Taiwan Takes First Step Back to World Health Organization

But now there has finally been a breakthrough in this tragic story of the international orphan. When health minister Yeh Ching-chuan stepped up to the podium to speak, and received a warm reception from the international community, citizens felt not only excited but also profoundly moved after all the disappointments of the past. With this step having been taken, it will now be up to us to show how well we can do, for our performance will determine how long and how broad the road ahead will be.

On April 28, 2009, Minister of Health Yeh Ching-chuan received a letter from Margaret Chan, director-general of the World Health Organization, formally inviting Taiwan-under the name "Chinese Taipei" and with "observer" status-to attend the 62nd World Health Assembly (WHA) meeting to be convened in Geneva on May 18. After 37 years and 12 previous failed attempts, Taiwan was finally going to once again have its own seat at the WHA.

When President Ma Ying-jeou received the news, he maintained his usual aplomb and gave the credit to the collective efforts made by both the "green" and "blue" political camps over the past decade-plus, to goodwill on the part of mainland China, and to strong support from the international community. Coming around the first anniversary of Ma's inauguration as president, Taiwan's participation in the WHA has been seen as an important test of Ma's conciliatory cross-strait policies and "survivalist" foreign policy. The credit that Ma himself has gotten for the fact that Taiwan has overcome this hurdle so smoothly is reflected in political opinion polls.

Taiwan in fact had links with the WHO very early on. In 1945, just after the end of World War II, the Republic of China and Brazil cosponsored a proposal to create an international health organization. The WHO was established the following year. For over 20 years thereafter, the ROC was an active member, until it was forced to withdraw in 1972 after losing its UN member status.

The withdrawal from the WHO seemed to have no major effect on Taiwan, which was able to rely on its own public-health and medical resources. But there has been both tangible and intangible harm. For example, it has been impossible for Taiwan's medical achievements (such as the eradication of childhood polio) to be internationally recognized, donations and assistance offered to international organizations have been refused, and so on, leading the government to decide in 1997 to try to reenter the WHO.

The SARS crisis of 2003 was a turning point. Because on the WHO's map of the world, Taiwan is part of the same country as mainland China and Hong Kong, Taiwan was listed as an "affected area" even before there had been a single case. After the illness did spread to Taiwan, Taiwan made emergency appeals to the WHO, but these were rejected and Taiwan was told that its appeals "should be made to Beijing." It was only in May of 2003, when all of Taiwan was in crisis mode and the number of deaths was rising continually, that the WHO reluctantly sent two experts to create new standard operating procedures for use at hospitals throughout the island to help prevent the spread of the epidemic. This constituted the first contact between the two parties in 31 years.

Despite fighting essentially alone, Taiwan showed great resilience. In late April of 2003 the world's first international conference on SARS was convened in Taipei and experts from Taiwan were invited to Hong Kong to lecture. Exchanges of ideas were actively pursued with many countries as the world strove to make breakthroughs in analyzing the disease and developing a vaccine.

Taiwan's fighting spirit won global respect, and in May 2003 Taiwan was invited for the first time to sit in and listen at a meeting of the WHA. At the same time foreign policy agencies ramped up efforts to get Taiwan into the WHO, making their case to other countries with arguments like "Please don't enforce 'health apartheid' against the 23 million people of Taiwan" and "Leave no holes in the global epidemic prevention network."

The government, under both major parties, had been trying for more than a decade to come up with a strategy and a name under which Taiwan could get back into the WHO. At first applications were made for observer status at the WHA under the name "Republic of China." This being refused, other names were tried, including "Taiwan (ROC)," "Republic of China (Taiwan)," "Taiwan," "Taiwan health authority," and even, following the WTO pattern, a "health entity" consisting of Taiwan, Penghu, Kinmen, and Matsu. However, because membership in the UN and its subsidiary organs is only for "sovereign countries," the answer was always "no." The sense of frustration mounted in Taiwan year after year until people could stand it no more!

In 2005, Lien Chan, in his status as honorary chairman of the KMT, undertook an "ice-breaker" journey to mainland China. Thereafter, other political notables traveled to the mainland where, in meetings with mainland Chinese president Hu Jintao, they repeatedly emphasized the importance of Taiwan's participation in the WHO, while at the same time politely rejecting the mainland's offer to allow Taiwan to participate under the name "Taiwan, China." After much effort by all concerned, Taiwan's new observer status is taking place under the name "Chinese Taipei." Though not ideal, polls show that 60% of citizens find this to be an acceptable compromise. In particular, with the outbreak of the H1N1 influenza virus, citizens have been plunged again into a state of apprehension, making WHA attendance all the more meaningful.

Of course the opposition party has their own views on the subject. For one thing, the word "Taiwan" is missing from the name. For another, getting invited to a WHA meeting with "observer" status is a one-off event, that can happen at most once a year, and although the "observer" has speaking rights, there are no voting rights. This is still quite far removed from the formal "member" status of sovereign countries. Moreover, since this year's invitation depended on mainland Chinese goodwill, in the future is it not possible that Taiwan's ability to participate could be left beyond its own control? These issues all need to be considered.

Nonetheless, substantive participation is at least the first step. Now Taiwan will have to win international approbation by making a unique contribution. Let us hope that, having succeeded in its "economic miracle" and "democratization miracle," Taiwan will create a new international miracle by turning itself from "marginalized" into "role model."