DEMARCHE ON WHO INTERNATIONAL HEALTH REGULATIONS

C O N F I D E N T I A L SECTION 01 OF 03 TAIPEI 003325

SIPDIS

STATE PASS AIT/W

E.O. 12958: DECL: 10/22/2014
TAGS: AORC PREL TBIO TW ESTH
SUBJECT: DEMARCHE ON WHO INTERNATIONAL HEALTH REGULATIONS

REF: STATE 225331

Classified By: AIT Deputy Director David J. Keegan, Reason: 1.4 (B/D)


1. (C) Summary: AIT Econ Chief delivered reftel talking
points to MOFA Department of International Organizations
(DIO) and the Taiwan Center for Disease Control (CDC) on
October 21. DIO provided additional detail about its
proposal to add language to Article 65 of the draft
International Health Regulations (IHRs) and requested US
assistance in getting it accepted. AIT expressed support of
Taiwan's goal of being included in an international
surveillance system, but emphasized the importance of timing
and getting the substantive portions of the regulations
agreed. To this end, AIT urged Taiwan to closely coordinate
its position and strategy with the US delegation. DIO said a
lesson was learned at the May meeting of the WHO, concluding
that it was not in Taiwan's interest to derail the revision
of the IHRs by prematurely proposing its amendment. CDC said
it understood and was satisfied with the US position on the
IHRs and would continue expanding its surveillance and
response capabilities to safeguard global public health. End
Summary.

MOFA Requests Help Amending Article 65
--------------


2. (C) AIT Econ Chief called on MOFA Deputy Director General
for International Organizations Jieh Wen-Chieh on October 21
to convey the reftel demarche. Jieh explained that Taiwan
was sending a delegation to the meeting under the cover of an
NGO, and said that Nicaragua had submitted a proposal to
amend Article 65 of the IHRs to allow Taiwan to be included
in the global disease surveillance program. He requested US
assistance in getting it accepted and provided AIT with a set
of talking points supporting Taiwan's participation (see para
6). AIT stated that the US was still examining Taiwan's
proposed language for Article 65 of the IHRs and could not
comment at this time.

Not in Taiwan's Interest to Derail Proceedings
-------------- -


3. (C) AIT suggested Taiwan's "NGO" delegation should
coordinate with the US delegation before the meeting. Jieh
agreed, saying that Taiwan would welcome any pre-negotiation
discussions. He said that Taiwan did not want to make a
"sudden attack" or provoke a heated debate. Jieh said that
Taiwan had learned a lesson during the May WHO meeting that
it is not in Taiwan's interest to derail the proceedings by
prematurely bringing the controversial topic of Taiwan and
the WHO into the debate. He said Taiwan would be reasonable,
but was committed to seeing its cause brought up.

CDC: Taiwan will be Cooperative and Patient
--------------


4. (C) AIT also called on the new CDC Director Steve H.S.
Kuo. Kuo assumed the position on October 18 after four years
in Washington as the TECRO Health Advisor. After AIT
conveyed the reftel talking points, Kuo noted the issue of
IHRs was not necessarily linked to Taiwan's main concern,
which was participation in the WHO. He said he understood
that the US goal of revising the IHRs was to bring a measure
of transparency to countries like China and Vietnam. He said
he agreed that it would not be productive to block progress
on that issue or give China an excuse to delay reform by
prematurely bringing up the controversial topic of Taiwan's
WHO membership.


5. (C) Kuo said his agency would be cooperative and patient,
promising to remain open and transparent about public health
issues. Taiwan would not become an information "black hole"
on public health to blackmail the world into allowing it
access to the WHO. He said he agreed that Taiwan's interests
are best served if it tries to set an example for good
conduct, plays by the rules, and proves to the world that it
has much to contribute to global health. Kuo warned,
however, that some in Taiwan question this strategy, saying
it is flawed because if Taiwan already provides the world
with everything, there is no incentive for other countries to
allow it access to the WHO. He said it was important for the
US to push harder for Taiwan's expanded role in the WHO to
prevent such voices from getting stronger.

DIO's Talking Points (Verbatim)
--------------


6. (C) Begin verbatim text.

Talking Points for Supporting Taiwan's Participation in the
International Health Regulations (IHR)

(1) The importance of the principles of "universality" and
"inclusiveness" cannot be overemphasized in the International
Health Regulations (IHR). Dr. Jong-wook LEE,
Director-General of the World Health Organization (WHO),
recognized the importance of those principles in his address
to the World Health Assembly (WHA) on May 18, 2004, by
stating that "the SARS epidemic showed us that we cannot
afford any gap in our global surveillance and response
network."

(2) Epidemics and other international health risks do not
recognize political borders. It is of paramount importance
that the IHR should apply to people, conveyances, cargos
(sic),containers, and the like from both Member States and
non-members of the WHO if the WHO is to cope effectively with
any health risk of international magnitude (e.g. SARS). This
is not a political issue, but a health one. The
effectiveness of the IHR should not be compromised by any
unwarranted obstruction.

(3) The forthcoming IHR cannot afford excluding Taiwan.
Taiwan is not only the 15th largest trading power in the
world, but also one of the most important international
transportation hubs linking Northeast Asia and Southeast Asia.

-- (1) In addition to its 23 million people, Taiwan's health
administration annually has to deal with the health matters
of 22.4 million international air passengers, 161,847
international flights, 51,000 international-serviced vessels
and hundreds of millions of tons of international cargo.

-- (2) Moreover, the Taipei Flight Information Region (Taipei
FIR),an area covering around 200,000 square kilometers
designated by the International Civil Aviation Organization
(ICAO),with 12 major international air routes as well as 4
domestic air routes passing through it, constitutes an
integrated route network. Over 1.54 million flights receive
air traffic control services within the Taipei FIR annually.
This area is an important international air services market
in the world, where the annual international passenger
traffic volume is around 22.4 million passengers and the
freight traffic volume is around 1.47 million tons. There
are 38 airlines operating international scheduled services in
this area, among them 32 foreign carriers, which fly into and
from there around 150,000 flights each year. None other but
Taiwan's health administration can enforce the new IHR and
handle any health-related crises emerging from such a huge
international traffic volume.

-- (3) It is indisputable that only Taiwan's health
administration and health authorities can enforce the new IHR
and handle public health emergencies related to such a huge
volume of international traffic.

(4) In addition, while the 23 million people of Taiwan are
entitled to equal and fair protection within the new IHR
system, Taiwan is also committed to doing its part by working
together with the world community and contributing its
resources and experience in order to advance the noble goal
of health for all peoples.

(5) In order to make IHR more inclusive, an amendment to
Article 65 (*1) in the current draft of the IHR will be
needed. The text (*2) presented by the Nicaragua government
is generally conducive in that regard. My government
strongly supports Nicaragua's proposal and wants to see the
amendment of the Article 65 of the draft of IHR in accordance
with the Nicaragua text.

(6) Articles 65 and 59 of the IHR draft regulate the
participation of States who are not members of the WHO to the
new IHR. Article 65 provides the conditions and procedure
for non-WHO member states to become a party to the new IHR.

There are two separate c o n d i t i o n s for States not
members of the WHO to become a party to the IHR:

- Already existing legal grounds: Any State, that is not a
member of the WHO, needs to be a party to at least one of the
existing 11 conventions, regulations and similar agreements
as listed in Article 59; or,

- On "invitation" by the Director General: Any State, that
is not a member of the WHO, receives from the WHO's Director
General a notification of the adoption of the IHR by the WHA.

The p r o c e d u r e to become a party to the IHR first
requires from the non-member State to meet one of the two
conditions mentioned above. After that, it will need to
notify its acceptance of the IHR to the Director General.
Finally, entry into force will become effective upon the day
of the entry into force of the IHR, or, if the acceptance is
notified after, three months after the date of receipt by the
Director General.
- The Republic of China, or Taiwan, in the past has signed
6 of the 11 conventions, regulations and
similar agreements as listed in Article 59 (*3).

- It is proposed that an amendment be made to Article 65 to
include, in addition to non-member states, any entity
with a separate health administration as well.
Otherwise, under the current language, it seems only the Holy
See and Liechtenstein will be qualified.


--------------


(*1) Article 65 of the current IHR working paper:

"Any State not a Member of WHO, which is a party to any
international sanitary agreement or regulations listed in
Article 59 or to which the Director-General has notified the
adoption of these Regulations by the Health Assembly, may
become a party hereto by notifying its acceptance to the
Director-General and, subject to the provisions of Article
62, such acceptance shall become effective upon the date of
entry into force of these Regulations, or, if such acceptance
is notified after that date, three months after the date of
receipt by the Director-General of the notification of
acceptance".

(*2) The comments presented by the Nicaragua government:

"Any State not Member (sic) of WHO, which is a party to any
conventions, regulations, and similar agreement listed in
Article 48 or to which the Director-General has notified the
adoption of these Regulations by the World Health Assembly,
may become a party hereto by notifying its acceptance to the
Director-General. In the same way, due to the importance of
participation of those areas that have independent systems of
health, these can be parts in the same one, also signing
their acceptance to the Director-General and, subject to the
provisions of Article 50, such acceptance shall become
effective upon the date of entry into force of these
Regulations, or, if such acceptance is notified after that
date, three months after the date of receipt by the
Director-General of the notification of acceptance."

(*3) The 6 (six) international health conventions refereed
(sic) to in Article 59 of the current draft which were signed
by the Republic of China on Taiwan are:

- International Sanitary Convention, signed in Paris, 21
January 1926;

- International Sanitary Convention for Aerial Navigation,
signed at the Hague, 12 April 1933;

- International Sanitary convention (sic),1944, modifying
the International Sanitary Convention of 21 June 1926, opened
for signature in Washington, 15 December 1944;

- Protocol of 23 April 1946 to prolong the International
Sanitary Convention, 1944, signed in Washington;

- Protocol of 23 April 1946 to prolong the International
Sanitary Convention for Aerial Navigation, 1944, signed in
Washington;

- International Sanitary Regulations, 1951, and the
Additional Regulations of 1955, 1956, 1960, 1963, and 1965.

End verbatim text.
PAAL