Taiwan Today

The 66th World Health Assembly at World Health Organization HQ in Geneva, Switzerland concluded with neither breakthroughs nor surprises, and evoked little domestic enthusiasm. For the ROC, however, the venue presents both challenges and opportunities as it seeks to progress toward greater participation in such U.N. bodies. Forced to participate in the WHA under the rubric “Chinese Taipei,” ROC nationals are bound to feel unfairly treated. At the assembly the country takes a back seat to other members in spite of its medical advances. Nevertheless, it is only by participating can opportunities be grasped and progress made. The crux is whether the ROC government can seize opportunities and win popular support for its goals. This year’s meetings covered a wide range of subjects, with the concept of universal health coverage commonly mentioned by just about every representative. A subject of brainstorming for more than a decade at the U.N., WHO and World Bank, the topic was a focus of a position paper presented at the assembly for open discussion. The paper concludes that poverty leads to sickness and vice versa, and that this vicious cycle is an important cause of social injustice. The WHA called on every country to adopt proper measures to create a system of universal coverage and fair treatment, which serves as the cornerstone for promoting health, social participation and public security. Mexico, Thailand and Turkey were put forward as role models for the approach. ROC nationals would only sigh over the conclusions. After decades of coordinated efforts between the public and private sectors, the country has long achieved these goals with the introduction of a National Health Insurance system. The single payer system adopted by the NHI allows for powerful integration of various resources, distribution of risks from catastrophic disease and provision of complete coverage without discrimination. ROC diplomatic allies urged members at the assembly to pay due attention to these achievements, but nothing was mentioned in WHO official documents, making Taiwan’s success unlikely to serve as a reference for other countries. Rather than looking at the situation as an obstacle, it should be viewed as an opportunity. Cuba’s experience is a useful paradigm. It is a small underdeveloped nation, under a U.S. trade embargo and also under pressure in the international arena. But it has become a health mecca among African, Caribbean and Latin and South American countries, with the University of Medical Sciences of Havana training more than 120,000 doctors from 49 countries. Cuba has leveraged its advantage to create an international reputation. Taiwan’s advances in medicine and health, especially the success of the NHI program, can likewise be used to raise its international visibility. But this in turn depends on whether the people of Taiwan are willing to support their national health authority. In 2006, the ROC Department of Health established Taiwan International Health Action to provide medical aid to countries suffering natural disasters. Although TaiwanIHA has performed well, its reach is limited from a global perspective, making it hard to serve as a vehicle for a wide and regular sharing of Taiwan’s medical achievements with the rest of the world. At this year’s WHA, eight countries praised Taiwan’s medical achievements and expressed thanks for Taiwan’s humanitarian aid. Some members called for Taiwan to be formally admitted to the body. To expand its aid to these nations means huge investment in financial and human resources, which will require popular support. The WHA meeting gave the nation a heads up of the international talent gap. The ROC has long been excluded from international organizations and the rules and systems of such organizations are typically extremely complicated. Thus, even if opportunities present themselves for Taiwan to join such bodies, it would be hard to seize them if there are no qualified personnel. Taking the WHA as an example, member countries can participate year-round, but Taiwan only gets to take part in the annual general assembly with little knowledge in the background or follow-up to matters discussed. This is a far cry from the meaningful participation and respectful treatment the DOH expected. Before Taiwan can gain a greater role in international bodies, it should encourage nationals to join international nongovernmental organizations to gain international experience. The WHA also has NGO participants. If Taiwan can secure leading positions within such organizations, it can indirectly participate in international bodies similar to the WHA. For example, Taiwan health officials played an important role in the recent annual conference of the International Network of Health Promoting Hospitals and Health Services in Sweden, which is under the aegis of the WHO. As the Chinese philosopher Xunzi said, it is only by long and assiduous application that you can truly achieve anything. (This commentary first appeared in the China Times, May 25, 2013.)