Global health diplomacy in times of COVID-19

In times of COVID-19 politics must be quarantined from healthcare efforts. Transparent information sharing between the WHO and States should be encouraged. But will the issue of Taiwan hamper this?

The World Health Organization (WHO) is a special UN agency tasked with dealing with issues of ‘public health’. Now the world is trying to combat a public health crisis related to the spread of the Coronavirus (COVID-19), which the WHO has declared as a pandemic. As part of its mandate to deal with public health, the WHO has been providing reports, recommendations and avenues for research and development to combat this pandemic.

Another important aspect to be emphasised in this fight, is the relationship between the WHO and the States. Once the initial outbreak of COVID-19 had been detected in the People’s Republic of China (PRC), the Director-General of the WHO wasted no time and met with the President of the PRC. The discussion aimed to make sure that there was an open door for data sharing between the WHO and PRC and continuous collaboration for containment measures. Despite the WHO’s efforts to communicate with the States, it has come under sharp criticism from the World Medical Association for excluding Taiwan from discussions pertaining to global health. The issue of Taiwan is an important test of the WHO’s independence and impartiality.

Within the framework of the WHO’s membership, Taiwan is not represented as an independent State; instead it is a province of the PRC. The PRC’s involvement in Taiwan’s relationship with the WHO manifested into the World Health Assembly Resolution WHA25.1 which placed the PRC in the Chinese seat by removing the Taipei-led government at the WHO. Then in 2005, contact between Taiwan and the WHO was defined by a Memorandum of Understanding (MoU) astonishingly not between Taiwan and the WHO, but between the PRC and the WHO. This MoU authorised the PRC to decide ‘when’ the contact between Taiwan and the WHO should be established. Thereafter, in 2009 Taiwan was invited as an observer to the World Health Assembly (WHA), however under the name of ‘Chinese Taipei’ or ‘Taiwan, Province of China’ and not as an independent State.

As an observer in the WHO, Taiwan was able to achieve some international space and at the 67th WHA Taiwan was able to share its accomplishments in preventing noncommunicable diseases. This form of free information sharing at the WHO is essential for improving global healthcare. However, in 2016 after President Tsai Ing-wen was elected to office in Taiwan, the PRC again prevented Taiwan from attending the WHA even as an ‘observer’ because President Tsai Ing-wen stands for a pro-sovereignty approach for Taiwan. Therefore, Taiwan continues to be effectively left out of all substantive public healthcare decisions.

Despite not being able to communicate with the WHO, Taiwan adopted a nationwide healthcare system. In 2017, the Taiwanese healthcare system secured the 14th rank in the Global Access to Healthcare Index. These positive efforts are supporting Taiwan in the fight against COVID-19 to the extent that it is now donating healthcare equipment. Regardless of these positive efforts, Taiwan is not an independent member State of the WHO.

In March 2020, in an interview between Mr Bruce Aylward, Assistant Director-General at the WHO, and journalist Yvonne Tong, Mr Aylward eluded the question of Taiwan’s membership to the WHO. The WHO is complicit when it is listing Taiwan’s data along with the PRC’s data for COVID-19. This format of data presentation will lead to the misconception that Taiwan and the PRC adopt similar healthcare/governance models. While the PRC’s governance model centres around clamping down on early warning signs, not being transparent about its data, and issuing misleading statements that there was no indication of COVID-19 being able to transmit between humans, Taiwan has not placed any quarantine on information sharing. In fact, Taiwan even sent an early warning sign to the WHO about the virus, which was ignored by the WHO. Subsequently, Taiwan set up the Central Epidemic Command Centre which provides updated information on COVID-19.

Despite the contrasting approaches between the PRC and Taiwan, the merging of information by the WHO only violates Article 2 of its constitution which mandates accurate information sharing. In February 2020, the merged information from the WHO led Italy and Vietnam to ban all flights to Taiwan even though Taiwan only had 10 confirmed cases, as compared to China which had more than 11,000 cases.

In the end, Taiwan’s membership mystery can be decoded by one political ideology, the PRC’s unwillingness to recognise Taiwan as an independent State, which is supported by the State-centric membership requirement under the WHO Constitution. As per Article 3 of the WHO constitution, WHO membership is open to all States. As Taiwan is not recognised as an independent State, it does not fulfill the criteria under Article 3 of the WHO constitution and its membership is blocked by the PRC. This is because the PRC believes that Taiwan is its province, which ‘illegally usurped China’s UN seat.’

This political fallout is having repercussions in global health care, as in March 2020 there was a sudden spike in COVID-19 cases in Taiwan. It is important to remember that the WHO is an international organisation and it belongs to all members and to none. The word ‘none’ denotes a certain level of independence from State ideology. Given that Taiwan’s actions have international consequences, the WHO as an independent organisation should be interested in maintaining at least communication with Taiwan. This will enable the WHO to be better equipped to assist and measure Taiwan’s functional performance in combating COVID-19 and in turn assist in verification and assessment measures under the International Health Regulations 2005 (IHL 2005).

The Center for a New American Security, released a report in May 2019 which held that, “International organizations thus have become an arena for ideological contestation, in which Beijing’s goal is to make authoritarian rule seem as legitimate as democratic government.” However, pandemics don’t respect governmental ideologies. Therefore, international organisations which are created as the salvation of mankind for a collective common good, should not exclude Taiwan, which is an important stakeholder in matters of public health. If the WHO continues to exclude Taiwan, it can never be an international organisation representing universal public health. At the very least, Taiwan should be readmitted to the WHO as an observer.


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