US embassy cable - 04TAIPEI3325

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