To establish a "special medical zone" in the Greater Bay Area, the field of public health is indispensable
Text/Zhao Tianyu
Editor/Wang Xiao
How to enhance connectivity in the Guangdong-Hong Kong-Macao Greater Bay Area is one of the issues of concern to NPC deputies and CPPCC members, including the local medical and health sectors.
Cai Weiping, a deputy to the National People's Congress and chief expert of the Infection Disease Center of the Eighth Affiliated Hospital of Guangzhou Medical University, arrived in Beijing on March 3, 2022 to attend the national "two sessions", bringing suggestions such as "providing vaccine facilitation vaccination services for residents in the Guangdong-Hong Kong-Macao Greater Bay Area".
Starting from 2021, in the Greater Bay Area, some medical institutions in the mainland can use drugs or medical devices that are urgently needed clinically and have been listed in Hong Kong and Macao, and can be approved by the Guangdong Provincial Government. Nine of the first approved medicines and two medical devices were approved for use. This is known as the "Hong Kong and Macao Medicine and Equipment Pass", and patients in the Greater Bay Area can take the lead in using drugs and devices that have not yet been listed in the mainland to solve the urgent need.
Cai Weiping told the "Finance and Economics Health" reporter that based on the "Hong Kong and Macao Medicine and Equipment Pass", he suggested that vaccines should also be included, used in designated medical institutions in Guangdong Province, and build a vaccination information system interconnected in the Guangdong-Hong Kong-Macao Greater Bay Area.
One Greater Bay Area, three immunization programmes
Finance & Health: What are the barriers to vaccination for residents in the Greater Bay Area?
Cai Weiping: Residents of Guangdong, Hong Kong and Macao in the Greater Bay Area have frequent daily exchanges.
Previously, I read a report on the people's livelihood needs of vaccines in the Guangdong-Hong Kong-Macao Greater Bay Area, mentioning that many young people in Hong Kong and Macao who started businesses in the mainland could not return to Hong Kong and Macao in time because of poor customs clearance after the new crown epidemic, and they could not continue to vaccinate their children according to the strategy of Hong Kong and Macao. In fact, before the epidemic, a large number of mainland residents in the Greater Bay Area already traveled to Hong Kong and Macao every year to get vaccinated, especially the multiple vaccines listed in Hong Kong.
Although the state is constantly increasing its efforts in vaccine production and research and development, the mainland is relatively lagging behind in the introduction of international vaccines due to some considerations in the introduction procedures and approvals.
Out of long-term concern for infectious diseases, I have noticed that the current vaccine supervision and immunization in the Greater Bay Area actually belong to Guangdong, Hong Kong and Macao, and are divided into territorial management, forming a disconnected status quo of "one bay area, two systems, three vaccine supervision systems, and three immunization programs".
This has led to the cross-city movement of people in the Greater Bay Area, such as Hong Kong and Macao people who have started businesses and established businesses in the Greater Bay Area, and people from the Mainland of the Greater Bay Area who travel, work and live in Hong Kong and Macao, etc., who have encountered many obstacles in their daily lives in terms of mutual vaccination recognition, renewal and re-vaccination, and the residents of the Greater Bay Area have not met the diversified vaccination needs.
Therefore, it is necessary to provide more convenient solutions for Hong Kong and Macao vaccination for Hong Kong and Macao residents living in the Mainland.
Photo/pixabay
Finance and Economics: What are the "two systems, three vaccine regulatory systems, and three immunization programmes" in the Greater Bay Area?
Cai Weiping: In the Three Places of Guangdong, Hong Kong and Macao in the Greater Bay Area, because of the different vaccination management systems, the same vaccine may be vaccinated differently in different places; or the vaccine to prevent the same disease, the vaccination method is different in different places. These are related to the production and origin of vaccines.
For example, children are vaccinated against polio, one is injected with inactivated polio vaccine, and the other is to take live attenuated polio vaccine sugar pills, which require multiple vaccinations. If you don't use the same vaccine, the procedure for vaccination is different. In this case, the vaccines provided by the mainland, Hong Kong and Macao cannot be mixed.
Now the new crown vaccine to strengthen the injection mixed beating, in fact, have done a lot of research, based on sufficient research to confirm that the mixed hit first safety is no problem, and then the effectiveness is also very good. However, if you have not done clinical trials, you can not go to mixed beatings, and you can only follow the original vaccination plan.
The trouble is that due to the launch of THE NEW CROWN vaccines with different technical routes in Hong Kong, Macao and the mainland, for the residents of the Greater Bay Area, they will either all be vaccinated in Hong Kong and Macao or in the mainland.
According to the results of the survey in the Greater Bay Area, more than 70% of Hong Kong and Macao respondents living in the mainland said that if there is no impact of the new crown epidemic, they are more willing to return to Hong Kong and Macao to get vaccinated, because it is more convenient for them.
In Hong Kong and Macao, most of the vaccines used are multivalent or multi-linked vaccines.
The so-called multiple vaccine is to prepare a variety of pathogenic microorganisms into a vaccine to achieve the purpose of preventing a variety of diseases by vaccinating a vaccine. Compared with the monovalent vaccine for the prevention of single diseases, not only can there be many types of preventable diseases, the immunization effect is similar, and the number of vaccinations is small, the procedure is simplified, and it is more popular with parents and vaccination doctors.
In the past two years, due to the new crown epidemic, the passage between the mainland and Hong Kong and Macao has not been as smooth as before the epidemic, and the inconvenience of vaccination for residents in the Greater Bay Area has become more prominent, so I put forward this suggestion.
Finance & Health: In your daily work, what are the most common questions people are asking about vaccines in Hong Kong?
Cai Weiping: More inquiries are still about hpvide vaccines, especially when the mainland has not yet been listed. In addition, my patients are mainly AIDS patients, their immunity is relatively low, suitable for polyvalent pneumonia vaccine, but the availability of polyvalent pneumonia vaccine in the mainland is relatively poor, so they will go to Hong Kong, China, and even go abroad to vaccinate.
It complements the mainland healthcare system
"Finance and Economics Health": Benefiting from the "Hong Kong and Macao Medicine and Equipment Pass", there are already more than a dozen kinds of drugs or devices from Hong Kong and Macao introduced into the mainland for use, what kind of judgment criteria are based?
Cai Weiping: At present, the standard for the introduction of pharmaceutical equipment is the urgent clinical need of mainland medical institutions in the Guangdong-Hong Kong-Macao Greater Bay Area. There are also some prerequisites, such as these drugs and devices do not belong to the special management category of narcotic drugs, psychotropic substances, etc., and have been listed in Hong Kong and Macao but not in the mainland.
However, vaccines are different from drugs, it is not treatment, but the role of prevention, from the perspective of public health emergency and prevention and control of infectious diseases, to understand the "urgent need" of vaccines.
Finance and Economics: In the integration of public health services in the Greater Bay Area, which ones do you think can be taken first?
Cai Weiping: The integration of public health services in the Greater Bay Area, in fact, vaccines are a very important part of public health, and to achieve integration, vaccines need to be taken into account.
In fact, the most obvious difference between Hong Kong and Macao and the mainland now, I think it should be a second-class vaccine, that is, a vaccine that everyone voluntarily administers at their own expense.
For example, the flu vaccine is self-funded, in fact, there are fewer people getting the flu vaccine in the mainland and more people in Hong Kong. If there is a flu at this time, it may not cause an epidemic in Hong Kong, but it may cause an epidemic in the mainland. At present, there are too many exchanges and exchanges between the mainland and Hong Kong and Macao, so if the public health services between the two sides can be consistent, the mutual transmission of some pathogens brought about by the movement of people can be avoided to the greatest extent.
At present, the problem is that the vast majority of vaccines in Hong Kong and Macao have not actually been approved for use in the mainland, and the previous "Hong Kong and Macao Medicine and Equipment Pass" policy is actually to solve this problem. However, this policy does not include a vaccine, so I suggest using the same method, treating the vaccine as a special drug, and first giving it to Hong Kong and Macao residents living in mainland cities in the Greater Bay Area.
Photo/Pexels
Finance & Health: If you want to achieve more Hong Kong and Macao drugs, devices, including vaccines in the Greater Bay Area, according to your observation, what are the difficulties?
Cai Weiping: I think it is still a matter of "degree".
What is now relatively easy to implement can start with hospitals jointly operated by Hong Kong and Macao in the mainland. Then, the hospitals in the mainland will be gradually liberalized to see what kind of impact it will have later. I don't think it will have a big impact. In this way, the number of people vaccinated is also limited, and the amount used will be limited.
Caijing Health: What is your advice for the need for vaccines in the Greater Bay Area mentioned earlier?
Cai Weiping: I bring two suggestions.
The first is to recommend that Hong Kong and Macao residents in Guangdong be given local vaccinations for Hong Kong and Macao in accordance with the requirements of the immunization programmes in Hong Kong and Macao. For vaccines that have been listed in Hong Kong and Macao but have not yet been approved in the mainland, according to the policy of "Hong Kong and Macao Medicine and Device Pass", these vaccines are allowed to be used in designated medical institutions in Guangdong Province first, so as to provide vaccination services for Hong Kong and Macao residents working and living in Guangdong, so that Hong Kong and Macao compatriots in Guangdong can obtain the same vaccine protection as In Hong Kong and Macao.
The second is to provide pilot projects for mainland city residents in the Guangdong-Hong Kong-Macao Greater Bay Area to provide mature vaccines listed in Hong Kong and Macao, for example, to open the "Hong Kong and Macao Vaccine Pass" channel to allow vaccines widely used by Hong Kong and Macao to enter the non-immunization program vaccine category in the Greater Bay Area; to build a vaccination information system interconnected in the Guangdong-Hong Kong-Macao Greater Bay Area; to set up special vaccination points for Hong Kong and Macao vaccines in nine cities in the Greater Bay Area; to focus on the accumulation of real data on innovative vaccines in the Guangdong-Hong Kong-Macao Greater Bay Area, and to explore the possibility of vaccine inclusion in immunization programmes.
If it can be achieved, people can get the same vaccine as Hong Kong and Macao at some designated vaccination points in the Greater Bay Area, so that the biggest benefit is that the vaccine strategies of Guangdong, Hong Kong and Macao in the Greater Bay Area can be consistent.
Caijing Health: Will this have an impact on the mainland vaccine industry?
Cai Weiping: In fact, the advantage is to promote mainland vaccine companies to develop and produce some new vaccines. At present, the vaccine production in our mainland is very large, but the production method is traditional, and it is difficult to make a multivalent and multi-inactivated vaccine.
If you can introduce some vaccines that have been listed in Hong Kong and Macao and are more commonly used in the world through the "Hong Kong and Macao Medicine and Equipment Pass", if the effect is better for mainland residents, one can introduce a part, and the other can also promote some domestic vaccine production companies to see the vaccine opportunity and seize the research and development.
There are also some with higher technical content, such as mRNA new crown vaccine, which mainland companies should also keep up with, and even have their own innovative methods to make.
Caijing Da Health: If you want to make the "Hong Kong and Macao Medicine and Device Pass" benefit a wider group, what kind of suggestions do you have?
Cai Weiping: It is still necessary to take it step by step, through a small-scale pilot to see the impact, which is actually a bit similar to Hainan Boao Lecheng (Note: Hainan Boao Lecheng Pilot Zone, allowing patients to use new drugs that have not yet been listed in China), but also starting from the pilot, and then slowly liberalizing, complementing the mainland medical system.