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By Hou Sheng-mou, Minister, Department of
Health, Taiwan (R.O.C.)
The World Health Report 2007—A Safer Future:
Global Public Health Security in the 21st Century, issued by the
World Health Organization (WHO), elucidates the importance of
cooperation and information sharing among countries in the fight
against disease. It emphasizes that more resources are required to
establish a seamless global disease prevention network. WHO
Director-General Margaret Chan stresses in her message published in
the report that “international public health security is both a
collective aspiration and a mutual responsibility . . . The new
watchwords are diplomacy, cooperation, transparency, and
preparedness.”
We highly approve of the importance the WHO
attaches to health security because as one of the main victims of
the 2003 SARS (severe acute respiratory syndrome) epidemic, Taiwan
had to learn firsthand that once a gap appears in the health
security system, epidemics can spread with alarming rapidity and
seriously impact the global economy and trade. Given today’s high
level of social mobility, maintaining international health security
has become more urgent than ever and requires close cooperation
between all countries. There is no space for loopholes or lack of
transparency in the disease reporting system.
Situated in the West Pacific, Taiwan plays a
vital role in disease prevention. Every winter, nearly 1.25 million
migratory birds of 351 species fly from Siberia and China to Taiwan,
either to stay for the winter or to continue on to the Philippines,
Indonesia, Malaysia, or Australia. In the event of an outbreak of a
lethal strain of bird flu that is highly communicable between human
beings, the exclusion of Taiwan’s 23 million people from the WHO
could make it extremely difficult for the global health network to
control the international spread of the disease.
Taiwan’s determination to participate in the
global health network and the sincerity of its motives have been
made abundantly clear to the international community. On its own
initiative, it began implementing the revised International Health
Regulations (2005) one year before they came into force in 2007, and
has now completed all necessary preparations mandated by the
regulations. Taiwan continues to be excluded from the IHR (2005)
notifiable disease reporting system, however, and is thus unable to
immediately access information on disease outbreaks in other parts
of the world or report local outbreaks to the WHO.
Regrettably, the WHO Secretariat and China
signed a secret memorandum of understanding in 2005, stipulating
that the WHO must receive clearance from Beijing before engaging in
any interaction with Taiwan. Undeniably, this agreement seriously
hampers disease prevention efforts and violates the rights of
Taiwan’s people. Following the shigellosis outbreak in Denmark
associated with baby corn exports from Thailand in September 2007,
for example, the WHO conveyed the news to China, but it took China
ten days to notify Taiwan about this health threat. We were lucky
this time round: Our Department of Health confirmed that none of the
affected corn had been imported. Though infection by the Shigella
bacterium is seldom life-threatening in adults, this example
underlines the risk incurred by leaving Taiwan out of the global
health network.
Since Taiwan is a sovereign and independent
nation, its public health system differs entirely from that of
China. If an epidemic broke out in Taiwan, China could not replace
Taiwan in monitoring it and providing assessments and reports to the
WHO.
Such events and considerations demonstrate that
the dependence of Taiwan and the WHO on China as a go-between for
the transmission of epidemiological information inevitably creates a
serious gap in the global disease prevention network. They
underscore the necessity and urgency of establishing a direct
communication channel between Taiwan and the WHO.
The first Director General of the WHO, Brock
Chisholm, was right when he said, “We cannot afford to have gaps
in the fence against diseases, and any country, no matter what its
political attitudes or affiliations are, can be a serious detriment
to the effectiveness of the WHO if it is left outside.”
It is important that health should be regarded
as a worldwide question, quite independent of political attitudes in
any country in the world.” In this era of globalization, the risk
to human health and the consequences of the responses we make have
long since expanded beyond the boundaries of individual sovereign
countries and become issues that must be handled within the
framework of a global governance regime. No country can be excluded.
Taiwan is doing everything in its power to
engage in constructive cooperation and fulfill its responsibility so
that global health security can be guaranteed. Can the same be said
of the WHO?
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