moved:
That this House, acknowledging that health issues transcend political borders as seen with the recent outbreak of Severe Acute Respiratory Syndrome (SARS), express its support for the admission of Taiwan as an Observer to the World Health Organization and call upon the government to actively urge other member states and non-governmental organizations to support this goal.
Mr. Speaker, Canada is in the middle of severe acute respiratory syndrome, SARS, West Nile virus, and mad cow disease and its possible spread to humans, just to name a few of the current challenges.
Canadians are dealing with these problems, but we are not an island. We are citizens of a world of billions and billions of people, each one of us susceptible to be plagued by disease. As a developed nation Canada has serious responsibilities.
The World Health Organization, WHO, a specialized agency of the United Nations, formally came into existence in 1948. Two of the basic principles of the organization are:
The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.
And:
The health of all peoples is fundamental to the attainment of peace and security and is dependent upon the fullest co-operation of individuals and States.
Unlike the United Nations proper, which recognizes political states, the WHO set out to address the common issues of health and disease, issues that relate to all persons without reference to geographic location or political affiliation.
Article 1 of the WHO constitution defines the organization's objective as “the attainment by all peoples of the highest possible level of health”.
Communicable disease, the incidence of which has been increasing alarmingly in recent years, led Nobel laureate Joshua Lederberg to state:
The world really is just one village. Our tolerance of disease in any place in the world is at our own peril.
Canada has historically taken its leadership role in the WHO seriously. Canada was a charter member in 1948. A Canadian, Dr. Brock Chisholm, was elected the first director-general. Our commitment has continued to be evident in the fact that, since 1948, Canada has been elected to nine three-year terms as a member of the WHO executive council.
The WHO does not share common membership with either the UN General Assembly or with other specialized agencies. The universal health care mandate that it administers has prompted it to include as members over the years states that do not belong to the UN, as well as giving certain entities observer status with the right to participate in the WHO world health assembly.
For example, two states that belong to the WHO that are not UN members are: Niue, a tiny island with an estimated population of 2,100; and the Cook Islands with an estimated population of 21,000.
However, Taiwan's application has been continuously opposed by the People's Republic of China. The refusal to admit Taiwan as either a full member of the WHO or to accord it observer status is patently contrary to the universal intentions of the WHO constitution, and is arguably illegal under the terms of that constitution. Taiwan, with a population of 23 million, is larger than 148 sovereign countries in the world. It is certainly larger than the 2,100 residents of Niue.
Taiwan is the only remaining sizeable territory in the entire world whose people are denied the benefits that accrue from WHO engagement. As the world has cooperated fighting the international outbreak of SARS, Taiwan's exclusion from even observer status in the WHO is not just an affront, but a grave peril to the health of the population of the entire world.
Let us review what has happened. SARS broke out in November 2002 in Guangdong province in China. Fast forwarding to March 10, 2003, China disclosed the epidemic four months after the outbreak and asked the WHO for help in identifying this unknown disease.
March 14, SARS broke out in Taiwan. Taiwan immediately informed the WHO of its first suspected cases, but the WHO ignored the information and did not list Taiwan's SARS cases.
March 16, two American CDC epidemiology experts arrived in Taiwan to study Taiwan's SARS cases and to determine their relationship to others around the region.
March 18, the WHO listed Taiwan's SARS information but politicized the issue by categorizing Taiwan as a province of China, like Guangdong or Hong Kong.
March 28, Canada listed Taiwan on its travel advisory. On that date Taiwan had only 10 reported cases and no deaths. Health Canada explained that Taiwan was geographically close to Hong Kong, with 425 reported cases and 10 deaths, and mainland China, at that time with 806 cases, 34 deaths, and that there were 20 flights between Taiwan and Hong Kong daily.
April 7, China finally admitted entry to a WHO team sent to hunt down the source of SARS in Guangdong. When the team arrived in Hong Kong one of its members, Dr. James Maguire, was interviewed by Hong Kong Wen Wei Daily . Dr. Maguire said that if Taiwan wanted to invite WHO's experts to come, it would have to go through Beijing and that Taiwan cannot deal directly with the WHO.
May 3, the WHO dispatched an ad hoc team of two officials to Taiwan. They stayed for one week to investigate the situation. This is important. During their stay in Taiwan the WHO inspectors made no public statement, nor did they meet with the Taiwanese health minister.
May 14, Taiwan's SARS situation had increased to 238 reported SARS cases with 30 deaths and was continuing to worsen when on May 18 last week Taiwan reported a record daily rise of 65 probable cases, for a total of 483, the third highest in the world after China and Hong Kong.
The People's Republic of China says that there is no need for Taiwan to participate in the WHO because, in part, the PRC looks after Taiwan's health interests. It says:
The Chinese central government is always committed to the health and well-being of people from Taiwan... Taiwan, like any other Chinese province, has full access to [the] WHO's health information including that of the early warning of global epidemics and can benefit from the progress made by [the] world in the health field.
That statement is simply untrue. The PRC has never cared for Taiwan's health needs.
Since 1949 Beijing has never exercised jurisdiction or control over Taiwan, not for one single day. The PRC has never exercised any authority or jurisdiction over Taiwan's health care system, nor has the PRC contributed its national budget in any way to the health needs of Taiwan.
Globalization has vastly increased cross-border flows of goods and services and peoples. Consequently, it has also facilitated the spread of infectious diseases across the world. Any loophole in a global health network presents a danger for the entire world. Taiwan's exclusion from the WHO creates such a loophole.
Taiwan is a major transportation hub linking northeast and southeast Asia. In 2002 Taiwan registered almost 8 million outbound travellers and 2 million inbound travellers. By the end of 2002 over 300,000 migrant workers from Thailand, Indonesia, the Philippines, Malaysia and Vietnam were living and working in Taiwan. Taiwan is at the crossroads of any infectious disease outbreak in the region.
Given the increasing economic and people to people ties between Taiwan and the People's Republic of China, Taiwan is on the front line of any cross-border epidemic originating in China or its neighbours. When the “bird flu”, known as the A influenza, re-emerged in Hong Kong and mainland China, it underscored the danger that Taiwan's exclusion from the WHO creates. The WHO quickly offered its support to the authorities in Hong Kong and China through the global influenza surveillance network, yet if such an outbreak originated in or spread to Taiwan, the WHO would be helpless to respond.
Taiwan must be allowed to participate in the WHO because the health authorities of Taiwan are the only ones possessing the information and the data permitting the WHO and the world to be informed of and respond effectively to an outbreak of any epidemic on the island that could threaten global health.
Taiwan is excluded from the WHO's global outbreak alert and response network. Through this mechanism, the WHO transmits reports of current outbreaks to and receives important health data from public health professionals and global surveillance partners worldwide. This network permits the member states of the WHO to take appropriate protective measures.
A clear example of the dangers that Taiwan's exclusion from the WHO creates is the enterovirus epidemic that struck Taiwan in 1998. Having spread to Taiwan from Malaysia, this virus infected over 1.8 million Taiwanese people, hospitalized 400, caused 80 deaths and resulted in over $1 billion U.S. value in economic losses.
Taiwan's observer status in the WHO would also enable Taiwan to contribute to the global community more effectively.
Taiwan has special experiences, resources and achievements that it can share with the world. In 2000 the economist intelligence unit of the United Kingdom rated the medical practice in Taiwan as being second among all the developed countries and newly industrialized countries, next only to Sweden.
Taiwan has established a universal health care system, the first in Asia, with 97% coverage.
In 2001 there were 18,265 health care institutions in Taiwan, one physician for every 649 people, one dentist for every 2,570 people, one nurse for every 280 people and 30 hospital beds for every 10,000 people. Taiwan has established a respectable network of disease treatment, reporting and medical research facilities.
Taiwan enjoys one of the highest levels of life expectancy in Asia. At present the life expectancy at birth is 73 for males and 78 for females. Taiwan's maternal and infant mortality rates are comparable to those of western countries.
Taiwan has eradicated infectious diseases such as plague, smallpox, rabies and malaria. No new poliomyelitis cases have been reported since 1983. Taiwan has also been the first country to provide children nationwide with free hepatitis B vaccinations and, in the early 1980s, established effective monitoring and control systems to respond to the HIV/AIDS epidemic.
Taiwan's active pharmaceutical industry is exploring new drugs for cancers and viral diseases as well as chronic diseases such as cardiovascular illness.
Despite being excluded from the WHO, Taiwan has shared its resources with people around the world. From 1995 to 2002, Taiwan donated over $120 million U.S. in medical or humanitarian relief to 78 countries spanning five continents.
Taiwan is involved in Care France's AIDS prevention program in Chad, donates yellow fever vaccines to Senegal and provides condoms and medicines to Burkino Faso and Swaziland to promote anti-AIDS campaigns.
Taiwan also funds a polio eradication program through Rotary International and is involved in malaria eradication and hospital improvement programs in Sao Tome and Principe.
Clearly then Taiwan's participation in the WHO would not be one simply of a modest recipient of benefits.
Taiwan boasts 14 internationally recognized medical schools and supports sophisticated health care delivery and health research systems that are on a par with those of many industrialized countries. Taiwan is fully able to offer financial and technical support to the World Health Organization for the benefit of all members. Its absence from the organization represents an epidemiological “black hole” in the functioning of the World Health Organization.
In order to achieve universality, the WHO has interpreted its rules on participation very flexibly. Many non-nations have been allowed to participate in the WHA sessions as observers. This practice is well established, with a number of entities having been routinely invited for years. This trend has given rise to a new category of quasi-permanent observers.
At present there are five such entities: the Holy Sea; Palestine; the Order of Malta; the International Committee of the Red Cross; and the International Federation of Red Cross and Red Crescent Societies. These entitles are allowed to participate actively in the activities of the WHO, in particular by sending observers to the sessions of the assembly, precisely because they have responsibilities falling within the purview of the WHO and their aims conform with the organizations's objective.
It is clear that the intent of the WHO is to extend its functions and benefits as broadly as possible to all peoples.
In the light of these direct precedents, it is obvious that Taiwan is fully qualified to participate as an observer in the sessions of the WHA. We should note that Taiwan is not applying as an independent state but as an independent health entity. Taiwan possesses the health infrastructure, requisite manpower and scientific knowledge necessary to achieve the objectives fixed by the WHO constitution.
By establishing and continuously improving various projects in public health, sanitation, immunization and drug research, Taiwan's government has genuinely sought the attainment of the highest possible level of health as called for in the WHO constitution. Taiwan surely exercises complete authority and control over its health policy and administration and thus satisfies all the requirements for participation in the work of the WHO.
Let us be crystal clear. The Canadian Alliance motion today reads:
That this House, acknowledging that health issues transcend political borders as seen with the recent outbreak of Severe Acute Respiratory Syndrome (SARS), express its support for the admission of Taiwan as an Observer to the World Health Organization and call upon the government to actively urge other member states and non-governmental organizations to support this goal.
Canada's one China policy is irrelevant in this debate, except to the extent that the Liberal government is using it to stand as an impediment to the health of the world.
The Canadian government falsely claims that Taiwan has full access to WHO services through other agencies without being a member. This is totally contrary to the known facts.
Let us again review why the Canadian Alliance is trying to force the Liberals to do the right thing.
During the recent outbreak of SARS, Taiwan immediately informed the WHO of the first suspected cases on March 14. In the beginning, the WHO's network did not list any information about Taiwan's SARS cases. However, when the network later listed Taiwan's information on March 18, the WHO politicized the issue and categorized Taiwan as a province of China, like Guangdong or Hong Kong.
The WHO refused to send its health experts directly, choosing instead to transfer the case to the U.S. Centers for Disease Control and Prevention in Atlanta, Georgia. As a result, Taiwan could not get valuable health information directly from the WHO or its regional office for the western Pacific. Taiwan was not able to compare its cases of the disease to those in mainland China, Hong Kong or Vietnam under the WHO structure. Valuable time was lost in preventing the spread of the epidemic.
Taiwan's medical experts tried to find out more information about the virus in order to take the appropriate protective measures. Unfortunately the efforts were unsuccessful, despite many attempts. One example was a video conference held by the World Health Organization in which over 30 invited experts discussed SARS. However, Taiwanese experts could not participate in the conference to discuss their experiences. Instead they had to get the information from the Internet 20 hours later. This represents disregard for the health and medical human rights of the Taiwanese people, and is also a great loss to the World Health Organization.
In a press conference on April 11, Chinese official Mr. Liu Peilung mentioned that if Taiwan wanted to have the WHO's assistance it should raise this issue with China, that they would consider it and then collaborate with the WHO to deal with Taiwan. China refused to allow the WHO experts to have entry to Taiwan for seven full weeks.
On the other hand, China has sought assistance from Taiwan through its NGOs. A deputy researcher from the Institute of Biomedical Sciences of Academia Sinica in Taiwan arrived in Beijing on April 8 so that China could benefit from Taiwan's experience.
In the control of communicable diseases, the greatest obstacle that Taiwan faces is the lack of direct and prompt access to information concerning the policies and strategies of the WHO, the recommended specifications for laboratory testing, and the technical details of control measures. Professionals from Taiwan, governmental or otherwise, are denied participation in any symposium, workshop or training program organized by the WHO, even the ones that do not specify “by invitation only”.
This is a clear cut case of the Canadian government dangerously out of touch, grabbing on to its one China policy. I urge the government to stop posturing and fretting over politics. I urge it to support our motion:
That this House, acknowledging that health issues transcend political borders as seen with the recent outbreak of Severe Acute Respiratory Syndrome (SARS), express its support for the admission of Taiwan as an Observer to the World Health Organization and call upon the government to actively urge other member states and non-governmental organizations to support this goal.
