Author: Chunhuei Chi, Oregon State University
The people of Taiwan have been living in a parallel world since June 2020, with the island recording more than 250 consecutive days without any domestic cases of COVID-19. This paradise was brought back to the reality of the pandemic in late April 2021, when a pilot violated strict quarantine laws and sparked a series of domestic outbreaks. The fight against the virus is only made worse by Taiwan’s unique geopolitical position.
Before the outbreak on 20 April 2021, Taiwan had a total of 1047 COVID-19 cases and 11 deaths among a population of 23.8 million. By 11 August, total cases numbered 15,814 with 816 deaths. Taiwan’s unusual success in 2020 left it ill-prepared for this surprising turn.
Though Taiwan’s government procured 30 million vaccine doses in 2020, the global shortage of supply meant only around 400,000 doses were delivered before the April outbreak. Even this small quantity of vaccines proved difficult to distribute, with the lull in domestic cases fuelling vaccine hesitancy.
Along with the SARS-CoV-2 virus, Taiwan is also fighting a political virus. International media have reported how Taiwan has been persistently targeted for political and COVID-19-related misinformation attacks. The new outbreak, coupled with vaccine shortages, provided the perfect foundation for these attacks in May 2021 — both from the outside by China and from within by pro-China media and politicians. These attacks focused on portraying the Taiwanese government’s pandemic control measures and vaccine procurement as incompetent while also suggesting grossly exaggerated numbers of cases and deaths.
Taiwan faces a unique barrier in vaccine procurement that no other nation experiences — the ‘China factor’. Its deal procuring 5 million doses of the Pfizer–BioNTech vaccine fell through in early 2021 due to Chinese interference.
Throughout these dual virus attacks, the United States and Japan sensed the political crisis in Taiwan and began donating vaccines in late May and June. The United States shipped 2.5 million doses of Moderna vaccines to Taiwan, while Japan donated 3.4 million doses of AstraZeneca. These are not just biological vaccines — they are political vaccines to stabilise a vibrant democracy from external interference, and economic vaccines to maintain a stable supply of semiconductor chips to the world.
Taiwan’s plea and support from its allies also helped to speed up the delivery of vaccines that it ordered in 2020, resulting in a total of 8.9 million doses being delivered by 15 July. At the same time, Taiwan also mobilised its national health system to accelerate distribution. The number of doses administered per 100 people increased from 0.14 on 20 April 2021 to 37.18 on 10 August 2021.
On 18 July 2021, Taiwan granted emergency-use authorisation for its first domestically produced vaccine, Medigen. Of the five Taiwanese biotech companies that started developing COVID-19 vaccines in 2020, Medigen and United BioPharma are the only two that have received or are close to receiving approval. Taiwan’s government just announced that starting 23 August, eligible individuals will also have the choice of being vaccinated by its domestic Medigen vaccines.
Given Taiwan’s unique geopolitical vulnerability, it is critical for the island to develop its own COVID-19 vaccines. While Taiwan celebrated its first domestically produced COVID-19 vaccine, external and internal misinformation attacks questioned its quality. The main opposition party, the Kuomintang, even filed a lawsuit against the Minister of Health and Welfare Chen Shih-chung and the director of Taiwan’s Food and Drug Administration.
After two months of strict control, Taiwan again demonstrated its capability in containing the new outbreak, including both the Alpha and Delta variants. Daily cases dropped from a peak of more than 700 in late May 2021 to just 12 at the end of July. Not to be caught with a vaccine shortage again, Taiwan’s government worked with two tech companies and the Tzu Chi Merit Society to procure 15 million doses of Pfizer–BioNTech vaccines. The government also procured 36 million doses of Moderna for 2022 and 2023 while expanding the production capacity of Medigen vaccines.
Taiwan is now in a position to provide vaccine aid to countries in need. It wants to assure the world that it will continue to be a reliable partner, while also showing both willingness and capability to lend a helping hand.
Chunhuei Chi is Professor and Director at the Center for Global Health, Oregon State University.
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Author: Chunhuei Chi, Oregon State University