Update: How the World Health Organization works with all people, everywhere

In recent months we have seen misunderstandings in social media and the news media about how WHO manages global public health issues. In particular, there are a lot of questions about Taiwan, China issues. Some people are confusing WHO’s technical global public health mandate, with the mandate of countries to determine WHO’s membership. Countries decide this. The WHO Secretariat focuses on keeping the world safe.

WHO works to promote the health of all people, everywhere. Indeed, one of our overarching goals is Universal Health Coverage. #healthforall. We are an organization with a staff of physicians, scientists, researchers and public health experts who are committed to serving all people regardless of nationality, race, ethnicity, religion, gender. 

This includes the people of Taiwan. We serve them through regular interactions with their experts and authorities on vital public health issues. This has been the case over many years, including during the COVID-19 pandemic.

It is understandable that some people might think that the composition of WHO’s membership affects our ability to keep the world safe. But it is important to understand both how we are governed and how we operate in practice.

WHO is part of the United Nations, whose membership is the mandate of countries. In 1971, countries of the world participating in the United Nations General Assembly recognized the People’s Republic of China as “the only legitimate representative of China,” in effect, a one-China policy. That is contained in UNGA Resolution 2758. In 1972, the World Health Assembly decided in WHA Resolution 25.1 to follow that.

Every year, members have a chance to discuss important proposals during the World Health Assembly, where rules and policies governing WHO are decided. For example, at different times, some countries have proposed giving Taiwan’s authorities a special status – that of observing the annual World Health Assembly.

There have been 14 times over the last 22 years (1997-2006; and in 2008, 2017, 2018, 2019) when countries discussed whether a delegation from Taiwan could attend the World Health Assembly as an observer. Each time the countries decided against it by consensus – except in 1997 and 2004 when there were votes: (by 128 votes to 19 in 1997; and by 133 votes to 25 in 2004). In 2007, the issue wasn’t observer status, but membership, and countries decided against considering that by a vote of 148 to 17.

There have been occasions when it was clear that there was general support among WHO countries for Taiwan to take an observer seat at the World Health Assembly. Between 2009 and 2016, it did so under the name “Chinese Taipei.”

But having a seat at the WHA, or not having a seat at the WHA, does not affect, in any way, whether an area or population benefits from WHO expertise and guidance. WHO helps all people, everywhere.

WHO and Taiwan’s health experts interact throughout the year on vital public health and scientific issues, according to well-established arrangements.

During the current COVID-19 pandemic, interactions have been stepped up, both through existing channels and new ones as well.

 

Here are examples of WHO-Taiwan interactions around the coronavirus pandemic:

— There is an established International Health Regulations (IHR) Point of Contact (POC) for Taiwan. Taiwan’s POC receives IHR (2005) communications, provides IHR information updates from Taiwan directly to WHO Headquarters, and has access to the IHR Event Information Site (EIS) system. The EIS system is a password-protected database and information exchange platform supporting the IHR. It is the well-established platform for all IHR communications, back and forth, between WHO and IHR contacts.

— Health experts from Taiwan participate in two of the key WHO networks set up in January 2020 to support WHO work in the global COVID-19 response. Three experts from Taiwan are part of the WHO Infection Prevention and Control Network: two are part of the WHO Clinical Network. Every week, they join some 60 to 80 other experts from around the globe through a WHO-hosted teleconference, working to advance our knowledge and guidance in this response.

— Two public health experts from Taiwan participated in the Global Research and Innovation Forum organized by WHO on 11-12 February 2020. They took part, alongside other world scientists, in considering critical research questions and in finding ways to work together to advance the response.

— Taiwan’s Field Epidemiology Training Program is a member of the Training Programs in Epidemiology and Public Health Interventions Network (also known as “TEPHINET”). WHO shares Global Outbreak Alert and Response Network alerts and requests for assistance with TEPHINET, and those messages are cascaded to the TEPHINET members.

— WHO, through its technical lead, has directly briefed health authorities from Taiwan and has offered again.

–Taiwan’s health experts and authorities have open access to developments, guidance and other materials through the WHO’s website (www.who.int) and other digital platforms.

–They can access the www.OpenWHO.org platform, which hosts open online courses for decisionmakers and responders around the world. During the COVID-19 pandemic, OpenWHO usage has reached more than 1 million.

–WHO has a designated contact point with their office in Geneva. Through this channel, general questions are handled and when technical concerns arise, WHO technical responses are coordinated.

–WHO also interacts with Taiwan’s health authorities through the European Centre for Disease Prevention and Control.

Importantly, the COVID-19 caseload in Taiwan is low relative to population. We continue to follow developments closely, and WHO is taking lessons learned from all areas.

 

Interactions with Taiwan during the response to the pandemic is not exceptional. Here are some examples of regular interactions with Taiwan’s health authorities and WHO, over many years, through well-established arrangements, and across many different global health concerns:

  • Over the course of 2019, Taiwan’s experts were invited to attend 9 WHO technical meetings. They attended 8 of these meetings, contributing to WHO expert processes on issues including immunization, drug-resistant TB, assistive technologies, vaccine safety and SDG targets on NCDs and Mental Health. Prior to the Covid-19 emergency, work was underway for more expert participation from Taiwan in 2020.
  • On influenza, Taiwan vaccine manufacturer Adimmune contributes to the WHO Pandemic Influenza Preparedness Framework (PIP Framework) and preparations are underway for concluding an agreement between WHO and Adimmune under the PIP Framework for pandemic influenza vaccine products;
  • In the fight against cancer, experts from Taiwan have contributed to key publications issued by the WHO International Agency for Research on Cancer;
  • In support of the International Health Regulations, an expert from Taiwan has been appointed to the IHR Expert Roster; and
  • On a range of other issues, from WHO pre-qualification practices for pharmaceutical manufacturers to malaria, there are exchanges with WHO on practical and technical issues.

It is fair to say that the contribution of Taiwan’s health experts to WHO, and their interactions with us, are well-developed and broad-based. And these interactions add value to the work of WHO and to global health.

 

Building Health Lab

Architect since 2002, experienced in healthcare environment design. Master in public health sciences from the Charité Medical University in Berlin. Evidence-based Design researcher at TU-Berlin, helping ensure that urban & architectural design projects build positive health effectively. Founder of the Building Health Lab. BHL Building Health Lab Is a think tank that develops urban concepts for neighborhoods as strategy to build a sustainable healthy city. Our mission is to help government, industry, and citizens develop projects with social impact that protect people and planet health. With our expertise in health and design, we support health promotion and disease management through people-centred and climate adaptive designs.