CFR Publication: Why Does the WHO Exclude Taiwan?

By USALI Affiliated Scholar Yu-Jie Chen and USALI Faculty Director Emeritus Jerome A. Cohen
Originally published by the Council on Foreign Relations


Given Taiwan’s proximity and ties to mainland China, where the coronavirus first appeared, how has Taiwan kept its number of cases low?

Taiwan’s experience has been a rare positive example of how governments can contain the spread of the new coronavirus disease, known as COVID-19. As of April 9, Taiwan had 380 confirmed cases and 5 deaths, a stunningly low number for a population of 23.6 million. This is particularly impressive given the high level of travel between China and Taiwan.

Taiwan’s success should be attributed to early preparedness, health expertise, government competence, and popular alertness. On December 31, Taiwan’s government, alarmed by developments in Wuhan, the Chinese city where the virus first appeared, expressed concerns to the World Health Organization (WHO) about the virus’s potential for human-to-human transmission. But it received no reply. Instead, the WHO endorsed China’s denial of human-to-human transmission until January 21. While the WHO appeared to downplay the global threat, Taiwan adopted vigorous measures for screening, testing, contact tracing, and enforcing quarantines. These measures were aided by technology and big data, as well as the cooperation of citizens who remain highly vigilant due to their traumatic 2003 experience with Severe Acute Respiratory Syndrome (SARS).

Particularly important in Taiwan’s approach are transparency and open information. Taiwan’s Central Epidemic Command Center, established after SARS, releases information in daily briefings. This starkly contrasts with China’s initial cover-ups of the outbreak and its continued suppression of independent reporting. Taiwan’s experience rebuts the misleading narrative that only countries with draconian authoritarian powers can effectively combat the virus. 

Why isn’t Taiwan a member of the WHO? 

China, officially called the People’s Republic of China (PRC), refuses to allow that to happen. The PRC claims that Taiwan is a province of China, not an independent state. It says that only the PRC has the right to represent all of China in the United Nations and other international organizations, including the WHO, that limit membership to states.

Taiwan’s government, generally called the Republic of China on Taiwan, has all the elements of statehood required by international law and maintains diplomatic relations with fifteen countries. Yet due to the PRC’s great-power status, including its seat as a permanent UN Security Council member, Beijing has been able to impose its “One China” policy upon the world.

What is the U.S. position on Taiwan’s membership in the WHO?

The United States has attempted to maximize Taiwan’s involvement in international relations and has, without success, supported Taiwan’s “meaningful participation” in various institutions, including the World Health Assembly (WHA), the WHO’s highest decision-making body. In March 2020, the Donald J. Trump administration enacted the Taiwan Allies International Protection and Enhancement Initiative Act, aimed at supporting Taiwan’s international presence. U.S. Secretary of State Mike Pompeo said that the State Department would “do [its] best to assist” Taiwan’s “appropriate role” in the WHO.

While Beijing will never accept Taiwan’s formal entry into organizations that require statehood, lesser forms of participation are possible. For example, during the 2008–2016 political detente between Beijing and Taiwan’s Kuomintang (KMT) government, Taiwan was invited to be an observer at the WHA under the name “Chinese Taipei.” This invitation, however, had to be renewed annually with China’s approval, and Taiwan was blocked from most WHO technical meetings where important health information and decisions were discussed. Since Taiwan elected President Tsai Ing-wen of the Democratic Progressive Party (DPP)—which Beijing condemns—in 2016, Taiwan has not been able to return to the WHA.

If ever Taiwan is going to break through Beijing’s barriers to its participation in international organizations, now is the time and the WHO is the place. This is not a minor issue and it is directly related to the world’s preoccupation with the ongoing pandemic.

Why is Taiwan’s exclusion a problem, especially during the coronavirus pandemic?

Taiwan is an important stakeholder and a valuable partner in fighting this unprecedented crisis. Taiwan’s government is donating masks to countries in need and sharing its experience using technology to investigate outbreaks. It is also working with U.S. experts to develop more rapid diagnostic test kits and vaccines.

Despite Taiwan’s valuable input, the WHO continues to shun it. For example, when asked by a journalist about Taiwan’s exclusion and experience dealing with the pandemic during a recent interview, WHO senior advisor Bruce Aylward hung up the call after trying to avoid the questions. After this public relations disaster, the WHO claimed it was closely working with Taiwan experts, which Taiwan’s government refuted. Taiwan has continually shared coronavirus data with the WHO, but the WHO has never released this information to its members. Additionally, in a February coronavirus status report, the WHO misreported the number of cases in Taiwan based on information provided by China. It also continues to deceptively list Taiwan’s case numbers under China’s. Taiwan was snubbed by the WHO yet again when it was not invited to the organization’s emergency meetings in January. After repeated requests, in February, the WHO finally allowed two Taiwanese experts to attend an online forum. Such ludicrous limitations have rightly been scoffed at by many governments and critics.

The WHO’s exclusion of Taiwan from the global fight against the pandemic is a reckless dereliction of duty. WHO Director General Tedros Adhanom Ghebreyesus, whose election was due in large part to China’s support, has been widely criticized for actions that appeared to help China downplay the outbreak, delaying the international response as a result. Taiwan’s exclusion is an example of how the world’s health body puts politics before public health. Governments and concerned citizens must demand that the WHO fulfill its obligation—to represent the world’s health interests, not China’s—and hold the WHO accountable when it fails.

Yu-Jie Chen, a Taiwan lawyer, is a global academic fellow at Hong Kong University’s Faculty of Law and an affiliated scholar at New York University’s (NYU) US-Asia Law Institute. Jerome A. Cohen, an adjunct senior fellow at the Council on Foreign Relations, is professor of law at NYU and founding director of the US-Asia Law Institute.