The Health Promotion Administration (HPA) of the Ministry of Health and Welfare (MOHW) is the health promotion authority that promotes comprehensive health services to all residents of Taiwan. HPA upholds the spirit of “Prevention is better than cure.” HPA reinforces preventive medicine and community health, intimately integrates social welfare and cross-functional resources, implements the concept of the womb to tomb, citizen health promotion from family to the community. With the director-general in overall charge of the HPA, the administration is also supported by two deputy director-generals and one secretary-general. There are seven operational divisions and four administrative offices responsible for the planning and implementation of health promotion policies.

HPA’s mission includes the promotion of public health, maternal and child health, and primary preventive health services. The ultimate goal of the Administration is to prolong healthy life expectancy for all.

The goal of HPA is to extend the longevity of citizens’ health, reduce health inequality, and achieve “Health for all.” The HPA gives priority to four major initiatives: (1) enhancing health literacy and promoting healthy lifestyles; (2) promoting preventive healthcare, effective prevention, and screening; (3) upgrading the quality of healthcare and improving chronic disease control and prognosis; (4) creating a friendly and supportive environment and bolstering healthy options and equality. It plans and implements measures to promote reproductive health, maternal and child health, adolescent health, and the health of middle-aged and elderly people as well as to advance the prevention and control of health hazards such as smoking and betel-quid use, cancers, cardiovascular diseases, and other major non-communicable diseases. It is also responsible for conducting public health surveillance and related research about other special health topics. Moreover, the HPA joins forces with all the public health agencies in the country’s counties and cities, hospitals, and other medical institutions. It also works with private groups to implement health policies and build a healthy environment for the entire population.

The HPA programmes include:

• healthy birth and growth;
• healthy lifestyles and community development (tobacco control, obesity prevention and control, and a healthy environment including creating healthy cities and communities, advancing health-promoting schools, hospitals, workplaces, and building a network of safe communities and promoting safe schools);
• healthy aging (active aging, chronic disease prevention, and control, cancer prevention and control);
• healthcare for the underprivileged; and
• a life-course approach to NCD surveillance, research, and health education.

The main funding source for HPA is derived from tobacco health and welfare surcharges. This was in response to a strong campaign by numerous NGOs to push for levying tobacco health and welfare surcharges specifically for tobacco hazards prevention and control, social welfare, and health preventive services. The Tobacco and Alcohol Tax Act 2000 came into force in 2002. Prior to this, there was a Tobacco Hazards Prevention Act passed in 1997. In 2007, Tobacco Hazards Prevention Act was mandated to be the source of law for levying tobacco health and welfare surcharge. About USD 0.67 per pack of tobacco health and welfare surcharge has been collected since 2009. The tobacco health and welfare surcharge is allocated for national health insurance reserves and health promotion activities to provide health equality to all citizens.

Tobacco health and welfare surcharge distribution and utilization including

• 50% for National Health Insurance reserves;
• 2% for the Ministry of Health and Welfare to support medical subsidies for rare diseases and for cancer prevention and tobacco control and health promotion;
• 8% for improving medical affairs such as
• 4% for the Ministry of Health and Welfare to subsidize medical shortage areas and upgrade the quality of clinical care;
• 3% for the Centers of Disease Control (CDC) to upgrade the quality of vaccines;
• 1% for the MOHW to promote public health and social welfare;
• 1% for the Ministry of Finance to support the investigation of smuggled or inferior tobacco products and prevent tax evasion of tobacco products;
• less than 1% for the Ministry of Agriculture to provide assistance to tobacco farmers and workers of related industries.

Based on the budget distribution, the HPA received 27.2% of the total tobacco health and welfare surcharge with an estimated budget of USD 250 million (NTD 7 billion 515 million) in 2019; USD 247 million (NTD 7 billion 421 million) in 2020; and USD 243 million (NTD 7 billion 285 million) in 2021. The funding is used for medical subsidies for rare diseases and for cancer prevention and tobacco control and health promotion at the national and local levels.

The Tobacco Hazards Prevention and Health Protection Funds are controlled by MOHW, and HPA is the managing and implementing unit. To ensure the transparency and accountability of the tobacco health and welfare surcharge distribution and utilization, a council of the fund was established to review and evaluate the activities of the fund. It comprises a convener represented by the Deputy Minister of the Ministry of Health and Welfare, the executive secretary held by the Director-General of HPA, and 13 to 17 experts or scholars to support them.

With the greater proportion of tobacco health and welfare surcharges allocated to national health insurance, subsidization, and investigation of smuggled or inferior tobacco products, not all health promotion activities can be funded adequately. An evaluation system is being developed to measure outcomes to support any changes in the tobacco health and welfare surcharges distribution and utilization. In addition, to gain more financial resources, HPA works to strengthen its partnerships with other agencies or organizations that have similar goals and tasks.