Few Friends and Few Allies: Taiwan in the WHO

Frank Ching | 20 May 2020

For the last ten years, Taiwan has attempted each year to be admitted into the World Health Organisation (WHO), only to be rejected every time. In previous years, to maximize its chances, it asked to be admitted as an observer—not a full member—of the World Health Assembly, the supreme decision-making body of the WHO, and did not ask to be regarded as a country but simply as a "health entity."

This year, it tried again and, this time, it decided to go for broke. It applied for full membership as a sovereign state. As expected, Taiwan was rebuffed again. In fact, the issue was not even included in the assembly's provisional agenda after a vote of 148 to 17 to cut off the three-hour debate.

But Taiwan considered this a victory of sorts. Deputy Foreign Minister Yang Tzu-pao said that Taiwan had succeeded in raising its profile in the international arena and enhancing awareness of Taiwan's exclusion from the world health body.

However, there were also danger signs. Although Taiwan has 24 diplomatic allies who are members of the WHO, only 17 of them voted in its support. Costa Rica actually voted against Taiwan, though its delegate subsequently claim the action was a mistake.

Nicaragua, Panama, the Marshall Islands and St. Lucia did not vote because their representatives were absent from the assembly. The Marshall Island's delegate explained that he was ill with diarrhea and could not leave his hotel but it is not clear why the other delegates were absent. All of them, after all, are recipients of economic aid from Taiwan.

From Taiwan's perspective, it is certainly not a good sign that Nicaragua, Panama and St. Lucia—which had switched recognition from Beijing to Taipei only a few weeks ago—do not seem willing to take action that would offend Beijing. Central America, after all, accounts for about half of the countries that maintain diplomatic relations with Taipei and any defections will be a major blow to Taiwan.

The application for WHO membership never stood a chance. The health body's constitution stipulates that only sovereign states can be members, and Taiwan is not recognised as a sovereign state by the vast majority of WHO member states. Even the United States, the country that underwrites Taiwan's security, voted against it.

Washington is not too enamored these days with Taiwan's leader Chen Shui-bian, who despite having repeatedly pledged not to declare the island's independence, has recently come out publicly declaring that Taiwan wants independence and a new constitution. His every action, therefore, is judged with cynicism.

But while President Chen no doubt has his own political agenda, on the issue of participation in the world health body, he is voicing a sentiment that is almost universally shared in Taiwan. In fact, the legislature voted unanimously to "fully support the government's struggle to become a WHO member and uphold the basic health rights of Taiwan's 23 million people.¨

In fact, in the wake of SARS and avian flu, there is general awareness that Taiwan needs to be included in a global health network not only for the welfare of its people, but also because any pandemic can easily spread from Taiwan and threaten the whole world. For this reason, there was a consensus that Taiwan, while not a member, needed to be able to enjoy "meaningful participation¨ in the work of the WHO.

But Beijing will not allow Taiwan to do so in its own right. China asserts that it looks after Taiwan's health needs. Two years ago, China signed a memorandum of understanding with the WHO which directed that the body could, if necessary, send experts to the island to provide assistance. Moreover, Taiwanese experts are allowed to take part in health conferences. But, the memorandum provides that each proposal would have to be approved by Beijing. The WHO secretariat is obliged to contact the Chinese embassy in Geneva, which will pass on the proposal to the Ministry of Health in Beijing for its decision. In the last two years, this avenue has enabled Taiwanese experts to attend 45 WHO-sponsored conferences but Taiwan complains that more than two dozen proposals were vetoed by Beijing.

This system may not be fully satisfactory but it is unlikely that there will be any major improvement as long as Taiwan is seen by Beijing as seeking independence. If there is more trust between the two sides, then a lot more can be done. But first, the cross-strait dialogue, suspended since 1999, must be revived. This may well be possible after the presidential election next year.

Frank Ching is a Hong-Kong based commentator. 

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