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The U.S. secretary of Health and Human Services is scheduled to visit Taiwan in coming days in the highest-level visit by an American Cabinet official since the break in formal diplomatic relations between Washington and Taipei in 1979.

The visit by Alex Azar, and especially a planned meeting with Taiwan’s president, will likely create new friction between the U.S. and China, which claims Taiwan as its own territory, to be annexed by force if necessary. Taiwan is a key irritant in the troubled relationship between the world’s two largest economies, which are also at odds over trade, technology, territorial claims in the South China Sea and China’s response to the coronavirus.

In Beijing, foreign ministry spokesman Wang Wenbin said China has lodged “solemn complaints” over the visit with U.S. officials in both Beijing and Washington.

“The Taiwan issue is the most important and sensitive issue in China-U.S. relations,” Wang said, adding that Washington needed to stop all official contact with Taiwan and make good on its commitment to Beijing to “avoid serious damage to China-U.S. relations and peace and stability across the Taiwan Strait.”

The U.S. maintains only unofficial ties with Taiwan in deference to Beijing, but it is the island’s most important ally and provider of defense equipment.

The American Institute in Taiwan, which operates as Washington’s de facto embassy on the island, said Wednesday that Azar’s “historic visit will strengthen the U.S.-Taiwan partnership and enhance U.S-Taiwan cooperation to combat the global COVID-19 pandemic.”

In a tweet, Taiwan’s Ministry of Foreign Affairs said it looked forward to welcoming Azar and his delegation. “This is the highest-level visit by a U.S. Cabinet official since 1979! Taiwan and the U.S. are like-minded partners cooperating closely in combating coronavirus and promoting freedom democracy & human rights worldwide.”

The ministry said Azar would meet with independence-minded Taiwanese President Tsai Ing-wen, with whose government Beijing cut off virtually all contacts four years ago, and with Foreign Minister Joseph Wu and top health officials.

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