Taiwan's WHO Membership as Necessary Response to the Rising Threat of Newly Infectious Diseases

Failure to integrate Taiwan into the global health network leads to danger; for the infectious diseases will not only threaten the Taiwanese population and national security but will also eventually threaten the entire world. Thus, it is urgent for Taiwan to join the WHO.

When the World Health Organization (WHO) confirmed the death of a Chinese soldier from Avian Influenza on June 4th, one cannot help but relate this ominous event to the 2003 SARS outbreak, which was a haunting experience for Taiwan, the WHO and the entire world community. The fundamental root of the SARS epidemic lies in countries’ unfamiliarity with newly infectious diseases, which precluded them from recognizing the importance of systematic surveillance and prevention network. However, one should not forget China’s role in this outbreak. It was China’s self-interested, intentional restriction of information that delayed the efforts to control the epidemic and thus increased the scope of the damages.

Taiwan’s geographic location allows it to become a convenient transit point for trade, transportation and tourism. Unfortunately, it also becomes a transit spot for SARS virus and other infectious diseases. Such negative “exposure” is costly—in 2003, the SARS epidemic caused massive infection and deaths of health personnel, shutdowns of hospitals, quarantine of more than 151 thousands people, travel restrictions (which drastically reduced the number of tourists visiting Taiwan), shutdowns of schools and other costly measures. During the beginning of the epidemic Taiwan took immediate initiatives to provide the WHO relevant information, but China’s constant meddling forced the latter to remain silent. It was not until several weeks later when the WHO finally responded by sending two WHO officials to Taiwan, and it was the first time Taiwan has ever received any official WHO representative since 1972.

The 2003 SARS epidemic and the impact it had on global economy and wellbeing heightened the importance of a more throughout surveillance and response network. Such need finally led international community to the acknowledgement of Taiwan’s significance and effort to integrate Taiwan into the global health network: in 2004, Taiwan’s health specialists were invited to several WHO-sponsored conferences regarding newly infectious diseases; meanwhile, Taiwan was granted the WHA Observer status with overwhelming approval and even public supports from the US and Japan. Those supports, however, could not overcome China’s constant intervention, which consists of the greatest obstacle for Taiwan.

The following instance further reveals China’s determination to exclude Taiwan from the WHO. In 2005, the WHO passed the International Health Regulations (IHR). What is significant about IHR is its Article 3, Clause 3, which states the following: “The implementation of these Regulations shall be guided by the goal of the universal application for the protection of all people of the world from the international spread of disease.” The clause’s emphasis on universal application serves to legitimize Taiwan’s official participation in the world health community. In response, China immediately signed a Memorandum of Understanding with the WHO Secretary in which both sides agreed to establish numerous conditions. Those conditions consist of obstacles that prevent Taiwan from successfully participating in WHO’s technical meetings. Having a Chinese serving as WHO’s Director-General adds to the multi-layered restrictions that China has put on Taiwan’s path to WHO membership.

As indicated above, those moves not only hurt Taiwan but also the international community. By yielding to political pressure rather than upholding fundamental “Health for all” and IHR principles, the WHO’s behaviors increase the likelihood of another flu epidemic, which will cause severe consequences—based on WHO and World Bank’s calculation, another flu epidemic will cost about 2-7 million deaths and 1.25 trillion dollars of economic loss. One should not ignore the losses that those seemingly minor behaviors can potentially generate.

Avian Flu is now the most prevalent and worrisome infectious disease. Statistics show that 59 countries have already reported cases of animal infection with H5N1 virus, while 12 countries have confirmed human cases of avian influenza infection (http://www.who.int/csr/disease/avian_influenza/country/en/index.html). The overall mortality in reported H5N1 cases is about 60% and is highest in Asia. As of now, China has the highest mortality—in June 15, there are 25 people infected and 16 people who died from Avian Flu. Although Taiwan is the only Asian country with no known human and animal cases, its geographic proximity and extensive contacts with other Asian countries greatly increases its exposure to such risk.

Infectious diseases, such as SARS and Avian Flu, are not the only risks that Taiwan faces. According to several research findings, Taiwan’s geographic proximity to the heroin trade in Southeastern China resulted in the transmission of a particular strand of HIV from the drug trade region to Taiwan. Smuggling, which is another form of illegal trade, also exposes Taiwan to greater health risks—live poultry, illegal medicines and low-quality (which often contain poisonous ingredients) toiletry products from China often end up in Taiwanese markets, which are then purchased and consumed by Taiwanese people. Those illegal activities require transnational surveillance, information sharing and crime prevention, but so far there is little progress in this area.

For both Taiwan and China, both sides would have to cooperate closely to reduce the threats posed by infectious diseases, and this requires Taiwan to have equal access to WHO rights and treatments as China. As IHR has been effective since June 15th, the WHO is obligated to implement the IHR and allow Taiwan to enter the Global Outbreak Alert and Response Network (GOARN). Fulfilling the IHR, which does not give Taiwan carte blanche to the WHO but nevertheless allows the latter to truly participate in WHO-sponsored activities, is not just a task that the WHO needs to uphold. It is also a way for the WHO to commit and respect the basic human rights of 23 million Taiwanese people.