While racism has spread rapidly as the covid-19 pandemic disrupted global health systems, this study focuses on the case of Tedros Adhanom Ghebreyesus, the first African Director-General of the who, and his allegations of racism against Taiwan, which has been excluded from the who for decades. This study theorises ‘health apartheid’ as a conceptual framework to critically analyse three forces—global racial politics, imperial logics of global health, and state-centrism of international institutions—that relate to Taiwan’s exclusion in various ways. We argue that Tedros’s allegation was instrumentalised to overshadow the systemic, structural, and institutional racism reproduced by the who during the competition between Chinese and American hegemonies. This study shows that the pandemic exacerbates health apartheid against unrecognised nations, like Taiwan, when global solidarity is desperately needed. We call for a systematic transformation of the who to resist racist state-centrism and pursue a people-centred approach to global health governance.