Taiwan will vent new anger towards political rival China if the World Health Organization, dominated by Beijing's allies, keeps Taiwan out of an annual assembly this month despite rigorous lobbying from Taipei.
Taiwanese President Tsai Ing-wen urged Beijing, one of 192 World Health Organization members, to avoid standing in the way of an invitation to observe the WHO's May 22-31 assembly. It has been invited every year since 2009.
Tsai gets along poorly with the government in Beijing and the issue has not come up since she took office in May 2016.
"We must reiterate that whether Taiwan can observe this year's World Health Assembly is a very important indicator for cross-Strait [China-Taiwan] relations," Tsai said on the presidential office website April 27, citing remarks from a new interview. "If China's decision shows any deviation, the impact on cross-Strait relations is very great."
Her foreign minister said in March he saw "no room for optimism" and cited "contingency measures" if the WHO had not sent an invitation by the end of April, according to Taiwan's Central News Agency.
Taiwan is unlikely to retaliate against China or the U.N. health agency in material ways, analysts say. But China may face a longer-term backlash from the Taiwanese public, which is weary of facing limits to its role in international, non-political organizations.
Another year of health assembly participation "would help improve the atmosphere of cross-Strait relations," said National Chung Hsing University international politics professor Tsai Ming-yan.
The two sides dropped formal dialogue about a year ago and have sparred over tourism, military maneuvers and the detention of a Taiwanese human rights activist in China.
"If not, then Taiwan society's reaction toward the pressure from Beijing on the path to participation in international events, even on non-sensitive issues like health, will cast China in the wrong in terms of developing that atmosphere," he said.
The two sides have been separately ruled since the 1940s, but China claims sovereignty over Taiwan and believes international organizations should bar Taiwan for lack of statehood. Beijing insists that China and Taiwan must eventually unify.
The island has just 21 diplomatic allies compared to more than 170 that recognize China, snarling Taiwan's efforts at lobbying for entry to international agencies.
Taiwanese have said in government surveys since 2015 they prefer today's level of autonomy from China over unification. They have long resented Beijing for using its clout as the world's second largest economy to curb Taiwan's diplomatic recognition and role in international organizations.
Taiwanese are watching this month's decision as another "isolated case" in the bigger trend of being blocked, the professor said.
Taiwan cannot join the United Nations, and the U.N. International Civil Aviation Organization declined to let it observe a session in September. During the Olympics, Taiwan must call itself "Chinese Taipei" to imply a link with China.
"It always baffles me to see how badly the Chinese treat the Taiwanese," said Coen Blaauw, executive director of the Washington-based advocacy group Formosan Association for Public Affairs.
"If I wanted to annex another country I would charm the pants of the other country," Blaauw said. "So, China blocking Taiwan [from] joining international organizations does not enamor them to the people of Taiwan."
The Taiwan government hopes to get updates from the WHO on international disease outbreaks and share its own experience in overseas health care.
Taiwanese "medical teams" have visited Africa, the Americas and other parts of Asia to provide medical care, the government in Taipei says. The island leadership has lobbied since 1997 for a spot in the WHO.
Some experts say Taiwanese people, stung by a WHO rejection, may pressure their president to approach China for dialogue. Tsai's predecessor's government talked regularly with China about economic issues, signed 23 agreements with Beijing and was allowed to start observing World Health Assembly events.
Tsai disputes Beijing's dialogue precondition that each side see itself as part of one China. The two have quit formal talks since she took office last May 20.
"I just don't see China would make any further concession at this moment," said Liu Yih-jiun, public affairs professor at Fo Guang University in Taiwan. "When the expectation was upgraded, and then when it cannot materialize, the chance of disappointment on the part of the Taiwanese gets the situation even worse."