to 25 per cent of revenue for the hospitals. Although there is still no any clear drug pricing guideline, the research firm believed any impact on the selling price of drugs can be partially covered by other charges (such as hospital bed charges, consumables and medical devices), limiting the impact to its margins.

QFFD Humanitarian Clinic for refugees in Malaysia The Malaysian Reserve 23rd Dec 2019
To implement the Universal Health Coverage as recommended by the World Health Organisation, Qatar Charity (QC) and Yayasan Kebajikan Negara (YKN) has launched its first clinic in Malaysia to cater to healthcare needs of refugees in the country. The opening ceremony of the Qatar Fund for Development (QFFD) Humanitarian Clinic was officiated by Malaysian Medical Relief Society (Mercy Malaysia) president Datuk Dr Ahmad Faizal Mohd Perdaus, YKN CEO Datin Paduka Che Asmah Ibrahim and QC country director of Malaysia Karam Zeinhom Aly. The three-year project, which is fully funded by QFFD, will be rolled out in collaboration with three leading medical relief non-governmental organisations (NGOs) — Mercy Malaysia, Islamic Medical Association of Malaysia and Malaysian Relief Agency, with support from the United Nations Commissioner for Refugees (UNHCR). The clinic will offer primary healthcare services, which include outpatient treatment, vaccinations and health education programmes in order to effectively address the comprehensive health needs of refugees. This will enable them to be transferred to their third country for resettlement or to return to their own country after the conflict. The project also aims to reduce the healthcare burden of the Malaysian healthcare system in the long run. Malaysia is host to many refugees and migrants from all over the world such as Myanmar, Syria, Afghanistan, Sri Lanka and Somalia. There are over 180,000 refugees and asylum seekers registered with UNHCR in Kuala Lumpur, with many more unregistered.

Malaysia reports first case of polio since 1992 Reuters 8th Dec 2019
A three-month-old Malaysian infant has been diagnosed with polio, the first case reported in the country in nearly three decades, a top health official said on Sunday. The baby boy from Tuaran in Malaysia’s Sabah state on Borneo island tested positive for polio on Friday after being admitted to hospital with a fever and muscle weakness, Director General of Health Noor Hisham Abdullah said in a statement. Malaysia was declared polio-free in 2000, after reporting its last known case of the disease in 1992. Its resurgence comes just months after the Philippines, north of Borneo, reported its first cases of polio since 1993 in September. Noor Hisham said tests showed the child was infected with a polio strain that shared genetic links with the virus detected in the Philippine cases. Checks in the area where the baby lived showed 23 of 199 children between 2 and 15 had not received the polio vaccine, he said. The authorities have also stepped up monitoring of acute flaccid paralysis (AFP) cases, a common sign of acute polio, he said. In recent years, Malaysia has faced a challenge convincing some parents to immunize their children. In 2016, five children died from diphtheria, a vaccine-preventable disease, prompting an outcry here among health officials.

Myanmar

Myanmar govt to provide better health care in all prisons by 2025 The Myanmar Times 13th Jan 2020
Dr Sithu Aung, director of Prison Health under the Ministry of Health and Sports, said his office is already conducting pilot projects in prisons in Yangon and Mandalay to check tuberculosis and HIV diseases. He said they are also preparing to conduct regular check-ups on non-communicable diseases such as diabetes and hypertension in the prisons. U Sithu Aung said that under its current five-year Prison Health Strategic Plan, they hope to address problems related to communicable diseases such as TB and HIV by 2023. He said that his officers are also deploying more health staff in prison across the country to help in addressing normal illnesses suffered by inmates and they made arrangements with different hospitals to send doctors to the prisons to conduct checks on the health of prisoners once a month. The country’s 46 prisons and 50 labour camps are notoriously overcrowded, making the country’s over 90,000 prisoners prone to illnesses. 

Myanmar intensifies screening of travellers over China pneumonia outbreak The Myanmar Times 9th Jan 2020
The Department of Disease Control under the Ministry of Health and Sports is conducting surveillance on all arriving visitors at Yangon, Nay Pyi Taw and Mandalay international airports, according to Daw Khin Khin Gyi, deputy director of (Central) Contagious Disease Prevention and Eradication Sub-Department under the Department of Public Health. She said Infrared Thermal digital thermometers have been installed in the airports to check remotely the temperature of arriving travellers. The department is also conducting preventive measures across seaports and 14 land border crossings, to scan travellers who display signs of fever, one of the main symptoms of pneumonia, Daw Khin Khin Gyi said. "The health staff from international airports is checking travellers for mysterious pneumonia outbreak, assigned 24 hours daily on a rotational basis with the regional health department," she told The Myanmar Times. "So far, there is no suspected case in Myanmar until Wednesday,” she added. “This viral pneumonia from Wuhan can't transmit Human to Human. Airport Health Quarantine, Central Epidemiology Unit of the Ministry of Health and Sports, instructed to all international travellers and travellers coming from Wuhan to report to Airport Quarantine desk if they have symptoms of fever, cough, sneezing, and shortness of breath.

Ministry details plan to address important health issues in 2020 The Myanmar Times 3rd Jan 2020
The government will focus on several key health challenges facing the country this year, Health and Sports Minister U Myint Htwe said. They include patient safety, the public health and hospital information system, health literacy, and school health. The ministry will also pay more attention to the national medical supply chain management system; staff training; non-communicable diseases; medical, research, and public health ethics; e-health; budget management; implementation research; promoting an “Exercise is Medicine” programme; and monitoring and evaluation. U Myint Htwe said his office will work more closely with local and foreign non-governmental organisations, UN agencies and development partners to achieve its objectives. He said the National Health Policy is being reformulated to identify newer, nimble and realistic strategies to tackle changing conditions. The ministry was allocated around K1.2 trillion (US$812.3 million) for fiscal year 2019-2020, which is 9 percent more than in the previous fiscal year.

Myanmar seeks migrant-worker protections in Malaysia and Thailand The Myanmar Times 18th Dec 2019
U Thein Swe, minister of Labour, Immigration and Population, said the Myanmar Social Security Board is leading the negotiations with their counterparts in Malaysia and Thailand. New types of jobs have appeared worldwide as a result of technological innovations and advances but some jobs have been rendered obsolete, so social security programmes are needed, he said. “We are working hard on making the department an agency that workers can rely on,” U Thein Swe said. “We hope to provide quality medical services, and issue insurance benefits faster.” The department has 1492 management and 988 medical staff members. For quicker delivery of medical services for insured workers, seven clinics have been opened in cooperation with private clinics in Nay Pyi Taw, Pyigyitagun and Chan Aye Tharzan townships in Mandalay, North Okkalapa in Yangon, Myeik in Tanintharyi, Myitkyina in Kachin, and Taunggyi in Shan. Over 1.43 million workers have health insurance and receive medical services at three worker’s hospitals with 78 branches across the country. They can also receive medical services in 96 township clinics, 58 main clinics, five Care Well clinics, one traditional medicine clinic, seven public-private partnership clinics, and two mobile clinics. The Social Security Board provided medical services for more than 1.16 million workers and financial benefits exceeding K16.627 billion (US$11.02 million) in fiscal 2018-2019.

Philippines

I will sign medicine price cap EO ‘twice over’ –Duterte Manila Bulletin News 13th Jan 2020
President Duterte assured the public that he will sign the draft Executive Order (EO) setting maximum drug retail prices (MDRP) submitted by the Department of Health (DOH) last month despite the strong opposition from pharmaceutical firms. In an interview with ABS-CBN, Duterte said he will definitely sign the draft EO once he sees it because a price cap on medicines would be good for the people. The DOH said last month that it has already submitted the draft EO to the Office of the President. The proposed order seeks to regulate prices of at least 120 drugs and medicines used to treat several diseases and health conditions. The health conditions include hypertension, diabetes, cardiovascular disease, chronic lung diseases, neonatal diseases or those affecting newborn babies, and major cancers. Earlier, the Pharmaceutical and Healthcare Association of the Philippines (PHAP) said that while the MDRP appears beneficial, similar measures were eventually withdrawn in other countries since they were found to be counterproductive.The PHAP said pharmacists in small and medium-sized drugstores in other countries were affected as their pharmacies were forced to close down, or were sold to bigger chains due to the measure.

Higher 2020 budget seen supporting healthcare market growth philstar.com 10th Jan 2020
The “significant” increase in the budget of the Department of Health will be a “positive” for the Philippines’ healthcare sector this year and should provide commercial opportunities for pharmaceutical firms and healthcare providers. President Rodrigo Duterte last Monday signed into law the P4.1-trillion national budget for 2020, his government’s largest spending plan to date. The social services sector accounts for the largest bulk of the budget at P1.495 trillion or 36.5% of the total. The funds would be used to support capital development programs in education, health and social protection. The Philippines' healthcare and pharmaceutical market is also expected to experience robust growth driven by the country's concerted effort to improve the health and well-being of its population.

FDA gets high rating from ASEAN states Manila Standard 29th Dec 2019
ASEAN Member States officially listed the Philippine Food and Drug Administration under the ASEAN Mutual Recognition Arrangement on Good Manufacturing Practices for Medicinal Products during the 28th ASEAN Consultative Committee on Standards and Quality Pharmaceutical Product Working Group Meeting in Indonesia. Undersecretary of Health and FDA’s Officer-In-Charge Director General, Rolando Enrique D. Domingo underscored the importance of the inclusion of the FDA in the ASEAN registry for both the industry and consumers. The inclusion, he said, will also increase confidence in the quality of medicines for consumers, increase in reliability and quality of medicines, improved consumer safety and protection, better control of counterfeit medicines, and improved access to affordable quality medicines. Domingo also said that the successful inclusion “is a major step and contribution of the FDA to the government’s strategy to expand economic opportunities in industry and services through Trabaho at Negosyo as mandated by Philippine Development Plan (PDP) 2017-2022 anchored on a long-term vision or AmBisyon Natin 2040.” The endorsement was agreed upon after the ASEAN Panel of Experts’ assessment of the FDA and successful establishment of the agency’s technical competency for inclusion in the register of accepted ASEAN Inspection Services. The Philippines is the fifth country to be listed under the ASEAN MRA on GMP for Medicinal Products after Singapore Health Sciences Authority, Malaysia National Pharmaceutical Regulatory Authority, Indonesia National Agency of Drug and Food Control and Thailand Food and Drug Administration.

Senate Oks bill on alcohol, e-cigarette excise tax hike The Inquirer 16th Dec 2019
The Senate on Monday approved on third and final reading a bill increasing the excise tax on alcohol, heated tobacco and vapor products. With 20 affirmative votes and zero negative votes, the Senate approved Senate Bill No. 1074, which was earlier certified as urgent by President Rodrigo Duterte. The Senate also adopted an amendment, introduced by Senate President Pro Tempore Ralph Recto, exempting the sale or importation of prescription medicine from value-added tax (VAT). The Senate passed the bill with 20 affirmative votes and no negative votes or abstention. Finance Undersecretary Karl Kendrick Chua earlier said the sin tax measure was “part of a broader agenda of investing in the Filipino people.” He said the bill would generate an additional P47.9 billion in the first year of implementation and around P356.9 billion over the next five years, which would help fund the implementation of the Universal Health Care Act. The House passed its version of the bill last August.

DOH on alert over ‘mystery’ disease in China | Claudeth Mocon-Ciriaco BusinessMirror 6th Jan 2020
THE Department of Health (DOH) on Sunday ordered a strict check on incoming travelers at the airports and seaports amid reports of a mysterious disease in China, with symptoms similar to pneumonia but with fatal results in some cases. Health Secretary Francisco T. Duque III also assured the public that the Bureau of Quarantine (BOQ) is closely watching all those traveling to the country.

Rody open to reviewing Kaliwa dam deal Philippine Star 2nd Jan 2020
President Duterte is open to reviewing the China-funded Kaliwa Dam project deal to address concerns that it may contain provisions disadvantageous to the public.Presidential spokesman Salvador Panelo said Duterte does not tolerate one-sided or onerous provisions in government projects. “If somebody points out onerous provisions, the President would immediately look into it. In case (such provision) escapes the one who was supposed to check it, he himself would look into it. You can remove the onerous provisions and push through with the contract,” Panelo said at a press briefing yesterday.? The P12.2-billion Kaliwa Dam to be built in Quezon province is one of the government projects funded by Chinese loans. Some groups are opposed to the project, claiming it would cause floods, displace communities and damage the biodiversity of the Sierra Madre. ?

DOH shuns big pharma firms’ warning vs price cuts Inquirer 17th Dec 2019
MANILA, Philippines — Health Secretary Francisco Duque III has said the government was determined to cut prices of over a hundred medicines by more than 50 percent, despite warnings from a group of pharmaceutical companies that such a move would be more detrimental than beneficial to the public. Duque earlier this week told reporters the Department of Health (DOH) was “fighting for the best interest of the Filipinos” in setting a price cap on 122 medicines used to treat chronic ailments.

Singapore

Second suspected case of Wuhan virus in Singapore tests negative The Straits Times 11th Jan 2020
The second person who was placed in isolation here in case he had contracted the Wuhan virus has been cleared, said the Ministry of Health (MOH) on Saturday (Jan 11). Epidemiological investigations, clinical assessment and laboratory test results from the suspect case reported on Friday found that it was not linked to the pneumonia cluster in Wuhan, said the ministry. The man, 26, was a Chinese national with pneumonia and a travel history to Wuhan. He also tested negative for coronavirus, MOH said. The coronavirus family includes the Wuhan strain, as well as Sars and Mers. MOH has said it will continue to monitor the situation closely, and pointed out that because medical practitioners are on the lookout for cases with pneumonia who have recently returned from Wuhan, Singapore is likely to see more suspect cases that will need to be investigated. It urged the public to remain vigilant and to adopt good personal hygiene practices.

Big jump in dengue clusters over just two days The Straits Times 9th Jan 2020
Twenty-two new dengue clusters have emerged over a period of two days, bringing the total number as at Wednesday (Jan 8) to 108. This is a 25 per cent increase over the 86 clusters reported on Monday. Dengue infections have been rising over the past two weeks, following five weeks of declining figures. There were 313 reported dengue infections last week. Between Sunday and 3pm on Wednesday, another 189 people were diagnosed with the viral disease. The current outbreak appears to be quite severe, with 20 people dying of it last year. Eighty-eight people had the more severe dengue haemorrhagic fever last year; this is more than quadruple the previous five-year median of 20 such cases a year. Generally, one in five people diagnosed by a doctor to have dengue is seriously ill enough to require hospital care. The infections appear to be spread islandwide, although there is a slightly higher concentration in the north and the east. The biggest cluster is in Pasir Ris, with 153 cases. Of these, almost a third are in the parallel roads of Riverina View and Riverina Crescent. Other big clusters include two in the Yio Chu Kang area, one with 134 people infected and the other with 129 cases. The National Environment Agency is concerned about increased mosquito breeding with the coming Chinese New Year festivities as "homes and other premises will be decorated with more ornamental plants".

Healthcare Services Bill: MOH can temporarily take over operations of healthcare services in financial trouble CNA 7th Jan 2020
The Ministry of Health (MOH) will be empowered to take over the operations of certain healthcare service providers who are in serious financial trouble, under the Healthcare Services Bill that was passed in Parliament on January 6, 2020. The step-in provisions will apply only to residential healthcare entities like nursing homes, hospitals and inpatient palliative care centres.  MOH or an appointed  "step-in" operator can also take over if the service provider flouts regulations under the Bill, or is operating in a way that is detrimental to the interests of its patients or customers, Senior Minister of State for Health Edwin Tong said during the second reading of the Bill. Under the Bill, there will be a services-based licensing regime, instead of a premises-based one under the Act. Private ambulance operators and telemedicine service providers will also be regulated for the first time.  However, some services such as traditional medicine and complementary and alternative medicine will not be licensed at the moment, MOH said. The Bill will be implemented in three phases from early 2021 to end 2022.

Wuhan pneumonia: First suspected case reported in Singapore The Straits Times 4th Jan 2020
The Ministry of Health said on Saturday (Jan 4) that it had been notified of the first suspected case of the mystery Wuhan virus here, involving a three-year-old girl from China who had pneumonia and a travel history to the Chinese city of Wuhan. She had been warded for further assessment and treatment, and isolated as a precautionary measure, said the ministry. Countries have grown concerned over a viral outbreak in Wuhan marked by unusual cases of pneumonia. These appear to be linked to a wholesale seafood market there, where not just seafood is sold, but also live animals, including, reportedly, birds and snakes, and the organs of rabbits and other wildlife. At least 44 people had been affected there; and 11 were seriously ill, raising the spectre of severe acute respiratory syndrome (Sars) which hit Singapore hard in 2003. Singapore has started temperature screening for passengers arriving from the city at Changi Airport, and doctors are on the look out for possible cases. Experts, however, say that there have been no reports of human-to-human transmission, which means much less risk to the public. The girl in Singapore was in stable condition, MOH said, without giving details on how the case had been uncovered.

The war on diabetes goes digital The Business Times 30th Dec 2019
Diabetes is one of the fastest growing health challenges of the 21st century. In Singapore, the prevalence of diabetes in adults aged 18 and above has nearly doubled in just 15 years - from 7 per cent in 2004 to 13.7 per cent today (about 606,000 people). Singapore, has the world's highest rate of diabetic kidney failure, despite its proclaimed war on diabetes. Therefore, companies such as Roche Diabetes Care have begun investing in digital alternatives to help people track their health information. The advent of digital technology is timely as the cost of diabetes treatment is increasing at double-digit rates throughout Asia. In Singapore alone, over S$1 billion is spent each year on managing diabetes. Rising trends skew disproportionately towards Type 2 diabetes, driven by growing urbanisation and changing lifestyle habits (higher calorie intake, increasing consumption of processed foods, sedentary lifestyles), said Mr Goncalves. This makes diabetes difficult to detect and manage without regular visits to the doctor. Compared to traditional methods, digital technology is able to facilitate not only reactive treatment but also proactive prevention, which many healthcare professionals agree is both more effective and less costly for disease management.

Thailand

Chinese woman with mystery virus quarantined in Thailand CNA 13th Jan 2020
A Chinese woman has been quarantined in Thailand with a mystery strain of coronavirus, the first time it has been detected outside China, the Thai Health Ministry said on Monday (Jan 13). A 61-year-old man last week became the first person to die in China from a respiratory illness that is believed to be caused by a new virus from the same family as SARS, which claimed hundreds of lives more than a decade ago. Forty-one people with pneumonia-like symptoms have so far been diagnosed with the new virus in Wuhan, with seven in critical condition, Wuhan health authorities said on Saturday. Thai authorities are stepping up monitoring at airports ahead of the Chinese New Year holiday next week, when hundreds of thousands of Chinese tourists are expected to visit. Of 12 passengers quarantined since Jan 3, lab results showed that a 61-year-old Chinese woman carried a strain of the coronavirus, the Thai Health Ministry said on Monday. The woman, who was quarantined on Wednesday, had received treatment and was well enough to return home, the ministry said. The World Health Organization confirmed Monday that the first case in Thailand is of a new virus from the same family as SARS that is behind a Chinese pneumonia outbreak.

Thailand launches full-time clinics dispensing cannabis oil ABC News 6th Jan 2020
Thailand on Monday opened its first two full-time clinics dispensing cannabis oil for medical treatment, a step forward in the government's policy of promoting the licensed use of marijuana products to relieve the symptoms of a range of ailments. About 400 patients, many of them with cancer, were given the oil for free at a flagship clinic at the Public Health Ministry in a suburb of Bangkok. The initial four formulations handed out are used for treating conditions such as migraines, insomnia, nausea, numbness and pain. The medicines are touted as being based on traditional remedies. Thailand was previously known for harsh anti-drug laws, but is now eyeing the economic potential of cannabis. A report last year by Prohibition Partners, which claims to be the leading authority on the subject, said Asia's medical cannabis market would be worth around $5.8 billion by 2024. Around 25 similar clinics have been operating part-time since the legislature agreed in 2018 to amend the country's drug laws to allow the use and production of medical cannabis. The Health Ministry clinic and another in Bangkok are forerunners of a planned nationwide network, if they show positive results.

Govt rolls out cannabis clinic based on traditional medicine Bangkok Post 6th Jan 2020
Thailand opened its first full-time clinic specialising in traditional and alternative cannabis-based medicine on Monday, as part of a move by the government towards developing a medicinal cannabis industry. Thailand, which has a tradition of using cannabis to relieve pain and fatigue, legalised marijuana for medical use and research in 2017 to boost agricultural income. There are already around 25 cannabis clinics attached to general hospitals around the country but, unlike the newly-launched pilot clinic, they operate for just a few days a week due to a lack of specialised staff. The largest producer of medicinal cannabis is currently the health ministry's Government Pharmaceutical Organization. Kasetsart University's director of medical cannabis research, Natakorn Thasnas, told Reuters that the university would supply 2,200kg of cannabis leaf to the ministry. Cannabis production, cultivation and sale has been limited to licensed Thai producers for the next four years to protect the domestic industry. Currently, only hospitals and research facilities are allowed to apply for cannabis production and extraction licences, but the government is reviewing regulations to enable Thai businesses to apply for permits. Last year, Thailand dropped cannabis and hemp extracts from its narcotics list and proposed a draft law that would allow each household to grow six cannabis plants.

Anutin calls for calm over viral outbreak Bangkok Post 6th Jan 2020
Public Health Minister Anutin Charnvirakul has urged people not to panic over the outbreak of a mysterious viral pneumonia in China, and gave assurances that measures are in place to keep Thailand free of the disease. Airport authorities have been ordered to adopt stricter screening of travellers from Wuhan, the most populous city in central China where the lung infections have been found, amid reports of a similar case in Singapore. The outbreak in Wuhan, with 44 cases confirmed, has led to speculation of a link to Sars which also originated in China and killed more than 700 people around the world in 2002 and 2003. The Department of Disease Control is working with Airports of Thailand Plc (AoT) to closely monitor tourists from Wuhan, said Mr Anutin. AoT President Nitinai Sirismatthakarn said infrared temperature screening devices have been installed at the four AoT airports -- Suvarnabhumi, Don Mueang, Phuket and Chiang Mai -- which currently serve daily flights from Wuhan. Singapore also implemented temperature screening at Changi Airport from Jan 3 for all travellers arriving from Wuhan. Its officials recently reported the first suspected case of pneumonia possibly linked to Wuhan, according to Bloomberg news agency.

Health insurance extended Bangkok Post 25th Dec 2019
In a move to help the government cope with Thailand's ageing society, the cabinet on Tuesday approved a proposal to let freelance workers up to 65 years of age register under the social security system. This decision will benefit the 4.36 million self-employed people aged 60 to 65 who are still working, deputy government spokeswoman Ratchada Dhanadirek said after Tuesday's cabinet meeting. Many of these people work as vendors, motorcycle taxi drivers and farmers, she added. Previously, the age limit was 60 for registering under the social security system's self-insurance option, referred to as "insured party under Section 40 of the Social Security Act", she said. The minimum age for this scheme is still 15, she said. Those interested in this social security programme will have three monthly contribution rates to choose from -- 70 baht, 100 baht or 300 baht -- which the government will match with contributions of 30 baht, 50 baht or 150 baht respectively. One of the core benefits of this social-security scheme, she said, is that in cases of severe illness, an insured worker will be provided with financial compensation of 300 baht per day for up to 30 days per year. Other benefits include financial compensation in case of physical disability and financial aid and allowances to cover funeral expenses in case of death, she said.

Vietnam

Central database to connect all patients' records by 2025 vietnamnews 31st Dec 2019
All residents in HCM City will have electronic medical records connected to the database of the city's health facilities by 2025, according to the HCM City People’s Committee.The records will be compiled from 2019 to 2025 which was approved by Lê Thanh Liêm, the committee’s vice chairman. The database connections will ensure updated information on patients, and ultimately universal health coverage for all its residents. By 2022, the city will collect initial data on residents’ health including name, age, gender, birth, address, ID, and medical history. The data will be updated year-by-year until 2025. After collecting and setting up the data, relevant agencies will analyse and carry out a surveillance health index of residents to evaluate disease scenarios in the city. Artificial intelligence will be applied in research and will forecast trends relating to health. Then suitable strategies to improve health of residents will be suggested. The committee has instructed relevant agencies to increase investment in IT infrastructure to ensure data security. Software used for electronic medical records will have to match the city’s electronic architecture and the Ministry of Health’s technical standards.

E-prescriptions to replace written versions in Vietnam AsiaOne 26th Dec 2019
Written medical records could be on their way out, as pilot software will allow patients to use codes to access their e-prescriptions on a national online prescription system. Speaking at a workshop last week, Associate Professor Luong Ngoc Khue, Director of Medical Services Administration under the health ministry, said the software would be applied across the country at all public and private healthcare facilities after a recently launched pilot in Ha Tinh and Hung Yen provinces. According to Khue, among nearly 50,000 medical facilities nationwide, 95 per cent have prescription management software. However, the data is not synchronised, making it difficult to share data among facilities. Up to 70 per cent of pharmacies have medicine management software but still sell medicine without prescriptions. All prescriptions sent from healthcare facilities nationwide would be saved on the software and shared with patients and medicine suppliers. The e-prescriptions would be connected with e-medical records. Through the system, only prescribed medicines could be sold to avoid the abuse of antibiotics and controlled medicine.

Pollution kills over 71,300 in Vietnam in a year - VnExpress International VnExpress 24th Dec 2019
An estimated 71,365 Vietnamese people lost their lives to pollution in 2017, the latest year for which data was available, according to the Pollution and Health Metrics report by the Global Alliance on Health and Pollution. It is the first international alliance of its kind to respond to the threat of toxic pollution on a worldwide scale. Drawing its data from the Institute of Health Metrics Evaluation, a Seattle-based institution founded by the Bill and Melinda Gates Foundation, the report breaks risk factors into four categories: air, water, occupational and lead. Of the total number of pollution-related deaths, air pollution killed 50,232 people in Vietnam, water pollution claimed 3,097 lives, 9,809 died of occupational pollution and 8,227 people were killed by lead pollution, the report said. Vietnam also entered the list of 20 countries with the highest rate of pollution-related deaths in the Western Pacific region per 100,000 people, in 10th position with 75 deaths, according to the report. In the latest move from the government, Minister of Natural Resources and Environment Tran Hong Ha has called for urgent measures to reduce air pollution, from improving monitoring system to ending people's use of coal stoves.

Vietnam wants WHO’s support to better healthcare system: Deputy PM SGGP News 18th Dec 2019
Hosting a reception for WHO Regional Director for the Western Pacific Takeshi Kasai in Hanoi on December 17, Deputy PM Dam spoke highly of WHO’s assistance for Vietnam in the past four decades, particularly in prevention and control of communicable and non-communicable diseases, expanded immunization programme, human resources training, and health insurance, among others. Vietnam is willing to continue cooperation with the WHO towards building a modern and complete healthcare system that helps improve living quality in the country and achieve targets set in the national strategy on public health protection and health care for 2020-2030 period, he stressed. For his part, Takeshi Kasai, briefed the host on WHO’s plan to reform the healthcare system in the direction of expanding access to quality medical services at suitable costs for Vietnamese people. He presented the WHO’s recommendations to the Vietnamese government regarding mid and long-term policies in several priority fields, including developing strong primary healthcare facilities, and applying the same price for the same service at hospitals of all levels.

Fostering medical tourism on the agenda of health ministry conference vietnamnews 18th Dec 2019
Chợ Rẫy Hospital, HCM City University Medical Centre, Gia An 115 Hospital, and Oncology Hospital are some of the popular destinations for foreign medical tourists. In the first six months of this year the HCM City University Medical Centre examined 8,282 foreigners and overseas Vietnamese and provided inpatient treatment to 927. For Chợ Rẫy Hospital the numbers were 1,793 and 292. According to the Ministry of Health, a total of 89,000 foreigners came to the country for medical reasons and 10,100 underwent treatment in the period. Most of the patients, from Cambodia, Laos, China, the U.S, the Philippines, and Australia, consider the quality of healthcare in Việt Nam good. They come mostly for cardiovascular, dental, oncological, and cosmetic surgery. The ministry held a conference on December 14 to discuss how to attract foreigners, Vietnamese living overseas and affluent locals to Vietnamese hospitals in case of ailments. Experts expressed concern about the fact that 40,000 Vietnamese choose to go abroad every year for medical treatment. Though the quality of the country’s medical services is better than in other countries in the region, they said the inefficient mechanism to collect international insurance payments discourages people from returning for further checks after having surgeries done here.