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Health problems in Hong Kong are mostly associated with lifestyle-related
chronic degenerative diseases. Among the leading causes of death, cancers,
diseases of heart and cerebrovascular diseases together accounted for
about 56 per cent of all deaths during the year. These diseases affect
mainly elderly people and will continue to dominate the mortality statistics
as the population ages.
In 2003, cancers were the top killer in Hong Kong
and claimed more than 10 000 lives. A Cancer Coordinating Committee has
been established to formulate comprehensive strategic plans and make recommendations
for the effective prevention and control of cancer in Hong Kong.
To reduce the number of women developing and dying
from cervical cancer, the Department of Health, in collaboration with
other health care providers, has been planning for the introduction of
a Cervical Screening Programme in 2004. It is recommended that women aged
25 to 64 years receive three-yearly cervical smears following two consecutive
yearly negative smears. In 2003, a Cervical Screening Information System
was under development by the department to collect and analyse data on
cervical smears.
Severe Acute Respiratory Syndrome (SARS)
In early 2003, infections caused by a previously unknown coronavirus
broke out in Hong Kong. The disease was later named as SARS by the World
Health Organisation (WHO). It proved to be a major new threat to international
public health. The epidemic in Hong Kong lasted for a period of three
months and infected 1 755 individuals, 299 of whom died.
The Government put in place comprehensive public
health measures to bring the epidemic under control. It declared SARS
a statutory notifiable disease and conducted a comprehensive public education
programme to heighten awareness of the SARS symptoms so that potential
cases were taken to medical facilities as early as possible. The Government
also stepped up health checks at boundary and immigration control points,
through health declarations and temperature screening, to prevent SARS
being spread by the travelling public.
Modern technology such as the online e-SARS database
developed by the Hospital Authority and the Major Incident Investigation
and Disaster Support System of the Hong Kong Police Force were utilised
to provide timely contact tracing of SARS patients as well as to expand
the scope of such tracing. To stop the spread of SARS in the community,
the Director of Health also required the close contacts of suspected and
confirmed SARS patients to undergo home confinement and medical surveillance
for a maximum of 10 days.
The Government established a multi-disciplinary response
team to carry out immediate investigation and undertake prompt remedial
action in buildings where SARS cases were reported so as to minimise the
risk of environmental transmission within the community.
Hospital infection control measures were heightened
through giving health care staff training in infection control and providing
staff with adequate protective gear. A region-wide cleansing and disinfection
campaign was also launched in late March to clean up public places and
to encourage all members of the community to clean their environment.
During the fight against SARS, the Government maintained
close liaison with the WHO and other national authorities, and held daily
press briefings to keep the local and international communities informed
of the latest developments concerning the epidemic. It also improved the
notification mechanism between Hong Kong and Guangdong Province and extended
it from May to cover Macau.
With the concerted efforts of the community, the epidemic
in Hong Kong, regarded by WHO as one of the hardest to contain because
of the region's high population density and extensive cross-boundary travel,
was successfully controlled. On June 23, the WHO removed Hong Kong from
the list of areas with recent local transmission.
The epidemic highlighted the urgent need to review
the capacity of the health care system, and to better prepare for any
future outbreak. The Chief Executive of the HKSAR announced on May 28
the setting up of a SARS Expert Committee to conduct a review. Members
of the Expert Committee were selected for their wide range of experience
in their respective fields, which included health systems, public health,
epidemiology and communicable disease control, medical expertise, and
hospital management and operation.
The Expert Committee reviewed the work of the Government,
including the Hospital Authority, in the management and the control of
the outbreak. It examined and reviewed the capabilities and structure
of the health care system in Hong Kong and the organisation and operation
of the Department of Health and the Hospital Authority in the prevention
and management of infectious diseases such as SARS. The Expert Committee
also identified lessons to be learnt, and made recommendations on areas
requiring improvements in order to better prepare the system for any future
outbreak.
The Expert Committee released its report on October
2, and proposed a comprehensive set of improvement measures. The Government
attaches much importance to full and timely implementation of these recommendations.
In November, the Chief Executive appointed a Monitoring Committee to oversee
the implementation of the recommendations. The Monitoring Committee will
make periodic reports to the Chief Executive on the progress of implementation.
Other Communicable Diseases
Hong Kong now lists 28 statutory notifiable infectious diseases, including
three quarantinable diseases, namely cholera, plague and yellow fever.
During the year, 15 885 cases of notifiable infectious diseases were reported,
of which 38.3 per cent were due to tuberculosis.
Children in Hong Kong are immunised against tuberculosis,
hepatitis B, poliomyelitis, diphtheria, tetanus, pertussis, measles, mumps
and rubella. Owing to high vaccine coverage, diseases such as diphtheria
and poliomyelitis have been eradicated and the incidence of other vaccine-preventable
infectious diseases among children is relatively low.
As at year-end, the cumulative number of HIV (human
immunodeficiency virus) infection and AIDS (Acquired Immune Deficiency
Syndrome) cases reported had exceeded 2 200 and 650, respectively. Each
year, about 200 new cases of HIV infection are reported. Sexual transmission
remained the most common mode of spread of the infection, though in recent
years there has been growing concern over reports of HIV infection among
injection drug users.
Centre for Health Protection
On May 5, the Chief Executive announced that the Administration had begun
a study on establishing a Centre for Disease Control type of organisation
in Hong Kong to strengthen its capacity to combat communicable diseases.
This initiative was echoed in the SARS Expert Committee's report issued
on October 2. The committee recommended, among other things, that a Centre
for Health Protection (CHP) with responsibility, authority and accountability
for prevention and control of communicable diseases be set up within the
Government and its existing public health infrastructure.
The Administration has taken active steps to move
forward the Chief Executive's undertaking and the Expert Committee's recommendations.
An advisory committee chaired by the Permanent Secretary for Health, Welfare
and Food and comprising health care professionals in the public and private
sectors and academics from four local universities was formed in November
to help establish the CHP. The committee was tasked to advise on the organisational
framework and functions of the CHP and to monitor the progress of its
development.
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