Ielemia continued Tuvalu's pursuit of close relations with Republic of China, and in December 2007 visited that country, when various bilateral issues were addressed.

He gained a higher international profile during the 2009 United Nations Climate Change Conference in Copenhagen by highlighting the dangers of rising sea levels.

In September 2008 Ielemia and the President of Kiribati, Anote Tong, attended a conference to improve relations with Cuba.

[4] Following the 2010 Tuvaluan general election held on 16 September Maatia Toafa was elected as prime minister with the support of five new members of parliament and three members that had supported Prime Minister Apisai Ielemia, this resulted in (8:7) majority in the parliament.

[5] As of September 2006, the government of Prime Minister Apisai Ielemia consisted of the following members:[6]