As populations age and chronic diseases emerge earlier and more pervasively, Taiwan is stepping forward with bold, collaborative solutions. The newly announced T-CaReMe – short for Taipei Cardiovascular, Renal, and Metabolism – Taipei Declaration signals a decisive shift in how chronic diseases such as cardiovascular diseases, diabetes, and kidney disease are understood, managed, and prevented.
This is a pressing national issue: according to the Ministry of Health and Welfare, chronic diseases such as cancer, heart disease, cerebrovascular disease, diabetes, and kidney disease consistently rank among Taiwan’s top 10 causes of death. For those aged 65 and above, nearly 70% are affected by two or more chronic conditions.
This nationwide effort reflects both Taiwan’s commitment to innovation in healthcare and the growing influence of the National Health Research Institutes (NHRI) as a driving force behind precision medicine and digital health.
“T-CaReMe is more than a declaration – it’s a blueprint for proactive, precise, and people-centered care,” says Dr. Wayne Huey-Herng Sheu, vice president of the NHRI and former superintendent of two of Taiwan’s major public hospitals. “We are leveraging big data, AI, and patient behavior feedback tools to empower individuals and transform chronic disease care from reactive to proactive and predictive.”
The Declaration was unveiled at the 17th Scientific Meeting of the Asian Association for the Study of Diabetes, in collaboration with major health institutions, including the NHRI, the National Health Insurance Administration, the Health Promotion Administration, and the Taiwan Diabetes Association. Its vision centers on a model of care built around risk stratification, digital innovation, and precision health – all aligned with President Lai Ching-te’s Healthy Taiwan initiative and the national 888 Plan, which aims to cut mortality from chronic diseases associated with the “three highs” by one-third by 2030.
Dr. Sheu, a veteran diabetes specialist and educator, underscores the promise of precision medicine in tackling chronic illness. “Not all patients face the same risks,” he says. “One may be more prone to kidney failure, another to stroke. If we can stratify risk dynamically, using AI and big data, we can intervene earlier – and far more effectively.”
The NHRI is piloting AI tools that analyze a broad range of data, including lifestyle habits and biometric indicators, to assess each patient’s long-term health risks. These systems are designed to evolve alongside the patient, detecting changes in risk over time and supporting the creation of personalized care plans.
Digital platforms play a central role in this approach. Patients can use mobile health apps, wearable devices, and interactive systems to receive medication reminders, track daily movement, and manage blood sugar levels. Continuous glucose monitors, for example, provide minute-by-minute updates, helping patients connect blood sugar fluctuations with specific behaviors or dietary choices and adjust their routines accordingly.
“Behavior change is the hardest part of chronic disease management,” notes Dr. Sheu. “But when patients see how their actions immediately impact their health data, they are more motivated to stay on track.”
In partnership with hospitals and medical associations, the NHRI is launching a pilot program for “precision diabetes education.” Under this model, patients receive targeted guidance based on their most likely future complications – be it kidney damage, eye disease, or cardiovascular events.
“Instead of overwhelming patients with information, we focus on what’s most relevant to their risk,” says Dr. Sheu. “That’s how we change outcomes.” He recently presented the NHRI’s work to the American Diabetes Association, where peers expressed surprise at how far Taiwan had advanced in implementing precision prevention strategies.
The long-term success of the T-CaReMe initiative will hinge on policy continuity and funding. The NHRI and its partners are now advocating for a National Chronic Disease Prevention Act, modeled in part on Taiwan’s Cancer Prevention Act, which has been credited with improving cancer screening rates and survival outcomes.
“Chronic diseases are now among the leading causes of death and disability in Taiwan,” Dr. Sheu says. “But unlike cancer, we still lack a dedicated legislative framework to guarantee long-term investment, coordinated strategies, and measurable targets for prevention.”
Support for such legislation is growing. Medical societies, lawmakers, and civil society groups increasingly recognize the economic and human toll of chronic conditions. Their goal is to institutionalize a system-wide approach focused on early detection, individualized care, and continuous outcomes tracking.
As T-CaReMe gathers momentum, Taiwan is emerging as a regional model for chronic disease management. Its population-level health data, integrated care infrastructure, and strong partnerships between the tech and medical sectors are drawing international interest.
With the launch of the T-CaReMe Taipei Declaration, Taiwan offers a compelling example of how data, collaboration, and policy can come together to strengthen chronic disease care. For countries facing similar health burdens, its approach may offer a valuable blueprint.
“We want to build a model that can inspire and inform other countries,” says Dr. Sheu. “The challenges we face – aging populations, rising three highs, and kidney diseases – are global, and so are the solutions.”
