US health secretary Alex Azar praises Taiwan president Tsai Ing-wen in 'breakthrough' meeting

The United States’ top health official praised Taiwan’s democracy and response to the coronavirus pandemic during a visit to Taipei on Monday that signals the island’s growing strategic importance to Washington as relations deteriorate with Beijing.

Alex Azar, the US health secretary, is the highest ranking official to visit Taiwan since Washington severed official ties with Taipei in 1979 and switched its diplomatic allegiance to Beijing. China has threatened unspecified retaliation for the trip to a state that it claims as its own territory. 

After touching down on Sunday afternoon, and testing negative for the coronavirus, Mr Azar’s first port of call on Monday morning was to meet Tsai Ing-wen, Taiwan’s newly re-elected president, who he praised for her “courage and vision” in leading a democracy that was an “inspiration” to the world.

Mr Azar told Ms Tsai that Taiwan’s response to the coronavirus pandemic had been “among the most successful in the world” and thanked her for providing “needed supplies” globally, including to the US and Pacific Island nations.

Ms Tsai responded that she looked for “even more breakthroughs and fruits of cooperation” in dealing with the pandemic and other issues to “jointly contribute to the sustained peaceful development of the Indo-Pacific region.”

Taiwan, which has a population of 23 million, has kept Covid-19 cases low at just 480 and 7 deaths, through a combination of strict border controls, quarantine and contact tracing. The US has suffered close to 5.2 million cases and more than 165,000 related deaths.

The US health secretary also met Chen Shih-chung, his Taiwanese counterpart, to oversee the signing of a memorandum of understanding (MOU) on health cooperation between the US and Taiwan that would boost collaboration on infectious disease prevention and the development of drugs and vaccines.

The meeting of two senior health international officials during a global pandemic would normally be a routine occurrence, but increasing clashes between Washington and Beijing over trade, human rights in Hong Kong and China's claims to the South China Sea elevated the significance of Mr Azar's visit. 

The US' decision to send such a high-level delegation in the current climate must be seen against the background of global and US domestic politics said Lev Nachman, a Fulbright research fellow in Taiwan.

“The timing of Azar’s visit cannot be separated from increasingly frequent military threats from China, deteriorating US-China relations, the Covid pandemic, and Trump’s domestic failing and handling the pandemic,” he told The Telegraph.

Although Taiwan functions like any other nation with its own government, currency and foreign policy, Beijing claims it as its own territory and seeks to annex the island, using force if necessary.

The Chinese government launched strong protests against the trip, calling it a betrayal of US commitments not to have official contact with the democratic island.

China is highly sensitive towards any form of recognition of Taiwan as an independent entity and has sought to isolate the Tsai administration on the global stage by blocking its participation in global bodies, including the World Health Organisation (WHO).

Beijing has also stepped up its military intimidation of Taiwan. On Monday, Chinese fighter jets crossed over the median line of the Taiwan Strait and into the country's airspace, said the ministry of defence – an incursion that has increased in frequency in recent months.

Washington, Taiwan’s top arms supplier, has rebuffed China’s accusations, basing its decision to send Mr Azar on the 2018 Taiwan Travel Act, which permits the travel of higher-level officials to Taipei after decades during which such contacts were rare.

Historic caution in dealing with Taiwan has changed significantly under a Trump administration which has grown increasingly hawkish towards China, but in an afternoon press conference, Mr Azar focused his remarks mainly on cooperation on global health security.

“We have long had a history of close collaboration in the field of healthcare. Taiwan has been a model of transparent collaborative, cooperative public health and information sharing. In the middle of Covid-19, it is critical that we support and recognise those who share those values of transparency in healthcare,” he said.

The health secretary cited Taiwan’s exclusion from the recent World Health Assembly, even as an observer, as a “major frustration that the Trump administration has had with the WHO and its inability to reform.” President Trump earlier this year pledged to exit the World Health Organisation. 

Taiwan stood to benefit from the praise of senior global officials, even if the MOU was more of a symbolic gesture, said Mr Nachman. “[It’s] a global win for Taiwan and creates space for Taiwan in a global order that has regularly left Taiwan out,” he argued.

“Given the contentious state of the world, the US choosing to applaud Taiwan’s efforts for handling COVID while China threatens the island with military force is exactly why more people in Taiwan today than ever are supportive of more US-Taiwan cooperation.”