Advancing U.S.-China Health Security Cooperation in an Era of Strategic Competition

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Although the United States and China have entered a period of strategic competition, bilateral cooperation on health security is more important than ever. The Covid-19 pandemic, with its novel nature and devastating impact globally, represents another critical opportunity for bilateral cooperation. A high-profile strategy to promote cooperation may achieve minimal traction when facing barriers that are difficult to overcome. One must remain realistic about what can be achieved in the near term. This report lays out six concrete, actionable streams where there could be collaborative work. Three areas of cooperation—travel, public health infrastructure, and supply chain resilience—stand out as most likely to deliver substantive results in the short term. They face relatively few barriers to implementation but could generate major positive spillover effects. U.S.-China health cooperation in another three areas—vaccines and therapeutics, biosafety and biosecurity, and countering disinformation—also promises high benefits for improving health security but faces higher substantive and political hurdles. The proposals suggested here can be advanced through a mixed, forward-looking strategy that involves mobilizing multiple stakeholders in promoting U.S.-China cooperation over health security, including intervention from top leaders from both sides. There are political, economic, and practical obstacles at almost every turn, and the United States should proceed with appropriate caution and care. But the opportunity space for engaging China remains larger than the risks of not doing so. At the same time, strengthening America’s health security is critical to the national interest and needs to be understood as an urgent challenge. Time is of the essence.

This report is a product of the CSIS Commission on Strengthening America’s Health Security, generously supported by Fred Khosravi.

Scott Kennedy
Senior Adviser and Trustee Chair in Chinese Business and Economics

Yanzhong Huang

Council on Foreign Relations