Thursday, April 18, 2002
Introduction
May 10, 2002, marks the 30th anniversary of Taiwan’s absence from the World Health Organization. Taiwan, a co-founder of the World Health Organization in 1948, was a member for 25 years. But Taiwan withdrew its participation in all U.N.-sponsored organizations when the People's Republic of China was admitted to the United Nations in its place in 1972.
A quarter-century ago, both Taiwan (formally, the Republic of China) and the People’s Republic of China claimed to be the one official “China.” Thus, in the eyes of both, membership in U.N. organizations by one precluded membership by the other. But as Taiwan has grown and prospered, become a democracy, and abandoned its claims to the mainland of China, this all-or-nothing approach has softened.
During recent years, Taiwan has attempted repeatedly to rejoin the World Health Organization not as a sovereign state (which would challenge Beijing’s claim to being the “one China”), but rather as an observer.
It is high time that observer status is granted to Taiwan. Taiwan’s inability to participate in the World Health Organization, which is responsible for combating disease outbreaks and providing emergency medical assistance, has repeatedly resulted in the unnecessary spread of preventable illness—as well as the unfortunate loss of thousands of lives. There is a perfect opportunity to rectify this, when the organization’s governing body of 191 member states—the World Health Assembly—meets May 13-17, 2002, in Geneva.
Lives at Risk
In 1998, a devastating outbreak of a rare epidemic virus—enterovirus 71—ravaged Taiwan. It affected nearly 10,000 children, killing 78 and debilitating thousands more. The airborne disease, which targets children between the ages of 3 and 5, results in “aseptic or viral meningitis, encephalitis, or a polio-like paralysis,” according to the U.S. Centers for Disease Control.
As the outbreak spread, Taiwan appealed to the World Health Organization for international assistance. But its request was stymied, due to Taiwan’s unique lack of association with the organization. As a result, Taiwan’s public health system was prevented from acquiring accurate real-time medical information about this rare disease, contributing to an unnecessarily high death toll, and many more cases of infection than would otherwise have occurred.
Following the epidemic, Taiwanese health officials reported that nearly 80 percent of the country’s children between the ages of 3 and 5 did not develop the immunity needed to fight the virus. Again, Taiwan appealed to the world community to share its expertise—and again, the United Nations’ global health organization was prevented from helping on political grounds.
Recent outbreaks in 1999, 2000, and 2001 have resulted in thousands more cases of enterovirus 71 and the death of 50 more children—all of which may have been prevented, or at least lessened, if Taiwan had been able to obtain medical information, technology, and assistance from the World Health Organization.
The importance of receiving international assistance following a major public health emergency was again brought to the world’s attention on September 21, 1999, when a magnitude 7.6 earthquake struck Taiwan, killing 2,378 people, and leaving another 8,000 injured. This natural disaster left thousands homeless, destroyed more than 40,000 homes, caused widespread infrastructure damage, and knocked out phone, power, and water lines throughout the region.
When Taiwan appealed to the World Health Organization during the crucial hours after the quake struck, politics once again stymied the international response. The PRC demanded that the United Nations obtain its approval before sending aid and assistance to Taiwan, halting critical emergency relief. For 10 hours, a Russian rescue team waited for the United Nations to obtain Beijing’s approval for its application. Worse, Russian airborne rescue assistance was further delayed by 12 hours (and forced to make two unnecessary refueling stops) when the PRC denied an air corridor to the team, thus requiring the aircraft to make a lengthy detour over Siberia.
Even the International Committee of the Red Cross, a non-governmental organization, was unable to deliver humanitarian assistance during the hours immediately after the earthquake, because it sought approval from PRC officials.
In March 2002, Taiwanese health officials reported that new cases of enterovirus 71 have been reported throughout the island. In addition, also in March 2002, yet another earthquake—this one registering 7.1 on the Richter scale—struck Taiwan. These very recent incidents remind us of the imminent threat to public health on Taiwan because of its continued exclusion from the World Health Organization.
Observer Status: A Pragmatic Solution That Protects World Health
Currently, Taiwan is the world’s only aspirant for World Health Organization observer status. While rogue nations such as Iran, Iraq, Libya, North Korea, and Cuba are entitled to all the rights and benefits associated with full membership, Taiwan does not seek this (in order to avoid the knotty “one China” politics). Rather, it seeks the same observer status accorded to such non-sovereigns as the Palestine Liberation Organization, the Holy See, the International Red Cross, the International Foundation of the Red Cross and Red Crescent Societies, and the Order of Malta. Yet this modest request, too, has thus far been denied. Taiwan is thus uniquely excluded from participation in World Health Organization activities and programs.
The official justifications for the People’s Republic of China’s opposition to Taiwan’s application essentially ignore the difference between observer status and full membership. Whereas membership in the World Health Organization requires sovereignty, observer status does not. Just as the Order of Malta can participate in World Health Organization activities as an observer, so, too, could Taiwan.
Yet as recently as January 2002, PRC Ambassador Sha Zukang stated that because “only sovereign states are eligible for membership,” Taiwan has “no qualification whatsoever to participate in the World Health Assembly.” Sha further added that to “raise a proposal” about Taiwan’s participation, “in whatever form,” would constitute “an act of infringement upon the sovereignty and territorial integrity of China and an active interference in the internal affairs of China.” (Emphasis added.)
Despite such unreasoning and politicized opposition, on January 15, 2002, the World Health Organization’s 32-member Executive Board considered a proposal by Nicaragua, Guatemala, Senegal, Chad, and Grenada to add Taiwan’s admission as an observer to the May 2002 World Health Assembly agenda. Once proposed by a member state—let alone by five of them—the question of Taiwan’s observer status should have gone to the full Assembly. Due to politics, it did not.
Communist Cuba joined the PRC in leading the effort to keep the proposal off the Assembly’s agenda, despite the fact that this violated the organization’s own rules of procedure. According to the U.S. State Department letter of protest, Rule 5 “requires that this Board include on the provisional agenda for the next Assembly ‘any item proposed by member.’ This rule is clear and is not optional. The rule says that the Board ‘shall include’ such items. It does not say ‘may include.’ There is no discretion.” (Emphasis added.)
In this fashion, the PRC has thus far been successful in thwarting every bid Taiwan has made for World Health Organization observer status. But that may soon change. Any member state may submit a proposal for observer status for Taiwan when the World Health Assembly convenes its annual meeting in May 2002 in Geneva.
Growing Support for Taiwan’s Observer Status
In recent years, international support for Taiwan’s observer status in the World Health Organization, particularly among Western nations, has grown. Since 1996, numerous legislatures, including the European, Czech, and Guatemalan parliaments, as well as many Canadian and British parliamentarians, have endorsed the proposal. In addition, non-governmental organizations throughout Europe and Latin America have written letters expressing their support for Taiwan’s bid.
Since taking office, the Bush Administration has demonstrated its strong support for Taiwan’s participation as an observer in the World Health Organization. In May 2001, while in Geneva, Health and Human Services Secretary Tommy Thompson announced that the U.S. backs the inclusion of Taiwan as an observer to the World Health Organization. In March 2002, the State Department reiterated that it has “urged the World Health Organization and its members to find appropriate ways for Taiwan to participate.” This is consistent with long-standing U.S. policy “to support Taiwan’s membership in international organizations where statehood is not an issue.”
Congress, too, has consistently supported Taiwan’s efforts to join the World Health Organization as an observer. Following the 1998 enterovirus 71 outbreak in Taiwan, numerous resolutions were introduced in Congress to address both the health tragedy and the international travesty. The following year, Congress passed H.R. 1794, supporting Taiwan’s participation in the World Health Organization, and President Clinton quickly signed it. It became Public Law 106-137.
In May 2001, Congress passed H.R. 428, which authorized the Secretary of State “to initiate a U.S. plan to endorse and obtain observer status for Taiwan” at the 2001 World Health Assembly and to “instruct the U.S. delegation to Geneva to implement such plan.” With President Bush’s signature, H.R. 428 became Public Law 107-10. And, on December 19, 2001, again with overwhelming support, the House passed H.R. 2739, authorizing the U.S. to endorse and obtain observer status for Taiwan at the 2002 World Health Assembly. The House vote was followed by Senate passage by unanimous consent on March 19, 2002. The President signed the bill on April 4th, making it public law 107-158.
The People of Taiwan Deserve Participation in the World Health Organization
According to the World Health Organization constitution, the “enjoyment of the highest attainable standards of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.” This fundamental human right is, however, currently being abridged for the 23 million people of Taiwan.
As Taiwan’s Health Department Director General Lee Ming-Liang observed in January 2002, disease is borderless. Politics should not prevent any of the world's citizens from acquiring the information and expertise they need for their health, medical care, and disease prevention. Granting observer status to Taiwan is a way to include its people in the global health system without intruding upon “one China” politics or jeopardizing the peace process between Taiwan and the PRC.
The 1979 Taiwan Relations Act states that it is U.S. policy to resist any “form of coercion” that would jeopardize “the social or economic system of the people of Taiwan.” Denying the people of Taiwan access to the health information, aid, and emergency resources of the World Health Organization poses a needless and grave threat to their society. In faithfulness to the Taiwan Relations Act and the policies of every American president since Jimmy Carter, and with concern and compassion for the health of the millions of people of Taiwan, it is essential that the United States continue to support Taiwan’s efforts to obtain observer status in the World Health Organization.
