Questions/Answers

The nominated Institution is the ‘Response and Coordination Centre for Novel Coronavirus Infection’ (hereinafter called ‘the Center’) established on 21 January 2020 . 22 January the first COVID-19 case was confirmed in Macao. The Center is under the overall supervision of the Chief Executive of Macao and consists of representatives from several government bureaus such as Health, Education and Youth Development, Transportation and Government Information.  The Center is responsible for planning, guiding, and coordinating all public and private entities in Macao linked to the prevention, control, and treatment of the outbreak. The Center actively uses digital technologies, such as the health code system, and embraces the SDGs with inclusive and sustainble decision-making. The Center has been the most critical component of public administration underpinning Macao’s highly successful whole-of-society response toward mitigating the risks imposed by COVID-19.  The Center took timely and effective measures to respond to three major challenges:   Macao is the world’s most densely populated city. The Center’s top priority in early 2020 was to minimize the risk of communal spreading to protect all residents, especially the most vulnerable. The Centre has been perseveringly securing mask supplies sold at 0.10USD/piece, to ensure no one is left behind.  Macao’s economy heavily relies on tourism, and 26% of labor force is migrant workers residing across the border. The Center applies a blockchain-based health code system to resume mobility securely with mainland China, while ensuring migrant workers’ employment. Since January 2020, Macao has registered nearly 9 million visitor arrivals through a travel bubble agreement with Mainland China thanks to this technology.  The Center disseminates crucial policy changes in a timely and transparent manner to minimize the misinformation. In a recent survey, 94.7% of Macao residents were satisfied with the overall performance of the government in dealing with the pandemic. 

The Center is being nominated for the UNPSA Special Category: Institutional resilience and innovative responses to the COVID-19 pandemic. The Center has demonstrated excellence in public service during the pandemic by convening and fostering collaboration between all relevant public and private stakeholders. The Center ensures inclusion of all residents, particularly the most vulnerable. It has developed prevention guidelines for the general public, healthcare and educational settings, and establishments operating in Macao’s mainstay industries of tourism and hospitality. The Center’s citizen-centric approach to anti-pandemic efforts has also included innovations in digital government and service adaptation utilizing frontier technologies such as blockchain. 

The Center’s ongoing work and its resultant broad impact on Macao society is directly and indirectly interrelated to almost all 17 of the Sustainable Development Goals (SDGs). More specifically, the Center has contributed to the implementation of SDGs 1, 3, 16, and 17 – No Poverty; Good Health and Well-Being; Peace, Justice and Strong Institutions; and Partnerships for the Goals - respectively. The Center has accelerated progress towards several specific Targets against the backdrop of the COVID-19 crisis, namely – Target 1.3 Implementing social protection systems and measures for the poor and vulnerable; Target 3.d to strengthen the capacity for early warning, risk reduction and management of national and global health risks; Target 16.6 to develop effective, accountable, and transparent institutions; and Target 17.17 to encourage and promote effective public and public-private partnerships. The Center’s concrete measures in facilitating the delivery of social protection measures for vulnerable groups and managing COVID-19 health risks were done through deep inter-departmental cooperation and rooted in the values of transparency and effective public administration. These integrated actions align with the policy framework enshrined in the 2030 Agenda for Sustainable Development and in the local context, served to promote the core dimensions of people, prosperity, and partnership.

The Center’s comprehensive, multi-level, and foresight approach to disease management has safeguarded residents’ health and safety, supported the maintenance of financial stability and security in Macao, and laid the foundations for building back better. The strong political commitment from the Macao government provides political reassurance for the sustainability of the initiative. Continuing to further optimize public health response mechanisms through the Center will be crucial to ensuring this pathway towards sustainability.

The COVID-19 pandemic is the most serious crisis the Macao SAR has faced since its establishment. Owing to its lack of economic diversification, limited land supply, and government revenues derived almost exclusively from gaming taxes, Macao was extremely vulnerable to the external shocks induced by the pandemic. In 2020, Macao experienced a 58.2% drop in real GDP, ostensibly one of the sharpest recessions recorded by the International Monetary Fund in modern history. Government revenues in the first three quarters of 2020 also fell by 66% year-on-year. However, due to accumulated revenues generated through taxes on the gaming sector and disciplined public spending, prior to the pandemic Macao recorded zero gross public debt, fiscal reserves equal to almost 95% of GDP, and had experienced almost two decades of double-digit current account surpluses. These factors equipped the government with the capacity of providing substantial financial assistance and social protection measures to minimize the burden shouldered by Macao residents and businesses. Due to increases in welfare spending to make up for shortfalls and the government’s insistence on prioritizing the protection of people’s livelihoods and health, Macao’s public expenditure rose by 20% year-on-year, demonstrating its commitment to leaving no one behind.

Gender equality in Macao is high overall and women’s equal participation in education, politics, and economic affairs has been actively promoted. According to government estimates, Macao’s 2017 Gender Inequality Index value was 0.067, ranking 14th amongst 189 countries and regions worldwide. In 2019, the government launched ‘Macao Women Development Goals’ to promote gender mainstreaming across all sectors of society to achieve gender equality and protect women’s rights. The Center has mainstreamed policy solutions for combatting gender inequality through its extensive social security measures targeted at the most economically disadvantaged, especially the elderly, the disabled, the chronically ill, and single-parent families.

Immediately following the stabilization of the first wave of COVID-19 in Macao, the government, through expert consultation and coordination with the Center, began implementing a wide range of policy and fiscal measures to stimulate domestic demand and help small-medium enterprises (SMEs) overcome the challenges they faced. These relief measures included subsidy programs for SMEs, tax reductions, livelihood support for vulnerable populations including subsidized utility payments, electronic consumption vouchers, one-time cash transfers, and tourism incentive schemes. A total of 640,000 residents claimed their consumption cards and more than 2 billion MOP$ (~250 million USD) were spent. Through the Employee, Freelancer, and Business Owner Subsidy Scheme, 307,000 beneficiaries and businesses were issued cash subsidies totaling 6.38 billion MOP$ (~796 million USD). Residents also received 600 MOP$ (~75 USD) healthcare vouchers. By liaising with trusted NGOs to reach communities of irregular migrants and setting up special ‘caring’ stations designed for the elderly and disabled for health measures like nucleic acid testing (NAT) and vaccination, the Center has ensured the inclusion of highly vulnerable groups. The Center has further promoted inclusion of those with limited digital literacy by offering numerous offline accommodations for the Health Code system, NAT, and vaccination appointments.

Following a meeting between high-level officials, the Health Bureau of Macao issued a Level III Alert on January 5th, 2020, responding to the emerging outbreak in Wuhan, China. That same day it established the “Interdepartmental Working Group Against Pneumonia of Unknown Cause” which was subsequently replaced by the establishment of the Center on January 21st. From that day forward, the Center began hosting daily press conferences at 5pm to provide updates on the development of the situation. On January 22nd, Macao confirmed its first case of the novel coronavirus and the government promptly suspended group tour visas for Mainland Chinese citizens to come to Macao. Starting from February 5th, the government mandated an unprecedented 15-day total closure of all 81 casinos in Macao, despite there only being 10 recorded cases at that time. By mid-February the government had already implemented quarantine policies for travelers from high-risk areas and announced a series of economic relief measures. On February 17th, the Personal Health Declaration app was launched. On May, 3rd the Health Code system based on blockchain technology was launched. On September 23rd, 2020, the IVS exit visa program was fully resumed after nearly a half-year suspension, which permits individual citizens from Mainland China to travel to Macao for tourism purposes, a crucial turning point for Macao’s economic recovery and the official establishment of a travel corridor between the two jurisdictions. The Center played a key role in the procurement of 1.4 million doses of vaccines, which became voluntarily available and free of charge to frontline personnel and the public in the first quarter of 2021. The Center has supported all logistical and operational arrangements for NAT and vaccination, with the maximum capacity of administering 8,000 vaccines doses and 300,000 NATs per day.

As the pandemic began to spread, the prices of critical personal protective equipment began to rise significantly and threaten supply chains. Just one day after the Center was established on January 21st, 2020, a campaign to guarantee that all Macao residents have a stable supply of surgical masks was launched. The government successfully purchased 20 million masks which were then distributed at centers throughout the city, enabling Macao residents to purchase a monthly mask supply (unit price of 0.10 USD). Now in its 35th distribution round, the guaranteed mask supply scheme has been perhaps the Center’s most crucial epidemic-control measure.

The Center’s most innovative initiatives were the launching of ostensibly the world’s first travel bubble between Macao and the Chinese Mainland and the world’s first cross-jurisdictional blockchain-based health code system to facilitate this. Due to strict border closures during the initial wave of infections, visitor arrivals to Macao declined 99.5% year-on-year to 49,730 in Q2 2020. Following the selective border reopening through a mechanism of mutual recognition, there have been 8,383,476 visitor arrivals recorded through September 2021. Despite these high volumes of cross border movements, only one family cluster of 4 imported cases has ever temporarily disrupted the travel bubble.

Under the framework of ‘One Country, Two Systems’ Macao exercises a high degree of autonomy and retains independent executive, legislative and judicial power. This means that despite being part of the same country, Macao and the Chinese mainland in fact have differential regulatory systems governing personal data protection and information exchange. Challenges related to privacy concerns and information verification on both sides meant that complex harmonization was necessary to ensure compliance with all relevant legislation, namely that of the Personal Data Protection Act of Macao, in order to successfully resume travel between the two jurisdictions. 

Under the Center’s coordination, in early 2020 the Health Bureau and the Macao Science and Technology Development Fund collaboratively developed an electronic health pass for residents to access public places, which was later extended to create the mutual recognition mechanism that facilitated travel resumption. The system is built on open source blockchain platforms FISCO BCOS (Be Credible, Open & Secure) and WeIdentity that facilitate robust, secure information exchange and verification capabilities across organizations. Private information, including ID numbers and health data, are encrypted and recorded on the consortium blockchain infrastructure that is shared between the relevant immigration and health authorities.

Although no single jurisdiction can claim a monopoly on implementing a travel corridor, the early launch (September 2020) and high-volume population flows (nearly 9 million arrivals) within the Mainland China – Macao travel bubble is notable given similar attempts to establish such mechanisms for travel around the world. For example, the border between Mainland China and Hong Kong remains closed at the time of writing, but during bilateral discussions between officials, there have been proposals to emulate the “Macao Model” for the resumption of quarantine-free travel. Beyond transferable lessons, Macao has also engaged in more direct manners of technical assistance with other countries and regions. With the support of the National Health Commission, five members of the China International Emergency Medical Team from Macao went to Algeria and Sudan to provide medical emergency assistance and share the Center’s collective knowledge and experiences in pandemic response. The Center’s efforts and Macao’s overall COVID-19 successes have been highlighted on numerous national and international media platforms - including the Global Times, South China Morning Post, The Wall Street Journal, Bloomberg, Fortune, East Asia Forum and more – increasing the likelihood of learning from Macao’s initiatives and replicating and adapting them to various local contexts.

There are many contextual characteristics of Macao, i.e. unique geography, easily regulatable border crossings, abundant fiscal reserves, etc. that cannot easily be replicated and directly transferred to other contexts, however lessons learned from Macao can still be used as a reference point for other highly urbanized and densely populated cities around the world that are heavily reliant on tourism and a mobile, cross-border workforce. For example, the Gongbei Port border checkpoint between Mainland China and Macao is one of the world’s busiest land borders (more than 134 million crossing in 2018), and its border management policies applied during COVID that safely facilitated the resumption of travel may be particularly useful for border checkpoints such as that between Singapore and Malaysia (the Woodlands Checkpoint receives a similar passenger volume) or that between Gibraltar and Spain to name a few. Likewise, the guidelines that the Center developed to allow for the safe resumption of gaming activities within casinos could be used in other cities that have gambling facilities. Perhaps most notable for other contexts though is the blockchain-based health code system that simultaneously allows for the transfer and verification of sensitive health information, while ensuring individual privacy through encryption.

Macao’s financial assistance measures in 2020, decided upon through consensus and negotiation within the Center’s constituents, totaled 52.6 billion MOP$ (~$6.6 billion USD) equivalent to 12% of GDP in 2019. This is comparable to the European Union’s fiscal stimulus packages that amounted to an 11% of share of GDP. At request of the Center, more than 10% of Macao’s total hotel room inventory of 40,000 rooms were allocated to serve as quarantine facilities for the medical observation program. All the residents in Macao have been fully supporting and cooperating in the implmenetation of the initiative.

In his 2021 policy address the Chief Executive (Chair of the Center) laid out the overall direction of his administration’s policies as – “fighting the pandemic, safeguarding employment, stabilizing the economy, caring for people’s livelihoods, implementing reform, and facilitating development”. The political commitment and policy pragmatism from the highest levels of government have laid the foundation for Macao’s post-COVID-19 economic recovery, while simultaneously protecting its constituents as vaccination rates gradually increase and herd immunity is eventually achieved. The support the Center has received, both financially and institutionally, will ensure its sustainability and capacity to fulfill its evolving mandates moving forward.

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Both. Internal evaluations are conducted on a regular basis to keep improving the effectiveness and efficiencies of the Center’s measures. The external evaluation was recently done by the Faculty of Health Sciences, University of Macao.

The internal evaluation assessed the Center’s performance towards meeting its mandated objectives measured against key operational indicators. The internal evaluation resulted in concrete practical and policy recommendations towards streamlining efficiency, maximizing impact, and strategic planning. The external evaluation is comprised of secondary data review and desk research, drawing from relevant government publications and policies, official announcements, publicly available datasets, and a non-systematic review of academic literature. It uses SDGs as a key benchmark, and highlights the technology’s essential role in COVID-management work coordinated by the Center.

The evaluations found that the Center’s ability to contain COVID-19 offers many key lessons in service delivery, community solidarity, and effective public administration. Through its convening power and central coordinating role in every major policy consultation and decision-making process related to COVID-19, the Center promoted proactive measures in a whole-of-society approach to deliver high quality results for its constituents, while leaving no one behind and fully embodying the UN SDGs. The Center further mobilized human and financial resources in an exceptional fashion and facilitated the timely resumption of public service delivery and economic activity by making innovation use of digital and frontier technologies (e.g. blockchain). The technological solutions would be a good reference for other countries in a similiar situation. The Center’s initiatives are not only sustainable but also sharable. Finally, Macao residents have been very cooperative with the government’s strategy to fight COVID-19, and this has been a decisive contributing factor to successful implementation of the Center’s policy measures. For example, in a recent survey of Macao residents, 96.4% of respondents indicated strong adherence to face mask wearing as a precautionary personal hygiene measure.

The Center was created on January 21st 2021 via Executive Order No.23/2020 and is directly under the supervision of the Chief Executive, who serves as the Center’s chairperson. The Center’s other members include high-level representatives from more than 20 government agencies and departments, solidifying the institutional relationships between the key operational actors necessary to achieve the Center’s mandated objectives. The Center draws together cross-sectional expertise to formulate policy through consensus. At the Director level, the Center includes the Director of the Health Bureau and the Director of the Office of the Secretary for Social Affairs and Culture (who serves as the vice chairperson). At the Representative level, the Center’s members include the following entities: Office of the Secretary for Social Affairs and Culture; Customs of Macao Special Administrative Region; Government Information Bureau; Urban Services Department; Public Security Forces Affairs Bureau; Fire Services Bureau; Judiciary Police; Civil Aviation Authority; Marine and Water Bureau; Office of the Secretary for Economy and Finance; Education and Youth Development Bureau; Social Welfare Bureau; Macao Government Tourism Office (recently merged to include the Tourism Crisis Management Office); and Consumer Council. The financial, administrative, and logistical support of the Center is the responsibility of the Health Bureau.

The Center was created on January 21st 2021 via Executive Order No.23/2020 and is directly under the supervision of the Chief Executive, who serves as the Center’s chairperson. The Center’s other members include high-level representatives from more than 20 government agencies and departments, solidifying the institutional relationships between the key operational actors necessary to achieve the Center’s mandated objectives. The Center draws together cross-sectional expertise to formulate policy through consensus. At the Director level, the Center includes the Director of the Health Bureau and the Director of the Office of the Secretary for Social Affairs and Culture (who serves as the vice chairperson). At the Representative level, the Center’s members include the following entities: Office of the Secretary for Social Affairs and Culture; Customs of Macao Special Administrative Region; Government Information Bureau; Urban Services Department; Public Security Forces Affairs Bureau; Fire Services Bureau; Judiciary Police; Civil Aviation Authority; Marine and Water Bureau; Office of the Secretary for Economy and Finance; Education and Youth Development Bureau; Social Welfare Bureau; Macao Government Tourism Office (recently merged to include the Tourism Crisis Management Office); and Consumer Council. The financial, administrative, and logistical support of the Center is the responsibility of the Health Bureau.

One important lesson learned is that the Center can never be static. Despite the low number of confirmed cases (77 in total until today), the Center remains constantly alert, flexible and future-oriented. It adjusts policies and measures based on the new local and global development, uses foresight to design coping measures, and embodies SDGs values such as inclusion, partnership, and engagement in every intiative developped. For example, to improve the accessibility and accommodate the elderly, disabled, and migrant workers, the Center has implmented a series of measures, such as incresasing nucleic acid tests stations from 41 to 52, and setting up green lines for them to receive vaccinations etc. . Currently the Center is developing artificial intelligence enabled chatbots to streamline inquires from the SMS-based and social media enquiry hotlines. A contact tracing application that ensures data protection is also in its final development stages and has been launched recently. The Center will continue to develop continency plans in consultation with its constituents, private sector, NGOs, civil society, and general public, to ensure an inclusive approach for Covid-19 management.