Shieh Jhy-wey, Minister of Taiwan's Government Information Office
In May 2005, the World Health Assembly (WHA)-the governing body of the UN World Health Organization (WHO)-enacted a thoroughly revised set of International Health Regulations (IHR). This marked a significant milestone in the history of cooperative efforts of governments to counter the increasing risk of cross-border spread of infectious diseases. Not the least reason for this appraisal is the addition to the IHR (2005) of Paragraph 3, Article 3, which reads as follows:
"The implementation of these Regulations shall be guided by the goal of their universal application for the protection of all people of the world from the international spread of disease."
The insertion of this "universal application clause" was motivated by the resolve of WHO member states to remove political barriers to comprehensive implementation of the regulations. It was aimed at empowering the WHO to communicate and cooperate with "all people of the world" regardless of whether they are citizens of member states.
Taiwan is excluded from the WHO for purely political reasons, and this exclusion undercuts the health security of its people. We therefore warmly welcomed this amendment to the IHR and looked forward to close cooperation with the WHO in IHR-related affairs. We must point out, however, that the WHO Secretariat has continued to spurn Taiwan's participation in cooperative efforts to implement the regulations, perpetuating the existence of a dangerous hole in the disease prevention network.
With the approach of the May 19-24 meeting of the WHA, therefore, it is vital that the leadership and member states of the WHO face up to this disturbing reality.
After all, Taiwan is home to 23 million people (more populous than three quarters of WHO member states) and is one of the world's busiest international transportation and shipping hubs. Every year, some 150,000 international flights carrying over 22 million air passengers pass through the Taipei Flight Information Region, and over 50,000 ships carrying hundreds of millions of tonnes of cargo traverse our territorial waters. A sizeable proportion of that traffic transits through Taiwan's airports and seaports. Hence, Taiwan must be acknowledged as a critical node in any credible global disease monitoring and prevention network-as the frightening SARS epidemic of 2003 so tragically illustrated.
WHO leaders have failed to heed this reality and to act in line with their avowed goal of pushing for universal application of the IHR. On the contrary, they have tied their own hands: On the eve of the WHA's enactment of the IHR (2005), the WHO Secretariat signed a secret memorandum of understanding (MOU) with China wherein, reportedly, it promised that the WHO would not communicate with Taiwan's health authorities on any matter, or invite them to take part in any WHO activity, without China's consent.
The MOU was characterized as a measure that would facilitate communication between the WHO and Taiwan in compliance with the IHR (2005), based on the premise that China has the legal authority, ability, and willingness to look after Taiwan's health affairs. Nothing could be further from the truth, however.
Politically, Taiwan and China are separate sovereign entities that do not exercise jurisdiction over each other's territories, although they share confusingly similar official names-the Republic of China and the People's Republic of China, respectively. China therefore cannot legitimately represent Taiwan's people in the international community. In practical terms, China is barely able to cope with its own public health problems, let alone take care of Taiwan's health interests. Moreover, events have shown that China has used the MOU to obstruct, rather than facilitate, implementation of the IHR with respect to Taiwan.
Now, almost three years after enactment of the amended IHR, it is time to assess whether the regulations' underpinning vision of a seamless disease prevention network is being furthered or hindered.
Such an assessment will reveal that, due to Taiwan's continued exclusion, a gaping hole in the global health security system remains. Further, it will show that the primary cause of this very real risk to world health is the WHO's reluctance-stemming from political concerns-to take action to implement the updated regulations universally.
Though Taiwan is not a WHO member state, it is a staunch proponent of the values and principles underlying the revised IHR (2005). As an economically advanced democracy, we are well-equipped to help implement IHR rules and standards and, indeed, are independently striving to do so in every possible way. We cannot act with maximum efficacy to prevent or respond to health crises, however, unless our health and customs authorities are fully integrated into the global health security system.
We in Taiwan look forward to playing a more powerful role in the cooperative fight against the international spread of disease. And we hope that WHO member states will call for an end to the secret dealings that prevent us from doing so. |
