China’s Unclean Bill of Health
The U.S. should confront China on Taiwanese participation in the WHO.


Just after sunrise on Friday, March 21, 2003, a U.S. Air Force C-20 Gulfstream jet outfitted as an air ambulance touched down at Taipei’s Sung Shan airport. It had flown through the night from Hanoi with its frightened passengers: a distraught American mother and her ten-year-old boy, who had been diagnosed in Vietnam with Severe Acute Respiratory Syndrome, or “SARS.” The jet taxied to a stop near the terminal, where several medical vehicles from National Taiwan University Hospital waited. The boy and his mother were met by a Taiwanese immigration official, who stamped their passports and filled out immigration papers as medics efficiently shoved the boy’s stretcher into an ambulance. The child, a dependent of an American diplomat in the Vietnamese capital, had apparently contracted SARS on a trip to Ho Chi Minh City several days earlier and had developed a life-threatening pneumonia after returning to Hanoi. When doctors in Hanoi diagnosed the illness, they recommended that the child be evacuated immediately.

Taipei was chosen as the medevac destination because Taiwan University’s hospital had one of the best contagious-disease-isolation facilities in Asia, and because the boy’s mother had family in Taiwan–and because no other country in Asia was willing to accept him. The State Department quickly arranged for the U.S. Air Force to fly the patient to Taipei, cutting through the red tape that generally paralyzes American bureaucrats whenever they have to contemplate flying an official aircraft to Taiwan.

The incident was not unnoticed in Taipei. Some Taiwanese legislators questioned why the boy was allowed to enter Taiwan when, earlier in the week, the government had asked Taiwanese businessmen who had been exposed to SARS in China not to return to Taiwan for treatment. In response, Taiwan’s premier issued a statement explaining that the American government had officially requested assistance, and that the U.S. had arranged for the boy to be airlifted directly to Taiwan in a controlled environment, thus minimizing the danger of spreading the still-mysterious disease.

In March 2003, SARS was a terrifying and little-understood illness that Canadian doctors had dubbed “Suddenly All Respiration Stops.” The World Health Organization was still grappling with the mechanics of the exotic epidemic. The WHO knew of ten deaths and more than 300 confirmed and suspected cases of SARS worldwide, including 123 ill and two dead in Hong Kong, 57 cases and one death in Vietnam, 23 ill in Singapore, and two dead with over a hundred sick in Canada. WHO experts had still not been able to get information from China, where foreign media reported an outbreak of a respiratory disease that began in southern China the previous November, sickening 300 people and killing five. Taiwan had its own SARS cases but no deaths–and it wasn’t interested in having any.

Given the political and public sensitivity to SARS, one would think that the U.S. would feel obliged somehow to repay the favor.


Washington now has its chance. Taiwan’s participation in the WHO will be a major topic at the World Health Assembly (WHA) in Geneva on May 17-22, 2004. The United States should take the lead in supporting Taiwan’s participation in the WHO and other international bodies–not only because the State Department owes Taiwan a favor for harboring the dangerously ill son of an American diplomat, but because it is in the U.S.’s strategic interests. The more Taiwan is accepted into the international community as a valuable contributor, the less legitimate is China’s claim of a legal right to use force against Taiwan.

Taiwan’s participation in the WHO–even as an observer–is also in U.S. public-health interests. China’s refusal to cooperate with the World Health Organization in the early months of the SARS outbreak exacerbated the epidemic, and China’s opposition to cooperation between the WHO and Taiwan complicated global efforts to control the outbreak.

In 2004, a new and lethal strain of avian flu slammed the agricultural sector in Southeast Asia and Taiwan. Yet China continues to use its permanent membership on the U.N. Security Council to block WHO cooperation with Taiwan’s health authorities. China insists–incongruously–that “since Taiwan is a province of China its interests in the field of public health can only be represented by the central government of China.”


In May 2003, after Taiwan’s bid to join the WHO was defeated, the Chinese representative lectured Taiwanese reporters: “What are you arguing about? The matter is over, who cares about your Taiwan?” As the Wall Street Journal noted, “It was a particularly callous comment considering that China’s own negligence led to the spread of the SARS virus to Taiwan, and Beijing then delayed the arrival of WHO trying to help the island respond to the disease.”

The government of the People’s Republic of China, of course, has never had jurisdiction over Taiwan. Instead of “caring” for the health of the Taiwanese, Beijing has followed a policy of isolating Taiwan from international health organizations, thereby hampering legitimate and important global public-health cooperation in East Asia.

This year, on March 25, several concerned members of the U.S. House of Representatives introduced legislation (H.R. 4019) urging Secretary of State Colin Powell “to introduce a resolution on the floor of the World Health Assembly… in support of Taiwan’s participation in the World Health Organization with observer status.” The bill was passed unanimously by the U.S. House of Representatives on April 21, and is expected to reach the Senate floor as S. 2092 imminently.

Although identical legislation was passed unanimously in 2002 and again in 2003 by both houses of Congress, and was signed by President Bush, an unenthusiastic State Department declined even to mention Taiwan’s proposed WHO participation on the World Health Assembly floor. As a result, the assembly never entertained motions for Taiwan’s participation.

This year, however, the bill specifically asks the U.S. delegation at the WHA, instead of lurking passively in the background, to introduce a resolution supporting Taiwan’s participation as an observer. “Observer” status at the WHO is granted to the Palestinian Liberation Organization, the International Red Cross, the Holy See–and even the Knights of Malta. Japan and Canada have indicated that they would support observer status for Taiwan if the U.S. would also support it. In the past, without U.S. leadership at the assembly, China has succeeded in quashing moves for any participation by Taiwan in the WHO.


Enabling the voice of Taiwan’s people to be heard in the international community is a long-established principle of U.S. foreign policy. Congress alluded to it in Section 4(b)(8) of the Taiwan Relations Act, expressing the view that Taiwan is qualified to be a member of “any…international organization.” President Clinton, in the September 1994 “Taiwan Policy Review,” pledged that “recognizing Taiwan’s important role in transnational issues, we will support its membership in organizations where statehood is not a prerequisite, and will support opportunities for Taiwan’s voice to be heard in organizations where its membership is not possible.” President Bush reaffirmed this word for word in a May 11, 2001, letter to the Senate.

Taiwan is a fully functioning state and a significant contributor to the world community. As the world’s tenth-largest trading nation, it is now a member of both the World Trade Organization and the Asian Development Bank. But Taiwan’s voice is not yet heard in other international fora overseeing global activities in which Taiwan plays a major role. For example, as a consumer of nuclear energy and a major producer of defense equipment, chemicals, and biotech products, Taiwan should be represented in world non-proliferation organizations, including the Nuclear Suppliers Group, the Australia Group, the Missile Technology Control Regime, and the Wassenaar Arrangement.

Ironically, the PRC not only does not participate in any of these arrangements, but also has been identified as a primary proliferator of dangerous technologies. Yet PRC pressures seem adequate to prevent Taiwan’s participation in them. So it is not surprising that China, whose mendacity and temporizing prolonged the SARS epidemic, would also pressure the international community to isolate Taiwan from global public-health policy.

Even with U.S. leadership, there has not been enough time to generate the momentum needed to overcome Chinese opposition at the May 2004 WHA. Nonetheless, American leadership is crucial to establishing the precedent of Taiwan’s participation in international organizations. This precedent will improve the chances of future successes, including inducing China to moderate its hostility toward Taiwan as new generations of leaders emerge in Beijing. It would also demonstrate some genuine gratitude to Taiwan for taking in a sick American child and treating his suffocating pneumonia–which, thankfully, turned out not to be SARS after all.

–Lee Edwards is the distinguished fellow in conservative thought and John Tkacik is a research fellow in the Asian Studies Center at the Heritage Foundation.


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