TAIWAN'S BIO-TERRORISM DEFENSE

UNCLAS SECTION 01 OF 03 TAIPEI 004951

SIPDIS

STATE FOR EAP /TC AND OES/IHA
HHS PLEASE PASS TO ERIKA ELVANDER
GENEVA PLEASE PASS HEALTH ATTACHE DAVID HOHMAN

E.O. 12958: N/A
TAGS: AMED AMGT CASC ECON SENV SOCI TBIO TW ESTH
SUBJECT: TAIWAN'S BIO-TERRORISM DEFENSE


1. Summary. Taiwan's Department of Health (DOH) held a
three-day International Conference on Bio-terrorism Defense
in Taipei December 6 -8, with international experts on bio-
terrorism and presentations on the economics, law, medicine,
public health, emergency management, epidemiology and other
fields. On December 8, the Taipei city government conducted
a bio-terrorism attack and response exercise. End Summary.

Taipei Int'l Conference on Bio-terrorism Defense
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2. AIT/T Science Officer and Regional Medical Officer
attended the 2005 Taipei International Conference on Bio-
terrorism Defense, held December 6 - 8, 2005 at the Grand
Hotel in Taipei. DOH and the Ministry of National Defense
(MND) jointly organized the conference. The conference
presented an opportunity for exchanges on how to prepare for
bio-terrorism. Speakers included experts from the U.S.,
Japan, Poland, Singapore, Indonesia, France and other
countries. The conference was divided into three sessions:

1. Governmental Preparedness for Bio-terrorism; 2. Response
to Bio-terrorism Attack; and 3. Taiwan's Response Team
reacting to a mock bio-terror attack in a subway (metro)
station.

How to deal with Bio-terrorism
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3. Taiwan Center for Disease Control (CDC) Director General
Steve Kuo said Taiwan is relatively new to bio-terrorism
defense and needs to coordinate with the global healthcare
community. Kuo stated that despite non-official status in
WHO, Taiwan participated on the basis of the recently
revised International Health Regulations (IHR) with
"universal application." He said DOH is in the process of
drafting plans for launching Taiwan's "Bio-terrorism
Preparedness Training Center," to be located in Taoyuan,
jointly with the National Defense Military Medical Bureau.
While bio-terrorism used to be considered a national
security issue entirely within the purview of the military,
Kuo said the DOH is now also actively involved. Kuo said
anthrax and smallpox are the most likely bio-terrorist
threats to Taiwan.


4. CDC Deputy DG Shih Wen-yi spoke on Taiwan's
countermeasures to biological attack. Shih said that Taiwan
has made a slow start in the area of bio-terrorism defense.
Shih described command and control structures, planning and
drills held, and laboratory capacity for identification of
biologic agents. In outlining Taiwan's national goals, Shih
said that priorities include completing a bio-terrorism
emergency response system, enacting anti-bio-terrorism
regulations and establishing a policy, recruiting personnel
to staff anti-bio-terrorism organizations and selecting and
procuring inspection and protection equipment. In 1993, the
Executive Yuan completed a draft plan to deal with
bioterrorism. Since that time the plan has undergone
multiple revisions including the July 2004 establishment of
the "Council of Bio-terrorism and Unknown Communicable
Disease Prevention and Control." At present, Taiwan's
national anti-terrorism system is modeled on a "3-3-1"
system. The first "3" refers to the different stages of
crisis management: preventing it, dealing with it and
recovering from it. The second "3" refers to the different
levels of risk associated with an incident: low, medium or
high. While the "1" refers to an emergency response system.

Disaster Response: Learning From Past Experience
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5. Session II of the conference focused on responses to a
bio-terrorism attack. DOH Bureau of Medical Affairs
Director-General Hsueh Jui-yuan reviewed disasters in Taiwan
over last 100 years. Health-related disasters have claimed
3600 lives in SIX incidents. Earthquakes have claimed 7900
lives in 14 episodes and other disasters have claimed a
total of 17000 lives over the past 100 years. Taiwan's
response system focuses on the role of the local and
national fire brigades. County authorities are the base
level, activating the response system and alerting the
national brigades. The National Security System and
Executive System would work in parallel in the event of a
crisis. Taiwan's vaccination, medicine stockpiles, law
enforcement and training programs for bio-terrorism were
also addressed in this session.


6. The experts stressed that surveillance, quarantine,
laboratory testing, and immunization are important bio-
medical defense measures against bio-terrorism. TCDC
pointed out that surveillance systems in Taiwan are active,
and over 500 medical staff report to the government each
week on medical developments. Reviewing lessons learned
from the SARS experience, Taiwan health experts highlighted
the importance of protecting medical staff in the event of
an outbreak.

Drills: need for better press management
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7. The conference ended with a demonstration drill of a bio-
terror attack. The scenario involved theft of lab samples
of Avian Influenza from a hospital lab, politically
motivated threats against the authorities, and a deliberate
release of the Avian Influenza virus in a local subway
(Metro) station. This event was witnessed by bystanders who
alerted the authorities, leading to a chain of events
culminating in closure of the MRT station. Simultaneously,
the emergency response system was activated with a
combination of forensic, public health, and medical teams.
The response teams, wearing protective equipment,
decontaminated victims in mobile units and moved them to
medical facilities. All went smoothly in the mock event,
except that the press was not properly managed and barged in
at every opportunity to take photos, causing delays.


Can they respond to massive casualties?
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8. After the drill, American experts and TCDC personnel
discussed the merits of the exercise. Dr. Allswede, head of
the American delegation, commented that the conference was a
good investment of time by the Taiwan authorities and that
good progress had been made over the past year.


9. The panel of experts raised many questions about the
equipment, organization and capabilities of the response
teams. For example, the response team at the scene of the
alleged attack, while well equipped with sensors for bio-
chem agents, did not carry radioactive detectors. If the
attack had involved radioactive agents, the response team
would have been unable to detect those agents. Further,
there was no provision for dealing with an explosive device.


10. The experts also questioned the police screening of
people at the attack site. The quick apprehension of the
alleged suspect was lauded but doubts were raised as to why
the public at the site of the attack (subway station) were
not screened for the possibility of additional attackers.


11. In the scenario a dozen or so subway riders were put
through an isolation tent and treated. However, in the event
of massive casualties, it was not clear that the authorities
have the ability to treat hundreds of patients and to test
them for exposure to pathogens. There were also doubts about
the one-hour response time capability claimed by the TCDC
response team considering traffic, accessibility and
interagency coordination issues.


12. The panel concluded this was a good exercise, but work
needs to be done to foster stronger interagency coordination
among agencies responding to a bio-chem attack. Currently,
the Atomic Energy Commission is responsible for radioactive
incidents, the Environmental Protection Agency for chemical
attacks and the Center for Disease Control for bio-attacks.
Ensuring that these different agencies cooperate in the
event of a bio-chem attack is an issue that the next
conference on bio-terrorism will need to address.
PAAL