On Feb. 21, Taiwan again missed the opportunity to be included in the World Health Organization's (WHO) International Health Regulations (IHRs).
If the WHO is the most important international organization for dealing with global health and epidemics, then the IHRs provides the WHO with the legal basis for adopting relevant measures. In contrast to the Kyoto Protocol, which has not been signed by the US, China, Australia and other countries due to economic concerns, Taiwan is the only country left outside the IHR. No doubt, the 23 million Taiwanese feel that this is a kind of "health prejudice."
The IHRs had not been revised since 1981. And since the late 1990s, every WHO member has made repeated calls for a revisions of them. The SARS epidemic of 2003 persuaded the WHO to speed up revisions in the hope that they be able to ratify them at the World Health Assembly (WHA) in May. The IHR meeting on Feb. 21 may have been Taiwan's last chance to be included in the IHRs.
Generally speaking, any WHO member can participate in IHR discussions to ensure that it will enjoy WHO guarantees when it comes to public health, transportation and communications issues. The recent IHR revisions detail what consitutes an epidmic and set detailed procedures for the deployment of food and personnel to help prevent the spread of possible large-scale epidemics.
Another major characteristic is the establishment in each country of epidemic report stations directly connected to the WHO. Officials therefore want inclusion in the IHRs to gain at least a semblance of WHO participation.
Since Taiwan is not a WHO member, the nation has been excluded from the whole process. At the IHR working meeting late last year, officials asked Taiwan's ally Nicaragua to propose that territories with independent medical systems also be included in the IHRs, instead of including only WHO members and observers.
Taiwan's use of the title "health entity" to gain observer status to the WHO, is another step backward for national sovereignty, but despite this retreat, China has not backed down from its hard-line stance on Taiwan's exclusion. The nation's suppression on Feb. 21 once again shows that Taiwan's playing down of national sovereignty is futile.
Looking at WHO operations and regulations, Taiwan must -- if it ever wants to gain WHO membership -- submit two applications to be subjected to a vote within one year; first at the meeting of the WHO executive committee in January, and then at the meeting of the WHA in May.
Since President Chen Shui-bian (陳水扁) has repeatedly stated that Taiwanese membership in the WHO within a two-year period is a major policy objective, he is left with just four more opportunities. Regrettably, officials didn't seeks the opportunity to join the WHO during last month's meeting of the executive committee. It seems they are placing all hope on being included in the IHRs.
The results can already be seen: Giving up on the executive committee and placing all hope on the IHRs has led to nothing.
I know that given the current international situation, Taiwanese membership may be difficult, but it not impossible. Officials therefore have to reconsider relevant strategies and approaches, because even if we fail in the executive committee, there is an opportunity for Taiwan to hold up China's despicable behavior for the world to see, as well as an opportunity for Taiwan to participate on this issue.
But if officials take a defeatist attitude or provide the government with false information, they may cause it to issue big political promises and place the health of the people of Taiwan at risk. Who should be held responsible for such an outcome?
Wu Shuh-min is the president of the Foundation of Medical Professionals Alliance in Taiwan.
Translated by Perry Svensson
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