by Niklas Swanström, Reihuan Wu and Lwanga Egbewatt Arrey

Revisiting Taiwan’s Case: Need for Meaningful Participation in the 76th World Health Assembly

Key Takeaways

  • Sweden should voice support for Taiwan’s inclusion in the upcoming WHA.
  • Statehood is not at the center of WHO/WHA membership; Taiwan was a WHA observer for eight years as Chinese Taipei.
  • Taiwan’s participation in the WHA is a global health issue.
  • Taiwan’s inclusion in the WHA can improve Cross-Strait relations.
  • Taiwan has made important contributions to global health, and it needs assistance from the global health system.
  • This is a chance for Sweden to show leadership on key global issues. It is also a chance to coordinate EU policy and engender solidarity.

Introduction

The World Health Assembly (WHA), the World Health Organization’s (WHO) decision-making body, will hold its 76th annual meeting from May 21-30. In the aftermath of the pandemic, it is more necessary than ever to have an inclusive and holistic approach to the WHO, especially as there is a higher likelihood of pandemics increasing in scope and intensity in the coming years. However, as the meetings commence in Geneva, a critical factor that needs scrutiny is the exclusion of Taiwan (Republic of China).

Taiwan is one of the actors that remain largely excluded from the world’s international health system, due to the politicization of what fundamentally should be a health and humanitarian consideration. Throughout the three years of the COVID-19 pandemic, Taiwanese experts have worked diligently and shown resilience in countering the global health crisis. This necessitates an urgent reconsideration of the status quo in the international health milieu.

WHO Observer Status Does Not Equate to UN Membership

Taking into account Taiwan’s contentious status and the People’s Republic of China’s (PRC) refusal to recognize the sovereignty of what it considers a renegade breakaway province, it must be noted that Taiwan’s admission into the WHA is not an acknowledgment of the island’s statehood, nor does it amount to a United Nations (UN) membership. In fact, it is a misunderstanding or even political Machiavellianism to link WHO observer status to membership in international organizations not exclusively focused on international health governance.

Several notable examples illustrate that the two are not interlinked: The Holy See was granted permanent observer status in the WHO in 2021. The Cook Islands and Niue are full members of the WHO without holding UN membership. Lichtenstein, on the other hand, is a UN member state that does not take part in the WHO. Thus, considerations for Taiwanese membership in the WHA should not be based on its political status, but on the needs of the island’s residents and what the island can contribute to the international health system.

In addition, Taiwan did participate in the WHA proceedings as an observer for close to a decade. During 2009-2016, Taiwan was invited as an observer at the WHA under the name “Chinese Taipei,” a worthwhile achievement despite the limitations of restricted association.

Nonetheless, the stability of Taiwan’s political status throughout these years did not prevent the PRC from blocking the entry of “Chinese Taipei” in the WHA in 2017. This was to no small extent due to the political pressure exerted on Taiwan and Beijing’s refusal to allow any international space for Taiwan, regardless of the nature of the platform. Moreover, the prospects of Taiwan’s participation in the WHA have been unnecessarily associated with the One-China Principle/policy, rather than considered an issue of health, as is appropriate. Therefore, we argue that statehood should be secondary to health.

Public Health Diplomacy

In disallowing Taiwan’s entry into global public health forums, China has missed an opportunity to shift the mode of interaction with Taiwan from coercive threats to constructive engagement. It should be possible for China to accept Taiwan as an observer, or even a full member, of the WHA as a first step towards a more positive engagement over the Taiwan Strait. As mentioned before, Taiwan’s participated as a WHA observer from 2009 to 2016. Surely, China can demonstrate goodwill once again and remove barriers to Taiwan’s readmission into the assembly.

By re-affirming that Taiwan’s admission into the WHA is not related to the debate over the One-China Principle/policy, but rather an opportunity to build trust on an issue that is humanitarian in nature and based on the common welfare of ordinary people, cooperation, and relations between both sides of the Taiwan Strait can be strengthened.

Taiwan Contributes to Global Health

Realizing that the issue is not relevant to political status but is about general welfare and the effectiveness of global health governance, there is a need to live up to inclusiveness as a beneficial virtue necessary to realizing a healthy global populace. Taiwan is an important contributor to international health know-how, and its inclusion in the WHA will be beneficial for all peoples, countries, and territories in the world.

During the early stages of the COVID-19 pandemic, Taiwan informed the WHO of signs of an unknown disease similar to SARS, with possible human-to-human transmission. If Taiwan’s insights had been considered earlier, the global response to the pandemic could have been much more effective with lesser fatalities. This experience demonstrated Taiwan’s ability to participate in international cooperation on healthcare, as well as its expertise in public health. During the pandemic, Taiwan also shared personal protective equipment with more than 80 countries around the globe, including Sweden and many other European Union (EU) member states. Therefore, including Taiwan in the WHA would benefit the international community through additional expertise and resources to combat global health challenges in the future.

Taiwan Needs the WHO

Despite its strong response to the COVID-19 pandemic as an entity operating outside the world health system, Taiwan faced tremendous difficulties receiving vaccines for its 23.6 million inhabitants. China blocked Germany’s BioNTech from supplying vaccines to Taiwan. As a result, Taiwan had to rely on vaccine donations from other countries. In total, Taiwan received around 10 million vaccine doses from six countries, including the US, Japan, and its partners in Eastern Europe. Such difficulties could have been avoided if Taiwan was included in the WHO. 

Excluding Taiwan from the workings of the WHO would also compromise global health and safety. Despite the PRC’s argument that Taiwan’s public health is represented by Beijing, the current situation shows that it is neither accurate nor feasible, as Taiwan is unable to provide virus surveillance information to other countries through the WHO’s Global Influenza Surveillance and Influenza Response System (GISRS). This lack of coordination and synergy between Taiwan and the WHO not only puts Taiwan’s 23.6 million inhabitants at risk but also imperils global health resilience. If Taiwan is invited to the WHA, such difficulties could be managed more effectively. Above all, if a new pandemic emerges, the global response will only be as strong as its weakest link.

The EU and Sweden Must Show Leadership

Healthcare is a fundamental human right, and Sweden must speak up for more inclusive multilateral health organizations and initiatives, both at the EU and the WHA. As the current president of the EU Council, Sweden can also initiate and coordinate EU member states to jointly support Taiwan in this year’s WHA, based on the health needs of the international community without obsessing on the question of Taiwanese statehood.

In fact, many European states have already called for Taiwan’s participation in the WHA. During the WHA Plenary Meeting in 2022, representatives from the US, the UK, France, Germany, Canada, Australia, Luxembourg, Lithuania, and New Zealand all voiced their support to Taiwan. Thus, as the EU Council president, Sweden can build on this momentum and harness the wide-ranging expression of goodwill toward the island’s inclusion in global health governance.

Sweden and the EU have made it clear that it is in their interest to support Taiwan’s meaningful participation in international organizations where statehood is not a prerequisite for membership. The arguments above demonstrate that Taiwan is qualified to participate in this year’s WHA as an observer. Taiwan’s inclusion in the WHO should not be made into a political issue, for it is fundamentally about humanitarian assistance and goodwill. Healthcare is a global priority that has served as a bridge for cooperation across borders. Sweden should not hesitate to pursue the right course of action. Notably, it will provide Sweden an opportunity to showcase its political and moral leadership on the global stage.