WHO You Gonna Call?
With the importance of global public health, the World Health Organization should consider whether its mission aligns with the nature of China's influence
The COVID-19 pandemic provided a blunt demonstration of how global health has the ability to impact all facets of human organisation. From how people work, to education, supply chains, social and cultural norms, as well as geopolitics. And, of course, how societies can protect the health of their people. This realisation has clearly placed greater importance on the work of the World Health Organization (WHO), and its annual forum the World Health Assembly (WHA), as the peak institutions for global public health.
The WHA convenes in Geneva this week. The theme of this year’s assembly is “All for health, health for all” – a noble sentiment. It is an objective that recognises the collective responsibility all countries have in not only their response to new viruses, but also how a variety of immunisations are rolled out to vulnerable communities. As well as striving towards the global goal of universal health coverage.
However, as WHA discussions take place, the meaning of “all” will be rather flexible, as one state that won’t be included at the 4-day summit will be Taiwan.
From 2009 to 2017 Taiwan held observer statues within WHO. This status was an acknowledgement that although Taiwan is only officially recognised by a handful of countries, in all practical measures it is an independent state whose knowledge and contributions to global public health were essential to the functioning of WHO.
However, after the election of Tsai Ing-wen as president in 2016, China pressured WHO to exclude Taiwan. This formed part of Beijing’s larger campaign to isolate Taiwan internationally. Which has also included successfully seducing 10 states who held formal diplomatic relations with Taipei to recognise Beijing instead, and blocking Taiwan’s accession to other major international bodies like the International Civil Aviation Organization and Interpol.
Of course, multilateral bodies are never going to be free of political wrangling. However, China’s rise as an authoritarian global power – with its deep suspicion of liberal internationalism – means that beyond mere politics it is the overall missions of these institutions that are coming under greater stress.
In 2020, WHO’s Assistant Director-General Bruce Aylward demonstrated the extent of this pressure in an interview with Hong Kong broadcaster RTHK. When asked about Taiwan’s response to the COVID-19 pandemic Aylward first claimed to not hear the question, then he simply hung-up the call, and upon reconnection claimed that “we’ve already talked about China.” His behaviour was not that of an organisation that is committed to global public health, but instead one that is operating in fear of reprisals should it not toe Beijing’s line. This institutional capture has continued, as in the lead up to this week’s WHA, Taiwanese journalists have even been refused permits to cover the forum.
An organisation as important as WHO has a responsibility to privilege the best possible information. This is not possible without it being truly committed to objectively collecting and analysing data from all governments and related agencies. It is also not possible unless it embodies the ethos of transparency.
Here there is a stark difference to how China and Taiwan approach their governance. Taiwan has understood that for its own security it has needed to embrace the ideals of transparency to prove itself a trusted and good faith actor to countries whose assistance it needs to deter any Chinese aggression. Despite its exclusion from WHO, throughout the COVID-19 pandemic, Taiwan engaged in a patchwork of mini-lateral arrangements to share its knowledge openly to ensure that its findings were being incorporated into other states’ analysis.
In an approach developed after the 2002-2004 SARS outbreak, Taiwan established three principles that aided its response to COVID-19 – Time, Trust, and Transparency. Given Taiwan’s essential knowledge of what goes on inside China, it was able to identify the problem ahead of other countries, activate its Central Epidemic Command Center and provide clear public information that brought its citizens on board with practical preventive measures quickly.
This was in contrast with China, which operates an opaque system of governance that sees the disclosure of accurate information as a threat. Initially Beijing denied WHO entry into China to investigate the origins of the virus, followed by, according to WHO, withholding critical data. When then-Australian prime minister, Scott Morrison, made the sensible suggestion that there should be a formal inquiry into the origin of the virus to better prepare for future pandemics, Beijing’s response was an extraordinary tantrum and a series of trade sanctions placed on Australia.
Additionally Beijing engaged in campaigns of obfuscation and spreading of misinformation in order to deflect attention and avoid responsibility as the country where the virus originated.
A state which embraces the ethos of transparency should clearly be deemed more valuable than one that doesn’t when it comes to global public health. Of course, the realities of power will mean that WHO are unlikely to endorse this distinction, but it is one that undoubtedly hinders their work, and is a matter that other member states should find deeply concerning. Especially given we have just lived through the enormous disturbance of a pandemic – which has included a significant effect on political stability, not just loss of life and economic and social costs.
We cannot assume that COVID-19 was a once off. More frequent international travel, the process of urbanisation, increased human-animal contact, and how disease carrying insects adapt to climate change all mean that there is greater potential for diseases to spread and mutate more easily.
This makes the politicisation of global health and submission to the Chinese Communist Party’s turbulent emotions a dangerous path for WHO to maintain. Despite a demand from Beijing that only “one China” is formally recognised, this doesn’t preclude Taiwan’s involvement in international institutions. In support of Taiwan’s participation in the WHA, the chair and the ranking member of the United States Senate Foreign Relations Committee, Senators Jim Risch and Ben Cardin, issued a statement that made this distinction clear:
“In recent years, the People’s Republic of China has attempted to use United Nations General Assembly Resolution 2758 as a pretext to obstruct Taiwan's engagement with the international community. It is crucial to clarify that Resolution 2758 addressed only the issue of China’s representation in the United Nations; it did not, in any part, determine Taiwan’s status or explicitly prohibit Taiwan's participation in UN agencies and other international fora, including WHO and WHA.”
Alongside this, Resolution 2758 does not authorise the PRC to represent Taiwan within the UN system. And, of course, how could they? Beijing cannot issue so much as a parking fine in Taipei. It has no credible way of gathering reliable data within Taiwan, and could not be trusted to accurately convey this data even if it could. The exclusion of Taiwan from WHO creates a significant blindspot for the organisation’s mission.
It should be no surprise to WHO that viruses don’t care for political borders. They don’t care who thinks they have sovereignty over whom. In an interconnected world, the success of viruses relies on failure to cooperate across borders, and their deadly impacts on whether all relevant institutions have the best available information to limit their advancement and negate their effects.
All states have an equal stake in quality information and the global coordination of best practices in health, and the mitigation of risks. Unfortunately, WHO undermines the credibility of this global information sharing when it submits itself to the demands of a state that not only seeks to exclude others from a vital multilateral institution, but whose authoritarian and defensive character is in grave tension with the spirit WHO needs to embody.