Stephen Orlins | Strengthening the collaboration between US and China

On December 22, 2022, the Peking University Global Health and Development Forum 2022 was held with the main theme of Digital Transformation and Development Divides. Co-organized by the Beijing Forum, Asian Development Bank and PKU Institute for Global Health and Development, this Forum brought together world leading scholars, policy researchers and industry leaders from both China and international communities to share their insights and recommendations on the thematic topics, attracted over 10 thousands online viewers participated in the event. Stephen Orlins, President of National Committee on U.S.-China Relations delivered a keynote speech at the session of Global Health and Diplomacy.


I am sorry that I can’t be with my friends at PKU today, and I’m worried about the swift spread of COVID-19 throughout China. I really hope we can get through this okay, but I really wish China had imported mRNA vaccines to combat, to combine with its vaccines and antivirals so that the Chinese population could be better protected. The US has offered help, and I hope it will be taken if you, as China, cooperate could save one life. This could be a shining example of the benefits of that cooperation. I miss being with you in person, and now I believe I’ll be able to hug my friends in Beijing, probably in the first quarter of next year. Unlike virtually every person at this conference and on these panels, I am not a doctor or a healthcare specialist. I’m someone who has spent the last 50 years believing in and working toward a constructive US-China relationship.

Cooperation between China and the United States benefits both sides

I have always believed that cooperation between our two countries benefits the Chinese and American peoples. As you know, the last few years have been difficult for someone with my beliefs, and the next few will not be easy. However, despite this environment, we are beginning to see green shoots appear in the relationship. Our presidents met on November 14th in Bali, Indonesia, and opened the door for meetings between Vice President Harris and President Xi, Secretary of the Treasury Yellen, and PBOC head Yi Gang. Defense Secretary Austin met with China’s Defense Minister Wei Fenghe and many other cabcinet-level discussions. We also saw an agreement between the PCALB, the Public Company Accounting Oversight Board, the Ministry of Finance, and the Securities Future Exchange of China. When it was reached in August, people doubted it would be implemented. But in the past few days, PCALB announced that it’d been given sufficient access to the accounts of the listed companies from Hong Kong and China, and the delisting which could have occurred would not, are not going to occur.

China and the United States need to lead the world in healthcare cooperation

In this toxic political environment, experts from China and the United States can still reach an agreement, which brings me to healthcare. We desperately need collaboration. Currently, efforts to cooperate globally on virus containment and treatment have been limited by nationalistic interests, highly varied policies, and mistrust of vaccines. The United States and China need to lead the world in this cooperation. In past years, our countries worked together on major global health issues such as combating Ebola and SARS. However, these efforts have mostly ceased with the spread of COVID-19 and increasingly fraught bilateral relations. Both governments have restricted the exchange of data and research based on data security and national security concerns. With all too often vague definitions of those terms, the ability to conduct joint studies and collaborate at every level is essential for promoting innovation in healthcare and improving healthcare outcomes. Lack of collaboration has real world consequences, and the global struggle that contains COVID-19 is emblematic of that terrible cost.

The United States and China can better deal with the current pandemic and prepare for future ones if they work together. Chinese and American scientists can still collaborate to develop combinations of vaccines and antivirals to combat COVID more effectively and deal with its long-term impacts. Greater research is also needed to address related issues such as vaccine hesitancy, adverse reactions and concerns related to long COVID, which can best be managed from joint studies by experts from both countries. Besides the COVID pandemic, both nations face similar health-related issues such as an aging population and increasing incidences of non-communicable disease.

The hurdles that need to be overcome

However, both countries have difficulty addressing these issues due to fragmented payment and care delivery models, which impede their ability to allocate resources in a more coordinated and efficient manner. Given the magnitude of healthcare issues, China and the United States need to consider where they can apply resources most effectively and efficiently. Many steps can be taken to help achieve these outcomes such as effective integrated chronic disease management, establishing adequate person-centered evaluations, promoting good data governments, including rules governing data privacy and data flows, and encouraging home-based treatment and better use of technology such as AI, virtual healthcare, and similar advanced technologies. Another hurdle to overcome is unclear government guidance on collaborations. Scientists cannot work together if government rules are not clear. Today, both governments use national security as the basis for prohibiting all kinds of exchange without any specific mention of the national security interest at risk.

How the two governments do can encourage collaboration

To help encourage collaboration, the two governments should clarify what constitutes national security and ensure that the use of national security concerns to restrict joint research is evidence-based. For example, all population data currently publicly available and needed for health research should be open and free for all medical and healthcare professionals and experts without fear of reprisal. None of this collaboration is possible without the free exchange of experts, including many in this room. A decade ago, it was common for Chinese and American healthcare professionals to meet with their counterparts and work in each other’s countries.

Both governments should encourage such programs to restart granting visas for the other’s nationals to come into their borders to collaborate. In addition, it is important to provide greater assurance for the protection and safety of experts from one country visiting or working in another. No scientist or doctor should be inhibited from working with colleagues from other countries. Healthcare experts need clarity on what is and is not permitted within existing regulatory and legal practices and norms. Alongside government guidance on collaboration and travel, both nations should allow for greater cooperation between their experts on clinical trials and provide clarity. So that data from clinical trials in one country can be utilized and accepted in another to help further the flow of good diagnostics and medicine between the two countries and around the world.

Such data sharing can also be conducted under the auspices of the WHO and the World Intellectual Property Organization. Moreover, it recognizes that IP is critical to promoting innovation. Both nations need to ensure that researchers can share IP with their colleagues and partners while fully enforcing their ownership rights. Government agencies also have a role to play in ensuring global health in pandemics past. In pandemics past, our country’s CDCs worked closely together to ensure public health regardless of nationality. In light of China’s accession to the ICH, the two nations should reestablish relations between the US Food and Drug Administration and the China National Medical Products Administration. Including sending representatives from each to work in the other country to help improve regulatory science and promote efficient and effective global regulation.

Some may argue that these goals are impossible and that the hurdles are too great to overcome. I know they are wrong. Much of what I have discussed tonight comes from a consensus agreement of our track two dialogue on healthcare which we hold with Peking University’s National School of Development. After many hours of difficult conversations, experts on both sides were able to find common ground. I hope our leaders are watching. I hope they know that when you get these experts in the same room and have them speak candidly about the issues of shared concern, you will see fulsome areas for cooperation. Only by talking and engaging in the hard work of diplomacy can we move forward. A healthy planet and populations are in the interests of China, the United States, and the entire world. I’m encouraged by last month’s meeting between our two countries’ leaders and the work of experts from the PCALB, Ministry of Finance and SFC. The work of the people in this room is too important to be deterred by political factors. I wish you success at this very important congress and promise I will join you in person next year.

病毒无国界,新冠疫苗和医疗合作也不应该有国界。祝论坛圆满成功!谢谢!There is no boundary of virus transmission, so there is no boundary for the COVID Vaccines and Medical Corporation, and I wish today’s forum a great success. Thank you.