WHO, COVID-19, and Taiwan as the Ghost Island

ABSTRACT

The Taiwan issue continually haunts WHO. However, before addressing Taiwan's inclusion into WHO, we first describe how the era in which WHO was founded, and WHO's resulting constitutional mandate, have focused the Organisation's work on infectious disease eradication. Narrowing in on pandemic management – one aspect of infectious disease eradication – we describe what WHO can offer. These two sections allude to what Taiwan is excluded from. Using Taiwan's COVID-19 experience as a case study, Taiwan's successful management suggests that it is excluded from little, and thus marginally benefits in terms of public health. Yet, there are beneficial political gains in its call for inclusion. Taiwan's recent leveraging and amplification of its COVID-19 success story is thus an extension of its health diplomacy. Extending the call for inclusion online captures a novel digitised health diplomacy effort from Taiwan. The present study computationally analyses press-release and Twitter data to understand how Taiwanese government engages in these channels to frame and respond to the Taiwan/WHO issue. We find that Taiwan brands and propagates a ‘Taiwan Model’ through hashtags that revolve around coordination and solidarity as opposed to exclusion, indirectly criticising WHO. The piece concludes by discussing the foundational weaknesses in WHO's pandemic management effort in contrast to Taiwan's successful effort despite exclusion. Although Taiwan's inclusion to WHO is improbable due to larger geopolitical factors, inclusion is not a zero-sum game, with potential bi-directional benefits and lessons that can fortify domestic health capacities in preparation for the next pandemic.

KEYWORDS:

• Taiwan
• TaiwanCanHelp
• World Health Organisation
• Twitter
• infodemiology

Acknowledgments

Dr Thorin Duffin and Kelsey Harris, for their critical eye on grammar and logic; Dr Kelley Lee, for comments and suggestions on structure, and connection to the FMPAT, an organisation advocating for Taiwan's inclusion in WHO; Mr Wong Hoi Wa, for tweet scraping and provision. The three anonymous reviewers who spent time to read and critically comment on the manuscript

Disclosure statement

No potential conflict of interest was reported by the author(s).

Nomenclature/Notation

CDC Act = Communicable Disease Control Act of Taiwan

CECC = Central Epidemic Command Centre

China CDC = China Center for Disease Control and Prevention

DPP = Democratic Progressive Party

IHR = International Health Regulations (2005)

KMT = Kuomintang

NHI = National Health Insurance (Taiwan's Universal Health Care Programme)

Taiwan CDC = Taiwan Centers for Disease Control and Prevention

MOFA = Ministry of Foreign Affairs

MOHW = Ministry of Health and Welfare

SDG = Sustainable Development Goals

UN = United Nations

WHA = World Health Assembly

WHO = World Health Organisation

Notes

1 ‘Taiwan’ will refer to Taiwan island, its outlying islands, and their administration by the ROC government

2 Although disease eradication is a main focus of WHO, it is multifunctional and still provides other services which fulfill the roles stipulated in the Preamble, and broadly the Constitution. Tensions and debates between biomedical and social approaches to international health cooperation are addressed elsewhere.

3 For a deeper discussion on previous revisions and sequences of events leading to the most recent IHR renewal, see Kamradt-Scott's chapter on revising the IHR(Kamradt-Scott, 2015b, pp. 106–107)

4 The process for Taiwan's WHO's bid is analysed elsewhere (Guilloux, 2009; Herington & Lee, 2014)

5 The term ‘universal application’ was explicitly included per request of Taiwan's diplomatic ally during Taiwan's bid for IHR membership (P. K. Chen, 2018)

6 Slaughter explores how the state ‘disaggregates into its component institutions, which increasingly interact principally with their foreign counterparts across borders’ in ‘trans-governmental’ networks with minimal supervision by ministries. These networks are structured and built on ‘peer-to-peer ties developed through frequent interactions rather than formal negotiation (Slaughter, 2005)