Credit: US Mission in Geneva

What is the Controversy Over Taiwan at the World Health Organization?

Representatives from most of the 194 member countries of the World Health Organization gather in Geneva each May for the World Health Assembly. This is a flagship event for the World Health Organization, and for global health more broadly.  The WHA is the governing body of the World Health Organization. It is at the WHA that representatives of these governments set the agenda for the World Health Organization and make other decisions about the WHO’s budget and overall operations.

The World Health Organization is an inter-governmental organization, and the WHA is the annual platform in which governments meet to determine their priorities for the WHO.

This year, the WHA will be held virtually on May 18 and 19. And, as one would expect the virtual gathering will be exclusively focused on COVID-19. However, lurking in the background of this meeting is the question of Taiwan’s status at the WHO.  Several powerful members of the World Health Assembly including the United States and many European countries are advocating for Taiwan’s participation in the WHA while others, namely China, are stridently opposed.

This is setting up a potential diplomatic showdown at the WHA at precisely the same time the World Health Organization — namely its Director-General Dr. Tedros — is calling for global solidarity.

Taiwan and the World Health Organization

The question of the Taiwan’s status at the WHO has long vexed diplomats and public health officials. On the one hand, Taiwan is a robust democracy with much it can contribute to the WHO. On the other hand, Beijing has stridently opposed any action that could suggest broader international recognition of Taiwan as an independent state.  In 2009, however, there was a breakthrough. A general warming of relations across the Taiwan Strait led to a bi-lateral agreement in which China acceded to Taiwan’s “observer status” at the World Health Organization, so long as it did so under the name “Chinese Taipei.”  Taiwan was able therefore to participate in the WHA. It was not a full voting member, but it could contribute and participate in other meaningful ways.

That agreement held until 2016, when there was a change of power in Taiwan following elections.

Those elections sparked a deterioration in cross-strait relations, with Beijing and the new administration in Taipei becoming increasingly adversarial. By the time of the World Health Assembly in May 2016, the previous agreement on Taiwan’s status at the WHO was fraying. Diplomats from the United States and Europe were involved in negotiations with China to help strike another deal enabling Taiwan’s continued observer status at the WHO. Ultimately, the conditions sought by China were untenable for Taipei. This included, among other things, specific references to the One China policy and a 1971 United Nations General Assembly resolution which gave China’s seat at the UN to the ruling Chinese Communist Party (and evicted representatives of Taiwan).

Since 2017, Taiwan has not participated in a World Health Assembly as an observer country. It does, however, still have points of contact at the WHO and receives communication from the WHO.

The decision to admit Taiwan to the WHO is up to governments of the world, not the WHO Director General

Taiwan’s diplomatic saga with the WHO over the last several years is a direct consequence of international politics and diplomacy. That is because Taiwan’s status at the WHO is ultimately decided by the membership of the WHO — in other words, the governments of the world that form the World Health Assembly. In practice, the Director General of the WHO would not approve or deny Taiwan’s status as an observer — or any other entity’s status.  It is a political decision that needs to be made by the membership of the World Health Assembly. So long as there is no diplomatic agreement among the governments of the world, namely between China and Taiwan’s supporters in the West, Taiwan cannot participate in the WHA.

A bi-partisan group of United States Senators, ranging from the most progressive to the most conservative, have called on the Secretary of State to develop a strategy to secure Taiwan’s re-enty into the World Health Assembly. If the Secretary of State is sincerely interested in achieving that goal, it would necessarily mean the US supporting meaningful diplomacy between Taiwan and China —  as was the case between 2009 and 2016. On the other hand, if the Secretary of State or others simply use Taiwan’s exclusion from the WHA as a cudgel against the WHO, it is unlikely that this diplomatic dispute will be resolved in a way favorable to Taiwan and US interests.

UPDATE:  Secretary of State Mike Pompeo released a statement on Taiwan’s exclusion from the World Health Assembly.

WHO’s Director-General Tedros had every legal power and precedent to include Taiwan in WHA’s proceedings. Yet, he instead chose not to invite Taiwan under pressure from the People’s Republic of China (PRC). The Director-General’s lack of independence deprives the Assembly of Taiwan’s renowned scientific expertise on pandemic disease, and further damages the WHO’s credibility and effectiveness at a time when the world needs it the most.

“Precedent” is interesting word choice. To be sure, there is precedent for Taiwan to join the World Health Assembly as an observer, as was the case from 2009 to 2017. But that was only achieved through a diplomatic solution in which a consensus reached among the parties. Taiwan’s participation in the WHA flows from that consensus.  It would actually be totally unprecedented for the WHO Director General to invite an observer to the World Health Assembly without the agreement of its member states, an in particular with profound disagreement of two of its more powerful members.

The reason that consensus is so important is that the WHO cannot operate as a global body without the support of its member states. If the Director-General were to invite Taiwan over the objections of Beijing, the Chinese government use its considerable diplomatic clout and retaliate against the WHO. This could include, among other things, ceasing to support the WHO’s critical work helping countries in the developing world confront Covid-19.  Meanwhile, the WHO is already under severe financial strain from the Trump administration’s decision to halt funding for the WHO in the midst of this pandemic, so any further moves that could divide the international community may fatally undermine its mission.

This predicament in which the Director General finds himself is the precise reason why he can only invite Taiwan if, first, there is international consensus to do so. In matters like this, the Director-General cannot operate independently from broader geo-political forces. Choosing between inviting Taiwan to join the WHA or fatally undermining the WHO’s ability to confront COVID-19 is not a choice he can make.