Joint Statement of the 6th APEC High-Level Meeting on Health & the Economy

1. Health Ministers of Chile, Malaysia, Peru, Philippines, and Vietnam; the State Minister of Health, Labour, and Welfare of Japan; the Deputy Health Minister of Chinese Taipei; the Head of the Department of Health of Papua New Guinea; senior officials; academic and industry leaders, representatives of non-governmental and international organizations met in Lima, Peru on 21-22 August 2016 for the 6th APEC High Level Meeting on Health and the Economy (HLM6). The meeting was chaired by the Minister of Health of Peru and organized jointly by the Health Working Group (HWG) and the Life Sciences Innovation Forum (LSIF). The overall objective of the meeting was to share and discuss perspectives and experiences prioritizing and financing investments in health and building innovative and efficient health systems to implement “Healthy Asia Pacific 2020 (HAP2020)” in support of the 2030 Sustainable Development Goals (SDGs). Both HAP2020 and the SDGs recognize that high impact investments in health systems yield tremendous benefits that help economies achieve their economic, social, and environmental goals.

2. HAP2020, welcomed by APEC Leaders in November 2014, calls on APEC Economies to develop sustainable and high performing health systems.  In 2015, APEC Economies, under the leadership of the Philippines, developed and endorsed the HAP2020 Roadmap to guide implementation.  Likewise, in September 2015 the United Nations (UN) General Assembly adopted the SDGs.  The focus for implementation of HAP2020 is specifically SDG 3 “Ensure healthy lives and promote well-being for all at all ages” and its 13 targets, including enhancing prevention and control of non-communicable diseases (NCDs) and promoting mental health and well-being, substantially increasing health financing, supporting the research and development of new vaccines and medicines, building a strong health workforce, and achieving universal health coverage. 

3. Partnerships – a key element of both HAP2020 and the SDGs – are recognized as a critical tool for building strong health systems.  HLM6 welcomed the opportunity for APEC Economies to collaborate closely and effectively with each other and with the private sector, academia, civil society including patient groups and other organizations, and recognized that neither HAP2020 nor the SDGs would be effectively achieved without this collaboration.  HLM6 recognized the importance of multi-sectoral action to implement the HAP2020 Roadmap and welcomed the formation of a small group by the LSIF and HWG to explore innovative approaches to further implementation of the Roadmap. 

4. HLM6 emphasized the importance of APEC Economies enhancing the fiscal space for health by developing strategies to streamline health systems by ensuring proper resource allocation; prioritizing health in domestic budgets; making high impact investments; aligning regulatory standards and procedures; and, promoting public-private partnerships.  Maximizing use of existing health infrastructures to integrate NCD prevention, treatment, and care is a critical first step. It was noted that improving health systems efficiencies can result in GDP improvements of 4% to 8% across various levels of economic development.[1]  

5. HLM6 noted that high-quality data is a valuable resource for building high performing health systems.  There are opportunities for APEC Economies to work together to develop and share high-quality data, taking into account domestic privacy laws and information sharing frameworks, to build the evidence base for effective health interventions, improve decision making, and measure progress.   HLM6 noted the joint initiative to investigate the viability of a common framework for responsible access to health data while maintaining appropriate ethical and data privacy controls. 

6.  HLM6 encouraged APEC Economies to document and share the outcomes of partnerships in health systems strengthening. HLM6 observed that data can also improve the scaling of innovative partnerships in the APEC region and that the evidence base for such partnerships at the economy-level could be improved. Public-private partnerships can also help build capacity to capture and analyze data across the continuum of care. It was noted that successful partnerships have the distinct synergistic benefits of bringing together the policy power of the public sector and the market-knowledge of the private sector to address common goals and have often resulted in a history of producing valuable research that drives innovation. 

7. HLM6 reaffirmed the importance of the 2011 APEC NCD Action Plan[2] and the urgent need to enhance and accelerate implementation of domestic NCD prevention and control strategies. APEC Economies currently face estimated GDP losses of between 6-8.5% over the next 15 years due to the impact of NCDs, mental health, early retirement, and aging.  APEC Economies recognize that investing pro-actively in health innovation can generate improved health and economic outcomes.[3] [4]  The 2008 LSIF Framework paper estimated that enhanced investment in healthcare innovation would result in a savings of 2.71% GDP of APEC economies by 2020 due to reductions in disability adjusted life years (DALYs), reduced treatment costs and increases in GDP from labor force and productivity effects.[5]  By 2030, the benefits of enhanced health innovation are predicted to have seven times the economic benefits compared to initial costs.[6]  A study by the Union for International Cancer Control (UICC) showed that investment in a core set of cancer prevention strategies can yield savings of 10 times the initial investment.[7]  

8. HLM6 examined the need for innovative financing mechanisms predicated on the return on targeted, high-impact investments in health systems strengthening.  HLM6 discussed specific approaches to achieving improved health financing including support for enforcement of current tax systems to prevent avoidance and evasion, avoiding regression in social health insurance, and promoting partnership with the private sector.[8]    Importantly, in engaging the private sector, APEC Economies emphasized the importance of establishing legal and regulatory standards that will ensure equitable and ethical treatment of all individuals.  HLM6 discussed ways of improving the efficiency and economic sustainability of health expenditures and commended APEC Economies for their efforts to carry forward the mandate agreed in 2015 by APEC Leaders for further work on the fiscal and economic impacts of ill-health and Ministers’ call for a cross-fora dialogue on ways of ensuring our workforce remains healthy and competitive. HLM6 took note of the LSIF proposal to host an informal health/finance discussion in October 2016 and encouraged economies to work together to carry forward this mandate. The HLM6 also welcomed future collaboration with APEC Senior Finance Officials in 2017.

9.  As APEC Economies continue to develop holistic approaches to strengthen their health systems, investments in research and development and life sciences innovation capacity are important considerations.  HLM6 recognized the importance of policy, regulatory, and legal frameworks in incentivizing the discovery and development of new medicines and technologies.

10. Finally, HLM6 welcomed Vietnam’s offer to host the 7th APEC High-Level Meeting on Health & the Economy in Ho Chi Minh City, Vietnam in August 2017.

RECOMMENDATIONS

HLM6 recommends that APEC Ministers and Leaders:

  • Note the importance of implementation of the HAP2020 Roadmap and the wide range of health initiatives underway in the HWG, LSIF, ABAC, and other APEC fora in support of the HAP2020 Roadmap as provided in the attached Annex.
  • Welcome the establishment of a small group to explore innovative approaches to further implement the HAP2020 Roadmap, consistent with existing mechanisms and activities underway in this space.
  • Welcome efforts to build more efficient and high-performing health systems by reducing waste, improving the quality of care, ensuring proper workforce planning, aiming for sufficient resources for health in domestic budgets, making high impact investments, and promoting public-private-academic partnerships.  Call on APEC Economies to continue to work together to develop and share high-quality data in order to build the evidence base for policy development, effective health interventions, improved decision making, and impact measurement.  
  • Recognize the role of policy, regulatory, and legal frameworks in providing incentives for the discovery and development of new medicines and technologies; and support the cooperation among universities, public research institutions, and the private sector on life science innovations.
  • Welcome future collaboration with Senior Finance Officials on the fiscal and economic impacts of ill-health.  Call on APEC Health and Finance Senior Officials and key stakeholders to convene a formal cross-fora dialogue during 2017. 


[1] Ministerial Forum for Finance Ministers.  Forum Summary. Harvard University. 2016  https://cdn2.sph.harvard.edu/wp-content/uploads/sites/61/2016/05/2016-MoF-Forum-Summary.pdf

[2] Addressing the Chronic Disease Challenge in the APEC Region: An Innovative Approach to Collaborative Action https://mddb.apec.org/documents/2012/HWG/HWG1/12_hwg1_007.doc

[3] The Impact of Health on Worker Attendance and Productivity in the APEC Region, VISES, Victoria Institute of Strategic Economic Studies, July 2014. https://www.abaconline.org/v4/download.php?ContentID=22612052

[4] Cost of Early Retirement due to Ill Health, Victoria Institute of Strategic Economic Studies, July 2015. http://vises.org.au/documents/2015_Rasmussen_et_al_Cost_of_Early_Retirement_Due_to_Ill_Health.pdf

[5]  APEC Life Sciences Innovation Forum. “Investing in the Future: An Assessment of the Returns to Investment  in Health Innovation”. Lima, Peru, August 2008.  http://vuir.vu.edu.au/4825/1/4825.pdf

[6] APEC Life Sciences Innovation Forum. “Investing in the Future: An Assessment of the Returns to Investment  in Health Innovation”. Lima, Peru, August 2008.  http://vuir.vu.edu.au/4825/1/4825.pdf

[7] According to the Union for International Cancer Control (UICC), investing $11.4 billion in a set of core prevention strategies in low and middle income economies can yield a savings of up to $100 billion in cancer treatment costs and hundreds of billions more in economic benefits.  Union for International Cancer Control. The Economics of Cancer Prevention and Control. Data Digest. http://issuu.com/uicc.org/docs/wcls2014_economics_of_cancer_final?e=0. Published 2014.

[8] World Bank – USAID “First Universal Health Coverage Financing Forum Raising Funds for Health” http://pubdocs.worldbank.org/pubdocs/publicdoc/2016/4/103621460561160053/DRM-policy-note-041216-clean.pdf