Good Graces

Strategic Vision vol. 9, no. 45 (March, 2020)

COVID-19 provides opportunity to highlight Taiwan’s healthcare proficiency

Ruei-lin Yu

World Health Organization Headquarters in Geneva, Switzerland.

photo: Yann Forget

The international community of nations should recall Taiwan’s contributions in dealing with the Severe Acute Respiratory Syndrome (SARS) outbreak in 2003, and recognize Taiwan’s knowledge and experience in managing such pandemics as they seek a strategy to protect the world’s populations from the current outbreak of COVID-19. Taiwan’s National Health Insurance (NHI) system has been deemed among the best in the world. It was rated as the best in the world by the CEOWORLD magazine Health Care Index in 2019. The editors took into account the overall quality of healthcare, including the infrastructure, staff competency, cost, availability and government readiness, in making their ranking. In short: Taiwan is more than capable of using its experience and expertise to support all states in the fight against the COVID-19 outbreak.

In 2009, Taiwan was invited by the World Health Organization (WHO) to participate as an observer in its World Health Assembly (WHA). China wields great influence in the WHO, and allowed this to happen in order to help boost the popularity of their preferred candidate, the Kuomintang’s (KMT) Ma Ying-jeou, after he was elected president of Taiwan in 2008. In 2017, after the KMT lost power to the Democratic Progressive Party (DPP), China pressured the WHO into rescinding that arrangement. China’s motivation for blocking Taiwan’s participation was because the DPP leader, President Tsai Ing-wen, refuses to embrace either the so-called 92 Consensus or the “one country, two systems” model Beijing employs in Hong Kong. In other words: Taiwan is barred from potentially lifesaving contributions for political reasons.

The COVID-19 pandemic originated in Wuhan, China. It then spread rapidly around the globe. Even though it is irrational, anti-Chinese sentiment has been spreading in the international community. Since the beginning of the outbreak, the Republic of China (ROC) government has expended a lot of effort explaining to many countries that Taiwan is not a province of China, and hence Taiwan must not be lumped in with measures, such as flight restrictions with China, designed to stem the spread of the disease. As a result of these efforts, international public opinion supporting Taiwan’s accession to the WHO has increased. Whether the WHO will ultimately decide to grant Taiwan membership, or even allow it to assist in global efforts in this situation, will depend greatly on what actions Taipei takes.

The WHO was founded in 1948 and has been coordinating international health policy and efforts to combat disease ever since. From its headquarters in Geneva, the WHO oversees more than 7,000 people from more than 150 countries working in 150 country offices, and six regional offices. All states which are members of the United Nations may become members of WHO by accepting its constitution. There are now 194 members and several observers in the WHO. The current Director General of the WHO is an Ethiopian politician, Tedros Adhanom Ghebreyesus, who was selected in 2017 as the first African to hold

“In annual WHA meetings, states with diplomatic relations with the ROC (Taiwan) such as Eswatini, Haiti, and Paraguay always demand that Taiwan be allowed a seat at the table.“

President Tsai meets with former Assistant Secretary of Defense for Indo-Pacific Affairs Randall Schriver.

photo: ROC Presidential Office

that post. Dr. Tedros has been criticized for being too pro-Chinese in dealing with COVID-19. In January, 2020, while the Coronavirus was spreading throughout China, Tedros met in Beijing with the Chinese leader, Xi Jinping, and praised the Chinese government for its response to the Coronavirus. Despite ongoing criticism of China’s mishandling of the viral outbreak from other quarters, Tedros continues to applaud Beijing’s efforts.

Member states who supply major funding to the WHO can have considerable influence, but who are they and how big can their influence be? Based on the “WHO Results Report, Program Budget,” the top three contributors are the United States, the Bill & Melinda Gates Foundation, and the United Kingdom. China only ranked 14th in 2016-2017, and 16th from 2017 to 2019, trailing Germany, Japan, the European Commission, Kuwait, Sweden, Australia, Norway, and others. Compared with these countries and organizations, China provides relatively little funding. In terms of influence, these countries and organizations should, in theory, be able to exert more influence on WHO operations than China does.

As considerations increasingly shift from playing politics to the more urgent efforts to deal with the worldwide spread of COVID-19, support for Taiwan’s participation in the WHO has grown in the international community. Before the COVID-19 outbreak, many countries had already supported Taiwan’s participation in the WHO. In December, 2018, the European Parliament passed the Common Foreign and Security Policy (CFSP) which included provisions for the European Union to promote Taiwan’s increased participation in international organizations. EU member nations with representatives on the WHO Executive Board include Germany, Italy, Finland, Romania, and the Netherlands. In May, 2019, the US Senate Committee on Foreign Relations unanimously passed a bill to support Taiwan to re-gain observer status in the WHA. In annual WHA meetings, states with diplomatic relations with the ROC (Taiwan) such as Eswatini, Haiti, and Paraguay always demand that Taiwan be allowed a seat at the table.

President Tsai tours a facemask production facility in Taiwan, which has agreed to help supply masks to the United States.

photo: ROC Presidential Office

After the COVID-19 outbreak, Canadian Prime Minister Justin Trudeau and Japanese Prime Minister Shinzo Abe both expressed their countries’ support for Taiwan’s meaningful participation in the WHA. The UK Minister of State for the Commonwealth and the United Nations, Lord Ahmad of Wimbledon, also expressed his support for Taiwan’s participation in the WHO in February. When the 146th session of the WHO Executive Board was held in Geneva this February, the outbreak of COVID-19, combined with Taiwan’s “online” participation, drew a lot of attention. During the meeting, the ROC’s diplomatic allies again spoke on behalf of the ROC and the US ambassador to Geneva also expressed his support, followed by Germany, Japan and England, and 27 EU representatives also issued a joint statement supporting WHO membership for Taiwan. International support for Taiwan is quite strong, especially amid the global impact of COVID-19.

Tedros Adhanom Ghebreyesus, World Health Organization director-general.

photo: MONUSCO

WHA observer

Between 2009 and 2016, during the Ma administration, Taiwan was invited to attend the WHA as an observer under the name Chinese Taipei. When Tsai, the DPP candidate, won the presidency in 2016, China began exerting pressure in the international community to curtail Taiwan’s engagement. This included the loss of WHA observer status. It was only after pressure was exerted via international public opinion that the WHO invited Taiwanese experts to participate in an online forum to share COVID-19 information in February. Despite this contribution, no one can guarantee that Taiwan will participate in the next annual WHA conference. The current outbreak, and Taipei’s exemplary record in protecting its citizens and stemming the spread, illustrate how important it is that Taiwan’s participation in the WHA be reinstated immediately. How can Taipei effect this outcome? There are several options to consider.

First and foremost, Taiwan must ensure that Beijing’s current face-saving efforts, as evidenced by their misinformation and propaganda campaign now underway, do not bear fruit, and that the global media do not whitewash China’s culpability for initially leaking the COVID-19 virus and then covering it up, contributing to its spread and to the growing casualty list. Taipei should encourage its allies that are currently members of the WHO issue a no-confidence motion in the leadership of the current WHO director general.

The coronavirus did begin in China, and the Chinese Communist Party’s lack of transparency and efforts to cover up the facts led to its spread, so Beijing must be held responsible. As a consequence of this behavior, China’s influence in the WHO must be reduced in favor of more responsible and transparent stakeholders. Moreover, if China should be held responsible for the outbreak of the coronavirus, then the WHO should be responsible for failing to respond quickly and failing to provide accurate COVID-19 information to other countries, which has severely impacted those countries.

COVID-19 Outbreak Cases in China

The United States, the WHO’s largest funder, is suffering greatly from increasing infections and deaths. Given this situation, Director General Tedros’ excessive pro-China attitude should make him the target of public condemnation. If the United Sates raises a no-confidence motion on Tedros, although the motion may not pass, he and his successor will likely have to adjust their strategy and change the organization’s culture of kowtowing to China.

An alternate route for Taiwan to find its way back into the WHA meetings would be to take the opposite tack: the ROC government could do what Beijing wants, and conditionally recognize the “One China Principle,” thereby improving cross-strait relations as per the Ma administration, and obtain China’s consent to rejoin the WHA. Since taking office in 2016, President Tsai has stated that she cannot accept the “92 Consensus,” but is willing to maintain the status quo: That is, maintain the current one China structure under the ROC Constitution, and handle cross-strait issues according to the stipulations of the “Act Governing Relations between the People of the Taiwan Area and the Mainland Area.”

DPP landslide

In 2020, Tsai won a landslide re-election again with historical high of 8.17 million votes. While it may be politically unrealistic for President Tsai to recognize the “92 Consensus,” it does not mean that the “One China Principle” cannot be discussed. Tsai has emphasized that the Republic of China (Taiwan), instead of Taiwan, is the official name of the country and the greatest common divisor. She has also said many times that she would be open to a meeting with China’s Xi. If the two leaders can reach a new consensus to replace the “92 consensus,” this may prove be a ticket for Taiwan to re-join the WHA.

Amid the COVID-19 pandemic, cross-strait relations have become more tense. Some current measures such as a ban on exporting masks to China, restrictions placed on Chinese citizens in Taiwan, and an increase in health insurance payments have not been so friendly to Chinese visitors to Taiwan. In order to find a win-win situation, Taiwan should change its strategic thinking. Our government should actively assist mainland China in controlling the epidemic and treat Chinese citizens kindly—like our relatives and friends. By taking such actions, Taiwan may be able to use goodwill and positive gestures to coax China into constructive dialogue.

At the same time, Taiwan must continue to seek the support of major WHO contributors such as the United States, the United Kingdom, Germany, Japan and the European Commission. If these countries and organizations are willing to issue a stronger written joint declaration in support of Taiwan, there would be considerable pressure placed on the WHO. Without China’s strong resistance, Director General Tedros, or his successor, may be more likely to respond in support of Taiwan’s efforts.

Then-president of the ROC, Ma Ying-jeou, left, shakes hands with China’s paramount leader, Xi Jinping, at their historic meeting on 7 November, 2015.

photo: Office of the President

Dr. Ruei-lin Yu is a professor at the ROC National Defense University.