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Taiwan said Tuesday it had been excluded from a major World Health Organisation meeting for the first time in eight years and blamed rival China for the snub as relations worsen.
Delegates attending the World Health Assembly (WHA) in Geneva later this month were supposed to receive their invites by Monday.
Taiwan, which is fighting international marginalisation as Beijing puts pressure on its allies, said it had not received one.
"Mainland China pressured the WHO and blocked it from issuing us an invitation... we express strong dissatisfaction and protest," the island's Mainland Affairs Council said in a statement.
Relations with China have become increasingly frosty since Beijing-sceptic President Tsai Ing-wen took power almost a year ago.
China still sees self-ruled Taiwan as part of its territory awaiting reunification and is incensed that Tsai will not agree to the concept that there is only "one China", unlike her Beijing-friendly predecessor Ma Ying-jeou.
Under Ma, Taiwan was granted "observer status" at the WHA in 2009 -- a rare acknowledgement on the global stage.
But since Tsai took the helm, Beijing has sought to block the island from a string of international events.
China reiterated Tuesday that Taiwan must accept the "one China" principle and said if it did not, it would not be welcomed into international forums.
"We've stressed many times that in dealing with Taiwan's participation in international organisations' activities, the 'one China' principle must be respected," said Geng Shuang, spokesman for China's foreign ministry.
Geng added that a "large majority" of countries supported China's position.
Taiwan's health minister has said he will lead a delegation to Switzerland anyway, despite the lack of an invite.
But Geng said any measures taken by Tsai's Democratic Progressive Party were "doomed to fail".
World Health Organization spokesman Christian Lindmeier said the issue was still "under discussion" among all parties, leaving some room for Taiwan to attend the meet.
Taiwan's participation was not an issue for the WHO to decide, he added, underscoring that China as the member-state had full power to make the call.
Asked about the Taiwan health minister's pledge to come to Geneva no matter what, Lindmeier said the WHO issues a limited number of day passes to members of the public who are not official delegates, observers or accredited journalists.
Taiwan was expelled from the WHO in 1972, a year after losing the "China" seat at the United Nations to Beijing.
With China in the ascendant, Taiwan has shed global allies in recent decades and only 21 countries now recognise the island's sovereignty.
Even its most powerful ally, the United States, has no official diplomatic relations.
US President Donald Trump recently rebuffed the idea of another phone call with Tsai after their protocol-busting chat following his election victory, saying he would not want to damage relations with China's President Xi Jinping.
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