Is Taiwan’s Participation in the W.H.O. During COVID-19 on the Horizon?

The emblem of The World Health Organization. Photo by Miguel Á. Padriñán.

On November 9, the World Health Assembly (W.H.A.)—the decision-making body of the World Health Organization (W.H.O.) comprising 194 member states—convened virtually without the participation of the Republic of China (Taiwan), a key player which has proven to be a model for its domestic response to the COVID-19 pandemic. 

Since the outbreak of the pandemic, Taiwan has efficiently adopted a range of measures including activating its Central Epidemic Control Center, organizing mask rationing, implementing social distancing, and increasing mask production to meet the needs of the population. Taiwan’s success in containing the virus has earned it global praise, as well as support for its bid in May 2020 to participate in the W.H.A. as an “observer.” Aside from Taiwan’s formal diplomatic allies, health officials from the United States and Japan have also backed Taiwan’s bid. Secretary of State Mike Pompeo accused the W.H.O. of “play[ing] politics while lives are at stake” and politicizing an issue fundamentally oriented around global health. Other member states of the W.H.O., including Australia, Canada, France, Germany, New Zealand and the United Kingdom have also shown their support for Taiwan by emphasizing the need for “inclusiveness” in the global health agency. 

Yet despite these efforts, Taiwan remains excluded from the W.H.A.. This situation raises several questions: Why has the People’s Republic of China (China) persistently opposed Taiwan’s participation? Have international efforts advocating for Taiwan’s inclusion been futile? Most importantly, is the possibility of Taiwan’s participation in the W.H.O. even on the horizon, particularly in the current climate where international cooperation is cardinal for global health and security? 

Historical Context: Reviewing Taiwan’s 2009 Participation in the W.H.A.

Taiwan’s exclusion from the W.H.A. is largely attributed to the current political deadlock between China and Taiwan. This conflict dates back to the Chinese Civil War (1927-1949) between the Kuomintang (KMT) led by Chiang Kai-shek and the Chinese Communist Party (CCP) led by Mao Zedong. The war prompted the KMT’s withdrawal to Taiwan, marking the breakdown of relations between a once united nation due to differences over whether the Republic of China or the People’s Republic of China was the sole legitimate representative of China in its entirety. 

Over the years, however, there have been periods of détente between Beijing and Taipei, such as in 2009 with China’s acceptance of Taiwan’s participation in the W.H.A. to a limited extent. In April 2009, the W.H.O. extended an invitation to Taiwan to attend a W.H.A. meeting as an “observer,” a status that Taiwan enjoyed until 2016. This “observer” status marked a stark change from China’s repeated denials of Taiwan’s bids to join the W.H.A. in 1997, 2004 and 2007, despite the fact that statehood is not a requirement for participation. The clash between Taiwan and China stems from a disconcurrence regarding the One China Principle, which refers to the notion that there is only “one China” which encompasses both the Mainland and Taiwan. The CCP views the acceptance of the One China Principle as a non-negotiable linchpin for cross-strait dialogue, yet Taiwanese officials prior to 2009 mostly disagreed with this perspective, since an acceptance of the One China Principle would imply that Taiwan indeed belonged to a larger China. Former Taiwanese leader Lee Teng-hui (1988-2000), for instance, described the relationship between China and Taiwan as “special state-to-state relations,” which insinuated that Taiwan was a “state” separate from China and therefore not part of “one China.” 

However, when Ma Ying-jeou from the KMT party was elected in the 2008 presidential elections and accepted the existence of “one China,” he opened up a new realm of possibilities for cross-strait discussions. Both sides of the Taiwan strait developed a mutual consensus to base dialogue on the acceptance of “one China”—albeit with differing interpretations of which government was the sole legitimate representative of the whole China. This common ground prompted China’s acceptance of Taiwan as an “observer” in the W.H.A. in 2009, where the latter could participate in meetings and activities under the moniker “Chinese Taipei.” Groups which were in favor of a compromise viewed this move as a breakthrough for Taiwan and a significant “diplomatic truce” between Beijing and Taipei. The agreement brokered in 2009 would crucially define and set the broad terms that need to be respected in order for Taiwan to participate in the W.H.O.. 

Contemporary Implications: The DPP’s Stance on “One China”

Under the current Democratic Progressive Party (DPP) administration, leader Tsai Ing-wen (2016-present) has refused to acknowledge and accept the notion of “one China.” While the CCP demands that the DPP recognize the One China principle premised on the former’s interpretation of the 1992 Consensus, Tsai recognizes that an acquiescence with the CCP would be equivalent to affirming that Taiwan is indeed a part of China. This assent would directly contravene the DPP’s “independence clause” enshrined in its 1991 charter, which advanced the party’s aim of “establish[ing] a sovereign, independent, and autonomous Republic of Taiwan.” 

These different perspectives towards “one China” might also explain why adopting the title “Chinese Taipei” in W.H.A. activities, as the KMT-led government had done from 2009 to 2016, is deemed unacceptable by the DPP. A piece by The Diplomat elucidating the DPP’s stance called this moniker “highly demeaning,” and contended that “many people in Taiwan… argue that Taiwan should be allowed [to participate in the W.H.A.] under its own name,” either as “Taiwan” or the “Republic of China.” The fundamental opposition between the stances of the CCP and the DPP ultimately implies that a middle ground is unlikely to be found vis-a-vis cross-strait dialogue and—to a larger extent—Taiwan’s participation in the W.H.O., as long as the two parties are in power. 

The Road Ahead: Weighing Methods for Taiwan’s Participation in the W.H.A.

Moving forward, are there any potential solutions that could enable Taiwan to be granted some form of participation in the W.H.O.? 

For the time being, the One China policy is unlikely to be renounced or jettisoned by the international community, given Beijing’s unflagging insistence on adherence to the One China policy. States and international actors are hesitant to push back on the One China policy in fear of retaliation from the rising global superpower. However, there have been previous instances where international pressure has successfully pushed for some inclusion of Taiwan in the W.H.O. within the framework of the One China policy. In 2005, for instance, international pressure for Taiwan’s inclusion in the W.H.O. following the outbreak of the avian flu pandemic enabled Taiwan to participate in some meetings. Thus, in order for Taiwan’s participation in the W.H.O. to become a plausible reality, member states with significant clout on the global stage must act as a bloc to make stronger demands for its inclusion. While this move may be politically risky, the international community has an obligation in the interest of global health to include all entities which have been successful in combatting the pandemic. Such an inclusion would increase transparency among global players and widen access to critical health-related information. 

Another recommendation to circumvent current constraints would be to switch from multilateral cooperation (basing participation on nationhood/statehood) to omni-lateralism (widening up participation to all regardless of political status) within the W.H.O. to accord Taiwan with the ability to participate without obvious contraventions to the One China policy. This idea was elaborated by E.U. and Asian policy expert Wolfgang Pape, who wrote that an omni-lateral system would encourage the inclusion of “local, state and regional as well as global governance,” which could allow for Taiwan’s involvement regardless of its legal and political status. This suggestion would expand the current W.H.O. system where membership is limited to states, which has ultimately prompted a situation where “the nation state, with its claim of absolute—in spite of obvious global interdependence—remains the political bottleneck.” 

By switching from a system of multilateralism to omni-lateralism, a more agreeable solution that would both enhance Taiwan’s functional participation in the W.H.O. while strengthening global health cooperation could be achieved, all without directly calling into question Taiwan’s sovereignty status. However, given the complexity of the current situation and the unpredictability of the global world order, whether these solutions can realistically be implemented given their potentially destabilizing consequences is another hard question that may remain unanswered for a long time to come.

Ashley Tan is a sophomore under the Dual BA program with Sciences Po Paris. She has previously served as a judge for The Queen’s Commonwealth Essay Competition and as the editor-in-chief of a history and politics publication. In her spare time, she enjoys watching Outlander on Netflix, contemplating which bubble tea flavor to opt for, and planning (for a now indefinitely postponed) Western civilization tour starting from Athens, across the Baltic region, and ending in Rome.