Coronavirus | Taiwan is eager to work with India to fight the COVID-19 pandemic, says Foreign Minister Joseph Wu

“We could consider setting up a communications channel between our medical agencies to ensure the availability of medical resources,” Mr. Wu says.

Joseph Wu.

Taiwan has proposed a regular communication channel with India to link up medical agencies to better cooperate in the fight against COVID-19, Foreign Minister Joseph Wu told The Hindu in an exclusive interview on May 13.

He said Taiwan’s sharing of information on COVID-19 with countries had been limited by its arrangement with the World Health Organisation. “[India and Taiwan] have engaged in dynamic ongoing communication on many levels. Our sharing of information... has been restricted to relying on the IHR [International Health Regulations] focal point... The arrangement is far from satisfactory. Information has not been shared in a timely fashion,” he said.

Edited excerpts:

What are the main lessons from Taiwan’s experience in battling COVID-19?

Our experience with SARS in 2003 was traumatic. We learned the importance of epidemic control and better testing and quarantine, and the need for a Central Epidemic Command Center. The experience taught Taiwan that acting quickly and ensuring advanced deployment are the keys to preventing the spread of an epidemic. The most fundamental reasons for Taiwan’s success against the present epidemic are that we remembered the lessons of the past and that the people of Taiwan are willing to work together to get through this difficult period. Our government, moreover, has been transparent and has kept the public up-to-date at all times. This is why the Taiwan model of fighting disease has proven effective.

In dealing with the pandemic, several major steps we took seem to be effective, and I would like to share with you here. On December 31, the same day we reached out to WHO about this mysterious SARS-like atypical pneumonia in Wuhan, we started screening passengers on board all flights coming from Wuhan. When the first case of the coronavirus arrived on January 21, we set up the Central Epidemic Command Center (CECC), which was fully authorized to do whatever was necessary. We not only enacted border control procedures, but also enacted relief measures to counter the economic impact. After its setup, the CECC began a daily press conference to share information about the pandemic, honestly and transparently, with the public once a day. It also worked to combat disinformation from China. We quickly issued an export ban on critical medical supplies, and began a massive increase of production of medical masks as well as sanitizing alcohol. In addition, we started rationing face masks, and quickly established a national team for medical mask production.

All central government ministries, as well as local governments, were brought together under the CECC’s command, with the full backing of the president and the premier. We have designated 160 testing facilities around the country. From these facilities, people with the disease are either sent to one of 134 medical facilities for milder cases, or 50 large regional centers for more severe cases. This system allows us to quickly isolate patients based on their severity, as well as allocate medical personnel and equipment. We quickly activated the emergency procedures for patients entering hospitals, and had hospitals clearly demarcated internally so that medical personnel and staff in different wards and floors do not interact. We have also made certain that personal protective equipment for medical personnel is sufficient to prevent in-hospital infections. Through the use of technology, we can cross-reference health records and personal travel histories. As a result, we have been able to identify people who had been in contact with a confirmed case as possible cases. I would like to point out that National Health Insurance, which covers 99 percent of our people, is the key to our success in rationing critical supplies and contact tracing.

Have Taiwan and India been in touch during the pandemic, such as sharing information? Can you share details?

Despite the lack of official diplomatic ties between Taiwan and India, both countries set up representative offices in each other’s respective capitals in 1995. Since then, we have engaged in dynamic ongoing communication on many levels. However, our sharing of information on COVID-19 has been restricted to relying on the IHR focal point under the World Health Organization. The arrangement is far from satisfactory. Information has not been shared in a timely fashion. The pandemic did not draw due global attention until late January, when it was finally declared a Public Health Emergency of International Concern by WHO. In retrospect, it is clear that the international community was not fully informed as to the risk of a devastating pandemic. Taiwan had tried to sound the alarm through WHO, but this information was not passed on to other countries.

Are there particular areas where you think Taiwan and India can work together to fight the pandemic?

Let me give you two examples of how we are doing so already. First, on February 20, researchers at Academia Sinica announced they had synthesized over 100 milligrams of Remdesivir, an experimental treatment for COVID-19, to 97 percent purity. It took the team, which includes two members from India, just two weeks. Second is how Taiwan’s medical institutions have been sharing related information. On April 2 and 14, two Taiwan-India Webinars on COVID-19 were held. These were a product of collaboration between National Cheng Kung University Hospital and the All India Institute of Medical Science. Over 14,000 healthcare workers in India benefited from these webinars. Taiwan’s physicians shared their experience fighting the pandemic, including testing methods, treatments, approaches to containing infection, and measures concerning masks. Also Taiwan will provide face masks to India in support of frontline medical personnel. Taiwan is eager to work with India to fight COVID-19.

Is Taiwan concerned by the disruption of global supply chains for both medicines and personal protective equipment?

The continuing spread of COVID-19 has affected global pharmaceutical supply chains. Prices of active pharmaceutical ingredients have gone up. Taiwan has naturally been affected to a certain extent. Our government has been working with domestic manufacturers of pharmaceuticals to source needed inputs from, for example, India, Europe, or the United States. With regard to medical equipment, we have limited concerns for the short-term about raw materials from China. Over the medium-term, the government will assist manufacturers with localization and certification. Over the long-term, we will continue to seek to expand the international market and also work with other countries to further ensure the safety of supply chains.

Do you see room for India and Taiwan to coordinate on this front?

Information sharing and multilateral coordination play a critical role in preventing pandemics. A joint effort is needed to keep the world safe. I would like to see closer interactions and engagement by our research teams on medicine and related technology. Taiwan and India could consider setting up a regular communications channel between our medical agencies in order to ensure the availability of medical resources. We could also work to explore the feasibility of mutually beneficial investments and cooperation to strengthen supply chains for pharmaceuticals, inputs, and equipment.

Can you share with us when Taiwan first alerted the WHO on human-to-human transmission and the response?

The Taiwan Centers for Disease Control learned from online sources that there had been at least seven cases of atypical pneumonia in Wuhan, China. In China, the term “atypical pneumonia” is commonly used to refer to SARS, a disease transmitted between humans caused by coronavirus. Owing to its experience with the SARS epidemic in 2003, Taiwanvigilantly kept track of information about the new outbreak. On December 31, 2019, Taiwansent an email to the International Health Regulations (IHR) focal point under the World Health Organization, informing WHO of its understanding of the disease and also requesting further information from WHO. Given the lack of clarity at the time, as well as the many rumors there were circulating, Taiwan’s aim was to ensure that all relevant parties remained alert, especially since the outbreak occurred just before the Lunar New Year holiday, which typically sees tremendous amounts of travel. To be prudent, in the email we took pains to refer to atypical pneumonia, and specifically noted that patients had been isolated for treatment. Public health professionals could discern from this wording that there was a real possibility of human-to-human transmission of the disease. However, because at the time there were as yet no cases of the disease in Taiwan, we could not state directly and conclusively that there had been human-to-human transmission.

The WHO IHR focal point only responded with a short message stating that Taiwan’s information had been forwarded to expert colleagues. No follow up information was provided. Even though Taiwan strongly suspected that human-to-human transmission of the disease was already occurring at the time, we were unable to gain confirmation through existing channels. Therefore, on the same day the email was sent to the WHO, December 31, the Taiwan government activated enhanced border control and quarantine measures based on the assumption that human-to-human transmission was in fact occurring. These measures including screening passengers on flights from Wuhan prior to disembarkation.

In January, Taiwan, South Korea, and Singapore took early measures while many countriess did not. What explains this uncoordinated global response?

The disease has spread differently in every nation, and each country’s medical capacity is different; it would thus be unfair to make a comparison. I cannot judge the timing other nations chose to enact response measures. I have already spoken as to why Taiwan was early to impose measures against the disease. It is possible that South Korea and Singapore took measures early on given their experience with SARS combined with the fact that they neighbor on or have close people-to-people exchanges with China.

What in your view are the main lessons for the WHO going forward?

Since the outbreak of the pandemic at the beginning of the year, although WHO has said little about Taiwan’s disease-prevention efforts, Taiwan is willing to share its experience with WHO and other nations. If Taiwan could participate fully in WHO and if it could interact with other countries on an equal basis under the WHO framework, more nations would receive Taiwan’s early warning. The world might be a different place today. Where possible, Taiwan is willing and eager to continue providing medical supplies to nations suffering badly from this disease. Taiwan has recently, for example, donated over 17 million medical masks to countries around the world. We are also making donation arrangements for India, which is an important partner for Taiwan. We will continue operating in the spirit of “Taiwan Can Help” and share Taiwan’s experience with the world.