Global health security – a call for Taiwan’s i... - Taipei Economic and Cultural Office, Muscat, Oman 駐阿曼王國台北經濟文化辦事處

The threat of emerging infectious diseases to global health and the economy, trade and tourism has never lessened. Pandemics can spread quickly around the world due to the ease of international transport. Among the most prominent examples are the Spanish flu of 1918, the outbreak of severe acute respiratory syndrome (SARS) in 2003 and the H1N1 flu of 2009. Intermittently, serious regional epidemics, such as the Middle East respiratory syndrome (MERS) in 2012, Ebola in West Africa in 2014 and the Zika virus in Central and South America in 2016, also manifested themselves.

Today, a new form of pneumonia that first appeared in Wuhan, China, in late 2019 and was later classified as 2019 coronavirus disease (covid-19), caused a global pandemic. On April 8, 2020, data from the World Health Organization show that 1.35 million people were confirmed to have the disease, with 79,235 deaths in 211 countries / areas / territories. Taiwan was not spared.

In the 17 years since it was hit hard by the SARS outbreak, Taiwan has been in constant preparation for the threat of emerging infectious diseases. As a result, when information about a new outbreak of pneumonia was first confirmed on December 31, 2019, Taiwan began to implement quarantine on board direct flights from Wuhan on the same day.

On January 2, 2020, Taiwan established a disease response team and activated the Central Epidemic Command Center (CECC) on January 20 as a level 3 government entity, upgrading it to level 2 and level 1 on 23 January and 27 February, respectively. The CECC is able to effectively integrate resources from various ministries and invest fully in containing the epidemic. On April 9, Taiwan had already tested a total of 42,315 people, confirming 380 cases, of which 54 were indigenous, 326 imported and five deaths; 80 people left the hospital after negative tests.

Despite its proximity to China, Taiwan ranked 123 out of 183 countries in terms of confirmed cases per million people. This showed that Taiwan’s aggressive efforts to control the epidemic are working.

The disease knows no boundaries. In response to the threat of the COVID-19 epidemic, Taiwan has implemented dynamic plans for border quarantine measures, including onboard quarantine, fever screening, health declarations and a 14-day domestic quarantine for passengers arriving from countries listed on Level Alert 3. In addition, Taiwan has established an electronic system for entry quarantine, which allows passengers with a local mobile phone number to fill in health information via mobile phone. A health declaration will then be sent via text message. This is linked to the community assistance support management system, which allows government agencies to provide health and medical care services.

The travel history of individuals is now stored on the National Health Insurance (NHI) card to alert doctors to possible cases and prevent transmission in the community. For those in quarantine or residential isolation, the government is working with telecom operators to allow GPS tracking of their location. Quarantine offenders are subject to fines or mandatory location in accordance with relevant laws and regulations, to prevent transmission.

Taiwan has also increased the capacity for laboratory testing, expanded the scope of its surveillance and inspections based on trends in the COVID-19 epidemic and retested people at higher risk who had previously tested negative, including patients with severe flu symptoms, community cases with high respiratory tract infections that were already monitored and to group cases of upper respiratory tract infections, to identify suspected cases and perform treatment in isolated wards.

Meanwhile, Taiwan has designated 50 regional hospitals and medical centers and 167 community hospitals and clinics to create an orderly testing system. These hospitals and clinics must create wards or special areas; in principle, patients with covid-19 are isolated and individually treated in these wards and areas to prevent nosocomial infections. In addition, Taiwan has banned the export of surgical masks since 24 January, ordered masks and expanded the production of domestic masks to allocate them more effectively. On February 6, Taiwan launched a name-based rationing system for purchasing masks at pharmacies contracted by the NHI and local public health agencies. And added a mask ordering system on March 12th. This allows people to place orders online and pick them up at convenience stores. These measures have helped us achieve an effective allocation of limited resources and meet health needs, epidemic prevention and domestic and industrial needs.

A crisis anywhere quickly becomes a problem everywhere. Global health security requires the efforts of all people to ensure an optimal response to threats and challenges to public health. Taiwan, although not a member of the World Health Organization (WHO), cannot be alone and must be included in the fight against such threats and challenges. Taiwan has fulfilled its responsibilities as a global citizen and has complied with the 2005 International Health Regulations (IRH 2005) by notifying WHO of confirmed cases of covid-19.

In addition, Taiwan communicated with other countries such as Japan, the Republic of Korea, Singapore, Malaysia, the Philippines, the United States, Canada, Italy, France, Switzerland, Germany, the United Kingdom, Belgium and the Netherlands, in addition to the European Center for the Prevention and Control of Diseases, to share information about confirmed cases, travel histories and patient contacts and border control measures. Taiwan sent the covid-19 genetic sequence to the Global All Data Sharing Initiative (GISAID). Taiwan worked with global partners to respond to the covid-19 threat to ensure that global health is not hampered by a lack of communication and transparency.

If it is WHO’s mission to ensure the highest possible standard of health for all human beings, WHO needs Taiwan, just as Taiwan needs WHO. However, Taiwan has long been excluded from WHO due to political considerations. This has been unfortunate, considering all that Taiwan could share with the world thanks to its recognized experience in public health, health care, national health insurance and the ability to conduct rapid tests, in addition to research and manufacture of vaccines and medicines against covid-19.

We can also share our methods for analyzing the virus. We hope that after this pandemic has subsided, WHO truly understands that infectious diseases know no borders and that no country should be excluded, lest it become a major gap in global health security. WHO should not neglect any nation’s contribution to global health security.

We urge WHO and related parties to recognize Taiwan’s longstanding contributions to the international community in the areas of public health, disease prevention and the human right to health, and to include Taiwan in WHO and its meetings, mechanisms and activities. Taiwan will continue to work with the rest of the world to ensure that everyone enjoys the fundamental human right to health, as stipulated in the WHO Constitution. Echoing the mantra of the United Nations Sustainable Development Goals for 2030, that no one should be left behind.

Minister of Health and Welfare Republic of China (Taiwan)

Global health security – a call for Taiwan’s inclusion

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