A
US Drug Enforcement Administration chemist checks confiscated pills
containing fentanyl at a laboratory in New York. Future discussions
among Chinese and Americans concerned about the state of relations
should make opioids – fentanyl in particular – a focus. Photo: AFP
Resumption of cooperation in public health was not highlighted as a deliverable following the recent meeting in Beijing between US and Chinese diplomats, but it deserves a concerted effort from both sides to keep up the momentum.
Days before US Secretary of State Antony Blinken’s trip, senior officials from American and Chinese drug regulatory authorities met in Beijing and “exchanged views on cooperation for 2023 and in the future”. That meeting marked an end to the suspension of contacts between the two agencies.
Two issues stand out in promoting public health cooperation between the two societies. The first is the fate of the science cooperation agreement.
Over the past four decades, collaborative projects among health scientists, universities and research laboratories in the US and China were underpinned by the 1979 bilateral Umbrella Science and Technology Agreement. Citizens of the two countries benefited as the medicinal and healthcare industries grew more intertwined.
Renewal of the agreement, set for this August, is being debated in the United States. The debate has been in the news because the last renewal, in 2018, slipped through the “maximum pressure” campaign of Donald Trump’s administration.
In the more recent years, however, government-endorsed health science cooperation has suffered from a drastic curtailment. Part of the cause is that, in the 2000s, increasing levels of US procurement of medicine – generic drugs and active pharmaceutical ingredients – from China grew to be a political issue. Ascertaining the degree of US dependence is a complex task in and of itself.
Worse still, along with concerns about dependence in supply came worries about the weaponisation of drug exports by China, which grew louder as the tit-for-tat trade tariffs and export restrictions kicked into full gear in 2019. So far, though, there is no evidence of either side treating trade in medicine or medical products as a national security issue.
However, adding to the complexity is the fact that national security has crept into what is left of collaboration among the health sectors of the two countries. As participants in the China-US Track II dialogue on healthcare wrote in their 2022 agreement, “both [the American and Chinese] governments have restricted the exchange of data and research based on data security and more broadly national security concerns, with often vague definitions of the terms”.
Still, there is no reason not to renew the agreement – all things considered, progress in medicinal and medical sciences ought to prevail. Even during times of high tensions between the two countries, China’s status as one of the world’s most populous nations makes it a rich source of medicinal and medical data for researchers and developers in the US. This fact defies diplomatic preferences.
Equally significant for China, the Biden administration’s identification of biotech as a target for “de-risking” should not limit the space for cooperation with anyone, including the US. Good-faith negotiations towards renewal of the agreement is the right thing to do for the sake of public health protection and improvement of its own population.
The other issue has to do with the US assessment of the level of Chinese action in helping curtail the opioid epidemic in the US. Controlling the flow of fentanyl precursors from China is a standard topic in the US political arena.
China first instituted regulations on fentanyl use and export in 1996. In 2015, it included six fentanyl analogues and 110 other pharmaceutical chemicals in its list of controlled substances, and imposed controls on four more fentanyl analogues and fentanyl-related chemicals in 2018.
In November 2019, US and Chinese drug law-enforcement agencies jointly uncovered a fentanyl smuggling case, which ended in a trial of wrongdoers in Xingtai, Hebei province. This took place against the backdrop of generally low levels of cooperation between the governments.
As US Ambassador to China Nicholas Burns said last month in reference to the flow of fentanyl, “the government here in Beijing is not contributing to that problem”. The task is to strengthen international cooperation to punish black market firms in China and transnational criminal networks that ship illicit precursor chemicals and products to the US.
Such cooperation is not a favour from China for the US. On the contrary, knowledge gained about challenges within the US on opioid regulation and treatment can be valuable for Chinese public health practitioners and regulators.
Future discussions among Chinese and Americans concerned about the state of relations should make opioids – fentanyl in particular – a focus and involve experts in medical research, pharmaceutical production and trade, and public health. Such exchanges should also aim at a shared understanding of the cross-border movement of chemical precursors, the manufacturing of medicine for pain relief and illicit transborder flows.
Last, but not least, the thaw in government-to-government contacts between China and the US, however tentative, is premised on the protection of their people’s welfare. For both countries, there is every reason to make renewal of the science agreement and enhancement of dialogue on addressing the misuse of fentanyl and other opioids a manifestation of people-centred diplomacy.
Zha Daojiong is a professor in the School of International Studies and Institute of South-South Cooperation and Development, Peking University. He is also a participant of the China-US healthcare track II dialogue