The 56th session of the WHA opened in Geneva on May 19. On the first day, in the meeting of the General Committee, responsible for setting the agenda, Taiwan's allies asked that the agenda include discussion of a proposal to invite Taiwan to attend the WHA meeting with observer status. After 90 minutes of debate, the General Committee ruled that in the absence of a consensus on the issue it would not put the Taiwan question on the agenda for this year. Taiwan's seventh attempt to win entry into the WHO, like the other six tries dating back to 1997, thus ended in disappointment.

Aware that the US planned to publicly support Taiwan's bid this year, and also aware that the raging SARS epidemic on both sides of the Taiwan Strait has drawn international attention to Taiwan, the PRC adopted an especially uncompromising position. The delegation was led personally by vice-premier and minister of health Wu Yi, and the PRC not only spoke out at the General Committee meeting, but mobilized 27 other countries to voice support for its position at that meeting. The PRC and its allies repeated the tired old arguments made in past years for opposing Taiwan's participation in the WHO, such as that Taiwan is not a sovereign state and that the PRC will look after the health of the people of Taiwan.

The US broke its long silence on the Taiwan issue for the first time this year. Not only did the US support WHO participation for Taiwan at the General Committee meeting, but Tommy Thompson, secretary of the US Department of Health and Human Services, also made a clear statement of the same position at the full WHA session. Thompson declared that the SARS outbreak has made it clear to everyone that public health has no borders and is apolitical; he said that if there is no truly global mechanism for public health cooperation, it will be impossible to effectively fight epidemics, and this is why the United States strongly supports Taiwan.

Besides US support, and in contrast to the opposition to Taiwan's WHO entry voiced in the past by France and Spain, this year the EC and Japan both remained silent.

After the General Committee on the morning of the 19th rejected putting the Taiwan issue on the agenda, in the full assembly meeting that same afternoon Taiwan's allies Senegal and Panama both moved to have the proposal for Taiwan's entry added to the agenda, but after further debate, this effort too came to naught.

In his remarks, Wu Yi said that China would welcome the Taiwan representative team to participate in the WHO as part of the PRC representative team. He also said that China is very concerned about the SARS situation in Taiwan, and welcomes exchanges between the two sides on ways to stop SARS. He also noted that China has agreed to Taiwan's participation in a global SARS conference to be held by the WHO in June.

On the 20th, technical briefings were given on the SARS situation, with public health officials from six affected countries (including China, Hong Kong, and Singapore) giving reports on their respective progress. But Taiwan, considered the third worst affected area in the world (after only mainland China and Hong Kong), was not permitted to make a report. ROC minister of health Chen Chien-jen, who has just taken office recently and made a special trip to Geneva just for this purpose, could only sit in attendance but had no right to speak.

When news of this development got back to Taiwan, there was great disappointment both in the government and general public. While Taiwan's efforts to participate in the WHO have always been problematic because they touch on questions of sovereignty, by May 23 this year SARS had already taken more than 60 Taiwanese lives. The disease, which had by that point been in Taiwan for two months, was running rampant, with Taiwan being deemed the area in which transmission was occurring fastest of any place in the world. But, even as Beijing was unable to offer any substantive assistance to Taiwan at all in stopping or treating SARS, it was blocking a channel by which Taiwan could tap into outside information and technical assistance.

Given the seriousness of the epidemic, bringing Taiwan into the WHO has become an even more serious humanitarian and human-rights issue, and it is incumbent upon the WHO and its member states, who are still stuck in the mindset of putting political considerations first, to seriously reassess what they are doing.

Commentators in Taiwan have noted that Taiwan's record in preventing SARS has been disappointing. The public has lacked awareness and self-discipline, and the government had no experience dealing with an outbreak of this magnitude. Taiwan has well-trained medical personnel and excellent facilities, but because it was not able to get advice and practical support from the WHO in a timely manner-for example, on preventing hospital transmission and implementing in-hospital prevention measures-much energy has been misspent and the holes created by mistakes have yet to be plugged. Vietnam, in contrast, has far fewer resources of its own compared to Taiwan, but received a great deal of WHO help and was able to rapidly control the spread of the virus.

Former minister of health Twu Shiing-Jer points out that when the first case of SARS was discovered in Singapore on March 6, that country immediately received from the WHO information on preceding cases in Vietnam. Taiwan, not being a WHO member state, has been unable to get WHO information directly, and even had to learn about the global alert issued by the WHO on March 20 from the Internet. Chen Chien-jen says that from the very first case in Taiwan on March 12, Taiwan took the initiative to report to the WHO and ask for help. But the WHO merely asked Taiwan to continue providing statistics on probable cases, and did not invite Taiwan to either of the meetings of SARS experts held in mid-March and mid-April. This attitude deprived Taiwan of the opportunity to get access to valuable SARS-related information.

Chen says that since the WHO finally sent two experts to Taiwan on May 3, they have proven to be extremely helpful, but Taiwan still needs assistance from specialists in hospital transmission, negative pressure isolation rooms, and clinical treatment. Taiwan has asked that the WHO include Taiwan in the Global Outbreak Alert and Response Network in order to make it easier to get assistance from non-governmental medical groups, but has been refused.

SARS has had global repercussions, but the rejection of Taiwan's WHO bid again this year and the continued exclusion of Taiwan from international SARS prevention mechanisms reveal that there are still gaps in the global epidemic prevention network, holes that should not be ignored indefinitely just because of political considerations.