A few days ago, Taiwan again received an invitation to attend the World Health Assembly (WHA) as an observer. Officials of related government ministries are all overjoyed at the invitation, which they attribute to warming cross-strait relations and the success of Taiwan’s “diplomatic truce” with China.
However, since Taiwan’s attendance at the WHA last year, neither medical professionals nor the general public have got the feeling that we are taking part in the WHO at all. While those at the top are fired up with enthusiasm, the rest of us have been left out in the cold.
In the present global setup, Taiwan’s participation in any kind of international organization is bound to be influenced by cross-strait interaction and rivalry. Be that as it may, to invest all our hopes in so-called “cross-strait harmony,” without thinking, daring or even desiring to deepen our meaningful participation in the WHO, is a hindrance to Taiwanese people’s access to their health rights. By focusing on the symbolic while neglecting practical issues, this attitude amounts to giving up without a fight.
This year, Taiwan received its invitation to attend the WHA on the same day as all the WHO member countries. Government officials read this as indicating that Taiwan’s participation in the assembly has been “normalized,” but they are intentionally overlooking a number of practical obstacles that Taiwan faces.
First, we should call for the May 2005 memorandum of understanding (MOU) between China and the WHO on Taiwan’s participation to no longer be applied. In it, contact between Taiwan and the WHO was to take place under the framework of a “one China” policy. Even after Taiwan gained observer status at the WHA, the MOU is still in effect. This observer status only allows Taiwan to attend the annual assembly, and interaction with the WHO when the WHA is not in session is another matter.
In this respect, there are fairly clear regulations with regard to those observers whose status was bestowed through a resolution of the WHA, such as the Palestinian Authority. The constitution and other official documents of the WHO have no clear regulations in this respect regarding other observers, including tiny sovereigns like the Holy See and non-governmental organizations like the International Committee of the Red Cross. That means that the only legal basis for Taiwan’s participation is still the MOU.
Unfortunately, since last year, government departments have been ignoring this problem. The MOU downgrades Taiwan’s status at the WHO — a UN-associated body — to that of a local Chinese government and prevents Taiwan from using its national title. There have been several instances of contacts between Taiwan and the WHO having to wait for China’s approval before they could go ahead.
Chen Chien-jen (陳建仁), an epidemiologist at the Academia Sinica, reported that it had even proved impossible for Taiwanese experts to be invited to write a monograph for a WHO-peripheral independent body, the International Agency for Research on Cancer. This shows how pervasive the MOU’s influence is.
Second, we should keep trying to consolidate our participant status by means of a WHA resolution or other legal mechanism of the WHA. The matter by which Taiwan received observer status last year was quite unique in that neither did we submit an application to the WHO head, nor did the assembly approve our participation through a resolution. At no time during the assembly did WHO Director-General Margaret Chan (陳馮富珍) officially mention the presence of a Taiwanese delegation and she was absent from the meeting when then-health minister Yeh Ching-chuan (葉金川) spoke. In short, Taiwan arrived at the assembly unannounced and left in the same way.
It is clear that Taiwan’s participation is almost entirely dependent on China’s “goodwill.” However, one thing Taiwan’s government and opposition agree on is that our side alone cannot control the hidden intricacies of cross-strait relations and we must make provisions for the possibility that the rug could one day be pulled out from under our feet. That is why we must try our utmost, by various means, to consolidate the legal basis for Taiwan’s participation in the WHA and WHO.
Finally, the government’s “diplomatic truce” policy has still not enabled Taiwan to take part in the international tuberculosis prevention network, or get hold of information related to stemming the global trade in fake medicines, or to become a signatory to the WHO Framework Convention on Tobacco Control, and so on. Even government officials admit that Taiwan still faces obstacles regarding these matters.
At the same time, we also need to communicate with other countries and international bodies to seek their understanding and support. The complexity of global health issues has given rise to the need for global health control structures. Governments and NGOs alike have important roles to play in sharing epidemiological information and setting medical standards and we should try to take part in these efforts.
A more fundamental question, however, is whether we should see our participation in the WHO as a starting point for involvement in global health affairs, or merely as a “token of love” from our negotiating partner on the other side of the Taiwan Strait.
Lin Shih-chia is executive director of the Foundation of Medical Professionals Alliance in Taiwan.
TRANSLATED BY JULIAN CLEGG
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