According to the WHO estimate released on April 21, 2004*, a total of 774 lives were claimed in the SARS outbreak in 2003. Far beyond the nations where it claimed the most victims, SARS traumatized the world with vast economic disruptions, deeply impacting international trade and travel that year and in the nervous months that followed.
Yet such threats are far from over: Emerging infectious diseases such as Ebola and MERS have followed. These are the threats we understand a little about – yet what we really have to fear are the threats we cannot name. Even as global health experts gather, new and unmapped outbreaks can spread rapidly across the globe. More rapidly than ever, arguably, as air travel statistics show that more people are flying, with more of the world than ever within a day’s travel.
Zika virus emerged in South America late last year, and has since swept across every continent, challenging disease control efforts worldwide. The World Health Organization in 2014 estimated that vector-borne diseases account for 17 percent of the global burden of all infectious diseases, killing up to 750,000 people each year. Dengue, the fastest-growing vector-borne disease, is endemic in more than 100 countries – with four out of ten people worldwide potentially at risk. Last year, Taiwan confirmed a total of 43,419 indigenous cases, in one of the most severe dengue outbreaks since 1987. Since Zika virus is transmitted by the same mosquito species that transmits dengue virus, Taiwan also faces increased risk of a Zika virus outbreaks.
Because we know infectious diseases do not respect boundaries, Taiwan has fulfilled its International Health Regulations responsibilities since 2009, when we were officially included in the implementation framework. We have established an IHR Contact Point with WHO to enable regional and global responses to public health threats. We assessed and improved our surveillance and response capacities to meet the Annex 1B IHR core requirements in a timely manner. Taiwan closely monitors international trends to optimally promote and enhance health security. In response to Ebola in West Africa, we provided 100,000 sets of Personal Protective Equipment and donated $1 million to international Ebola aid efforts in 2014. Since then, we have organized four training workshops for Asia-Pacific and Southeast Asian health and laboratory workers to improve regional capacity to detect and respond to Ebola, MERS, dengue and Zika virus. Participants from 14 countries exchanged experiences and formed regional networks to address such public health threats.
Taiwan has expanded mosquito-related preparedness and response with four strategies: health system planning, prevention of Zika virus importation, border quarantine, and vector control measures. Yet better vector control, effective vaccines, and proper clinical management are still needed.
Our people also face pandemic and seasonal influenza threats. Previous outbreaks have demonstrated that seasonal influenza virus strains can pose major challenges to our health systems. Because the highest hospitalization rates are among senior citizens, we encourage annual seasonal influenza vaccination to achieve herd immunity.
As we continue to improve our influenza-related planning, we retain a global vision and work hard to maintain the widest possible international health networks. To bring together nations to promote global health security, prevent disease outbreaks, detect threats early and respond rapidly, the United States launched the Global Health Security Agenda with WHO, the Food and Agriculture Organization of the United Nations (FAO), and the World Organization for Animal Health (OIE). Its goals include consistent and widely supported standards like IHR, including the Performance of Veterinary Services Pathway and other health security frameworks. By adopting these frameworks, Taiwan promotes human medicine and veterinary collaborations and constructs a unified system for infectious disease control.
Nothing less than this multilateral and multi-sectoral approach is needed to fight infectious diseases. While we still hope for better alignment with the international community, we are reorganizing at home to pursue best policies and practices. We are establishing a national research institute for vector-borne diseases in southern Taiwan to integrate resources and assist local governments with prevention.
It is no news to this expert audience that a crisis anywhere easily and soon can become a problem everywhere. Global health demands that all populations have optimal capabilities to respond to such threats.
Taiwan will continue to pursue bilateral, multilateral and research cooperation. We can be relied on to assist our Asia-Pacific and Southeast Asian neighbors as they enhance their own response capacities. And for the reasons I have discussed, we will actively participate in international arenas.
Such participation ensures that global health security will never again have deadly blind spots due to blocked communication and a lack of transparency.
Dr. Tzou-yien Lin is Minister of Health and Welfare, Republic of China (Taiwan).