1. APISA 5 – Sigrid Winkler 24-25 November 2011 1 The Patterns of Interaction Between Taiwan and China in the World Health Organization Dr. Sigrid Winkler Institute for European Studies, Vrije Universiteit Brussel sigrid.winkler@vub.ac.be

2. APISA 5 – Sigrid Winkler 24-25 November 2011 2 Introduction How far is Taiwan’s participation in the WHO independent from China’s? Sovereignty Early attempts for participation SARS Memorandum of Understanding (2005) International Health Regulations (since 2009) Observer in World Health Assembly (since 2009)

3. APISA 5 – Sigrid Winkler 24-25 November 2011 Sovereignty International Legal Sovereignty Diplomatic recognition Domestic Sovereignty Effective governance Functional Sovereignty International Actorness without diplomatic recognition 3

4. APISA 5 – Sigrid Winkler 24-25 November 2011 4 Sovereignty The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition. (WHO Constitution, Preamble) The objective of the World Health Organization shall be the attainment by all peoples of the highest possible level of health. (WHO Constitution, Art. 1) Membership in the Organization shall be open to all States. (WHO Constitution, Art. 3) Observer status: PLO, ICRC, Order of Malta…

5. APISA 5 – Sigrid Winkler 24-25 November 2011 5 Early Attempts YearNameStatusSovereignty 1997-2005Republic of Chinaobserverfunctional 2006Republic of Chinameaningful participation functional 2007-2008TaiwanmemberILS 2009-?Chinese Taipeiobserverfunctional YearVote in World Health Assembly 199719:128 (5 abstentions) 200425:133 (2 abstentions) 200717:148 (2 abstentions) Inclusion of Taiwan’s bid on WHA agenda?

6. APISA 5 – Sigrid Winkler 24-25 November 2011 SARS Taiwan’s death toll 3 rd highest WHO took 50 days to react to Taiwan’s requests for emergency support Observers, not support China claimed: Agreed to WHO dispatch Agreed to Taiwanese participation in WHO SARS conference provided Taiwan with SARS information exchanges with Taiwan’s medical professionals Cross-Strait SARS symposium 6

7. APISA 5 – Sigrid Winkler 24-25 November 2011 MOU (2005) Secret, but leaked internal WHO implementation document 3 cases: Taiwanese public health and medical experts in WHO technical meetings WHO medical and public health assistance for Taiwan WHO assistance in public health emergency (1)+(2): China needs to give consent (3): China needs to be consulted Problems: Lengthy procedures Low participation rate in technical meetings “Taiwan, China” 7

8. APISA 5 – Sigrid Winkler 24-25 November 2011 IHR (2009) IHR renegotiated 2005: “The implementation of these Regulations shall be guided by the goal of their universal application for the protection of all people of the world from the international spread of disease.” (IHR 2005, Art. 3) China: “The Government of the People’s Republic of China decides that the International Health Regulations (2005) (…) applies to the entire territory of the People’s Republic of China, including the Hong Kong Special Administrative Region, the Macao Special Administrative Region and the Taiwan Province.” (Statement of the Government of the People’s Republic of China on China’s Implementation of the International Health Regulations (2005)) Letter from WHO to Taiwan CDC Benefits: IHR event information site 8

9. APISA 5 – Sigrid Winkler 24-25 November 2011 IHR (2009) Taiwan CDC received invitation letter from WHO Benefits: IHR event information website Taiwan CDC = “contact point” WHO support in outbreak emergency Member for expert roster Reasons for inclusion China’s consent Improved cross-Strait relations (Ma Ying-jeou) 9

10. APISA 5 – Sigrid Winkler 24-25 November 2011 WHA (since 2009) April 2009: consultations between Taiwan and China Annual invitation “Chinese Taipei” 10 Source: http://www.csmonitor.com/World/Asia- Pacific/2009/0429/p06s19-woap.html

11. APISA 5 – Sigrid Winkler 24-25 November 2011 Criticism Asking China for permission “Taiwan, China”, “province of China” Still not high level of participation in technical meetings MOU still alive? 11

12. APISA 5 – Sigrid Winkler 24-25 November 2011 Conclusions For WHO Taiwan is a part of China (ILS), albeit with large autonomy (FS) Logic of the institution: state-based If MOU is not abolished: Beijing as Taiwan’s central government If MOU abolished: Taiwan still needs general consent from China Can China take Taiwan’s participation away IHR: invitation directly from WHO WHA? 12