- The Washington Times - Sunday, August 7, 2005

Taiwanese Health Minister Dr. Sheng-Mou Hou last week spoke to reporter Seth Rosen of The Washington Times about the threat of an avian-flu outbreak in Asia and the consequences of Taiwan’s exclusion from the World Health Organization (WHO):

Question: The WHO has warned of the possibility of a worldwide flu pandemic as avian flu appears in new locations in Southeast Asia and Siberia. How grave is the threat of the disease spreading?

Answer: Avian flu is really a threat to Taiwan, the United States and the rest of the world. The question is not if it attacks, but when it attacks. It mutates so quickly that I believe that in the coming months it will be a human disease and pass from human to human — and that’s a big problem. The people of the world have no immunity to that kind of virus. In my belief, avian flu will come and it’s best to prepare for it.

Q: Though the deadlier H5N1 strain of avian flu has not been found in Taiwan, two milder forms of the virus have. What steps is Taiwan taking to protect itself against an outbreak?

A: We have a four-strategy approach: The first is to fight the disease outside our borders. We have donated 600,000 Tamiflu tablets [a drug used for prevention and early treatment of bird flu] to Vietnam. Second, we are detecting the disease on the border by checking every visitor’s temperature if they come from abroad and monitor them.

Third, is getting our community ready. We had experience with SARS and stocked up on so much equipment then. Last, we are making sure our medical services are well-prepared, that we have the capability to produce vaccine and prepare Tamiflu for 10 percent of the population. We are also talking to government officials and educating the public about prevention measures.

Q: What role does Taiwan play in the global fight against avian flu and does there need to be increased international cooperation on this issue?

A: Taiwan has a very unique geographical position. We are close to the danger zone. Our health officials are well-equipped and highly knowledgeable. We can play an important role for global health by being a sentinel guard against avian flu.

I call upon all the countries in the world to create a network to fight this possible epidemic disease. I would like to have an avian-flu summit meeting every two months so all nations can share information and surveillance. The WHO has done something with this, but unfortunately, Taiwan is not a member.

Q: Amid strong opposition from mainland China, the WHO’s World Health Assembly avoided voting on Taiwan’s application for observer status as a “health entity” during its annual meeting this past May. This is the ninth consecutive year that WHO has turned away your nation.

A: We’re disappointed that the WHO did not admit Taiwan, but we will keep on trying. How can you leave a very important country out of the network? How can they say you’re Taiwanese so you have no rights for you to try to promote your health?

But things are going better and better. In the past, our experts could not attend any kind of WHO meetings. For a tsunami meeting in April, the WHO accepted our experts and registered them. Unfortunately, they were refused entry at the door due to someone’s protesting and that’s not fair.

Q: What are the consequences of Taiwan’s exclusion from the WHO and does this endanger the health of the Taiwanese people?

A: Diseases have no boundaries and birds can fly anywhere they like. Health is a basic human right. To keep Taiwan out of the WHO umbrella is not only unfair to Taiwanese people, but also dangerous to others around the world. There are 6 million flights a year from Taiwan to neighboring countries. Traffic from Hong Kong to Taiwan is very heavy. [30,000 people a day according to a Health Ministry official.] Infected people could come from Vietnam to Taiwan, disseminate the disease, and then go on to the U.S.

Q: What happens if avian flu mutates, and you are not in the WHO?

A: If you exclude Taiwan, we can’t get information, surveillance data and might have deficient measures to fight [avian flu]. If avian flu attacks, we need that kind of a network. Without Taiwan involved, there may be a leak if we are short of information. We have to share specimens and blood. We need to isolate the virus and immediately produce vaccine. We have to share resources because we can’t do it alone and don’t have enough specialists.

Q: Though the United States and Japan strongly backed Taiwan’s WHO bid, most other Western countries did not. Are you disappointed by the lack of support?

A: I really appreciate that the United States and Japan stood firmly with us. Both countries respect that health is a basic human right.

I traveled a lot in European Union countries where health officers are very sympathetic and the parliament agree with us completely. They say it is very important to work together to fight the disease. But on membership in the WHO, they hesitate and have a struggle in their hearts. They have to ask for approval from their ministry of foreign affairs because of their diplomatic relationship with China.

Q: Taiwanese opposition leaders visited China before the May WHO meeting, and there was some speculation that China might soften its stance. Were you surprised that didn’t happen?

A: Initially, I was very happy that perhaps there will be a change in this because I welcome these kinds of efforts. Later, I’m disappointed because China kept on talking that they have been taking care of Taiwanese people — but this is not true. Remember, they objected that WHO sent officials in to Taiwan with SARS. At the tsunami meeting, our people were shut out at the door. And that happened right after our political leaders were there.

Q: China failed to disclose accurate information about the extent of the SARS outbreak in their country two years ago. Do you believe they are providing the global community with accurate and complete statistics on avian-flu cases?

A: My speculation is that there is something we don’t know that is happening in south China. They have made a lot of improvements, and everyone wants to help China. This is a disease that everyone can be affected by. I want to cooperate and develop mechanisms through which we can share surveillance. If mainland China has difficulties in talking with us alone, then invite all the neighboring countries.

Q: China and the WHO signed a “memorandum of understanding” in May that would allow the WHO to send experts to Taiwan with China’s permission in the case of a deadly epidemic. Your government has been very critical of this agreement.

A: This memorandum is ridiculous. If you are dealing with someone, you have to cooperate. For example, if you would like to invite a beautiful lady to dinner, you have to ask her yourself or send an invitation. You can’t just ask me and then the two of us decide what this lady should do. That’s not right.

According to the memorandum, if Taiwan needs assistance, it should send a request to Beijing and through Beijing to the WHO. I’m frustrated. I pay no attention to the [memo of understanding] because our name is not on it.

Q: At its May meeting, the WHO revised its international health regulations (IHR) to include a goal of “universal application for the protection of all people of the world.” Does the new IHR give Taiwan a legal basis to participate in WHO programs?

A: That is right. One of the fundamental spirits of the IHR is to have universal application so no person on earth can be shut out from the global fight against infectious disease. There should not be any leaks in fighting communicable disease. To include Taiwan in the WHO is mandatory and good for Taiwan and the rest of the world. Everyone should work together to fight disease.

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