The controversial participation of Taiwan in the WHO is more complicated than the designation “Taiwan, China,” over which the Chinese Nationalist Party (KMT) and the Democratic Progressive Party (DPP) have traded fire, analysts said.
Despite being harshly criticized for a recently leaked procedure concerning the implementation of the International Health Regulations (IHR) — a set of WHO global health rules — with the instruction the refer to the nation as “Taiwan, Province of China,” the government has vehemently defended its WHO strategy.
The government has raised two key arguments in its defense.
On the one hand, the administration has emphasized the importance of participating in the WHO’s decision-making body, the World Health Assembly (WHA), as an observer under the name “Chinese Taipei,” on an annual basis and its inclusion in the IHR.
On the other, it has protested with the WHO over the reference to Taiwan as “a province of China” or “Taiwan, China,” a practice that has existed within the UN since 1971 and has been so strictly enforced that, in some occasions, the former DPP administration went along with it, the KMT administration said.
However, the problems facing the nation in terms of its WHO participation extend beyond the dimensions mentioned by the government, analysts said.
The KMT has strongly dismissed accusations by the DPP that arrangements in which Taiwan’s participation in the WHA and access to the IHR were made with Beijing’s involvement, though it did not deny that Chinese “goodwill” was beneficial.
However, the WHO procedure for IHR implementation has “put the government in an untenable position” to justify its WHO strategy, said Lin Shih-chia (林世嘉), chairman of the Foundation of Medical Professionals alliance in Taiwan.
The IHR implementation was the latest document regulating Taiwan’s interaction with the WHO. The Ministry of Foreign Affairs has confirmed that China and the WHO in 2005 signed a memorandum of understanding (MOU) that has since been implemented.
“The WHO case shows that China has changed its strategy to repress Taiwan internationally from pursuing a policy of containment to establishing legal frameworks with international organizations that categorize Taiwan as part of China,” Lin said.
Chiang Huang-chih (姜皇池), a professor of international law at National Taiwan University’s College of Law, said there were fears that Taiwan would have to follow the “WHO model” in its quest for participation in other international organizations.
The 2005 MOU was proposed by Beijing against the backdrop of strong support for Taiwan by countries such as the US, Japan and the EU after Taiwan’s years of efforts in its WHO bid, Chiang said.
Increased awareness of the need to include Taiwan in the world health body after the SARS epidemic in 2003 was also a factor, Chiang said.
“Taiwan’s quest for a seat at the WHO hit a wall with the MOU, but not a single country blamed Taiwan for not accepting the MOU because it was China that wanted to change the ‘status quo,’ which no one would agree to,” he said.
However, in 2008, the KMT administration accepted the arrangement, in which Taiwan’s participation as an observer at the WHA and access to the IHR “were made with China’s involvement,” which was tantamount to its acquiescence to the MOU.
That “turned the situation around,” Chiang said.
“Now, Taiwan would bear the blame if it said it did not want the ‘WHO model’ to be applied in its quest for membership in other international organizations,” he said. “Who would support you if you wanted to back away from deals you agreed to?”
The MOU also means that Taiwan is not treated as an equal observer in the WHA, Chiang said.
“The main difference is that the invitation to Taiwan to attend WHA sessions is subject to review by China on an annual basis, while the WHO Secretariat extends the invitation to other observers without any prior review [by an external player],” he said.
What’s worse is that WHA observers are informed of WHO executive board meetings, technical meetings, experts meetings and are invited to attend the events at their discretion, but Taiwan can only attend the meetings at the invitation of the WHO Secretariat and with Beijing’s consent, Chiang said.
“In short, Taiwan has no rights in the WHO — only China does,” he said.
Since 2009, the WHA is the only occasion hosted by a UN agency in which the Republic of China has been able to participate since it exited its UN seat to China in 1971.
However, the exclusion of Taiwan in the WHO does not mean it had no opportunity to access the organization before its invitation to attend the WHA in 2009, said Peter Chang (張武修), a professor at the school of public health at Taipei Medical University.
“At one point, Taiwan had a high-profile presence in the WHO, especially after the outbreak of SARS in 2003, with medical professionals actively attending experts and technical meetings, sometimes under the name we liked,” Chang said. “However, the chances for Taiwanese experts to attend WHO meetings decreased significantly after 2008.”
The arrangements by which Taiwan could participate in the WHO’s technical or expert meetings were made through multilateral negotiations with concerned countries, he said.
Having served as a health attache at Taiwan’s representative offices in Geneva, Switzerland, and in Brussels from 2002 through 2009, Chang attributed the change to several reasons.
It took about a year for the KMT government to reorganize its diplomatic operations, which led to a decision that gave more weight to Taiwan’s participation in the WHA via talks with Beijing than a presence at expert or technical meetings, Chang said.
At the same time, the WHO Secretariat, headed by former Hong Kong director of health Margaret Chan (陳馮富珍), since 2007, gradually developed its strictly enforced standard operating procedures in accordance with the MOU, Chang said.
After Chan took office, she appointed Fu Cong (傅聰), a former Chinese Minister of Foreign Affairs official, as an adviser in her office and one of his main jobs was to keep an eye on Taiwan’s activities in the WHO, he said.
The government said the MOU and the IHR implementation did not infringe on the country’s sovereignty because of its “three noes” policy.
Following the inclusion of Taiwan in the IHR, when Taiwan needs to notify the WHO on health information, it will now first have to notify Beijing, he said.
“Health information should be a country’s sovereignty. [But now], when Americans need disease information about Taiwan, it won’t need to ask Taiwanese authorities, as it can obtain it from China,” he said.
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