Taiwan, now in the grip of a second outbreak of severe acute respiratory syndrome (SARS) that has infected over 8,000 people and killed nearly 700 worldwide as of May 22, had hoped to see its bid for observer status at the World Health Organization be placed on the agenda of the organization's annual meeting now being held in Geneva.

Taiwan did not expect success this year, considering China's full-scale campaign to keep it out of the WHO. However, Taiwan had good reason to hope that support from the United States would deliver a moral victory, attracting support from other countries and demonstrating the irrationality of its exclusion. Yet at the crucial moment, the U.S. State Department stood aside in a move that contradicted U.S. policies favoring Taiwan's observer status at the WHO.

Washington's moral support for Taiwan's participation in the international community isn't new. It has been a consistent tenet of American policy since the United States de-recognized the "Republic of China" government in Taipei in 1979. At the time, Congress enjoined the State Department from construing de-recognition as "a basis for supporting the expulsion or exclusion of Taiwan from continued membership in any international organization."

Nor has this been a strictly Republican stance. Early in the Clinton administration, U.S. policy was set explicitly to "support Taiwan's 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 George W. Bush, in a May 2001 letter to Alaska senator Frank Murkowski, averred that "we should find opportunities for Taiwan's voice to be heard in organizations in order to make a contribution, even if membership is not possible," thus hinting that he wouldn't limit Taiwan's international participation solely to organizations where "statehood was not a prerequisite."

Where the World Health Organization is concerned, American support for Taiwan's observer status had been crystal clear. Congress has repeatedly passed, and presidents have repeatedly signed, legislation directing the executive to undertake concerted efforts to bring about Taiwan's observer status in the WHO. Just last week (May 13), Deputy Assistant Secretary of State for East Asian and Pacific Affairs, Randall G. Schriver, told Taiwan journalists that the U.S. delegation "will be very clear what our position is and we'll be overt about that, vocal about that, and all participants at the [conference] will understand what our position is."

But when push came to shove, the United States got shoved, and never pushed back. Seven countries spoke in support of an agenda motion on Taiwan's participation. Eight other countries submitted letters to the chair explicitly urging WHO observer status for Taiwan. The United States was not one of them. The U.S. representative simply rose to say that his country had sent a separate letter to the chair, which stated vaguely that "the United States has strongly supported Taiwan's inclusion in efforts against SARS and beyond."

What is clear, however, is that the State Department instructed the American delegation in Geneva to withhold support of Taiwan at the WHA General Committee agenda meeting (over the weekend of May 17-18). As a result, the issue of Taiwan's participation was barred from a vote at the assembly plenum on May 19. The most the State Department would permit was a vague statement by the U.S. delegation, which said positive things about Taiwan (but didn't call for Taiwan's WHO participation) at the first day of the assembly plenum. Moreover, according to one press report, the U.S. delegation stressed that its statement did not mean it supported the inclusion of Taiwan's observer status bid in the assembly agenda.

Of course, if the U.S. delegation had really wanted to support Taiwan at the WHA meeting, it would have insisted that the issue be placed on the agenda back during an executive board meeting in January when the agenda was prepared. It did not.

How does the State Department explain this failure to implement its own policies? Department officials say privately that China had threatened to call for a vote in the plenum if the United States supported Taiwan in the agenda committee. Because any Taiwan motion would lose, the U.S. delegation reasoned that it "didn't want Taiwan to humiliate itself."

Instead, the United States humiliated itself. While Taiwan was not expected to win a vote this year -- not without a concerted diplomatic effort over many months led by America and supported by other countries -- "clear, overt, and vocal" U.S. support would itself have been a victory for Taiwan. Such support was promised, but never given. Other countries, including Japan, and European Union delegations, said they would have followed if the Americans had taken the lead. In the end, Taiwan's continued isolation during an international health crisis was guaranteed by Washington's inaction.

On May 21, a unanimously passed bill went to President Bush, which sought a "United States plan to endorse and obtain observer status for Taiwan at the annual week-long summit of the World Health Assembly." A real plan would include four stages: (1) putting the issue on the agenda at the WHO Executive Board session; (2) active lobbying of the Japanese, European delegations and other friendly delegations; (3) forcing debate on the WHA floor as to why the Knights of the Order of Malta, the International Red Cross, and the Palestinian Liberation Organization can be members, while a "health jurisdiction" of 23 million otherwise uncovered cannot; and (4) proposals to establish a separate international health body for East Asia that could include entities that may not necessarily have "statehood."

In future, if Congress hopes to get the State Department to implement U.S. policy, it may well have to link appropriations for U.S. participation in the World Health Organization to administration efforts on behalf of Taiwan. It shouldn't have to come to that.