Written by Kyle Kai-Yuan Cheng.
The outbreak of the 2019 novel coronavirus has widespread ramification that transcend the pathological effect of the disease, one of which has been to reinvigorate the ongoing discussion about the continuous denial of Taiwan’s participation in the World Health Organisation (WHO).
The exclusion paradox
One of my first exposures as a student to global health governance was the opportunity to attend WHO’s Western Pacific Regional Meeting at Manila, the Philippines. There I met then Director-General of the WHO, Dr Margaret Chan, formerly Hong Kong’s Director of Health during the SARS outbreak. Young and eager to make an impact, I approached her during a recession and, after introducing myself, asked her if she thinks the exclusion of Taiwan from the WHO was problematic for an organisation who is supposed to serve “every human being”. I thought it to be such an impeccable argument that she could only agree, as a global health framework leaving out Taiwan, or indeed any population, is by definition flawed. I was therefore surprised when she answered my question, without discernible hesitation or indication of surprise, with a confident and straightforward “no”.
For most Taiwanese people, there is no doubt that Taiwan’s not being a member of the WHO, denied access to the WHA, to most of the other WHO meetings, and to WHO’s databases and mechanisms are indisputable proof that Taiwan is excluded from the organisation. For the WHO, however, who acknowledges People’s Republic of China (PRC)’s sovereignty over Taiwan, the Taiwanese people are clearly represented in WHO through PRC’s membership. For someone who believes that PRC indeed rules over Taiwan, Taiwan’s claim of exclusion would be as easily disregarded as domestic affairs if not absurd as if Bayern of Germany, Assam of India, or Rhode Island of the United States put forward a similar claim.
This is what I think of as the exclusion paradox for Taiwan’s WHO campaign: that the validity of the claim of Taiwan’s exclusion finds itself dependent on one’s interpretation of the cross-strait situation, specifically, whether PRC has sovereignty over Taiwan. The available objective facts are insufficient to argue for Taiwan’s exclusion; it must be coupled with a subjective judgement of one of the most complicated geopolitical situations in the world.
The old global health: a world that goes around sovereignty
As things are, if there is a coordinate system on which global health functions, it is sovereignty. WHO grants memberships to sovereign states, and works to empower states to carry out public health policies. When WHO’s constitution speaks about promoting health for “every human being”, it fails to specify that sovereign states must work as a middle-man. So crucial is sovereignty to the global health community, even when, in light of the recent coronavirus outbreak, like-minded countries were calling to improve Taiwan’s participation, we saw them speak in ambiguous terms that avoid judgement on Taiwan sovereignty.
The recent outbreak sees a particularly desperate measure taken by the WHO to stabilise this sovereignty-based system at a time of crisis, when in one of its report for cases of the new coronavirus, Taiwan was listed as the confusing “Taipei and environs”.
Nevertheless, while Taiwan’s sovereignty status may pose difficulty for our participation in WHO, one must not forget that WHO is not the synonym of the global health community. Furthermore, this community has been undergoing drastic changes in the recent decades that Taiwan should welcome and take advantage of.
The new global health: new rules and new players
Just as youtubers and Instagram models are becoming more influential than conventional celebrities, we also see unconventional players becoming more and more welcomed and playing more important roles in the global health community.
While WHO remains the moderator and leader when it comes to global actions and technical recommendations, many newly founded, powerful, wealthy organizations have made WHO more of a moderator and less of a leader. This includes the Coalition for Epidemics Preparedness Initiative (CEPI), a novel initiatives formed by countries and private sectors that funds vaccine development and recently announced three multi-million projects all aiming to develop vaccines for the new Coronavirus.These emerging initiatives often have a business model, keen to engage non-state actors (actors that are not a sovereign state) such as NGOs and corporates to promote cost-effectiveness and innovation.
To attract the attention of these new players, Taiwan will need to strengthen its civil society and private sectors, including philanthropic organisations, students and professional associations, and bioengineering industries. More long-term funding and trust should be made available for think tanks to carry out research so that strategic advices are available when in need. The academic community should begin to think of global health as a standalone subject with its own framework, history, philosophy, methodology, and training regimen, rather than simply “public health on the global level”. Perhaps most fundamentally, Taiwan needs to make young Taiwanese believe that, despite our sad past and difficult present, going into global health as a Taiwanese is a promising career filled with opportunities and excitement. Building a global health-informed civil society will appeal to the new generation of governance bodies whose more flexible frameworks are ready to engage Taiwan, not necessarily because of the globalist ideal of leaving no one behind or the humanitarian concern for the Taiwanese population health, but because we have something to offer.
Cultivating an energetic civil society does not mean that Taiwan should stop reminding the world of continuous injustice that is Taiwan’s exclusion from the global health community. Nevertheless, at a time when unconventional players take the main stage, Taiwan would do well to allow civil society to play a more important role in its global health campaigns.
Kyle Kai-Yuan Cheng is a PhD student in Psychiatry at University College London. This article is part of the special issue on COVID-19.
Along with Taiwan Insight’s special issue on Covid-19, we also introduce a timely special issue of the International Journal of Taiwan Studies (IJTS) on “Taiwan, Public Diplomacy, and WHA”. Taiwan’s exclusion from the WHO and the WHA is now a major cause for concern. To understand the reasons, consequences and possible remedies for Taiwan’s exclusion, one has to adopt a multi-disciplinary perspective. In this IJTS’s special issue, we have brought together political scientists, IR specialists, communication scholars, and health experts. For more details, please visit here.