Ever since the 2016 election of Taiwanese President Tsai Ing-wen, whose ruling Democratic Progressive Party rejects the one-China policy, Beijing and Taipei’s relationship has been rocky. A few months after Tsai took office, Beijing paused bilateral talks with Taipei. Relations grew tenser after U.S. President Donald Trump took a call from her a month following his election, after which Beijing cautioned U.S. officials not to speak to the Taiwanese president. Cross-strait relations are now set to face yet another dramatic test: the World Health Organization is currently considering whether to invite Taiwan to its annual World Health Assembly (WHA) in Geneva in May. Pressure from Beijing could lead them to pull back an offer should Taiwan refuse to comply with China’s terms—namely, attend the WHA formally recognizing the one-China Policy.

The controversy extends beyond this particular meeting. Since Tsai’s election, Beijing has used international conferences to check Taiwan’s stature, nearly blocking it from attending the WHA last year, and successfully pressuring the International Civil Aviation Organization last September to revoke its invitation to Taiwan for a triennial assembly on aviation safety. Such international conferences are important for Taiwan because they grant the territory some sort of international status, even if it is usually only allowed to attend as an observer. Meanwhile, Taiwan’s increasing participation in international events, particularly the WHA since 2009 (which was possible thanks in part to efforts by former Taiwanese President Ma Ying-jeou to cultivate ties with Beijing), is a sign of warming relations between Beijing and Taipei. 


In 1971, Beijing replaced Taipei at the WHO, and since 1997, Taiwan has tried applying for reentry into the organization without success. In 2004, after the uproar over China’s mishandling of the 2003 SARS epidemic, in which it initially tried to censor coverage of the outbreak, the international community rallied around Taiwan’s push to partake in global health initiatives. (Taiwan had over 300 cases of SARS with over three dozen deaths, a count that could have increased given Beijing’s initial refusal to admit to the problem.) 

Still, it was not until after cross-strait relations improved in 2008 because of Ma’s efforts to reach out to Beijing that Taipei finally received an invitation to attend the WHA as an observer in May 2009. Its status, however, was below even that of “non-state observers” such as the Holy See and Palestine. At the meeting, the Taiwanese Minister of Health, Yeh Ching-chuan, was referred to as the Minister of Health for “Chinese Taipei.” This practice continued at the following WHAs without any issue—that is until 2016 after Tsai’s election.

That year, the WHA failed to issue Taiwan its annual invitation to the assembly by the normal date of early April. As weeks passed without a sign of an invitation, rumors began circulating that Taiwan might not get one at all because China, in suspicion of Tsai’s anti-China stance, was attempting to boycott Tsai’s incoming government, which would take over from Ma on May 20, just a few days before the assembly. 

The rumors about a Chinese boycott were never officially confirmed, and the invitation letter from the WHO Secretariat eventually arrived on May 6, just three weeks before opening day on May 23.

This letter, however, was only a conditional offer. It premised Taiwan’s participation on the basis that Taiwan accept “the United Nations General Assembly Resolution 2758 (XXVI) and WHA Resolution 25.1, and in line with the one-China principle as reflected therein.” Such a statement was absent in the previous seven invitations.

The response became a political headache for Taipei, particularly at a time when the government was in its final two weeks of transition—it was Ma’s duty to respond, but the media’s attention fell on Tsai, and they both had opposing responses to the letter. In a surprising but wise move, Taipei offered two separate letters three days later. The formal letter from Ma’s government reaffirmed its commitment to the 1992 Consensus, the political basis for the one-China policy, while offering the traditional and expected caveat that Taiwan had a different interpretation of it (meaning it considered the government of that one-China to be Taipei’s Republic of China). Tsai, as expected, condemned the conditioning of Taiwan’s participation at the WHA on acceptance of the one-China principle. In the end, this strategy worked. Taiwan was allowed at the WHA, once again, as “Chinese Taipei.”

But this year, the situation is much more difficult. Tsai no longer has Ma to shield her, and she must balance between angering Beijing or her supporters at home. 


The most likely scenario is that Taiwan will receive an invitation to the WHA, but conditioned again upon accepting the UN and WHA resolutions. Of course, Beijing could pressure the WHA to pull the invitation entirely, but that could be viewed as overly hostile and could spark direct confrontation across the Taiwan Strait. Tsai might feel obliged to take a tough stance against Beijing in order to appease her constituency. Beijing would also lose some maneuvering power when it comes to cross-strait relations and might spark diplomatic fights.

How, then, might Tsai respond?

Although Tsai may want to keep Taipei’s seat in the WHA, she campaigned on a platform not to compromise with Beijing’s one-China principle. There are three ways she could respond: condemn the one-China principle and refuse to acknowledge it; take Ma’s “One China, different interpretations” approach; or offer an entirely new take on the 1992 Consensus that accommodates the core concept of One China but in vague, uncommitted terms. 

The first two options are politically untenable—the first will likely anger Beijing and the second, Tsai’s supporters. That leaves Tsai with only the third approach, one that she has, unfortunately, already tried without much success. During her inaugural address last year, she skirted mention of the 1992 Consensus, instead referring to that “historical meeting” as an “acknowledgement” or “understanding.” Beijing interpreted her ambiguity as an attempt to weaken the one-China principle and its Taiwan affairs office released a statement shortly after her remarks expressing disappointment. “Tsai made no concrete proposal for ensuring the peaceful and stable growth of cross-strait relations,” the statement said. “The Taiwan authorities must give an explicit answer with concrete actions to all these major questions and face the test of history.”

The outlook for Taiwan is rather gloomy. If Taiwan loses its spot at the WHA, it could end up being excluded in the future from other international organizations it seeks to join, such as the International Criminal Police Organization or the United Nations Framework Convention on Climate Change. Even worse, the loss could further exacerbate cross-strait relations. Since San Tome and Principe severed ties with Taiwan in December 2016 ostensibly for financial reasons, Taipei has only 21 remaining allies. Many of them, particularly those in Latin America where there has been heavy Chinese investments in recent years, could be easily lured away by Beijing. Trump might be unhappy to see China’s economic influence growing in the United States’ backyard, but he might be reluctant to help Taiwan secure its allies in this region if the island is no more than a bargaining chip on his negotiation table.

Tsai has long promised to maintain the status quo in cross-strait relations, but the question now is whether she can deliver. She probably could, should her government come out with a new one-China policy in the weeks ahead, one that is better than the 1992 Consensus, but the chance such a scenario is rather small.

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