Taiwan Communiqué No. 105 June 2003

SARS, China, Taiwan and the WHO

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Chinese captain: "Good morning passengers. The pilot-comrade has a confession to make."

Much has been written during the past two months about the spread of the severe acute respiratory syndrome (SARS). It originated in China's southeastern province of Guangdong in November 2002, and was able to spread rapidly due to the habit of Chinese officials of suppressing information, so that countermeasures could not be taken in time. By the time it became a known phenomenon in mid-March 2003, it had spread widely to Hong Kong, Vietnam, and the rest of China. It was only a matter of time before it would reach other countries such as Canada and Taiwan.

Because it is affecting travel in such a major way, it is highly likely to have a significant effect on the region's economy. On the following pages we will focus on three other aspects: 1) the effect on China's political system itself, 2) the effect on relations between Taiwan and China, and 3) the reluctance of the WHO to assist Taiwan in the fight against SARS.

China's Chernobyl?

In an excellent article on 24 April 2003, the London-based Economist suggested that SARS may be equivalent to Chernobyl, the 1986 nuclear accident in the Ukraine that helped precipitate the disintegration of the old Soviet Union. While it may be too early to tell, there are certainly important parallels: in China, SARS is leading to widespread skepticism about the government and in particular the Communist Party.

SARS may also turn out to be the needle that burst the economic balloon: while more sober foreign observers have long argued that China's economy was not growing anymore, the authorities in Beijing tried to keep the locomotive going by inflating growth figures, and even now are misleading the rest of the world that the economy is growing by some 9%. SARS is bringing this all back down to earth, and will put the brakes on the overblown expectations of China by foreign investors.

We must quarantine China

This editorial first appeared in the Taipei Times on 26 April 2003. Reprinted with permission.

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China: "we must keep him quarantined"

Taiwan's health authorities have worked hard to prevent the spread of severe acute respiratory syndrome (SARS), but unfortunately the country lost its "zero community-acquired infection, zero death, zero export" record after a mass infection occurred at the Taipei Municipal Hoping Hospital.

The nation's fight against SARS has now entered a new phase, as the previous approach of simply screening individuals entering the country is no longer effective. President Chen Shui-bian has announced that Taiwan is raising the seriousness of the fight against SARS by responding to it as a "national security" problem. Taiwan must build new defenses against SARS at hospitals, within communities and in public venues. Large-scale or community quarantine measures will become inevitable in the all-out effort to stop the spread of the disease.

Taipei Municipal Hoping Hospital was shut down after a mass infection was detected among medical personnel. All the patients and medical personnel at the hospital have been quarantined. Venues suspected of having been visited by possible SARS carriers are being sterilized. People suspected of having come into contact with SARS patients are being put under home quarantine. Such measures, coming without warning, have caught many people off guard. Some medical personnel at the hospital are finding these actions unacceptable. They have staged protests by putting up placards on the hospital's windows.

The unhappiness of those quarantined is understandable and we must thank them for the sacrifice they are making for the public's welfare. By having their freedom of movement temporarily curbed, they are making it possible to limit the SARS infection within specific areas. Confining both healthy people and suspected SARS patients in the same building may increase the possibility of healthy people being infected, but the risk is one that must be taken for the greater good.

In China, where SARS originated, the authorities lost the best opportunity to prevent the outbreak when they covered up the situation and rejected the World Health Organization's offers to help. Now SARS has become a public-health crisis in many countries. In March, we suggested that any contact with China be curtailed, in an effort to crank up international pressure to force China to face the outbreak. Now we make the same suggestion again, this time for self-protection.

Twelve countries have given travel warnings about Taiwan as a SARS-affected area. The SARS situation in China is a thousand times more serious than it is here. It is imperative and understandable for the government to adopt quarantine measures against China.

On Thursday (24 April 2003), the Mainland Affairs Council announced control measures on travel across the Taiwan Strait based on the principle of "minimal control." This is the beginning of cross-strait quarantine measures. In light of the rapidly deteriorating situation in China and Hong Kong, "minimal control" measures are not enough. The government must adopt tougher controls and make it a rule to stop personal travel from China, allowing passage in exceptional cases only. It must do this to effectively implement all necessary preventive measures inside this country. If we do not nip SARS in the bud, all preventive measures may be futile.

The dubious role of the WHO

As the world body responsible for health, the WHO has a prime responsibility to ensure that all countries are adequately informed and advised in the case of new outbreaks like SARS. However, in the case of Taiwan the WHO has been negligent and impotent: in March and April 2003, when SARS could still have been contained in Taiwan, the world body refused to adequately inform Taiwan medical authorities who were requesting assistance and information from the WHO. It wasn't until SARS was starting to spread rapidly at the end of April 2003, that the WHO sent two of its staff to Taiwan to consult with the island's medical officials.

The reason of the WHO's reticence is of course the fact that China is insisting that it has sovereignty over Taiwan, and that the island therefore cannot be a member of an international organization.

Since 1997, the Taiwan authorities have mounted a campaign for WHO membership at the occasion of the annual gathering of the WHO World Health Assembly. This year, the SARS epidemic provided a new urgency to the campaign: President Chen Shui-bian repeatedly spoke out on the issue of Taiwan's unfair and unjust exclusion from the WHO, and on 9 May 2003, the Washington Post published an OpEd article by the President, forcefully arguing the case for Taiwan's participation in the WHO.

A few days later, on 16 May 2003, the Paris-based International Herald Tribune published an article by Taiwan's foreign minister in which he urged the WHO and its member states to "…stop allowing political expedience to dictate WHO policy." He stated that "Taiwan needs the WHO just as much as the WHO needs us in fighting SARS and future epidemics."

However, on 19 May 2003, the member states attending the annual WHO World Health Assembly in Geneva, the WHO caved in to China's bullying, and decided not to put the issue of Taiwan's membership on the agenda of the organization's annual meeting.

In a strongly-worded editorial on 20 May 2003 titled "Shutting out Taiwan", the Washington Post criticized the WHO and those countries which supported China's position. It stated: "For the U.N. system to be taken seriously, it ... has to junk some of the political baggage it has acquired over the years. The WHO needs to recognize that China's musty objection to Taiwanese independence is no longer a good reason to deny Taiwan the help it needs to combat the health problems of the future."

The following is an editorial on the matter by the Taipei Times, written when the issue just started to develop in early April 2003.

The WHO should live up to its name

This editorial first appeared in the Taipei Times on 6 April 2003. Reprinted with permission.

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Chinese officaldom to WHO: "SARS will disappear quickly if you use the mask correctly."

As if it didn't already have its hands full fighting the outbreak of severe acute respiratory syndrome (SARS), Taiwan also has to deal with the appalling way it is treated by the World Health Organization (WHO). The WHO's disregard for the health and welfare of the people of this country for political reasons is no better than China's deliberate concealment of the epidemic. At least the Chinese government has finally managed to muster a long-overdue and now meaningless apology for its shameful conduct. When will the WHO correct its own mistake?

The WHO has consistently referred to this country as "Taiwan, China" or "Taiwan Province" of China, totally disregarding the nation's sovereignty. Perhaps in the eyes of the international community the statehood of Taiwan continues to be a question open to debate. But, as a supposedly non-political international organization, it is entirely out of place for the WHO to take sides in this debate. The least it could do is to remain neutral on the issue by simply referring to this country as "Taiwan," without making any further interpretation of the country's status.

When asked by the media about the issue, WHO officials have replied that what Taiwan is called is a "political question" about which they cannot comment. But by reducing Taiwan to a mere Chinese province in its lists and news releases, the WHO is clearly "commenting" on the issue.

Worse yet, in the global battle against SARS, Taiwan is excluded from all WHO assistance. The only outside help it has received thus far is from the US Centers for Disease Control and Prevention.

WHO officials have openly conceded it is "difficult" to offer Taiwan any assistance since it is not a WHO member. But doesn't this demonstrate the need to allow Taiwan to join the organization, or at the very least let it be an observer? If Taiwan was truly a Chinese province, then it should be able to receive WHO assistance via China, which is already a WHO member. In reality, that is entirely impossible, because China and Taiwan are ruled by different governments.

The message is loud and clear: Unless Taiwan reduces itself to become a Chinese province, no WHO help will be forthcoming, however badly needed this assistance may be. China naturally did not miss the chance to highlight this point by offering to help Taiwan combat the SARS epidemic. In view of China's disastrous handling of the epidemic so far, only a fool would accept that kind of offer.

Much to the comfort of Taiwanese, some true friends have expressed their support. In the past few days, both the Canada-Taiwan Parliamentary Friendship Group and the US Congress' Taiwan Caucus have criticized the WHO and called for Taiwan to be allowed to be a WHO observer. Furthermore, on Thursday, the Canadian Parliament passed a resolution supporting Taiwan's WHO bid. The US House of Representatives has also passed legislation requiring the US secretary of state to help Taiwan join the organization.

On the other hand, there is Thailand, which treats travelers from Taiwan the same as those from China by requiring them to undergo physical checkups upon arrival and wear surgical masks for the first 14 days of their visits. This is obviously because Thailand thinks that Taiwan is part of China. It is very likely that Thailand was influenced by the WHO's attitude.

The WHO should live up to its name and truly serve as the health organization for the whole world, including Taiwan.

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