Friday, August 13, 2021

China's Drug War: Coming Soon to a Taiwanese Hospital Near You


Hey look it's an accurate cover photo and you know it. 

If you're wondering where I've been these past few weeks, it's still the same old thing: moving all of my work online means I'm in front of a computer all day, and I just get tired of it. I want to read a paper book or look at something that's not a screen.

I've also been working on that longer project with Brendan comparing every general history book about Taiwan available in English. It took some time, but look for it to be coming out soon.

But, as usual, something got stuck in my head that won't get out. So here we are. 

About two weeks ago, the Taipei Times published this piece on China snapping up the Taiwan distribution rights to almost a third of all new pharmaceuticals. It was a good article, and important warning -- and seems to have been largely overlooked: 

In a report dated Monday, the Legislative Yuan’s Judiciary and Organic Laws and Statutes Bureau decried the arrangement as unreasonable.

“Requiring South Korea to purchase vaccines through a North Korean distributor or Israel to go through a Palestinian firm would be preposterous,” the report said.

Granting exclusive distribution rights in a nation to its political and military adversary is ethically problematic, it said.

Due to the antagonism and mutual distrust between the two nations, it is highly unlikely that they would complete a contract and instead use it as a tool for political manipulation, it added.

This would further hinder transactions and jeopardize the right to healthcare of the “represented country,” the report added.

I would switch Israel and Palestine in that analogy, personally, but the point holds. This is terrifying, and you should be terrified. It is not crisis-mongering. It's an actual crisis in the making. 

Imagine a future in Taiwan where about a third of new drugs on the market are difficult to get or simply not available because China holds the distribution rights, but it would be political suicide to buy from China (not to mention playing directly into CCP hands).

Now, expand that thought: not just you at the doctor's office unable to get the drugs you need. Imagine millions in that same position, and how angry they'd be. Imagine the political crisis that would create: we already saw it with the BNT vaccines. Visualize that, but with a huge percentage of all new drugs on the market. 

Consider as well the opportunities for malicious actors and disinformation purveyors, populists riling up the people who are rightfully mad because they can't get medicine, sharpening that public anger into a poison spear and throwing it at exactly the wrong target. Not China, whose fault this is, or even those in Taiwan who insist China can be dealt with reasonably and warmer relations are possible without undermining one's own position. Rather, the protests would be directed at those trying to protect Taiwan from Chinese interference and annexationism -- the people who best understand that Taiwan needs to stand up for itself. 

Think of the destabilization: a KMT that wins, and caves in to buying medicine through Chinese channels, whose own supporters voted them in so that they could do this, and a furious opposition. Or DPP in power, but furious KMT voters who blame the DPP, not China, for the existence of the problem. Imagine a DPP who cannot cave (it would be political suicide with their own base) but has trouble withstanding that kind of pressure. It's not hard to imagine, because that's already what they do! 

With a segment of the population -- albeit a shrinking one -- who still does not understand that it is impossible for Taiwan to deal with China without China trying to undermine the country, it would be...well, a crisis. It would be difficult to have a functioning democracy in a country who can't access a huge portion of the latest medicines.

Let me make it worse. Consider as well that there are always two players in these games. China's gonna China, that's how the CCP rolls. Subjugation-happy assholes to the last. But those pharmaceutical companies agreed to those terms. They didn't see anything wrong with selling the rights to the Taiwan market to Taiwan's biggest existential threat. 

Taiwan watchers have been talking a lot recently about the good press and stronger support Taiwan has been getting. I admit, I've been glad to see it too. But while we've been celebrating, entire vital sectors of the economy have been quietly turned against Taiwan by the CCP. And those international entities let it happen. 

You might not be mad about the airlines caving to China. Perhaps you're not mad about the major language proficiency tests doing it (still, fuck IELTS). Maybe you couldn't work up sufficient anger over exclusion from international organizations, "Chinese Taipei", the end of actual Taiwanese representation in the Taiwanese representative office in Hong Kong or the BNT fiasco. In a lot of cases, it's a name change, purely aesthetic, or it's one medication. Those international organizations are pretty useless sometimes, it seems.

But all of those slights, all of those insults, all of those successful attempts to undermine Taiwan: they were always leading up to bigger, bolder plans for forced subjugation. 

That's what this is. 

I hope you were mad before. If not, I hope you're furious now. 

This proves without a doubt that the Shanghai Fosun deal with BNT (Shanghai Fosun, as a large company in China, is ultimately beholden to the CCP) was not an unfortunate accident, an oversight, a one-off. It was a direct attempt to harm Taiwan, and BNT let it happen. They agreed to it. Everyone who said it wasn't a big deal, that the DPP were wrong for declining to consider working with Shanghai Fosun, that the distribution rights were above board and negotiated in good faith, not an attack on were wrong. Your opinion was bad and you should feel bad. 

I've said it before and I'll say it again: the weird workaround of letting Terry Guo, TSMC and Tzu Chi buy the doses was not some odd accidental outcome. I have thoughts about TSMC's role that I won't share, and not much of an opinion on Tzu Chi (though I dislike religious organizations generally), but I stand firm on this: Terry Gou is a gamepiece. Perhaps he knows it to some degree, but I'm not sure if he realizes the extent to which is is a CCP pawn.

It also proves that the only way to deal with China is to refuse to play. If Taiwan bends over and accepts drugs through Chinese distribution channels -- as the torch-and-pitchfork types are likely to scream that the country should do -- then it'll be more drugs next time. Then something else. And another thing. And soon the CCP plan to get its claws inextricably into Taiwan will actually have worked. 

There is no way to talk to China, no way to negotiate, no way to warm up relations. They will always try this. They will never come honestly to the table. They will always try to undermine you. It's like trying to have an honest relationship with a narcissist, abuser or compulsive liar. It's not possible. If you take this punch, if you let that comment slide, if you try to placate them, they only escalate. It never works. 

The only way to win is not to play. 

Finally, this proves that a basic understanding of Taiwan among the general international community actually does matter. I've heard people say that only policymakers matter, only politicians, only officials. There's no point in trying to reach a wider audience of people who are not in a position to effect change, because, well, they can't do anything. 

That attitude is wrong. 

You know who's sitting in that "general audience" section? Businesspeople. Talent that Taiwan might recruit. Several million people who might intentionally choose a Taiwan-made product over a Chinese one. Writers and newscasters who don't focus on Taiwan normally but at the Olympics, might take a stand and just call Taiwan by its name, rather than Chinese Taipei. Creators who might re-think what peddling their products in China will ultimately cost them, and ask if it's worth the market access. 

And, of course, another important segment of that audience: pharmaceutical executives

Not the people who are considered particularly important in Taiwan discourse. And yet, looking at those numbers, I sure do wish more international pharma execs were more knowledgeable about Taiwan. I wish we'd tried harder to reach people like that: not just in the drug industry, but all industries. Because today it's medicine, tomorrow it'll be something else. It always is.

Perhaps it wouldn't make a difference. Perhaps they'd have signed away Taiwan's distribution rights to its biggest enemy regardless. Perhaps there is nothing one can do to make them care. 

But perhaps not. Perhaps actually knowing what one is doing might cause one to choose a different option.

You honestly never know.

This is a great reason to sign my petition for Last Week Tonight to do a show about Taiwan, by the way. The whole point is to reach a general audience. Now available in Mandarin!

No comments: