Moving Toward a Better Life
Publish Date: 05/01/2004
Story Type: FOREIGN RELATIONS
Byline: PAT GAO
PHOTOS BY HUANG CHUNG-HSIN
Increasingsupport from the international community
and a new naming approach have significantly improved
Taiwan's chances to gain observer status in the World
Health Assembly.
In early March 2003, when the first case of severe acute respiratory syndrome (SARS) was reported in Taiwan, the country immediately asked for assistance from the World Health Organization (WHO). The global healthcare body, however, did not send its experts until two months later, only after the first SARS intra-hospital transmission broke out in Taipei, and fears spread that the infectious disease was out of control. "China's representative said in the 2003 World Health Assembly (WHA) that it had helped Taiwan by requesting that the WHO send representatives to the island as well as sending China's SARS data on to Taiwan's medical officials," says Chen Chien-jen, an epidemiologist who became the minister of the Department of Health during the SARS crisis. "But that was a big lie."
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| WHO's experts came to Taiwan only after the first SARS intra-hospital transmission broke out at the Hoping Hospital in Taipei. |
It is unlikely that anyone in the WHO will contradict China's story, for Taiwan is not even an observer in the WHA, the WHO's annual meeting. Taiwan is working to secure observer status, after having lost its membership in the WHO since its 1971 withdrawal from the United Nations. Taiwan could get observer status if the WHO secretary-general issues an invitation or if the member states secure enough votes for Taiwan's participation, but both approaches have failed since 1997 because of Beijing's opposition. Taiwan's allies, however, have continued to present proposals to the WHA calling for international recognition of the country as a natural and inseparable part of the global healthcare system.
Each May, when the WHA is held in Geneva, Taiwan's medical groups, scholars, and politicians go to Switzerland to promote the bid for Taiwan's observership at the meeting. A member of the Foundation of Medical Professionals Alliance in Taiwan said that long rounds of applause followed speeches made by Taiwan's allies in the WHA in support of the country's affiliation with the WHO during one of the group's Geneva trips. She also says that the participants were silent after Beijing's representative spoke out against Taiwan's status.
A doctor at the Taipei Veterans General Hospital, Dr. Deng Jou-fang, who also belongs to the foundation, was among the first activists to campaign for Taiwan's participation in the WHA. "We were there to make an issue of Taiwan's isolation in the international community," he says. Now, as director of the Taiwan International Medical Alliance, Deng is doing what he believes is an even more fundamental job--lobbying in the home countries of WHO members. When he visits European and Asian countries, he targets officials in charge of foreign and health affairs, parliamentarians, and doctors' groups.
Deng says his years of lobbying are finally paying off and that the international community is much closer to offering Taiwan a hand. For example, in February this year, the US House of Representatives and Senate passed bills calling for Taiwan's participation in the WHO. Also, the head of the US Department of Health and Human Services and the Japanese health minister have made official statements in support of Taiwan. In addition, major international medical groups such as the World Medical Association, International Council of Nurses, and International Pharmaceutical Federation have either sent letters to the WHO or issued press releases advocating Taiwan's move to seek the observer status in the WHA. "In the medical community, the support can't get broader because it's nearly absolute," says Jorg-Dietrich Hoppe, president of the German Medical Association. "There is no debate about whether Taiwan should be a member of the WHO and participate in the world's efforts in the medical community."
Such support is only natural, for good healthcare is a basic human right, says Chen Chien-jen. Without direct access to information and resources in the global health network, Taiwan has had to fight diseases on its own. In addition to the SARS outbreak, Taiwan had to cope with the 1998 outbreak of enterovirus 71, a solitary battle that killed 70 children and infected over 1,000. Foreign assistance did come, but only belatedly and indirectly through private channels. "The WHO sets forth in its charter the objective of attaining the highest possible level of healthcare for all people," says Chen, who heads a committee that integrates the resources from various ministries and departments to promote Taiwan's case. "So the WHO has no reason to ignore the health of Taiwan's 23 million people. Proper healthcare is an essential part of their human rights." Chen says that Taiwan's population is even larger than that of three quarters of the WHO's member states.
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| Taiwan has one of the best healthcare systems in the world, and it wants to share its knowledge and management skills with the international community. |
Song Yann-huei, research fellow and deputy director of the Academia Sinica's Institute of European and American Studies, elaborates on human rights and health issues concerning Taiwan's WHO campaign. "We have the right to participate," he says. "We have the right to maximize our potential through data collection, competition, and free association with the world's medical professionals. That's why we should actively try to join international organizations such as the WHO." He also says that the concept of human security has expanded from the traditional category of military threats to cover such concerns as the environment, food quality, and healthcare. "And joining the WHO is an important way to ensure the nation's health," he says.
In the meantime, Taiwan's exclusion from the global health body has kept the world from benefiting from Taiwan's medical innovations and its progress on health reform. In addition to having one of the highest levels of life expectancy in Asia, Taiwan has successfully eradicated infectious diseases such as the bubonic plague, cholera, smallpox, and polio. Its program to control the spread of hepatitis B since the mid-1980s is also noteworthy. In 1984, Taiwan became the first country in the world to implement a hepatitis B immunization program, which provides children with free vaccinations. Consequently, the rate of liver cancer has dropped significantly.
Chen is especially proud of Taiwan's National Health Insurance program, which was launched in 1995, for its high coverage (over 95 percent of the total population), low fees, and public support. Each year, more than 30 countries send medical and government officials to Taiwan to study the program. "It's a very developed healthcare system that delivers very comprehensive and high-quality care to everyone in the country," Hoppe says. "This of course is a model for other countries, and it's very important that the expertise and experience of Taiwan be made accessible to other countries. The WHO is an appropriate channel for such exchanges." Chen also points out that Taiwan's famed expertise in information technology could help other countries establish an electronic healthcare system.
Taiwan's status quo relationship with China has impeded Taiwan's efforts to participate in the international community while Beijing continues to stick with the "one China" policy. "Over the past several years, there has been a lack of understanding and trust between Taipei and Beijing," says Song. "But the basic human right of access to proper healthcare should be addressed in an international framework that excludes political factors." Chen also suggests that future cross-Strait talks should include health issues as one of the top concerns. "I can't imagine that these issues are less important than the ongoing economic, cultural, academic, or artistic exchanges," he says.
It seems, nevertheless, that Song's nonpolitical angle is making progress. In addition to Taiwan's accession to the World Trade Organization as a separate customs territory, another functional term of membership in international organizations has emerged in the fishing industry. In 2000, Taiwan's representatives signed the Arrangement for the Participation of Fishing Entities in Honolulu in accordance with the Convention on the Conservation and Management of Highly Migratory Fish Stocks in the Western and Central Pacific Ocean. When the organization convenes its first meeting, which will consist of Taiwan and the members of the convention, Taiwan will become a full member as a "fishing entity." Modeling its approach on this breakthrough, the government decided last year to use the designation "the health entity of Taiwan" rather than try to enter the WHO as the Republic of China or Taiwan.
Chen thinks this approach is likely to succeed within the next two years, and Deng's international lobbying is also bearing fruit. Chen emphasizes the magnitude of such an accomplishment. "Once we're in, it'll be the start of a long journey, one that will enhance our understanding and offer us a chance to further contribute to the international health community."
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