Taiwan and the World Health Assembly/World Health Organization: Perspectives from Health Services and Research

In: International Journal of Taiwan Studies
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  • 1 Associate Professor, Division of Health Sciences, Warwick Medical School, University of Warwick, UK

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Despite being one of Asia’s major economies with a population of over 23 million, Taiwan has been mostly excluded from the World Health Assembly/World Health Organization (wha/who) since 1972, due to China’s objection. While this has not stopped Taiwan from developing a comprehensive healthcare system and being an active member of international health community, the lack of membership in the world’s leading health authority undermines global health and presents perverse, and yet often neglected, inequality faced by Taiwanese people. This article aims to provide contextual information concerning the impacts of Taiwan’s exclusion from wha/who by: (1) enumerating health-related areas where Taiwan has rich knowledge and experiences that would have been cascaded much more widely and efficiently to those in need around the world had it been allowed to participate; and (2) highlighting difficulties faced by Taiwanese people and potential threats to international health arising from the exclusion.

  • Beasley Palmer ; Lin Chia-Chin ; Hwang Lu-Yu et al. (1981) ‘Hepatocellular carcinoma and hepatitis B virus: A prospective study of 22 707 men in Taiwan’, The Lancet 2(8256): 11291133.

    • Search Google Scholar
    • Export Citation
  • Central Intelligence Agency (2019) ‘The world factbook country comparison: Birth rate’, Retrieved 19 July 2019 from https://www.cia.gov/library/publications/resources/the-world-factbook/fields/345rank.html.

  • Chang Mei-Hwei ; Chen Chien-Jen ; Lai Mei-Shu et al. (1997) ‘Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in children’, New England Journal of Medicine 336(26): 18551859.

    • Search Google Scholar
    • Export Citation
  • Chen Calvin Yu-Chian (2011) ‘tcm Database@Taiwan: The world’s largest traditional Chinese medicine database for drug screening in silico’, PLoS ONE 6(1): e15939.

    • Search Google Scholar
    • Export Citation
  • Chen Chi-Ling ; Hsu Lin-I ; Chiou Hung-Yi et al. (2004) ‘Ingested arsenic, cigarette smoking, and lung cancer risk: A follow-up study in arseniasis-endemic areas in Taiwan’, Journal of the American Medical Association 292(24): 29842990.

    • Search Google Scholar
    • Export Citation
  • Chen Chien-Jen ; Chuang Ya-Chien ; Lin Tong-Ming . (1985) ‘Malignant neoplasms among residents of a blackfoot disease-endemic area in Taiwan: High-arsenic artesian well water and cancers’, Cancer Research 45(11): 58955899.

    • Search Google Scholar
    • Export Citation
  • Chen Ding-Shinn ; Hsu Nora Hsu-Mei ; Sung Juei-Low . (1987) ‘A mass vaccination program in Taiwan against hepatitis B virus infection in infants of hepatitis B surface antigen-carrier mothers’, Journal of the American Medical Association 257(19): 25972603.

    • Search Google Scholar
    • Export Citation
  • Chen Fang-Pey ; Chen Tzeng-Ji ; Kung Yen-Ying et al. (2007) ‘Use frequency of traditional Chinese medicine in Taiwan’, BMC Health Services Research 7: 26.

    • Search Google Scholar
    • Export Citation
  • Chen Huey-Ling ; Chang Mei-Hwei ; Ni Yen-Hsuen . (1996) ‘Seroepidemiology of hepatitis B virus infection in children: Ten years of mass vaccination in Taiwan’, Journal of the American Medical Association 276(11): 906908.

    • Search Google Scholar
    • Export Citation
  • Chen Yu-Chun ; Yeh Hsiao-Yun ; Wu Jau-Ching . (2011) ‘Taiwan’s National Health Insurance Research Database: Administrative health care database as study object in bibliometrics’, Scientometrics 86(2): 365380.

    • Search Google Scholar
    • Export Citation
  • Cheng Shou-Hsia and Chiang Tung-Liang (1997) ‘The effect of universal health insurance on health care utilization in Taiwan: Results from a natural experiment’, Journal of the American Medical Association 278(2): 8993.

    • Search Google Scholar
    • Export Citation
  • Cheng Tsung-Mei (2003) ‘Taiwan’s new national health insurance program: Genesis and experience so far’, Health Affairs 22(3): 6176.

    • Search Google Scholar
    • Export Citation
  • Cheng Tsung-Mei (2015) ‘Reflections on the 20th anniversary of Taiwan’s single-payer National Health Insurance System’, Health Affairs 34(3): 502510.

    • Search Google Scholar
    • Export Citation
  • Chiou Hung-Yi ; Chiou Shu-Ti ; Hsu Yi-Hsiang . (2001) ‘Incidence of transitional cell carcinoma and arsenic in drinking water: A follow-up study of 8,102 residents in an arseniasis-endemic area in northeastern Taiwan’, American Journal of Epidemiology 153(5): 411418.

    • Search Google Scholar
    • Export Citation
  • Cyranoski David (2003) ‘Taiwan left isolated in fight against SARS’, Nature 422: 652.

  • Cyranoski David (2018) ‘The big push for Chinese medicine’, Nature 561: 448450.

  • Drosten Christian ; Lau Arthur Chun-Wing ; Preiser Wolfgang . (2003) ‘Timeline’, in Bernd Sebastian Kamps and Christian Hoffmann (eds), SARS Reference – 10/2003. SARS Reference.com, Flying Publisher, 1529. Retrieved 28 March 2018 from http://sarsreference.com/sarsreference.pdf.

    • Search Google Scholar
    • Export Citation
  • GBD 2013 Mortality and Causes of Death Collaborators (2015) ‘Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: A systematic analysis for the Global Burden of Disease Study 2013’, The Lancet 385(9963): 117171.

    • Search Google Scholar
    • Export Citation
  • Herington Jonathan and Lee Kelley (2014) ‘The limits of global health diplomacy: Taiwan’s observer status at the world health assembly’, Global Health 10: 71.

    • Search Google Scholar
    • Export Citation
  • Hickey Dennis (2006) ‘The high cost of excluding Taiwan from the who ’, in Edward Friedman (ed), China’s Rise, Taiwan’s Dilemmas and International Peace, Abingdon, Oxon: Routledge, 6884.

    • Search Google Scholar
    • Export Citation
  • Hsing Ann and Ioannidis John (2015) ‘Nationwide population science: Lessons from the Taiwan National Health Insurance Research Database’, JAMA Internal Medicine 175(9): 15271529.

    • Search Google Scholar
    • Export Citation
  • Hsu Hsu-Mei ; Chen Ding-Shinn ; Chuang Cheng-Hua . (1988) ‘Efficacy of a mass hepatitis B vaccination program in Taiwan: Studies on 3464 infants of hepatitis B surface antigen-carrier mothers’, Journal of the American Medical Association 260(15): 22312235.

    • Search Google Scholar
    • Export Citation
  • Hui David and Sung Joseph (2003) ‘Severe acute respiratory syndrome’, Chest 124(1): 1215.

  • International Conference on Primary Health Care (1978) ‘Declaration of Alma-Ata’, International Conference on Primary Health Care, Alma-Ata, USSR. Retrieved 25 September 2018 from http://www.who.int/publications/almaata_declaration_en.pdf.

    • Search Google Scholar
    • Export Citation
  • International HapMap Consortium (2003) ‘The International HapMap Project’, Nature 426: 789.

  • Iuliano A. Danielle ; Roguski Katherine M. ; Chang Howard H. . (2018) ‘Estimates of global seasonal influenza-associated respiratory mortality: A modelling study’, The Lancet 391(10127): 12851300.

    • Search Google Scholar
    • Export Citation
  • Jones Gavin and Shen Hsiu-hua (2008) ‘International marriage in East and Southeast Asia: Trends and research emphases’, Citizenship Studies 12(1): 925.

    • Search Google Scholar
    • Export Citation
  • Ko Chih-Hung ; Yen Cheng-Fang ; Yen Ju-Yu . (2006) ‘Psychosocial impact among the public of the severe acute respiratory syndrome epidemic in Taiwan’, Psychiatry and Clinical Neurosciences 60(4): 397403.

    • Search Google Scholar
    • Export Citation
  • Ko Ying‐Chin ; Huang Yung‐Li ; Lee Chien‐Hung . (1995) ‘Betel quid chewing, cigarette-smoking and alcohol-consumption related to oral-cancer in Taiwan’, Journal of Oral Pathology & Medicine 24(10): 450453.

    • Search Google Scholar
    • Export Citation
  • Lee Chien-Hung ; Ko Albert Min-Shan ; Warnakulasuriya Saman . (2012) ‘Population burden of betel quid abuse and its relation to oral premalignant disorders in South, Southeast, and East Asia: An Asian betel-quid consortium study’, American Journal of Public Health 102(3): e1724.

    • Search Google Scholar
    • Export Citation
  • Lee Chien‐Hung ; Lee Jang‐Ming ; Wu Deng‐Chyang . (2005) ‘Independent and combined effects of alcohol intake, tobacco smoking and betel quid chewing on the risk of esophageal cancer in Taiwan’, International Journal of Cancer 113(3): 475482.

    • Search Google Scholar
    • Export Citation
  • Lee Kelley and Fang Jennifer (2016) ‘Challenges and opportunities for Taiwan’s global health diplomacy’, Brookings Institution. Retrieved 28 March 2018 from https://www.brookings.edu/opinions/challenges-and-opportunities-for-taiwans-global-health-diplomacy/.

    • Search Google Scholar
    • Export Citation
  • Lin Fang-yan (2003) ‘We want who membership, not sars ’, Taiwan Journal, 4 April, p. 1.

  • Ministry of Foreign Affairs (mofa) (2018a) ‘中國大陸阻撓我國際空間事例’ [Incidents of mainland China’s interference with Taiwan’s international space], Ministry of Foreign Affairs, Republic of China (Taiwan). Retrieved 24 March 2019 from https://www.mofa.gov.tw/Content_List.aspx?n=442A97CFB4A0C56C.

  • Ministry of Foreign Affairs (mofa) (2018b) ‘國際合作發展事務106年度報告’ [International cooperation and development report 2017], Ministry of Foreign Affairs, Republic of China (Taiwan). Retrieved 19 June 2019 from https://www.mofa.gov.tw/News_Content_M_2.aspx?n=A30D6E978846B3C0&sms=BA727B25FD99C6CC&s=CD25E4C1B455F119.

  • Ministry of Labor (2018) ‘Foreign workers’, Ministry of Labor, Republic of China (Taiwan), 20 September. Retrieved 13 October 2018 from http://statdb.mol.gov.tw/html/mon/i0120020620e.htm.

  • National Health Insurance Administration (2016) ‘2015–2016 全民健康保險年報’ [2015–2016 National Health Insurance Annual Report], National Health Insurance Administration, Ministry of Health and Welfare (Taiwan). Retrieved 21 March 2018 from http://www1.nhi.gov.tw/Nhi_E-LibraryPubWeb/CustomPage/Periodical.aspx?FType=8.

  • National Health Insurance Administration (2018a) ‘2017–2018 全民健康保險年報’ [2017–2018 National Health Insurance Annual Report], National Health Insurance Administration, Ministry of Health and Welfare (Taiwan). Retrieved 21 March 2018 from http://www1.nhi.gov.tw/Nhi_E-LibraryPubWeb/CustomPage/Periodical.aspx?FType=8.

  • National Health Insurance Administration (2018b) ‘National Health Insurance Annual Statistical Report 2017’, National Health Insurance Administration, Ministry of Health and Welfare (Taiwan). Retrieved 28 October 2018 from https://www.nhi.gov.tw/English/Content_List.aspx?n=0D39BCF70F478274&topn=616B97F8DF2C3614 [in both Chinese and English].

  • Ni Yen–Hsuan ; Huang Li-Min ; Chang Mei–Hwei et al. (2007) ‘Two decades of universal hepatitis B vaccination in Taiwan: Impact and implication for future strategies’, Gastroenterology 132(4): 12871293.

    • Search Google Scholar
    • Export Citation
  • ‘Not on the list’ (2017), Editorial, Nature 545(25 May): 385.

  • Qiu Wuqi ; Chu Cordia ; Mao Ayan et al. (2018) ‘The impacts on health, society, and economy of sars and H7N9 outbreaks in China: A case comparison study’, Journal of Environmental and Public Health. https://doi.org/10.1155/2018/2710185.

    • Search Google Scholar
    • Export Citation
  • Strong Matthew (2017) ‘China threatens Taiwan Medical Association with name change: doctor; Beijing threatens not to host 2021 wma General Assembly’, Taiwan News, 15 October. Retrieved 15 October 2017 from https://www.taiwannews.com.tw/en/news/3274810.

    • Search Google Scholar
    • Export Citation
  • ‘Taiwan: Time to end the exile’ (1999), Editorial, The Lancet 354(9196): 2093.

  • Tangcharoensathien V. ; Mills A. ; and Palu T. (2015) ‘Accelerating health equity: The key role of universal health coverage in the Sustainable Development Goals’, BMC Medicine 13: 101.

    • Search Google Scholar
    • Export Citation
  • Tourism Bureau Ministry of Transport and Communication (2016) ‘Annual statistical report on tourism 2015’, Ministry of Transport and Communication (Taiwan). Retrieved 1 November 2018 from http://211.79.207.171/ebook/A20013544.pdf.

  • ‘Uncharted territory’ (2011), Editorial, Nature 478: 285.

  • Vogel Ezra (1991) The Four Little Dragons: The Spread of Industrialization in East Asia, Cambridge, MA: Harvard University Press.

  • Wang Hui-Po and Wang Chun-Li (2018) ‘Risk undermined in the bilateral pharmaceutical regulatory system in Taiwan’, Journal of Food and Drug Analysis 26(2 Supplement): S3S11.

    • Search Google Scholar
    • Export Citation
  • Wen Chi Pang ; Tsai Shan Pou ; and Chung Wen-Shen Isabella (2008) ‘A 10-year experience with universal health insurance in Taiwan: Measuring changes in health and health disparity’, Annals of Internal Medicine 148(4): 258267.

    • Search Google Scholar
    • Export Citation
  • World Health Organization (who) (2003) ‘The operational response to sars’, who, 16 April. Retrieved 31 October 2018 from http://www.who.int/csr/sars/goarn2003_4_16/en/.

  • World Health Organization (who) (2006) ‘Constitution of the World Health Organization’, who. Retrieved 15 June 2019 from https://www.who.int/governance/eb/who_constitution_en.pdf.

  • World Health Organization (who) (2012) ‘Vaccines against influenza who position paper, November 2012’, Weekly Epidemiological Record 87: 461–476.

  • World Health Organization (who) (2017) ‘Global hepatitis report, 2017, who. Retrieved 14 October 2018 from https://www.who.int/hepatitis/publications/global-hepatitis-report2017/en/.

  • World Health Organization (who) (2018) ‘Dengue and severe dengue’, who, 13 September. Retrieved 31 October 2018 from https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue.

  • World Health Organization (who) (2019) ‘Global Influenza Surveillance & Response System (gisrs)’, who. Retrieved 1 April 2019 from http://www.who.int/influenza/gisrs_laboratory/updates/gisrs_one_pager/en/.

  • World Health Organization (who) Communicable Disease Surveillance and Response (2003) ‘Severe acute respiratory syndrome (sars): Status of the outbreak and lessons for the immediate future’, who, 20 May. Retrieved 31 October 2018 from https://www.who.int/csr/media/sars_wha.pdf.

  • World Medical Association (wma) (2005) ‘wma Council Resolution on observer status for Taiwan to the World Health Organization (who) and inclusion as participating party to the International Health Regulations (ihr)’, wma. Retrieved 1 November 2018 from https://www.wma.net/policies-post/wma-council-resolution-on-observer-status-for-taiwan-to-the-world-health-organization-who-and-inclusion-as-participating-party-to-the-international-health-regulations-ihr/.

  • Wu Grace Hui-Min ; Pwu Raoh-Fang ; and Chen Shih-Chung (2018) ‘Achieving hepatitis C elimination in Taiwan: Overcoming barriers by setting feasible strategies’, Journal of the Formosan Medical Association 117(12): 10441045.

    • Search Google Scholar
    • Export Citation
  • Yang Yung‐Mei ; Wang Hsiu‐Hung ; Lee Fang‐Hsin . (2015) ‘Health empowerment among immigrant women in transnational marriages in Taiwan’, Journal of Nursing Scholarship 47(2): 135142.

    • Search Google Scholar
    • Export Citation
  • Yeh Ming-Jui and Chang Heng-Hao (2015) ‘National Health Insurance in Taiwan’, Health Affairs 34(6): 1067.

  • Zhong N. S. ; Zheng B. J. ; Li Y. M. . (2003) ‘Epidemiology and cause of severe acute respiratory syndrome (sars) in Guangdong, People’s Republic of China, in February, 2003’, The Lancet 362(9393): 13531358.

    • Search Google Scholar
    • Export Citation

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