Health secretary Alex Azar pledges US support for island democracy as China condemns visit and threatens retaliation.

US Health and Human Services Secretary Alex Azar, the most senior official to visit Taiwan in 40 years, met the island’s President Tsai Ing-wen on Monday, praising her government’s response to the coronavirus pandemic and offering US President Donald Trump’s strong support.

China, which claims the democratically ruled island as its own, has condemned Azar’s trip as a threat to “peace and stability” and promised unspecified retaliation.

Washington broke off official ties with Taipei in 1979 in favour of Beijing. The Trump administration has made strengthening its support for the island a priority, and has also boosted arms sales.

“It’s a true honour to be here to convey a message of strong support and friendship from President Trump to Taiwan,” Azar told Tsai in the Presidential Office, standing in front of two Taiwanese flags.

Azar is visiting to strengthen economic and public-health cooperation with Taiwan and support Taiwan’s international role in fighting the pandemic, but the visit is taking place against a backdrop of heightened tensions between the United States and China over issues not only relating to the pandemic, but also trade, Hong Kong and the crackdown in Xinjiang.

“Taiwan’s response to COVID-19 has been among the most successful in the world, and that is a tribute to the open, transparent, democratic nature of Taiwan’s society and culture,” he told Tsai.

Douglas Paal, a former head of the American Institute in Taiwan, Washington’s de facto embassy, said the Trump administration was still paying heed to China’s red line – that no US official handling national security visit Taiwan – but the timing of the visit was key.

“Sending him to Taiwan shows respect for the old framework while putting a finger in China’s eye at the same time,” Paal told the AFP news agency.

“The fact that they didn’t choose to send a national security adviser or someone else suggests they are trying to come as close as possible to China’s red line but don’t want to cross it.”

Health concerns

The US, which has had more coronavirus cases and deaths than any other country, has repeatedly clashed with China over the pandemic, accusing Beijing of lacking transparency.

Taiwan’s early and effective steps to fight COVID-19 have kept its case numbers far lower than those of its neighbours, with 480 infections, including seven deaths. Most cases have been imported.

Tsai told Azar his visit represented “a huge step forward in anti-pandemic collaborations between our countries”, mentioning areas of cooperation including vaccine and drug research and production.

Taiwan has been particularly grateful for US support for its campaign to attend meetings of the World Health Organization’s (WHO) decision-making body the World Health Assembly, and to allow it greater access to the organisation.

Taiwan is not a member of the WHO due to China’s objections, which claims the island is a province of the mainland. 

“I’d like to reiterate that political considerations should never take precedence over the rights to health. The decision to bar Taiwan from participating in the WHA is a violation of the universal rights to health,” Tsai said.

Azar’s visit will last three days and will also include talks with his health counterpart Chen Shih-chung and Taiwan’s Foreign Minister Joseph Wu.

The last US cabinet minister to visit Taiwan was in 2014 when the then-head of the Environmental Protection Agency led a delegation.

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