The 71st World Health Assembly (WHA) took place in Geneva, Switzerland this past week from May 21 to 26. For the second year in a row, Taiwan was denied participation even as an observer. Given Taiwan’s contribution to global health and disease prevention, why was Taiwan denied an invitation? The clear answer is: “Because of Beijing’s pressure!” Taiwan’s Mainland Affairs Council (MAC), the cabinet-level agency in charge of cross-Strait relations, called out China’s politicization of the international organization, pointing out that “China’s move not only violates the World Health Organization’s Constitution but also constitutes deprivation of the rights of Taiwan’s people. […] Health is a universal value and knows no borders, and the right to health of Taiwan’s people should be protected.”
The latest outbreak of Ebola in the central African nation the Democratic Republic of Congo (DRC) once again underscored the global nature of diseases. This new outbreak was defined by the World Health Organization (WHO), which is the main body of the WHA, as a “public health emergency of international concern.” The previous Ebola outbreak in West Africa in 2014-2016 claimed 11,308 lives. When US Secretary of State John Kerry appealed to the international community to help the countries in West Africa afflicted by the previous outbreak, Taiwan immediately provided assistance, even though Liberia, Sierra Leone, and Guinea are not diplomatic allies of Taiwan. Nevertheless, Taiwan “donated 100,000 sets of personal protective equipment, along with $1 million in cash, to meet the most urgent needs of stricken patients in Liberia, Sierra Leone, and Guinea. Taiwan then established a training center to help equip health workers in the Asia-Pacific region with the tools needed to contain an outbreak of Ebola or other dangerous infectious diseases.” On May 26—despite being prevented from participating in the WHA—Taiwan pledged to donate US $1 million to combat Ebola.
Taiwan’s Ebola interventions in Africa is just one of its many contributions to global health and disease prevention. Taiwan is 4th in the world and 1st in Asia when it comes to medical technology, public hygiene, and transplants. Even as an unrepresented leader in global health, not only does Taiwan have one of the best national health care systems in the world, it also has one of the most competitive biomedical industries in Asia. Taiwan is among the leading nations when it comes to scientific research to improve prevention and detection of diseases. For instance, a new device to self-test dengue and zika viruses will reportedly be available for purchase in Taiwan in August. This new tool produced by a startup medical firm will allow people to verify, with a drop of blood, if they have the virus or not. The novelty is that it is a self-test (no need of medical professionals) that is done in 9 minutes and with 90-95 percent accuracy (while lab tests would take up to 5 hours). Taiwan also provides international aid and health assistance that since 1996 has amounted to US $6 billion benefitting people in 80 countries. Taiwan has one of the highest medical standards in Asia, and it also complies with international agreements regarding global health instituted by the very organizations that do not allow Taiwan to participate. Finally, Taiwan provides global health support, training, and aid even to those nations that do not recognize Taiwan because it believes in the universality of health care.
Even though Taiwan was not invited to the WHA, a Taiwanese delegation went to Geneva to hold an exhibition that showcased Taiwan’s medical care achievements, including a presentation by the Taiwan United Nations Alliance (TAIUNA), the Tyzen Hsiao Culture and Education Foundation, the Taiwan Medical Association, and the Medical Professional Alliance in Taichung, titled “Hospital Without Borders.” Also, the International Cooperation and Development Fund (ICDF) based in Taipei showcased the projects it carries out in Belize, and Saint Kitts and Nevis regarding prevention and control of chronic kidney disease, and training of local doctors. Since 2006, Taiwan has dispatched 100 mobile medical teams to more than 20 countries, including a team of doctors this past February from Asia University Hospital (AUH), Kaohsiung Medical University, and I-Shou University Hospital that traveled to the remote regions of the Amazonian forest of Peru to provide free medical checkups to the Indian tribes of the area. Since its foundation in 2002, the Taiwan International Health Training Center has trained 1,500 professionals from 62 countries, in “cutting-edge medical technology, emergency and healthcare management and traditional Chinese medicine.” The organization’s mission is to realize “the principle in the World Health Organization Constitution stating that the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being.” Additionally, as Taiwan’s President Tsai Ing-wen said during her speech via video before the Universal Health Coverage Forum this past week “in order to provide healthcare for all, Taiwan implemented the National Health Insurance (NHI) in 1995 […] For many developing countries, Taiwan’s NHI is a good model to achieve universal health coverage. I believe our experiences can serve as a paradigm, and we are happy to contribute our share to the health and welfare of all people in the world.”
As Universal Health Coverage is the focus of this year’s WHA, then why does the WHA (and WHO) not include the very country that has one of the most successful national health care insurance plan to join and share their know-how? Moreover, given all that Taiwan does for global health, why is it not allowed to participate to the WHA? And why is this important?
While Taiwan was allowed to attend the WHA from 2009 to 2016 (under the name of Chinese Taipei), since DPP President’s Tsai election in 2016 Taiwan has been barred from even participating as an observer. However, Taiwan’s exclusion from attending and participating in meetings regarding global health, not only hurts Taiwan, but the entire world. As Minister of Health and Welfare Chen Shih-chung (陳時中) pointed out “infectious diseases are no respecters of borders and outbreaks can spread rapidly to endanger people anywhere and everywhere around the world. It is therefore important that Taiwan participates in the WHA so that it can be included in the international response system to outbreaks of infectious disease and to share its expertise in those areas.”
Indeed, China has been squeezing Taiwan out of many international organizations even despite the support of many countries that have lobbied in favor of Taiwan’s participation, in particular at this year’s WHA. Among these supporters is the United States. Secretary of the US Department of Health and Human Services Alex Azar said during his speech at the WHA that the United States is disappointed by the decision of the WHA and WHO to not let Taiwan participate. He pointed out the importance of cooperating globally to fight infectious threats that can spread anywhere, and he added that “it is difficult to reconcile our shared concern over cross-border infectious diseases with excluding representatives of the 23 million people of Taiwan from this gathering.” This feeling of disappointment over Taiwan’s exclusion and how it contradicts the very theme of this year’s WHA, which is universal health, was also expressed by many representatives of Taiwan’s diplomatic allies, such as the Minister of Health and Medical Services of the Solomon Islands, and similar representatives from St. Kitts and Nevis, Paraguay, Nicaragua, Haiti, and many more.
By not participating in the WHA, Taiwan is excluded from having access to the International Health Regulations (IHR) through which countries can “directly contact the WHO and receive information on outbreaks and other health events.” Because of this exclusion Taiwan did not receive timely information regarding the outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003, which led to many deaths. As Taiwanese Vice-President Chen Chien-jen (陳建仁) pointed out, Taiwan needs “the most updated information about global health. […] Every year more than 60 million passengers stop by Taiwan’s airports and we need to vigilantly monitor for any kind of infection. Also, we would like to get strategies for early diagnosis of so-called mysterious or newly emerging diseases, the diagnosis and how to treat and control them. This information is disseminated and shared in the WHA.”
The main point: Taiwan is a crucial partner in global health security. Not only Taiwan provides global health assistance, shares its know-how with any other countries regardless if they recognize Taiwan or not, but also Taiwan’s inclusion is essential for Taiwan to gain information from the WHO about new outbreaks. Global health issues have no borders, as such there should be no reasons to exclude Taiwan from international health organizations and meetings.