邱文達部長於第67屆「世界衛生大會」（WHA）發言稿
二○一四年五月二十一日
Mr. President, Director-General Chan, health ministers, distinguished guests, ladies and gentlemen,
Thank you for giving me the opportunity to address the Assembly. As the journal Lancet once stated, “Climate change is the biggest global health threat of the 21st century”. I am pleased to have this opportunity to share with you Chinese Taipei’s experiences and views on this important issue.
Climate change is clearly affecting Taiwan. From 1909 to 2008, our average temperature increased by approximately 1.1 degrees Celsius. Between 2000 and 2009, 11 typhoons brought heavy rainfall that caused serious flooding. In contrast, before 2000 the average was only four such events per decade.
As we are aware, climate change can harm human health in three ways: infections, emergencies, and environmental changes. As for infections, evidence and the National Health Data Bank show that the spread of four communicable diseases in Taiwan is closely related to climate change, including dengue, leptospirosis, melioidosis, and tsutsugamushi.
Due to the heightened frequency of typhoons and intensive rainfall, dengue outbreaks since 2007 have grown from intermittent common-source outbreaks to continuous outbreaks. Over the past decade, three melioidosis cluster outbreaks all happened within one to three weeks after typhoons with torrential rain. After Typhoon Morakot hit Taiwan in 2009, a leptospirosis cluster outbreak brought about 130 confirmed cases. Moreover, since 2000, the incidence of tsutsugamushi has more than doubled.
As far as emergencies, the second way climate change can harm human health, the frequency of flooding caused by typhoons has tripled over the past decade in Taiwan, with a corresponding rise in casualties.
In order to meet such challenges, Chinese Taipei has set up the Central Emergency Operation Center, which is capable of responding to 22 types of disasters. Meanwhile, more than 500 hospitals across Taiwan have established emergency response mechanisms.
In terms of environmental changes, the third way climate change harms human health is the combination of rising temperatures and high humidity, which has magnified the number of related fatalities. Research shows that heat index readings above 38 degrees Celsius can cause a higher mortality rate, especially when humidity rises concurrently.
In response, Chinese Taipei has established a project that supports vulnerable populations before and during extreme weather events, such as overly high or overly low temperatures. For example, cardiovascular disease and stroke patients admitted into emergency rooms during the coldest months rose by 11% in 2012 so more lives were able to be saved with early prevention.
Other diseases caused by environmental change, such as cataracts and skin cancer, which stem from excessive ultraviolet radiation exposure, and airborne allergic diseases like asthma, have also gradually increased over the past decade.
Chinese Taipei fully supports the WHO’s work plan on climate change and health. We have established a cross-ministry standing committee that develops policy frameworks and action plans aimed at mitigating the impact of climate change.
The impact of climate change on human health is imminent and present. We need to work as a team to tackle this challenge. Chinese Taipei is willing and able to join and contribute to related global efforts. We hope that our good will is noted, and that our meaningful and dignified participation in the WHO can be broadened. I call for the model of our presence in the WHA to be further expanded to other WHO-related meetings, mechanisms and activities, so that we can join WHO efforts to fight health issues caused by climate change.
Lastly, I would like to express my best wishes for a successful 67th World Health Assembly! 台灣加油（台語）! Thank you.
非常謝謝主席給我發言的機會。「the Lancet」期刊曾說：「氣候變遷將是21世紀對人類健康最大的威脅」(“Climate change is the biggest global health threat of the 21st century”)。
台灣明顯受到氣候變遷的影響，從1909年至2008年，平均氣溫約增加1.1ºC。在2000至2009年之間，侵襲台灣的強降雨颱風次數即達11次，並造成嚴重水患，而過去每10年間卻僅有4次而已。
氣候變遷影響健康的因素有三，分別是感染、緊急事故、環境變化的挑戰。在感染方面，極端氣候表現將會造成災難的增加，進而影響各類傳染性疾病的發生。台灣的實證及國家健康資料庫數據顯示，與氣候變遷有關的傳染性疾病有四種，分別是登革熱(Dengue) 、鉤端螺旋體病(Leptospirosis)、類鼻疽(Melioidosis)及恙蟲病(Tsutsugamushi disease)。
由於颱風與降雨頻率增加，登革熱從2007年起由過去間歇性變成持續性群突發。過去10年來還發生3次類鼻疽群突發，均在颱風強降雨後1-3週內發生。鉤端螺旋體病亦在2009年莫拉克颱風過後，發生累計達130例的群突發。自2000年起至今，恙蟲病的發生率則倍增。
第二種氣候變遷對健康的影響是在緊急事故方面。台灣風災、水災在近10年增加了近3倍，死亡及傷害也相對增加。
面對這些挑戰，台灣有系統完整的「中央災害應變中心」，可以因應22種災害，至於全國超過500家醫院也都建立了緊急應變機制。
第三種氣候變遷對健康的影響是在環境變化方面，高熱、高濕度對死亡的衝擊最為顯著。台灣的研究顯示，死亡率可能大幅提升為熱指標溫度超過38 ºC時，一旦超過這個指標溫度，濕度越高，死亡率也越高。
為此，中華台北很早就設有「超低溫及超高溫弱勢關懷專案」，針對易受傷害族群等，在最冷及最熱的天候下，給予最直接的關懷及預防，比如2012年最冷的月份，心血管、腦中風急診就醫通報量就增加11%，事先的宣導及預防可減少罹病及致死率。
環境變化通常也會導致紫外線輻射的增加，台灣發現近10年白內障與皮膚癌個案有逐步增加趨勢，白內障患者也出現年輕化現象。空氣污染即過敏原的增加，在過去十餘年來，也導致過敏性疾病如氣喘等逐漸增加。
我們非常支持世界衛生組織對氣候變遷所訂的各項工作計劃。我們有常設性因應氣候變遷的跨部會委員會，針對氣候變遷調適制訂政策綱領及行動計畫，希望能緩解氣候變遷所造成的衝擊。
氣候變遷對健康的影響甚鉅且迫在眉睫，我們必須團結合作處理這項挑戰。中華台北不但期盼且有能力參與及貢獻心力和全球一同努力，我們希望我們的善意能被注意到，也希望能夠有意義及有尊嚴地擴大參與世界衛生組織。我再度籲請WHO採用我方在WHA模式所使用的名稱，讓我們進一步擴大參與世界衛生組織相關會議、機制及活動，讓中華台北和世界衛生組織夥伴共同對抗氣候變遷所帶來的健康危害。
最後，本人在此敬祝第67屆世界衛生大會圓滿順利。台灣加油！