臺灣可以幫忙-與世界建立更具韌性及包容力的全球衛生體系
陳時中部長
衛生福利部
中華民國(臺灣)
新興傳染病對全球人類健康及經貿旅遊的威脅從未間斷過，疾病大流行可因國際航空運輸而加速散播到全球各地，如今，2019年底從中國武漢傳出的新形態肺炎(COVID-19)，至2021年3月底為止，已造成全球超過1億2,600萬名確診病例、270萬人死亡，對全球衛生、經濟及社會等層面產生巨大衝擊，亦嚴重威脅各國為聯合國永續發展目標(SDGs)所做的努力。
臺灣因地理鄰近中國，曾被預測會是受疫情影響最嚴重的國家之一。然而，因為有2003年對抗SARS的經驗，我國並未忽視所收到的警訊，依據不斷更新的各種官方及非官方資訊，研判該新興疾病的傳播及嚴重程度已超過全球各界所認知，自2019年12月31日起充分利用各種資訊來加強監測，自2020年1月21日發生首例確診個案後，更不間斷地針對此疾病實施公共衛生阻絕措施。至2021年4月22日，我國僅有1,086起確診案例(含11例死亡)，大部分民眾維持正常的生活及工作。自大流行發生起，臺灣持續遏止COVID-19，且曾締造2020年4月至12月連續253天無本土傳播的紀錄。
臺灣自SARS後建立了全國傳染病防治醫療網，由六區域臨床傳染病專家領導及指揮，於全國擇定100多家隔離醫院納入醫療網，再於22縣市皆擇定一主要應變醫院。此醫療網運作獲法律授權，政府可依據公共衛生和臨床照護需求，指定網內的醫院收治高度傳染性疾病患者。而事實也證明此機制有助於保護醫療系統和醫療工作者免於負荷過重，讓大多數非COVID-19之醫療服務可以在COVID-19大流行期間正常運作不受干擾。至目前為止，臺灣僅發生兩次與醫院相關的COVID-19流行事件，且均獲有效控制，總共11例確診、無醫療工作者死亡。
因有及早且有效的公衛控制措施，COVID-19對臺灣所造成的經濟影響較輕微。又為維持必要的國際、社會、經濟及貿易活動，我們對相關的船舶及飛航彈性調整人員檢疫措施，故捕漁業、離岸風力場、航空業皆可繼續營運，臺灣2020年的GDP成長約為3.11%，其中第四季更成長4.94%，與全球經濟衰退形成鮮明對比。另一方面，民眾對於政府的信任及合作是此次臺灣成功抑制COVID-19大流行的一重要因素。政府秉持著合理應對、最小損失、循序漸進等原則制定疾病管制規定，努力符合民眾知的權利並同時維護個人隱私與自由，也堅持公平原則，對弱勢族群(包含移工)提供優先保護，以主動回應人民的期待。臺灣在COVID-19大流行中強調健康權及保護，並強烈反對侵犯人民權利，從未限制民眾自由表達、集會及參與公共活動等。
COVID-19大流行為所有國家帶來了沉重的打擊，尤其對於脆弱、高暴露風險、無法獲得良好醫療服務及因管制措施而遭受損失等族群影響更鉅，做為國際社會負責任之一員，臺灣將盡最大努力與世界衛生組織(WHO)及全球衛生領袖合作，確保每個人皆可享有健康的生活方式及工作條件，我們亦將監測健康不平等情形，以有效倡導所有人皆可獲得高品質的醫療衛生服務。
因醫療體系健全、檢驗策略嚴謹、資訊透明公開及公私部門合作，臺灣是全球應變疫情最成功的國家之一。COVID-19疫情再次證實臺灣不應被置於全球衛生網絡之外，我們是全球新興傳染病威脅之監測及警報系統中不可或缺的一環，且臺灣模式可以持續遏止大流行的蔓延。臺灣也在大流行中展現出對於生醫治療及相關工具的快速研發及產製能力 (包括兩款第二期試驗中的COVID-19疫苗)。因此，臺灣如能全面參與全球COVID-19診斷試劑、疫苗及治療藥物的供應平台，將能有所貢獻，攜手和世界合作。
我們籲請WHO及相關各方堅定支持將臺灣納入WHO，讓臺灣完整參與WHO各項會議、機制及活動，與世界各國攜手，共同落實WHO憲章「健康是基本人權」及聯合國永續發展目標「不遺漏任何人」之願景。
Building a resilient and inclusive global health system together—Taiwan can help
Dr. Shih-chung Chen
Minister of Health and Welfare
Republic of China (Taiwan)
The threat that emerging infectious diseases pose to global health and the economy, trade, and tourism never ceases. Pandemics can spread rapidly around the world due to international aviation and transport. As of March 2021, a novel form of pneumonia that first emerged in Wuhan, China, at the end of 2019 and has since been classified as coronavirus disease 2019 (COVID-19) has caused more than 126 million cases and more than 2.7 million deaths worldwide. The disease has had an enormous medical, economic, and social impact around the world, and significantly threatened global efforts to achieve the United Nations Sustainable Development Goals.
Due to its proximity to China, Taiwan had been expected to be one of the countries most severely affected by the epidemic. But given its experience of fighting the 2003 SARS outbreak, Taiwan did not ignore the alarms, piecing together evolving official and unofficial accounts to form a picture of the emerging disease that implied a scope and severity worse than the global public perception suggested. Authorities used this information to launch enhanced monitoring on December 31, 2019, and have tirelessly implemented public health containment measures since Taiwan’s first case was detected on January 21, 2020. As of April 22, 2021, there had been 1,086 confirmed cases, including 11 deaths, in Taiwan. Life and work have continued much as normal for the majority of the population. Taiwan has contained COVID-19 ever since the beginning of the pandemic, including a record 253 days without any cases of domestic transmission between April and December 2020.
After dealing with SARS, Taiwan established a nationwide infectious disease healthcare network that is led and overseen by infectious disease experts across six regions. More than 100 secondary response hospitals are included in the network and all twenty-two special municipalities, counties and cities have designated their primary response hospitals. The network also provides the legal authority for transferring patients with highly contagious diseases to designated facilities based on public health and clinical need. This has proven instrumental in protecting health systems and health professionals from being overwhelmed, and allowed most non-COVID-19 health services to continue to operate without disruption during the pandemic. To date, there have been only two hospital-associated COVID-19 outbreaks in Taiwan. Both were well managed resulting a total of 11 cases and zero death of health professionals.
By introducing public health control measures early and effectively, Taiwan has also mitigated the economic impact of COVID-19. To maintain essential international, social, economic, and trade activities, Taiwan implemented flexible adjustments for related quarantine measures for vessels and aircraft so that fisheries, offshore wind farms, and air transport industries could continue operations. In stark contrast with the global economic contraction, Taiwan’s GDP growth for 2020 was approximately 3.11 percent, with even higher growth of 4.94 percent in the fourth quarter. Furthermore, public trust and cooperation with the government’s response have been key to successfully containing COVID-19. In formulating disease control regulations, the government has adhered to the principles of reasonable response, minimum damage, and gradual adoption. It has worked hard to maintain the balance between people’s right to know and personal privacy and freedom, actively responding to people’s wishes by upholding the principle of fairness at the same time as prioritizing the protection of disadvantaged groups, including migrant workers. Throughout this pandemic, Taiwan has demonstrated an emphasis on the right to health and associated protections and strong opposition to human rights abuses. Indeed, at no point has Taiwan restricted people’s right to free expression, assembly, or participation in public life.
Although COVID-19 has hit all countries hard, its impact has been harshest among already vulnerable and high-risk communities, as well as those lacking quality health care services and those unable to handle the adverse consequences of antipandemic containment measures. As a responsible member of the international community, Taiwan will do its utmost to work with the World Health Organization and global health leaders to ensure that all people enjoy living and working conditions that are conducive to good health. We will also monitor health inequities to advocate more effectively for universal access to quality health services.
Thanks to its robust health system, rigorous testing strategies, information transparency, and public-private partnerships, Taiwan’s response to COVID-19 has been one of the world’s success stories. This pandemic has proven yet again that Taiwan cannot remain outside of the global health network. Taiwan plays an indispensable role in the global monitoring and early warning systems that detect the threat of emerging infectious diseases, and the Taiwan Model has proven consistently capable of containing COVID-19. The pandemic has also highlighted Taiwan’s capacity to research, develop, produce, and supply therapies and associated tools quickly (including two COVID-19 vaccines that are presently in Phase 2 trials). Being able to comprehensively participate in and contribute to international COVID-19 supply chain systems, as well as global diagnostics, vaccine, and therapeutics platforms, would allow Taiwan to work with the rest of the world.
We urge WHO and related parties to acknowledge Taiwan’s longstanding contributions to the international community in the areas of public health, disease prevention, and the human right to health, and to include Taiwan in WHO and its meetings, mechanisms, and activities. Taiwan will continue to work with the rest of the world to ensure that all enjoy the fundamental human right to health as stipulated in the WHO Constitution. Echoing the mantra of the United Nations’ 2030 Sustainable Development Goals, no one should be left behind.