In an annual exercise that became more urgent after severe acute respiratory syndrome – SARS – spread disease and fear, President George Bush this week signed legislation that would bring Taiwan into the World Health Organization, an endorsement that is both crucial and merely a first step to improved health care for that island’s 23 million people. Progress on this issue before WHO’s governing body, the World Health Assembly, is painfully slow but the president is right to keep trying.

SARS may have begun in mainland China, but it killed 73 people in Taiwan, which is prevented from becoming a member of WHO. Why it has been excluded is simple enough – mainland China opposes any measure that suggests Taiwan has independent legitimacy, even observer status at an organization that works to protect the health of people mainland China claims to care about.

The official Beijing response from Foreign Ministry spokeswoman Zhang Qiyue to President Bush’s signing of S. 2092 this week was, “The channels for Taiwan to acquire health information have been smooth. The real intention of Taiwan’s attempt to join the WHO is to create ‘two Chinas’ or ‘one China, one Taiwan’ on the international arena. The conspiracy is doomed to fail.”

“Smooth” is likely not the word Taiwan would have used after discovering that mainland China waited more than four months before warning the world about the SARS outbreak. Taiwan’s successful health care system would not only be improved through increased contact with health experts worldwide, but would contribute at least as much as it would gain. Its single-payer health care system, with relatively low cost and excellent outcomes – among the highest life expectancy, lowest maternal and infant mortality, eradication of infectious diseases – should have the spotlight of the world stage, not shoved to the wings for political reasons.

No one wants to anger mainland China, which has too many missiles and too many low-cost employees and eager consumers with which to trifle. Taiwan would not receive full membership to WHO, it would not set precedent as a non-nation in its attendance – the Palestine Liberation Organization became an observer in 1974 – it would not even be a first for it in international organizations.

The World Health Assembly meets annually in May. When it met last month, the hope for including Taiwan looked particularly poor. Unlike in past years, even Taiwan’s journalists were not allowed to attend this year’s conference. But with the support of the United States and countries that have formal diplomatic relations with Taiwan, the question of its observer status made it as far as a vote before an Assembly committee for the first time. The question was defeated badly, but the fact that it got a vote and an affirmative vote from the United States were both encouraging signs.

The quickening pace of globalization also means that disease will spread ever faster. To exclude from a world health body a transportation hub in the Asian market is shortsighted and probably dangerous. With President Bush’s support this week, the United States has another year to persuade member nations of the Assembly that world health is improved with Taiwan’s inclusion.