On a range of critical issues—from illegal narcotics to global economic stability—cooperation between the United States and China will have tangible benefits for Americans, and often also for people in China and the rest of the world.
Key assessments and recommendations
- Even as we acknowledge the competitive nature of much of the U.S.-China relationship, the United States should lean in to cooperate when we can to achieve tangible benefits for ordinary Americans or further U.S. interests abroad.
- China’s influence, for progress or not, is simply too large to ignore on issues such as combatting fentanyl; developing treatments for diseases like cancer; managing threats to global financial systems; and addressing climate change.
- Cooperating is a way to advance our mutual interests—not to do favors for each other. It is counterproductive to refuse to cooperate on issues of U.S. interest just because we disagree with China on other issues.
Context: Americans want savvy U.S. diplomacy and engagement with China
Polls show most Americans of all political affiliations want to balance strength with savvy diplomacy, despite predominant inside-the-Beltway calls for a get-tough approach toward China. Three-quarters of Americans support engagement with China, while only 13 percent want an “aggressive” approach and just 5 percent want a “confrontational” one. In October 2023, Secretary of State Antony Blinken identified climate, counternarcotics, public health, food security and global macroeconomic stability as possible areas of U.S.-China cooperation. (Climate cooperation is addressed in a separate paper.)
The role of Congress
At the most basic level, Congress should act to improve the daily lives of ordinary Americans, now and for the future, including by maintaining funding for programs that have made the United States a global leader in scientific research. For example, Congressional GOP proposals to cut 22 percent or more from the National Institutes of Health budget would gut cancer research. On certain issues, the United States can make advances on U.S. priorities by engaging with China. More generally, a relationship framed exclusively by competition and confrontation can easily slide into conflict. Congress can mitigate this by speaking publicly about the benefits to ordinary Americans from pragmatic, principled U.S.-China cooperation in common areas such as health and economic stability.
Fentanyl
More than 112,000 Americans died of fentanyl overdoses in 2023. Mexican drug cartels produce most illicit fentanyl consumed in the United States, using precursor chemicals from China. One important outcome of President Joe Biden’s November 2023 meeting with President Xi Jinping was China’s pledge to restrict the export of those chemicals. As part of that agreement, the United States lifted sanctions on the Chinese Ministry of Public Security Institute of Forensic Science. The opioid epidemic is not solely—or even primarily—a foreign policy issue. Even if China completely cut off all shipments, it would only provide temporary relief. Painful experience suggests that as long as U.S. demand remains catastrophically high, cartels will source precursor chemicals from elsewhere or produce other drugs. While China does not have a comparable opioid addiction problem, it has a strong interest in being seen as cooperative on the issue.
Cancer research
The United States and China have both the reason and capacity to cooperate closely to combat cancer. In 2022, the United States saw over 2.3 million new cancer cases and 640,000 cancer deaths. During that same year in China, approximately 4.8 million Chinese were diagnosed with cancer and 3.2 million died from it. These are tragic outcomes, which each government is seized to act upon. Working in tandem can certainly drive positive and faster outcomes. The United States and China also have extraordinarily deep ties in biomedical research. Of the thousands of Chinese nationals who have studied biomedicine at American universities, many are involved in the field in China and many others continue to pursue groundbreaking research at U.S. institutions.
On broader medical and health collaboration, previously productive U.S.-China public health-related research collaboration and information exchange has shut down following the COVID-19 pandemic. It will take a long time to build confidence and the required operational transparency to restore earlier levels of collaboration, but the endemic problems and looming risks on the global public health agenda make crystal clear the need for the two sides to begin that confidence building effort.
Macroeconomic stability
China and the United States are the world’s two largest economies, accounting for roughly 40 percent of global GDP and 20 percent of global trade. Six of the world’s seven largest banks are headquartered in either country and, thus, in addition to being major centers of commerce within their own domestic markets, their influence on global trade and investment remains significant. During the 2008–09 global financial crisis, U.S.-China coordination played a critical role in preventing even more damaging outcomes. Today, both countries have an interest in communicating and coordinating to ensure that risks in their economies—or elsewhere in the global economy—do not metastasize.
U.S.-China Science and Technology Cooperation Agreement (STA) renewal
It is in the U.S. interest to renew the U.S.-China STA. American and Chinese researchers have made consequential breakthroughs in such areas as influenza, childhood nutrition, and earthquake preparedness in cooperation enabled by the STA. Americans (as well as China and the rest of the world) benefit from these collaborations, particularly in an era where Chinese research organizations are richly resourced and making advances that U.S. researchers can learn from.
The STA sets the rules of the road for noncommercial scientific research collaboration, including intellectual property (IP) and potential dual use safeguards. The two governments review and renew the STA every five years. U.S. officials, who have used those occasions to fortify protections, are pursuing strengthened safeguards in the current renewal negotiations. While there are valid concerns about PRC theft of U.S. intellectual property, heavy-handed efforts to address these concerns have ruined careers, hampered research and, ironically, encouraged Chinese scholars to return to China and deprive Americans of the benefits their breakthroughs offer.