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opinion

Dr. Chen Shih-chung is Taiwan's Minister of Health and Welfare.

Disease knows no borders. Only by working together, leaving no one out, can we adequately address the challenges of emerging infectious diseases which have been made all the more complex by the effects of globalization. As influenza viruses are constantly evolving and circulating in humans and a number of animal species, the spectre of a potential influenza pandemic haunts us constantly. Outbreaks of avian influenza and novel strains of influenza have repeatedly threatened global health security in recent years. As a result, the World Health Organization (WHO) has continuously urged nations to invest more in the development and implementation of various pharmacological and non-pharmacological interventions against pandemic influenza.

Taiwan was devastated by the 2003 SARS outbreak. Many of our front-line health-care workers became infected while caring for patients, and unfortunately, some perished, including a nurse, then in her third trimester of pregnancy. Several hospitals were closed, more than 151,000 people were quarantined at home, a travel advisory was issued and schools closed. We paid a heavy price to learn that disease indeed respects no national borders and to recognize the importance of international collaboration in tackling the threat. Taiwan, not being a WHO member, did not receive timely information on the SARS virus. We were dependent on the expertise generously shared by the U.S. Centers for Disease Control and Prevention on how to control the outbreak. It was not until SARS spread to the Heping hospital that WHO finally dispatched experts to Taiwan. This was the first such assistance the organization had provided us in 31 years. SARS was a reminder to WHO and the international community that they could not afford to leave Taiwan out in the cold, and led them to ponder ways of bridging this gap in the global health network.

Since 2005, we have been invited to certain WHO technical meetings on influenza, where we are able to exchange experiences with experts from around the world. Also, Taiwan was included in the framework of WHO's International Health Regulations (2005) in 2009, establishing a direct liaison with WHO headquarters so we could report major public health events. Thanks to having these direct communication channels, Taiwan was able to effectively implement various control measures during the H1N1 influenza pandemic of 2009. We practised real-time surveillance, promptly notified WHO and shared genetic H1N1 virus information.

Taiwan confirmed the world's first human case of H6N1 avian influenza in 2013 and promptly shared genetic information on the virus. Earlier this year, we identified a human H7N9 case imported from China. Besides reporting the case and the test results to WHO through the National International Health Regulations (IHR) focal point, we submitted sequencing data to the Global Initiative on Sharing All Influenza Data (GISAID) within three days and voluntarily shared the virus strain with WHO-collaborating influenza centres in the U.S. and Japan within a month. Taiwan was glad to be able to offer information that can serve as important reference for WHO to select seasonal influenza vaccine strains.

It is regrettable that political obstruction has resulted in Taiwan often being refused attendance at WHO technical meetings. This situation has created grave difficulties in Taiwan's efforts to collaborate with the international community on disease prevention. We are profoundly disappointed that WHO has failed to abide by its Constitution and has ignored widespread international support for Taiwan's participation in the World Health Assembly (WHA), instead bowing to political pressure from a certain member by excluding Taiwan from that body. WHO is a professional, international health organization. It is obliged to abide by the principles espoused in its Constitution, particularly the enjoyment of the highest attainable standard of health for all people, regardless of race, religion, political belief, or economic or social condition. This right to health is the foundation underpinning WHO's previous invitations to Taiwan to participate in the WHA and, on an equal basis, in WHO activities and technical meetings.

We urge WHO and the related parties to acknowledge Taiwan's long-standing contributions to public health and disease prevention. Taiwan is capable of and willing to fulfill its responsibilities and to collaborate with WHO to deal with the challenges of disease control. WHO should recognize the legitimacy and importance of Taiwan's participation. To bridge the gap in the global disease prevention network, Taiwan needs WHO, but WHO also needs Taiwan.

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