ASIA: by Jeffry Babb News Weekly
Taiwan comes in from the cold
, May 18, 2002
"Health has no boundaries. Diseases do not respect borders," says Dr Shiing-jer Twu, director general at the Center for Disease Control in Taipei. Dr Twu, who has a degree in medicine and a Ph D from the University of California at Los Angeles (UCLA), is a leader in Taiwan's attempt to gain observer status at the World Health Organisation.
Taiwan has a lot to offer the WHO. In the 1950s, communicable diseases occupied the top 10 positions as causes of death in Taiwan. In the ensuing half century, Taiwan has eradicated bubonic plague - once a major killer disease - and other scourges like rabies, smallpox, malaria and polio.
Other diseases, like measles, hepatitis B and dengue fever have been brought under control. For many countries in Africa and the Pacific, these are still major killers.
Taiwan's experience in public health is a valuable lesson in what can be done, given sufficient will and resources.Local needs
Taiwan also needs the WHO. Diseases like drug-resistant tuberculosis and AIDS require international efforts to bring them under control. A Thai laborer recently came down with bubonic plague.
The enterovirus outbreak of June 1998 cost the lives of 78 innocent children, and Taiwan got no help from the WHO, even though the outbreak was a reappearance of an enterovirus strain found earlier in Malaysia.
The avian flu scare of 1997, which was defeated before it could cause a pandemic not seen for decades, could be controlled in Hong Kong because of swift and effective action, aided by the WHO.
"Had the same epidemic unfortunately occurred in Taiwan, for lack of international assistance of any kind and unavailability of international resources, the epidemic could have spread to other countries of the world in no time and very well end up in a worldwide catastrophe," says Dr Twu.
Why, then, is Taiwan not in the WHO, with so much to offer and in turn, so much to gain? The WHO is supposed to be a non-political agency, after all. The answer is pure politics. Mainland China does not want Taiwan to gain any form of international recognition. Despite the fact that the Vatican and the PLO have observer status - denied to Taiwan - China is using all its influence to keep Taiwan, a nation of 23 million people, out.
But the tide for Taiwan is turning. The US Congress and the parliament of the European Union have endorsed Taiwan's bid this time around. Taiwan is mobilising its NGOs, which have significant international links, to rally support for Taiwan's bid.
"With more frequent international trade and tourism, the arrival of the global village has brought about more threats of emerging and re-emerging communicable diseases. Early detection is essential to the prevention of these diseases. These communicable diseases, for being either emerging or re-emerging, are not familiar to most physicians and the public, their early prevention is not easy," says CDC's Epidemiology Bulletin
China's attempt to isolate Taiwan from the mainstream of the medical world seems to be remarkably callous and short-sighted, an action pursued for purely political motives with nothing to do with health.
From the world's viewpoint, preventing another outbreak like the Spanish flu at the end of World War I is to be avoided at all costs. This pandemic killed more people than died in the Great War, though these days it is hardly remembered.
However, out of Taiwan's population of 23 million, some 15 million overseas trips are made each year. With a lot of people coming and going, any disease arising in Taiwan would quickly be disseminated worldwide.
Taiwan, through its own efforts, has managed to improve public health remarkably, despite having little assistance from the international community apart from the US. AIDS is under control - certainly it is nowhere near the destroyer of lives and the economy it is in Sub-Saharan Africa.
At long last, the tide may be turning for Taiwan. President George W. Bush's Administration is taking a far more hands on role in Taiwan's defence and the various communiques that all US Administrations since Richard Nixon made his trip to China don't rate much of a mention in Washington these days.
Bush's commitment to "do whatever it takes" to defend Taiwan has greatly heartened Taiwan's beleaguered military and it seems likely that Taiwan will get the conventional powered submarines the US has promised Taiwan, despite the fact that the US hasn't built conventionally powered subs for 50 years.
Taiwan is also coming out of the worst economic slump since the oil crises of the 1970s. Shipments of information technology (IT), the lifeblood of the Taiwan economy, are picking up. In all, while unemployment is high - for Taiwan - at five per cent, its outlook is the brightest it has been for many years.