SARS and the WHO

As severe acute respiratory syndrome – SARS – leaps oceans and spreads from continent to continent, one key question is why the People’s Republic of China – communist mainland China – waited more than four months before warning the rest of the world about the deadly sickness that first appeared in its southern provinces. Another is why the Republic of China – democratic Taiwan – is, despite having at least four reported cases, being excluded from World Health Organization information and resources about diagnosis and treatment.

The answer to the first seems to be nothing more than the proclivity of oppressive regimes for secrecy; citizens within and the world without must not know any troubles in workers’ paradise. In this case, however, the PRC’s secrecy went beyond propaganda that twists the truth to something that is taking lives. If the PRC had not ordered the country’s journalists not to report the spreading disease early this year, if that government had instead notified the WHO promptly of this mysterious disease, the time-consuming work of isolating the pathogen and then developing the medicine and techniques to prevent or cure would be four months farther along. Rumor-driven panic within China could have been averted. The disease likely would not have spread throughout Asia to Europe and the Americas.

The answer to the second is, of course, politics. The PRC objects to anything that gives Taiwan even a hint of legitimacy. Official recognition as a nation is out, so is a seat in the U.N., so is membership in the WHO. The PRC’s stubbornness on this matter is so unyielding that the WHO has refused to reply directly to Taiwan’s requests for help and to Taiwan’s offer to provide information and expertise that may be helpful.

Nation or not, Taiwan is home to 23 million human beings who should be included in the WHO’s fundamental goal, according to its constitution, of “the attainment by all peoples of the highest possible level of health.” Taiwan has offered to participate in the WHO not as a member but as an observer, the same “health entity” status given the Red Cross and the Palestinian Authority. The PRC refuses to allow even that common-sense and humane solution.

Taiwan is a prosperous and well-educated place – its health care system is ranked among the very best in the world, its research and public health capabilities give it an extremely strong record in fighting infectious diseases. It shares its resources freely with the rest of the world – whether in Africa, Afghanistan or post-Sept. 11 America, Taiwan has responded quickly and with generosity to health emergencies elsewhere. It is considered particularly expert in earthquake recovery, family planning and the effective distribution of prescription drugs, yet whenever the WHO is involved, the PRC insists that Taiwan be left out.

Taiwan also is a major transportation hub of Asia. This is not the first time a disease originating elsewhere in Asia has spread to the rest of the world through Taiwan. The “bird flu” of this winter and a killer virus in 1997 both took that route. The global economy makes this sort of exclusion an antique the world cannot afford.

Professional medical organizations and legislative bodies (including the U.S. Congress) have called for Taiwan’s meaningful inclusion in the WHO. SARS is now an outbreak on the brink of becoming an epidemic. It is time for the WHO to live up to its constitution and for the People’s Republic of China to behave like a responsible nation.