From SARS to COVID-19: Rethinking Global Health Lessons from Taiwan

Taiwan has been successful in suppressing the highly infectious Coronavirus Disease 19 (COVID-19) despite its proximity to Wuhan, China, where the coronavirus first emerged in December 2019. Taiwan recorded 517 coronavirus cases and 7 deaths in contrast to the similarly sized population of Australia, which confirmed 27,133 cases and 894 deaths as of 3 October 2020 (Johns Hopkins n.d.). Journalists across the world have attributed Taiwan’s success against COVID-19 to its experience fighting Severe Acute Respiratory Syndrome (SARS) in 2003 (Fortune 2020; CNN 2020). “The secret of Taiwan’s success,” a Turkish journalist argued, “lies in the painful memories of the 2003 outbreak” of SARS (Anadolu Agency 2020). Yet, these journalists have found it difficult to elaborate on Taiwan’s learning from its SARS experiences in the format of a newspaper article. Drawing on historian Virginia Berridge’s (2018) approach in writing a policy-orientated contemporary history of medicine, this article shows how Taiwan centralized antipandemic measures, resolved the lack of personal protective equipment (PPE), and challenged the World Health Organization (WHO) and China’s state medical advisories to fight COVID-19. Just as Taiwan adopted these same measures to redress SARS-era issues, Taiwan’s COVID-19 actions could serve as global health lessons for other countries fighting the current and future pandemics.

In contextualizing Taiwan’s success in fighting COVID-19 in its longer political history, this article problematizes the straightforward utilization of global health lessons from Taiwan. Policy makers should strive to understand how international and domestic politics interacted with Taiwanese medicine to fully understand the historical conditions underpinning Taiwan’s successful antipandemic measures. Significantly, the same ruling political party, the Democratic Progressive Party (DPP), fought SARS in 2003 and COVID-19 in 2020. When fighting SARS in 2003, the DPP government had to engage with the United Nations’ health agency WHO, which it was no longer a member of because Chinese Nationalist Party (Kuomintang, KMT)-led Taiwan lost its UN seat in 1971 to the People’s Republic of China (PRC). Attempts by Taiwan to join the WHO from the 1990s onward have been stymied by the PRC, even though the PRC permitted pro-Beijing KMT-led Taiwan to attend the World Health Assembly as an observer under the name “Chinese Taipei” from 2009 to 2016 (AFP 2020).

In 2003, the DPP government fought SARS as a longstanding opposition movement struggling to run the country after fifty-five years of largely authoritarian KMT rule. An inexperienced DPP central government (which won its first presidential election in 2000) had to work with a popular KMT mayor of Taipei City, Ma Ying-jeou. (Epoch Times 2003). This resulted in a contentious central-municipal relationship, similar to the contentious federal-state-local-media dynamics that have been playing out in the United States fight against COVID-19 (Washington Post 2020). This article will analyze three specific elements of Taiwan’s antipandemic measures to explore the tensions between the central Taiwanese and municipal governments: (1) antipandemic leadership; (2) DPP’s engagement with WHO on the diagnosis, prevention, and treatment of SARS; and (3) medical connections between China and Taiwan in shaping pandemic measures.

The latter two cases reveal the importance of international health diplomacy in shaping antipandemic measures. The article argues that the KMT’s role was crucial, if understated, in shaping global and cross-straits medical norms in Taiwan, even though the DPP government has traditionally been seen in a better light in resolving these pandemic issues. It also shows how the DPP engaged with WHO guidelines even as its efforts to join the organization have not succeeded. The brief cooperation between Taiwan and China in fighting COVID-19 in early January 2020, despite the official tensions between DPP and China, reveals the surprising endurance of the political connections built by KMT and China a decade ago.

1 Importance of Central-Municipal Interactions in Fighting Pandemics

Taiwan’s Central Epidemics Command Center, or CECC, has been lauded by the media as the key to the country’s success at fighting COVID-19 (South China Morning Post 2020...