Taiwan Must No Longer Be Excluded From The World Health Organization
Thursday, April 18, 2002
Should Not Be A Political Weapon
May 10, 2002, marks the 30th anniversary of Taiwan’s absence
from the World Health Organization. Taiwan, a co-founder
of the World Health Organization in 1948, was a member for
25 years. But Taiwan withdrew its participation in all U.N.-sponsored
organizations when the People's Republic of China was admitted
to the United Nations in its place in 1972.
A quarter-century ago, both Taiwan (formally,
the Republic of China) and the People’s Republic of China
claimed to be the one official “China.” Thus, in the eyes
of both, membership in U.N. organizations by one precluded
membership by the other. But as Taiwan has grown and prospered,
become a democracy, and abandoned its claims to the mainland
of China, this all-or-nothing approach has softened.
During recent years, Taiwan has attempted
repeatedly to rejoin the World Health Organization not as
a sovereign state (which would challenge Beijing’s claim
to being the “one China”), but rather as an observer.
It is high time that observer status
is granted to Taiwan. Taiwan’s inability to participate
in the World Health Organization, which is responsible for
combating disease outbreaks and providing emergency medical
assistance, has repeatedly resulted in the unnecessary spread
of preventable illness—as well as the unfortunate loss of
thousands of lives. There is a perfect opportunity to rectify
this, when the organization’s governing body of 191 member
states—the World Health Assembly—meets May 13-17, 2002,
Lives at Risk
In 1998, a devastating outbreak of a
rare epidemic virus—enterovirus 71—ravaged Taiwan. It affected
nearly 10,000 children, killing 78 and debilitating thousands
more. The airborne disease, which targets children between
the ages of 3 and 5, results in “aseptic or viral meningitis,
encephalitis, or a polio-like paralysis,” according to the
U.S. Centers for Disease Control.
As the outbreak spread, Taiwan appealed
to the World Health Organization for international assistance.
But its request was stymied, due to Taiwan’s unique lack
of association with the organization. As a result, Taiwan’s
public health system was prevented from acquiring accurate
real-time medical information about this rare disease, contributing
to an unnecessarily high death toll, and many more cases
of infection than would otherwise have occurred.
Following the epidemic, Taiwanese health
officials reported that nearly 80 percent of the country’s
children between the ages of 3 and 5 did not develop the
immunity needed to fight the virus. Again, Taiwan appealed
to the world community to share its expertise—and again,
the United Nations’ global health organization was prevented
from helping on political grounds.
Recent outbreaks in 1999, 2000, and 2001
have resulted in thousands more cases of enterovirus 71
and the death of 50 more children—all of which may have
been prevented, or at least lessened, if Taiwan had been
able to obtain medical information, technology, and assistance
from the World Health Organization.
The importance of receiving international
assistance following a major public health emergency was
again brought to the world’s attention on September 21,
1999, when a magnitude 7.6 earthquake struck Taiwan, killing
2,378 people, and leaving another 8,000 injured. This natural
disaster left thousands homeless, destroyed more than 40,000
homes, caused widespread infrastructure damage, and knocked
out phone, power, and water lines throughout the region.
When Taiwan appealed to the World Health
Organization during the crucial hours after the quake struck,
politics once again stymied the international response.
The PRC demanded that the United Nations obtain its approval
before sending aid and assistance to Taiwan, halting critical
emergency relief. For 10 hours, a Russian rescue team waited
for the United Nations to obtain Beijing’s approval for
its application. Worse, Russian airborne rescue assistance
was further delayed by 12 hours (and forced to make two
unnecessary refueling stops) when the PRC denied an air
corridor to the team, thus requiring the aircraft to make
a lengthy detour over Siberia.
Even the International Committee of the
Red Cross, a non-governmental organization, was unable to
deliver humanitarian assistance during the hours immediately
after the earthquake, because it sought approval from PRC
In March 2002, Taiwanese health officials
reported that new cases of enterovirus 71 have been reported
throughout the island. In addition, also in March 2002,
yet another earthquake—this one registering 7.1 on the Richter
scale—struck Taiwan. These very recent incidents remind
us of the imminent threat to public health on Taiwan because
of its continued exclusion from the World Health Organization.
A Pragmatic Solution That Protects World Health Currently,
Taiwan is the world’s only aspirant for World Health Organization
observer status. While rogue nations such as Iran, Iraq,
Libya, North Korea, and Cuba are entitled to all the rights
and benefits associated with full membership, Taiwan does
not seek this (in order to avoid the knotty “one China”
politics). Rather, it seeks the same observer status accorded
to such non-sovereigns as the Palestine Liberation Organization,
the Holy See, the International Red Cross, the International
Foundation of the Red Cross and Red Crescent Societies,
and the Order of Malta. Yet this modest request, too, has
thus far been denied. Taiwan is thus uniquely excluded from
participation in World Health Organization activities and
The official justifications for the People’s
Republic of China’s opposition to Taiwan’s application essentially
ignore the difference between observer status and full membership.
Whereas membership in the World Health Organization requires
sovereignty, observer status does not. Just as the Order
of Malta can participate in World Health Organization activities
as an observer, so, too, could Taiwan.
Yet as recently as January 2002, PRC
Ambassador Sha Zukang stated that because “only sovereign
states are eligible for membership,” Taiwan has “no qualification
whatsoever to participate in the World Health Assembly.”
Sha further added that to “raise a proposal” about Taiwan’s
participation, “in whatever form,” would constitute “an
act of infringement upon the sovereignty and territorial
integrity of China and an active interference in the internal
affairs of China.” (Emphasis added.)
Despite such unreasoning and politicized
opposition, on January 15, 2002, the World Health Organization’s
32-member Executive Board considered a proposal by Nicaragua,
Guatemala, Senegal, Chad, and Grenada to add Taiwan’s admission
as an observer to the May 2002 World Health Assembly agenda.
Once proposed by a member state—let alone by five of them—the
question of Taiwan’s observer status should have gone to
the full Assembly. Due to politics, it did not.
Communist Cuba joined the PRC in leading
the effort to keep the proposal off the Assembly’s agenda,
despite the fact that this violated the organization’s own
rules of procedure. According to the U.S. State Department
letter of protest, Rule 5 “requires that this Board include
on the provisional agenda for the next Assembly ‘any item
proposed by member.’ This rule is clear and is not optional.
The rule says that the Board ‘shall include’ such items.
It does not say ‘may include.’ There is no discretion.”
In this fashion, the PRC has thus far
In this fashion, the PRC has thus far
been successful in thwarting every bid Taiwan has made for
World Health Organization observer status. But that may
soon change. Any member state may submit a proposal for
observer status for Taiwan when the World Health Assembly
convenes its annual meeting in May 2002 in Geneva.
Growing Support for Taiwan’s Observer
In recent years, international support for Taiwan’s observer
status in the World Health Organization, particularly among
Western nations, has grown. Since 1996, numerous legislatures,
including the European, Czech, and Guatemalan parliaments,
as well as many Canadian and British parliamentarians, have
endorsed the proposal. In addition, non-governmental organizations
throughout Europe and Latin America have written letters
expressing their support for Taiwan’s bid.
Since taking office, the Bush Administration
has demonstrated its strong support for Taiwan’s participation
as an observer in the World Health Organization. In May
2001, while in Geneva, Health and Human Services Secretary
Tommy Thompson announced that the U.S. backs the inclusion
of Taiwan as an observer to the World Health Organization.
In March 2002, the State Department reiterated that it has
“urged the World Health Organization and its members to
find appropriate ways for Taiwan to participate.” This is
consistent with long-standing U.S. policy “to support Taiwan’s
membership in international organizations where statehood
is not an issue.”
Congress, too, has consistently supported
Taiwan’s efforts to join the World Health Organization as
an observer. Following the 1998 enterovirus 71 outbreak
in Taiwan, numerous resolutions were introduced in Congress
to address both the health tragedy and the international
travesty. The following year, Congress passed H.R. 1794,
supporting Taiwan’s participation in the World Health Organization,
and President Clinton quickly signed it. It became Public
In May 2001, Congress passed H.R. 428,
which authorized the Secretary of State “to initiate a U.S.
plan to endorse and obtain observer status for Taiwan” at
the 2001 World Health Assembly and to “instruct the U.S.
delegation to Geneva to implement such plan.” With President
Bush’s signature, H.R. 428 became Public Law 107-10. And,
on December 19, 2001, again with overwhelming support, the
House passed H.R. 2739, authorizing the U.S. to endorse
and obtain observer status for Taiwan at the 2002 World
Health Assembly. The House vote was followed by Senate passage
by unanimous consent on March 19, 2002. The President signed
the bill on April 4th, making it public law 107-158.
The People of Taiwan Deserve Participation
in the World Health Organization
According to the World Health Organization constitution,
the “enjoyment of the highest attainable standards of health
is one of the fundamental rights of every human being without
distinction of race, religion, political belief, economic
or social condition.” This fundamental human right is, however,
currently being abridged for the 23 million people of Taiwan.
As Taiwan’s Health Department Director
General Lee Ming-Liang observed in January 2002, disease
is borderless. Politics should not prevent any of the world's
citizens from acquiring the information and expertise they
need for their health, medical care, and disease prevention.
Granting observer status to Taiwan is a way to include its
people in the global health system without intruding upon
“one China” politics or jeopardizing the peace process between
Taiwan and the PRC. The 1979 Taiwan Relations Act states
that it is U.S. policy to resist any “form of coercion”
that would jeopardize “the social or economic system of
the people of Taiwan.” Denying the people of Taiwan access
to the health information, aid, and emergency resources
of the World Health Organization poses a needless and grave
threat to their society. In faithfulness to the Taiwan Relations
Act and the policies of every American president since Jimmy
Carter, and with concern and compassion for the health of
the millions of people of Taiwan, it is essential that the
United States continue to support Taiwan’s efforts to obtain
observer status in the World Health Organization.
Source: House Policy Committee, April 18, 2002