Home / Articles / Taiwan and the WHO in 2020: A Novel Virus and Viral Politics
The World Health Assembly (WHA)—the annual plenary session of the 194 members of the World Health Organization (WHO)—convenes on May 18, 2020. The perennial question of Taiwan’s participation and access has again become especially prominent and contentious, largely because of the COVID-19 pandemic. The impact of the novel coronavirus has enhanced the arguments—and international support—for restoring Taiwan’s access and, with it, providing a boost to Taiwan’s international stature and, in turn, its security. But Beijing’s opposition and other factors create challenges more daunting than those that Taipei faced when it began its earlier eight-year run of WHA attendance. The push for Taiwan’s regaining engagement and participation is a case of what should be an irresistible force meeting what may be an immovable object.
Hindsight in 2020: COVID-19 and the 2003 SARS Crisis
Taiwan’s 2020 WHA/WHO bid is also an instance of “back to the future.” In several fundamental ways, it reprises Taiwan’s success in the aftermath of an earlier deadly coronavirus that spread abroad from the Chinese mainland in 2003: Severe Acute Respiratory Syndrome (SARS). The story of COVID-19, which is also designated as SARS-CoV-2, parallels that of SARS. A dangerous contagious disease emerges in China. Government authorities at various levels suppress initial local reports of the seriousness of the threat and suppress “rumors” (even as a whistleblowing doctor—Jiang Yanyong for SARS and Li Wenliang for COVID-19—seeks to disseminate accurate information), fail to report the risks promptly and accurately to the outside world, and do not contain the virus in time to prevent its fatal spread beyond China. In the weeks to months that follow, reports continue to grow of Chinese authorities’ prior and ongoing underreporting of developments in China, and recalcitrance toward foreign and international entities calling for cooperation and investigation. Due to geographic proximity and cross-Strait travel, Taiwan is especially vulnerable to the spread of the new virus during the early phases of an emerging international epidemic. Taiwan—which had a member of the WHO from its inception in 1948 until the People’s Republic of China replaced the Republic of China as the occupant of the one “Chinese seat” at the United Nations and affiliated organizations in 1971—argues that its lack of opportunity to engage fully with the WHO puts people in Taiwan and elsewhere needlessly at risk. China rebuffs calls from Taiwan and its supporters, sticking to its opposition to Taiwan’s meaningful participation in the principal UN-affiliated public health body and insists that Taiwan’s interests are adequately addressed by Beijing’s representation of all of China, including Taiwan.
After SARS, Taiwan eventually gained greater access to the WHO system, most prominently by receiving annual ad hoc invitations from the WHO’s director general to attend—under the status-deprecating name “Chinese Taipei”—the annual WHA session, beginning in 2009. The combination of China’s global health-endangering bungling of the response to SARS and Beijing’s politically tone-deaf bullying of severely-affected Taiwan (where between 5% and 10% of the global totals of nearly 800 deaths and more than 8000 cases were recorded among less than 0.3% of the world’s population) generated unprecedented support from the U.S. and others for Taiwan’s greater inclusion in the central institution of the international public health regime.
In its WHA/WHO quest, Taiwan also benefited after SARS and could benefit amid COVID-19 from several factors that have correlated with success in Taiwan’s persistent and existential pursuit of status and participation in the international order. First, Taiwan can argue at least plausibly, perhaps persuasively, and possibly accurately, that its exclusion from more full-fledged engagement with a key international institution puts Taiwan and Taiwanese people in significant peril. Even if there might be work-arounds through informal contacts and information sharing between Taiwan and the WHO or via the U.S.’s Centers for Disease Control and Prevention, any unnecessary impediment to cooperation and transparency in the context of a rapidly developing epidemic could bring significant adverse results, both for Taiwan and for the wider world.
Second and relatedly, if the international public health regime’s principal institution shuns Taiwan, Taiwan and its supporters can assert credibly that this makes the regime incomplete in a way that imperils its functioning. Amid recurring threats of pandemics emanating from the Chinese mainland, passing through Taiwan, and giving Taiwan valuable and shareable expertise, a WHO-centered regime that omits Taiwan is at risk of ineffective functioning—much as would be the case if major institutions for the global economy (such as the World Trade Organization (WTO)) were to exclude Taiwan. As if to make this point, in the early phases of COVID-19 outbreak, Taiwan authorities sent an email to the WHO on December 31, 2019 reporting on cases of a new, atypical pneumonia emerging from Wuhan and requesting any information the WHO might have. Consistent with Taiwan’s lack of access to the WHO, Taiwan reports receiving no reply, and the WHO has since sought to rebut Taiwan’s argument that the email provided an early, at least implicit warning of human-to-human transmission of the illness that would become known as COVID-19—a severe threat that China and the WHO would not acknowledge for three weeks.
Third, the regime for international public health (the WHO)—like regimes for the international economy (such as the WTO) or commercial air traffic (the International Civil Aviation Organization (ICAO))—regulates an issue area that does not much implicate the high politics issues of sovereignty that Beijing finds most neuralgic when it comes to issues of Taiwan’s international status. Participation in the WHA or in the ICAO’s Assembly meeting or full membership in the WTO (or the Asia Pacific Economic Cooperation group or the Asian Development Bank)—all opportunities that are or have been open to Taiwan—are less threatening to Beijing’s insistence on its one China principle than would be, say, Taiwan’s participation in the United Nations General Assembly or, perhaps, the UN Convention on the Law of the Sea.
Salient features of the SARS crisis that paved the way for Taiwan’s access to the WHO-centered regime thus reappeared with the COVID-19 pandemic. The much wider reach, much greater death toll, and much worse economic havoc wrought by the novel coronavirus would seem only to make Taiwan’s case even more persuasive in 2020 (and beyond).
Nothing Succeeds Like Success?
In another key respect, Taiwan is in a seemingly stronger position in the aftermath of COVID-19 than it was during the SARS crisis. Taiwan, which had been among the last places to bring SARS under control, has been arguably the world’s greatest success story in handling COVID-19. Taiwan has implemented the lessons of SARS. Authorities in Taiwan were primed to recognize and react to the new SARS-like ailment emerging in China, and to discount overly rosy accounts from Chinese sources. After SARS, Taiwan had strengthened a public health and emergency response system—particularly the National Health Command Center and its Central Epidemic Command Center—that was deployed quickly and effectively to address the novel coronavirus outbreak. Government briefings and directives to citizens were clear, and supplies of protective equipment, testing, high-tech tracing methods, and publicly provided support for quarantine were adequate to the challenge. With these elements of the government response in place, and public memories of SARS, the H1N1 flu, and other contagious diseases relatively fresh, Taiwan achieved high levels of societal compliance with containment practices. In a potent if accidental symbol, Taiwan’s sitting vice president is an epidemiologist. With the virus declared contained in April 2020 and no local transmissions recorded for a month by mid-May, Taiwan has suffered fewer than ten COVID-19-attributed deaths and fewer than 400 confirmed cases. Taiwan achieved these results without incurring the massive social and economic disruptions, or employing the draconian measures, seen elsewhere in less successful efforts to fight the pandemic.
This success story matters in the tangled international politics of the pandemic, the WHO, and Taiwan’s international status. Anything that looks like sidelining Taiwan, and the expertise it can offer, in global or national efforts to craft effective responses to COVID-19 begins to seem indefensible in light of Taiwan’s record as a front-line area in taming the first wave of COVID-19. The apparent churlishness and indefensibility of shunning Taiwan is all the more evident given that Taiwan handled the epidemic far more effectively than the United States and many other advanced countries, and without resorting to the harsh authoritarian methods that Chinese authorities employed with less success, and that would not be achievable, or tolerated, in Taiwan’s fellow liberal democracies.
As a rare exemplar of effectiveness amid failures by many seemingly formidable states and COVID-19’s terrifying prospects for the developing world, Taiwan is in a position to punch far above its weight and, in turn, bolster its international stature. And it has undertaken to do so, showcasing its accomplishments to audiences abroad, offering to share its expertise and lessons from its experience, and—reprising the international disaster relief and humanitarian assistance that Taiwan provides out of proportion to its small size—sending masks and other equipment to help alleviate shortages in over-matched countries, including the United States. Through its effective and benign crisis management at home, and its avoidance of a heavily political tone or quality problems with the assistance provided abroad, Taiwan has gained stature and standing from the inevitable contrast with the PRC (and, in some respects, the United States).
What a Difference a Dozen Years Make: The Very Different Politics of 2020
Despite these apparent advantages for Taiwan’s case for WHA participation and WHO engagement in 2020, Taiwan also faces conditions that—although mixed and complicated—may make its chances slimmer than they were in 2008.
China’s mishandling of a pandemic respiratory illness and the resulting international criticism were not the only developments that opened the door to Taiwan’s invitation to participate in the WHA in the 2000s. The opportunity came only several years after SARS and, specifically, after the election that brought the Kuomintang’s Ma Ying-jeou to the presidency in Taiwan. During the post-SARS/pre-Ma years, Beijing was not willing to drop its decisive opposition to Taiwan’s access to all UN-affiliated specialized organizations. China relented only after the departure from office of Ma’s predecessor, the Democratic Progressive Party’s Chen Shui-bian—whom Beijing deemed unacceptably pro-independence and who had contemplated a domestic referendum on a Taiwanese bid for WHO membership.
Beijing ended Taiwan’s eight-year run of ad hoc invitations to the WHA sessions in the first year following the coming to power in Taiwan of a second president from the DPP, Tsai Ing-wen—whom Beijing has shunned because of her refusal to embrace its one China principle. With the cross-Strait rapprochement of the Ma years superseded by Beijing’s cold shoulder—and cold peace—toward Taiwan under Tsai, China may well remain intractably unaccommodating to coronavirus crisis-enhanced calls for Taiwan’s return to the WHA. In this regard, the annual WHA meeting—to be held via COVID-19-induced teleconference in 2020—is unfortunately timed: it nearly coincides with Tsai’s second inaugural ceremony (which also has shifted to an online platform), following her landslide victory in January elections that turned heavily on China’s heavy-handed approach to the pro-democracy, pro-autonomy, and pro-rule of law protests that shook Hong Kong throughout 2019. Beijing’s stance toward Taiwan during Tsai’s next four years is, thus, highly likely to remain less yielding on WHA/WHO and other international status-affecting issues than was the case during Ma’s tenure.
China’s capacity and determination to resist foreign demands and criticisms, and to shape international institutions and rules, have risen significantly since the early to middle 2000s. As in the post-SARS period, a significant group of WHO members are backing Taiwan’s mid-COVID-19 push for renewed access to the WHA/WHO. But this coalition—which includes the United States, Japan, Germany, and several of Taiwan’s remaining diplomatic partners, but is far short of a majority of the WHO membership—is not very likely be enough to move China and, in turn, the large group of WHO member states that support, or do not wish to confront, China in 2020.
Especially under Xi Jinping, China has moved away from Deng Xiaoping’s dictum that Beijing should avoid a confrontational tone in foreign policy. Across issues from human rights, to basic models for an economy, to territorial and maritime disputes, Beijing has become less willing to accept or fully engage outside criticisms that its actions do not conform to international rules and norms, and more willing to question or challenge the content or applicability of those rules and norms. As U.S.-China relations have become more adversarial—from the long unravelling of the bipartisan Washington consensus in favor of constructive engagement through the sharp downturns of the Trump-era “trade war” and, especially, the recriminations over COVID-19—the U.S. is correspondingly less able to persuade or pressure China to yield on issues that China considers symbolically important, such as Taiwan’s WHO access.
Although the change in WHO Director General from Hong Kong’s Margaret Chan—the incumbent when Taiwan gained WHA access—to Ethiopian Tedros Adhanom Ghebreyesus might seem to suggest otherwise, Beijing has succeeded in its drive in recent years to install Chinese nationals—or others favored by China—in top positions at UN-affiliated organizations and other major international institutions. Tedros was the candidate Beijing favored in the WHO Director General selection in 2017. China’s now-formidable clout at the WHO, or the WHO’s marked solicitude for the sensitivities of a major power from which it needs support and cooperation (all the more so as the Trump administration withdraws U.S. support from the global public health body), have boded ill for Taiwan’s cause at the WHA/WHO. In a move that prompted strident denunciations from the Trump administration and congressional Republicans and significant international criticism, the WHO and its Director General offered effusive praise for China’s initial—and seriously flawed—handling of the novel coronavirus.
Prospects for Taiwan dimmed further with an ugly set of exchanges involving Taiwan and the Director General—formally the source of Taiwan’s ad hoc invitations to attend WHA sessions. After Taiwanese citizens on social media expressed frustration and anger at the WHO’s treatment of Taiwan amid the COVID-19 pandemic and in some cases did so in racially charged terms, Tedros complained that the government in Taiwan had not done enough to condemn or quash such attacks, and Taiwanese officials answered that principles and laws of free speech in Taiwan limited the government’s capacity to take action against noxious comments. As the date for the WHA meeting approached, the Director General and the WHO’s in-house counsel declared that Taiwan’s participation at the 2020 session is a politically contentious matter for the member states to decide, making it inappropriate for the Director General to issue an invitation of the sort that was forthcoming during China’s acquiescence from 2009 through 2016 and that was consistent with the secret 2005 WHO memorandum accepting that China is the gatekeeper to Taiwan’s engagement with the WHO.
On the other hand, some contextual differences from a decade or more ago cut in Taiwan’s favor as it seeks restored access to the WHA/WHO. With China’s growing power, influence, and assertiveness internationally, wariness toward China has surged among other states, including the U.S., in Europe, and across the Indo-Pacific region. Especially strong among key sponsors of Taiwan’s WHA/WHO agenda, this broader shift in attitudes toward China has been amplified by China’s role in the novel coronavirus pandemic’s origin and spread, and Beijing’s often obstreperous and recalcitrant responses to calls for greater cooperation, transparency, and acceptance of responsibility. Compared to the time of SARS, China in 2020 often is held more in ill odor and viewed with greater distrust in key foreign capitals and among global publics—a state of affairs not conducive to international deference toward Beijing’s views about, and opposition to, Taiwan’s participation in important institutions and regimes.
U.S. support for Taiwan, as well antagonism toward China, have increased substantially, compared to baselines of the early to middle 2000s. When Ma Ying-jeou came to office in 2008, U.S.-Taiwan relations recovered quickly from their recent nadir at the end of Chen Shui-bian’s second term, when the departing president had put a provocative referendum on whether Taiwan should seek UN membership under the name “Taiwan” and thereby drew a rare public rebuke of Taiwan’s democratic processes from the U.S. State Department. Around the same time, doubts were growing rapidly in Washington about the continuing wisdom of U.S. efforts to bring China into international institutions and thereby socialize China into supporting status quo international rules and norms. Tensions between Beijing and U.S. allies and friends resurged along China’s maritime periphery, and the Obama administration framed the Trans-Pacific Partnership as part of a contest with China over writing the rules for the twenty-first century global economy. In these contexts, the issue of Taiwan and U.S. support for Taiwan’s pursuit of international space shifted from being a relatively likely cause of crisis in a basically good U.S.-China relationship to being one among many problems—and a potential source of strength for the U.S.—in increasingly rivalrous relations between Washington and Beijing.
This trend has accelerated markedly during the Trump administration, with the December 2017 National Security Strategy declaring China a strategic rival and a Russia-like revisionist power, and with an unprecedented spurt of pro-Taiwan legislation. The Taiwan Travel Act, the Asian Reassurance Initiative Act, and especially the Taiwan Allies International Protection and Enhancement Initiative Act (TAIPEI Act) have called for stronger ties with Taiwan and support for Taiwan’s international space, including in the form of membership for Taiwan in international organizations for which “statehood is not a requirement” and observer status in other international organization, such as the WHA/WHO. In the context of the U.S. administration’s escalating arguments that China must be held responsible for COVID-19-related harms in the United States and elsewhere beyond China’s borders, the impetus from Washington to support Taiwan at the WHA/WHO has become still stronger.
The problem for Taiwan is that other Trumpian turns in U.S. policy threaten to undermine the value of increased American support at the WHA/WHO. The normative force of arguments that Taiwan should be included, and perhaps even the empirical claim that giving Taiwan access is important for global public health, are at risk of being tainted by suspicions that U.S. arguments about Taiwan and the WHA/WHO are being deployed instrumentally (and thus with limited sincerity) in a politically motivated brawl with Beijing that seeks to divert attention, and blame, from the federal government’s breathtakingly poor handling of the novel coronavirus crisis in the United States. U.S. backing for arguments that it is important to restore Taiwan’s access to the WHA/WHO ring a bit hollow, and lose force, when set against the backdrop of Trump administration denunciations of the WHO for failing in its fundamental responsibilities and serving as Beijing’s puppet and mouthpiece, and the U.S.’s moves to defund the WHO and support the development of alternative procedures and organizations.
For Taiwan, the Delicate Art of Not Letting a Crisis Go to Waste
The COVID-19 pandemic and its political context have given rise to an improved and perhaps compelling case for Taiwan to resume participation at the WHA and expand engagement with the WHO, even though serious impediments—both deeply entrenched and newly emerging—stand in the way. A crisis no one wanted has created an opportunity for Taiwan to make gains in protecting its citizens’ public health and enhancing Taiwan’s international status.
To maximize its chance to succeed with the WHA/WHO in 2020 and with other goals bearing on Taiwan’s international space, Taiwan must avoid miscues in playing the strengthened hand that it has been dealt. Taiwan must, for example, be careful not to feed suspicions that it is disingenuously invoking and exaggerating public health concerns in the service of a primary agenda of seeking symbolic wins to boost its international status—a concern that has made highly consequential the disputes among Taipei, Beijing, Washington, and the WHO over how much the limits on Taiwan’s access to the WHA and WHO threaten public health in Taiwan and around the world. Taiwan also must be attuned to the potential volatility and fragility of one pillar of its improved prospects: the recent dramatic apparent uptick in Washington’s support for Taipei, which partly is the product of the Trump administration’s highly transactional approach to foreign policy, largely epiphenomenal to a deteriorating U.S.-China relationship, and vulnerable to supersession by more conventional policies if a new U.S. administration comes to power in January 2021.
The views expressed in this article are those of the author alone and do not necessarily reflect the position of the Foreign Policy Research Institute, a non-partisan organization that seeks to publish well-argued, policy-oriented articles on American foreign policy and national security priorities.