因應下一波大流行，臺灣不能缺席
薛瑞元部長
衛生福利部
中華民國(臺灣)
歷時三年的COVID-19大流行，不僅造成眾多生命消逝，加劇各種健康不平等現象，亦導致前所未有的全球性經濟衰退，對世界上每個人的生活帶來持續影響，顯示既有的全球衛生治理架構並不能有效因應全球衛生安全危機。雖然COVID-19疫情不再是「國際關注的緊急公共衛生事件(PHEIC)」，國際貿易與經濟活動幾乎已恢復正常，但如同世界衛生組織(WHO)所不斷提醒的，「X疾病(Disease X)」大流行的威脅仍近在眼前，各國政府應共同提升全球衛生治理及全球衛生安全。
WHO與許多國家在COVID-19疫情的中期就開始進行檢討。針對現行國際衛生條例(IHR)在此次危機應變所暴露出的侷限性，未來該條例的條文將據以調整，包括強化監測通報與分享機制、提升應變量能、調整PHEIC型態及宣佈門檻等；同時新的大流行病協定(Pandemic Agreement)也在積極討論中，期待藉由制定新的全球疫病治理框架，納入問責制、透明度、公平性，做為全球因應下一波大流行的規範依據，並有望於第77屆世界衛生大會通過。
我國雖非WHO會員國而無法直接參與IHR(2005)條文修訂或新的大流行病協定起草，但依然熱忱地關切這兩份重要文件的內容與進度。因為我們亟欲分享自身的抗疫經驗並與其他國家學習交流。臺灣是最早覺察疫情風險並快速採取應變的國家，同時積極與國際夥伴分享資訊，秉持公開透明原則取得人民信任，從而使得防疫政策順利推動；面對大規模疫情，我們在疫苗取得、醫療資源配置、科技工具運用、人權保護與不實訊息因應等面向，未來也將尋求精進。
我們強力支持IHR(2005)修正條文及新創之大流行病協定的通過與實施，並呼籲WHO將臺灣納入這兩項文件的簽署方，共同監測新興病毒株，通報及分享病原體檢驗資料、疫苗或抗病毒藥物研發及臨床試驗結果等，為因應下一波大流行預作準備，共建具有防疫韌性的國際社會。
我們呼籲WHO支持臺灣參與全球衛生治理體系，臺灣堅定維護臺灣的承諾，以專業、務實、有貢獻的原則參與全球衛生安全網絡，並與WHO合作，填補全球衛生安全挑戰的地理空白，建構更全面的全球衛生架構。
WHO全民健康經濟學委員會發現，至少有140個國家在憲法中承認健康是一項人權。然而，各國並沒有推行法律來確保其人民有權獲得健康照顧。臺灣致力於實現全民健康覆蓋。過去幾十年來，臺灣參照世界衛生組織的指引持續精進衛生醫療專業、整合布建社會福利資源，藉由加強初級醫療、全人口腔照護、推動心理健康促進方案、強化社會安全網、並建構敏捷韌性醫療照顧體系，以防治傳染性和非傳染性疾病、建構健康支持的環境，同步提升全人全程健康環境。臺灣並致力於與世界分享達成全民健康覆蓋的經驗和專業知識，幫助實現全民健康的目標。
2024年世界衛生日的主題是「我的健康，我的權利」。世界衛生組織設定這個主題是為了捍衛世界各地的每個人都有權獲得醫療服務、教育和訊息，以及安全的飲用水、清潔的空氣、良好的營養、優質的住所、體面的工作和環境條件以及免受歧視侵害的自由。
臺灣一直以來透過政府或民間力量與友我國家及國際組織協力，協助國際社會實現健康權。我們在南太平洋小島國家提供醫療援助；在海地協助改善地震災區婦女及孩童的營養狀況；在羅馬尼亞協助建構烏克蘭難民援助組織工作人員及難民婦女兒童的社會心理支持能力；在加勒比海地區協助提升因應氣候變異調適能力；在肯亞協助提升衛生機構基礎供水與衛生可近性；在菲律賓、日本、夏威夷、土耳其、印尼等地發生的不幸緊急災難事件中，提供所需災後復原或重建協助，期能協助災民安度人道危機。
臺灣在協助世界衛生組織落實「健康是一種人權」，然而2300萬臺灣人的健康權益卻因政治因素而被WHO忽視。在捍衛世界各地的每個人都有權獲得健康的努力方面，臺灣一直是可靠的夥伴。我們籲請WHO及相關各方正視臺灣長期以來對全球衛生安全及健康人權的貢獻，敦促WHO應保持更開放的態度和彈性，秉持專業及包容的原則，主動並務實邀請臺灣參加WHA及參與WHO主辦的會議、活動和機制，包括刻協商中的WHO大流行病協定，得與世界各國攜手，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」的願景。
Taiwan’s indispensability in preparing for future pandemics
Dr. Hsueh Jui-yuan
Minister of Health and Welfare
Republic of China (Taiwan)
The three years of the COVID-19 pandemic resulted in a terrible loss of life and exacerbated health inequalities. The global economy slumped and, worldwide, people’s lives were affected. This experience demonstrated that the present global health governance framework is not effective in responding to threats to global health. Although COVID-19 is no longer labeled a public health emergency of international concern (PHEIC) and trade and economic activity globally have returned to normal, the World Health Organization (WHO) cautions against the threat of a Disease X pandemic. Therefore, it is critical that countries across the globe unite to bolster health governance.
WHO and many countries began reviewing response strategies during the COVID-19 pandemic. Weaknesses in the International Health Regulations (2005) as concerns managing this crisis were revealed. As a result, changes are afoot. Proposed revisions include enhanced surveillance, reporting, and information sharing; improved response readiness; and revised criteria for declaring PHEICs. At the same time, there is vigorous debate around a new pandemic agreement, which aims to craft a robust global pandemic governance framework grounded in accountability, transparency, and equity. It may be approved at the 77th World Health Assembly.
As Taiwan is not a WHO member state, we cannot directly influence revisions to the International Health Regulations (2005) or the drafting of the pandemic agreement. Nevertheless, we remain greatly concerned about the content of and developments regarding these central documents. We are eager to contribute our insights into pandemic management and learn from international best practices. Taiwan was the nation that initially identified the epidemic risk and promptly executed adaptive measures. Taiwan also proactively shared vital information with global partners and garnered public trust through a commitment to openness. This was crucial to effectively implementing pandemic policies. To address future pandemics, we will strive to refine approaches to obtaining vaccines, managing medical resources, utilizing technology, safeguarding human rights, and addressing misinformation.
We strongly endorse the passage and implementation of amendments to the International Health Regulations (2005) and the pandemic agreement. We call on WHO to include Taiwan as a signatory to these documents. This would enable us to collaborate on monitoring new virus strains, reporting and exchanging pathogen diagnosis data, and sharing novel vaccine and antiviral research or clinical trial results. This would further collective global action against future pandemics and more resilient antipandemic efforts by the international community.
We urge WHO to support Taiwan’s inclusion in overseeing global health. Taiwan remains committed to participating based on the principles of professionalism, pragmatism, and making contributions. Taiwan seeks to cooperate with WHO to remedy geographic gaps in global health security and to construct a comprehensive global health framework.
The WHO Council on the Economics of Health for All has found that at least 140 countries recognize health as a fundamental human right in their constitutions. Despite this, many nations have not passed and implemented laws to ensure that their citizens have access to healthcare services. Taiwan has worked hard to reach universal health coverage and has consistently improved the quality of health care over the past few decades in line with WHO recommendations. Taiwan has effectively integrated and allocated social welfare resources to enhance primary and oral health care for all, implement mental health programs, and strengthen the social safety net. Taiwan has put in place an agile and resilient healthcare system able to combat both communicable and noncommunicable diseases. We are improving health for all individuals over the course of their entire lives. Moreover, Taiwan is working to share its experience and expertise in achieving universal health coverage to help the international community realize health for all.
The theme for World Health Day 2024 is “My health, my right.” This is a way to advocate for every individual, everywhere, to have access to quality health services, education, and information, as well as enjoy safe drinking water, clean air, good nutrition, quality housing, decent working and environmental conditions, and freedom from discrimination.
Through a public-private partnership, Taiwan has been contributing to global efforts to realize the right to health in collaboration with partner countries and international organizations. We have improved medical care in small South Pacific island nations, enhanced nutrition for women and children affected by an earthquake in Haiti, provided psychological support to Ukrainian refugee women and children in Romania as well as aid workers; bolstered climate change adaptability in the Caribbean; and improved access to water, sanitation, and hygiene at healthcare facilities in Kenya. Furthermore, Taiwan has provided humanitarian assistance through postdisaster recovery and reconstruction efforts that have helped people get through disasters in the Philippines, Japan, Hawaii, Türkiye, and Indonesia.
Taiwan believes that health is a human right. Yet the rights of Taiwan’s 23 million people are disregarded by WHO for political reasons. Taiwan remains a steadfast partner in defending the right to health of all people everywhere. We urge WHO and all relevant parties to recognize Taiwan’s considerable contributions to global public health and the human right to health. It is imperative that WHO adopt a more open-minded approach and demonstrate flexibility, adhering to the principles of professionalism and inclusivity. Taiwan should be included, as a matter of pragmatism, in the World Health Assembly and all WHO meetings, activities, and mechanisms, particularly those concerned with the WHO pandemic agreement. This would better empower Taiwan to collaborate with global partners to uphold the fundamental human right to health stipulated in the WHO Constitution and the vision of leaving no one behind espoused in the United Nations Sustainable Development Goals.