The 67th World Health Assembly (WHA) was held from May 19 to May 24 in Geneva, Switzerland. Population aging is a worldwide issue. By 2050, it is estimated that there will be 2 billion people over the age of 60, and 400 million over 80. 80% of them will live in middle- and low-income countries. Population aging, together with the prevalence of heart disease, cancer, diabetes, and other non-communicable diseases (NCDs), had increased NCD’s GBD (Global Burden of Disease) ratio from 43% in 1990 up to 54% in 2010. Therefore, this year’s WHA technical committee (committee A) raised the topic of “The inter-departmental action using life course approach to achieve healthy aging.” It pointed out that healthy aging is influenced by the various exposures and experiences along the courses of life, and that the outcome of aging could be different subjected to the combined accumulative effect of risk factors and protective factors. Thus, the Secretariat of WHO encouraged nations to develop hardware and community support environment that can promote “Active and Healthy Aging” utilizing the WHO’s global network of age-friendly cities and communities. 

In Taiwan, the nation’s population is aging rapidly. Population over 65 years of age had increased from 7% in 1993 to 11% in 2014. It’s estimated to reach 14% in 2018 and 20% in 2025. This year, our country actively participated as an observer. In addition, representatives from the Health Promotion Administration, Ministry of Health and Welfare spoke at the assembly and reported to the Secretariat sharing our experiences. 

I. Adopting WHO’s concept of achieving healthy aging through life course approach, our nation provides a wide range of health promoting services covering the course from marriage and fertility, infants and toddlers, children, adults, to the elderly. We also provide prenatal health checkup for pregnant women, adult preventive care service, and annual health checkup for senior citizens. In addition, our nation is the only country in the world that provides free, fully subsidized four-cancer (colon cancer, breast cancer, cervical cancer, and oral cancer) screening to all citizens. Through preventive care and health promoting services designed for various stages of life course, we strive to improve our citizens’ health and quality of life during the process of growing and aging. 

II. Based on the WHO Secretariat’s report on using life course approach through inter-departmental action to promote healthy aging, we recommended to establish a framework for age-friendly health care institutions in order to facilitate the implementation of senior-friendly and holistic medical care by the health care systems of all nations. In 2010, using the concepts of “active aging” and “healthy aging” proposed by WHO as the blueprint, our nation developed an age-friendly health care framework by combining WHO’s three major principles for age-friendly health care and WHO’s standards for health promoting hospitals. The framework includes four major standards covering management policies, communication and service, care procedures, and physical environment. Since 2011 we have started promoting certification throughout the country, becoming the first nation in the world that promotes age-friendly health care institution certification through government effort. The promotion started out from the hospitals in 2011 and extended to clinics (medical groups), long-term care institutions, and other health care facilities in 2012. The certification standards provide institutions with self-assessment items so that they can follow, from the top down, in order to establish and implement age-friendly policies. The standards also facilitate the formation of organizational culture and adjustment of administrative procedures to meet the needs of the elderly, as well as encourage participation in volunteer services. By the end of April of 2014, 69 medical institutions (including 68 hospitals and 1 public health center) had passed the certification and 18 institutions (including 1 long-term care institution) had applied for site visit. In order to facilitate benchmarking, we have started to hold the “Age-friendly Health Care Model Institution Election” and the “Exhibition of Achievements of Age-friendly Health Care Promotion” since 2011 to issue certificates and grant awards (awards for exemplary model, proposal of creative ideas, and essay writing), which encourage the trend of age-friendly health care throughout the country. We also established an international committee for age-friendly health care, under the WHO’ international health promoting hospitals network, to promote internationally applicable age-friendly health care framework so that the whole world can jointly work together to provide the elderly with safe, health-enhancing, effective, holistic, patient-centered, and coordinated care; to enable the elderly and their families to better control their own health and care; to prevent and delay aging and disability; and to offer the elderly the opportunity to have the best health during the aging process. 

III. In 2010, following the 8 phases and promotional steps in WHO’s “Global Age-friendly City: a Guide” published in 2007, we guided all counties and cities to promote the age-friendly city project. In 2013, we became the first country to have the entire nation’s 22 counties and cities adopt the WHO’s age-friendly city concept; and we also signed the Dublin Declaration. The promotion of this project echoed the WHO’s emphasis on the importance of inter-departmental action. In the roles of “Advocate”, “Enable”, and “Mediate”, our nation’s highest competent health authority actively engaged in the promotion and received promises from the leaders of the 22 counties and cities to include the concept of age-friendly city in the policies; to ensure actual participation of all departments; to implement inter-departmental cooperation following the 8 phases in WHO’s guide; and to examine the degree of age-friendliness of the cities’ frameworks, environment, services, and policies. In addition, comprehensive partnership relationship was established between public and private sectors, including civic groups and academia. In order to assist the counties and cities in assessing their progresses in promoting the concept of age-friendly city, and in view of their different degrees of investment and focuses, a central promotion committee for age-friendly city was established in 2014, consisted of experts from different fields and representatives from all counties and cities, to serve as the nation’s assessment and suggestion platform for the age-friendly city project.