The China-Taiwan conflict is disrupting the WHO’s fight against Covid-19

In a highly-unusual speech, the leader of the World Health Organization (WHO) yesterday appealed to the international community to stop politicizing the fight against the novel coronavirus—and then proceeded to politicize it even further.

In an exchange with reporters, Tedros Adhanom Ghebreyesus, the first African director-general of the WHO, said he had experienced death threats and racist vitriol online over the past three weeks. He alleged that some of these attacks came from Taiwan and accused the Taiwanese government of knowing about, and refusing to do anything about, them. (Taiwan has denied and harshly condemned these accusations.)

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The speech, and its accusation that Taiwan tacitly condoned a racist campaign, is the latest chapter in an ongoing diplomatic saga between China and Taiwan, which both leverage the issue of membership in the WHO, a UN agency, to further their own geopolitical interests. That conflict has reached a new level of intensity as the WHO, which likes to think of itself as apolitical, attempts to lead the world through one of the worst health crises in its history.

The root of the problem is that China claims Taiwan as its own, though the ruling Communist Party has never had sovereign control over the territory. Almost all governments in the world recognize only the sovereignty of the government in Beijing. As a result, China has largely prevented Taiwan from membership in international organizations. But Taiwan has led a decades-long campaign for inclusion in the WHO, arguing that its highly-regarded healthcare system earns it a place in the world’s public health agency.

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The WHO, however, does not have the power to decide Taiwan’s membership status. And it depends on China for both funding and cooperation. This high-stakes geopolitical battle is now ensnaring the WHO once again, at what just might be the worst possible time.

Taiwan and the WHO

It’s somewhat ironic, given the tensions that exist between China and the WHO, that the latter wouldn’t exist without the former. In 1945, while world leaders were gathered in San Francisco to set up the United Nations, it was representatives from Brazil and China that proposed the creation of an international health organization.

At the time, China was governed by two political factions—Nationalists and Communists. The two groups had joined forces to defeat the Japanese occupation, but were otherwise fighting a bitter war for control of the country. The Chinese Communist Party ultimately defeated the Nationalist forces in 1949, and the Nationalists retreated to Taiwan. They would go on to rule Taiwan under martial law until 1987.

In 1972, the UN recognized the People’s Republic of China as the government representing China. Under the government’s One China Principle, Beijing considers Taiwan part of its country. As a result, China has prevented Taiwan from participating in multilateral initiatives as a member state. China fears that “if Taiwan gets recognized as an independent government by something like the World Health Assembly, that could potentially be the first crack in Taiwan trying to get independent membership in the United Nations writ large,” Jeremy Youde, an expert on global health politics, said.

After the 2009 H1N1 influenza epidemic, China had at times allowed Taiwan to send an observer delegation to the World Health Assembly, the yearly meeting of the WHO’s plenary body, under the name “Chinese Taipei.” But it stopped after 2016, when Taiwan elected a progressive president who refused to endorse the One China Principle. “China has used this over the years as a political tool, to demonstrate a level of unhappiness with Taiwan,” said Adam Kamradt-Scott, an analyst at the Centre for International Security Studies at the University of Sydney.

Taiwanese officials have also used public health as a political tool to press their case for independence, engaging in a similar form of “mask diplomacy” to that of Beijing, for example. It appears to be paying off: In a rare move, Ursula von der Leyen, president of the European Commission, publicly thanked Taiwan last week for donating masks to the European Union.

Public health experts have lauded Taiwan’s response to Covid-19. The island, which is about 100 miles (161 kilometers) away from mainland China—the suspected origin point of the outbreak—has reported only 380 cases and five deaths as of April 8. But Taiwan is still locked out of the WHO, in ways it claims are impeding public health. The WHO, meanwhile, says it is getting all the information it needs from Taiwan.

“Ostensibly, this is a public health emergency,” said Kelley Lee, Canada research chair in global health governance at Simon Fraser University. “But public health has always been political.”

Taiwan presses its case

Taiwan and its allies see this pandemic as an opportunity to press their case for independence, Lee said. “This is a moment where they can leverage some world attention. People are going to be more sympathetic, and Beijing is not in the good books of people around the world,” she said, referring to concerns that China initially covered up the existence of the virus.

Over the past few weeks, the US—Taiwan’s most important ally—has twice pushed publicly to give Taiwan a bigger role in world politics, including at the WHO. On March 26, US president Donald Trump signed the TAIPEI Act into law, directing the State Department to “strengthen Taiwan’s diplomatic relations with other partners in the Indo-Pacific region and alter United States’ engagement with nations that undermine the security or prosperity of Taiwan.”

Beijing has not taken kindly to these moves, warning the US and Taiwan not to “use this pandemic to play political games,” according to the South China Morning Post.

This issue has already become an obstacle for the WHO. On March 28, Radio Television Hong Kong (RTHK) reporter Yvonne Tong interviewed Bruce Aylward, a senior advisor to the WHO. Among other questions, Tong asked Aylward whether the WHO would consider letting Taiwan join its ranks as a member. In a video recording of the call later released by RTHK, Aylward replied that he didn’t hear her question and then, abruptly, appeared to hang up. It was an embarrassing misstep for the WHO.

While there is a lot of support for Taiwan’s position within the expert community outside of China, there is also some frustration with their methods and timing. “Picking on WHO is not the answer,” argued Kamradt-Scott, who is concerned that it could “distract from the broader global public health efforts and diminish the WHO’s voice at a critical time when the world is facing a global emergency.”

“I find it dismaying that we are having this conversation about Taiwan and China when I would’ve hoped that [on] both sides, cooler heads would prevail,” Lee added. “We are not going to be the same world when we’re finally out of our houses. We have to think on a higher level than what Taiwan’s going to be called and who’s done what.”

“It’s a diplomatic mess”

Separate emailed statements sent to Quartz by representatives of the WHO and of the Foundation of Medical Professionals Alliance in Taiwan (FMPAT)—a group that advocates for Taiwan’s membership in the WHO—make clear that the two parties are engaged in a distracting public-relations headlock.

After the RTHK interview was published, the WHO said in a statement that it was working closely with Taiwanese health experts. In response, Taiwan’s Ministry of Foreign Affairs said that the WHO’s statement “misrepresents the facts.”

But some of the facts in support of Taiwan’s case contradict each other. For example, a spate of recent articles—written by the Wall Street Journal editorial board, among others—claimed that Taiwanese health officials warned the WHO on Dec. 31 about the possibility of human-to-human transmission of the novel coronavirus, and that the WHO ignored their warning. The WHO told Quartz it did receive an email from Taiwanese health officials on Dec. 31, but that it contained “news reports of atypical pneumonia reported in Wuhan” and asked the WHO if it had any information to share.

“There was no mention in the email of human-to-human transmission,” the WHO said. Meanwhile, Lin Shih-Chia, executive director of FMPAT, told Quartz: “If WHO took Taiwan’s warning seriously in the beginning and launched discussions with Taiwanese experts accordingly, maybe their judgment about the development of [the] Covid-19 pandemic might be very different.”

In another example, Taiwan’s Ministry of Foreign Affairs said in a statement that its experts were only allowed to participate in the WHO’s February Global Research and Innovation Forum via video conference, and that this prevented their experts from “directly interact[ing] with other countries’ representatives and engag[ing] in exchanges about the development of the COVID-19 outbreak, and disease prevention and research.” The WHO told Quartz in an email that “nearly 200 participants connected remotely” out of 500 participants and that “no one was prevented from interactions.”

The minutiae of who-did-what-when matter a lot less than the central question: Taiwan has an undeniably reduced position in the WHO—one that Youde characterized as “second-class.” Does this actually impede its public health capacities, or the world’s response to Covid-19?

The truth is hard to untangle. It will always be possible for Taiwan to argue that they could do more, or contribute more, as full members of the WHO. Maximum inclusivity leads to the best results, as the argument goes, or as Lee explained it: “If we think of it as a chainlink fence, if we’re omitting some of those links, we’re going to weaken the whole system.” But Taiwanese officials have rarely provided concrete examples of ways in which their lack of membership has actually prevented them, or the WHO, from effectively responding to Covid-19. In this vacuum, all that’s left is to pick a side.

The WHO says Taiwan’s status doesn’t impede public health. “During the current Covid-19 pandemic, interactions have been stepped up, both through existing channels and new ones as well. WHO helps all people, everywhere.”

Taiwan says it does. “The so-called ‘interactions’… are only a small part of the global health affairs that WHO has to deal with every single day, and Taiwan can only participate in a passive manner,” argued FMPAT’s Lin Shih-Chia. “It is not acceptable that WHO thinks the status quo doesn’t need to be changed.”

In other words, Lee said: “It’s a diplomatic mess.”

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