Host Dr. Elizabeth Economy interviews Yanzhong Huang, a leading expert on China's public health system, examining how China has evolved from the COVID-19 pandemic and its growing role in global health diplomacy. The two explore China’s dramatic policy pivots—from initial inaction to draconian zero-COVID lockdowns to sudden reopening—and analyze why meaningful domestic reforms and transparency remain elusive despite lessons from the crisis. Huang discusses China's strategic health diplomacy, particularly how its provision of vaccines and medical supplies during COVID earned goodwill in developing countries. The conversation reveals how U.S. withdrawal from global health institutions creates opportunities for China to expand its influence through the Health Silk Road initiative, requiring minimal effort to fill the vacuum left by the American absence. Huang argues that the unresolved controversy over COVID-19's origins and deep mistrust between Washington and Beijing have effectively frozen bilateral health cooperation, making dialogue nearly impossible even in an area traditionally viewed as ripe for collaboration.
Recorded on October 1, 2025.
ABOUT THE SERIES
China Considered with Elizabeth Economy is a Hoover Institution podcast series that features in-depth conversations with leading political figures, scholars, and activists from around the world. The series explores the ideas, events, and forces shaping China’s future and its global relationships, offering high-level expertise, clear-eyed analysis, and valuable insights to demystify China’s evolving dynamics and what they may mean for ordinary citizens and key decision makers across societies, governments, and the private sector.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:07):
- Welcome to China
Considered a podcastthat brings fresh insight
and informed discussion to one
of the most consequentialissues of our time,
how China's changingand changing the world.
I'm Liz, Economy, Hargrove Senior Fellow
and co-director of theProgram on the US, China,
and the World at the Hoover Institution at
Stanford University.
Today we're gonna talk aboutChina and public health.
It may seem like a niche issue,
(00:29):
but from everything that theworld has seen with regards
to SARS and then with COVID, we know that
what China does at homehas enormous implications
for the rest of the world.
And to guide us on ourdiscussion, we're very fortunate
to have Yanzhong Huang.
He is a Senior Fellow at theCouncil on Foreign Relations
and a professor at Seton Hall University.
He's also the author most recently
(00:50):
of toxic politics inin-depth exploration into
how China's environmentalproblems contribute
to its health problems.
Welcome, Yanzhong. It's greatto have you with us.
- Well, thank you, Liz, for having me.
- So let's start with what'sgoing on inside China.
You have, I think, followedChina's public health system
(01:11):
for probably longer than almostanybody else in the field.
What kind of changes have youseen over time since you first
began studying, you know,China's public health system?
What has, what has really struckyou most about the changes
and what hasn't changed?
- Well, I think if you just look at the,
(01:33):
the, the public healthsystem in China, right,
that you've seen, right?
The, you know, they are makingsignificant strides, right?
With average life expectancyrising to 78.5 years.
That up, that was up from 77 2020.
They've made so much progressin biotech, you know,
(01:55):
that there is nowbecoming a global leader.
You know, quickly catchingup with the United States.
If you look at the data,you know, 20, 25, 30 7%
of molecules licensed
by major pharma firmsoriginated from China, right?
The, you know, they, youknow, also, you know,
(02:16):
major changes in,
I would say challenges, you know,
that are happening in thepopulation by population.
Aging certainly is acute.
Now, 20% of the population,
we are talking about nearly300 million aged over 60.
(02:36):
They have non-communicablediseases we call NCDs.
And they cause more than 80%of the death in China. That is
- Exactly, what are thoselike, that's like what?
Cancer, obesity, diabetes. These are ncd,
- Yeah.
We call the, the cancer,diabetes, you know,
cardiovascular disease, disease.
But all, all those issues, you know,
(02:58):
like respiratory conditions, you know, so,
and their risk factors youconsider like obesity, right?
Approximately 50% of Chineseadults are overweight
or obese according to a 2020 report.
Smoking continue to be a challenge, right?
Over 50% of the adultmen in Shriners smoke.
(03:21):
And there's, you know,infectious diseases continue
to be a challenge, right?
That is exemplified by the, this year,
by the, in the summer, right?
The, the chi gonia outbreakin Guangdong, right?
That started for Shang, you know, driven
by mosquito boom transmission,you know, raising concerns
(03:42):
for open spread.
You know, there are allthese challenges of problems.
But in the meantime, if you look at the,
the public health infrastructure, right?
Continue to be centrally coordinated
by the National HealthCommission, you know,
that oversees a vast network
of over 1 million healthcare facilities,
including state owned tertiary hospitals,
(04:05):
community health centers,specialized in centers
for disease control and prevention.
They call it also CDC, right?
But, you know, they haveCDCs at national prevention
and local levels, right?
Universal bail,
basic medical insurancenow covers over 95%
of the population.
(04:26):
You know, but you know, the,you know, the benefits varies,
depends on what schemesyou are subscribed.
The, and, you know,
the local government now arefacing in the post COVID year,
all this fiscal challengesin providing, right.
The, the public services, right?
(04:48):
And the, they're trying to fixthe loopholes, you know, left
by, in the post COVID era, right?
The, the public health system,you know, with this, the,
this newly revised infectiousdisease law, you know,
now encouraged for, which Ifound this is very interesting.
(05:08):
Now, finally, by thislaw effective, you know,
this last month encouragedthe individual sharing
and reporting disease relatedinformation by, you know,
mentioning that entities
and individuals will reportin good faith eligible
for rewards and exempt fromliability if the event is
(05:31):
later rolled out.
So, so yeah, we're seeing bothchallenges, you know, changes
and also stability inthe system, essentially.
- I mean, it used to bethe case that, you know,
doctors were not paid well.
So the medical profession, it was hard
to attract people sometimes.
(05:51):
Is that, has that changed?
Has investment, has government investment
in the practice medicine,for example, improved so
that now you're gettingmore and better doctors
and they're getting paid more?
- Well, well, in, in the United States,
but typical that you have,you know, the, the, the, some
of the best brightest people, right?
(06:13):
When go to a medicalschool, you know, that
is not the case in China.
The, although, you know, weare seeing over the past year,
this seems to be improving.
You have more people getinterested, you know,
studying at the medicalschools in top universities.
(06:34):
But I think for those doctors
who work at the, you know, thegrassroots level, you know,
even township health centers still, right?
They, they, there arefew people who trained,
you know, receive formal training, right?
To walk by in at that level, you know,
(06:55):
even though we were assignedto those institutions,
you know, still, right?
That you would try your best
to get into like a countyhospital urban hospital
because the pay is, you know,not good, is you have to,
you know, rely on, you know, basic salary,
which is really small,not attractive at all.
(07:16):
But in those institutions, you know, you,
if you rely on bonus, but the,you have to count on demand,
but the demand for theirservice is really still small.
People would still preferto bypass institutions
for urban health centers.
- Oh, interesting. And that of course,
also prompted anotherchallenge in, in sort
of the public health system,which was corruption, right?
(07:39):
Because you had a system
where the doctorsweren't making any money,
and so people would paythem extra to get seen,
or they would overcharge for medicines.
How, you know, effectively has, you know,
Xi Jinping's ongoingcampaign against corruption.
Now, I think it must be in its 13th year.
How effective has thatbeen in the medical field?
(08:01):
- Well, actually launched a, a,
a anti-corruption campaignin the medical sector in
2023, right after
- Oh, late. Oh, late, okay.
- I, yeah, the end of the, theCOVID pandemic, you know, so
this campaign so far has punished,
I believe over 40,000 people,
including like hospitalmanagers, you know,
(08:23):
the health officials by whoare involved in procurement
and bribes, you know, the,
although that enforcementgaps remain the, you know,
and that campaign continued that there is,
the government has not indicatewhen this is going to end.
I assume that if thatall systematic, you know,
(08:48):
problems, you know, sustained,there's no way to get rid
of all this corruptions in this sector,
- Right?
I mean, I think we've seenthat in many other sectors like
the military where itseems to be a never ending
- Candidate exactly.
- Against corruption.
So perhaps the same willunfortunately be true in
(09:09):
the, in the medical sector.
So let's talk a little bit about COVID
and what you've seen post COVID in terms
of the government's response.
I have to say, I was speaking
at a media round tablethe other day to a bunch
of journalists, and one ofthem asked me whether I thought
that China had been sufficiently punished
(09:32):
or had sufficiently takenresponsibility for COVID.
I wonder how you wouldanswer that question.
I mean, do you think
that China has been heldsufficiently accountable
for its role in COVI and its spread?
- Well, this is the, well,
(09:55):
interesting question, right?
I, I think in a way, like inFebruary, like early February
after Lee Leon died, youknow, the, by the way,
what Leon was the whistle blower, right?
That, you know, right? Theshare the information about the
upcoming, you know, pandemic.
And he was then punished, right?
(10:17):
And then he died from the, the, the, the,
the COVID himself, right?
So at that time whereyou, you have seen, right,
this is sort of like a China'sby noble moment, you know,
people really, you know,
like demanding accountability,you know, the, you know,
(10:37):
the flooded the internet, right?
Showing their dysplasia and frustration.
But I think, you know,
and many people I thought that what leads
to transformative political change, right?
But, you know, instead was followed by,
by the information, youknow, cracked down by more
(11:01):
tightened political control.
And so, you know, this, the, one
of the lessons we've learnedthat there all this major,
you know, crisis not alwaysfollowed by, you know,
liberalization ortransformative political change.
(11:22):
China, it might be the opposite
is true, you know, the, but,
but I think, you know, it's really, I,
I found it really fascinatingwhen I was studying, right?
That there's the, the, thestate response, you know,
to the, the, the pandemic.
(11:42):
You know, it's justthat kind of resilience.
I found very, you could say
impressive, you know, the, you know, if,
if you consider rightthis, this, this swing
between different political modes, right?
(12:04):
This, I think this is themost striking thing, right?
The, it's capacity for sudden
dramatic pivotals without apparent
legitimacy cost, right?
If you think about theshifts we witnessed,
right from initialinaction by December, 2019
and early January, 2020 tothe decisive lockdown of Wuhan
(12:29):
in late January, 2020,you know, then the swing
to overreaction with draconianzero COVID for three years,
but then almost overnightby, in early December, 2022,
there's a complete, there wasa complete reversal, right?
Sudden reopening with minimal preparation,
and then COVID justdisappeared from public
(12:52):
discourse entirely.
Like, you know, nothinghad ever happened, right?
So nobody mentioned it anymore,you know, so, you know, I,
I find, you know, this, this, that kind
of adaptability, or mayberesilience is the better word.
It tells us something profoundabout how the system operates
(13:13):
and maintains control.
- So I think that's really interesting.
Let me ask two follow-upquestions on that.
So first, what's yourexplanation for that?
I think it was a Decemberdecision to just lift the controls
and, you know, overnight,as you said, without thought
(13:34):
to some kind of ensuring thatpeople would be protected
or even the elderlysomehow, that, that, what,
what do you think wasbehind the decision at
that very moment?
And then do you think
that COVID is still anissue in people's heads?
I mean, despite the factthat it's not talked about,
is it still in the minds of, you know,
(13:57):
people in Chinese society?
I mean, presumably many peoplelost loved ones, you know,
to COVID as they did here inthe United States, of course,
you know, is it somethingthat's not talked about, but
nonetheless still has lessons, you know,
that people have taken away?
And what would those lessons be?
(14:18):
- Well, well, first of all,when we talk about the forces
or factors that led toby the reopening, right?
You know, certainly you couldhave, you know, the confluence
of factors, but the influences by the,
but you know, I think, youknow, we still need, right,
the more information, right?
And what exactly happened, right?
(14:39):
In Hai, you know, thatmade, you know, the,
the government leaderto make that decision
to completely right, ditch the zero COVID.
And we could just, you know,list some of the, you know,
the factors we know, right?
That, that, for example,by that time, by, you know,
(14:59):
November, December, 2022, it was clear by
that approach no longer sustainable right?
Diminishing returnsproblems, very clear, right?
And there was also by, according to
the media reports by those reporters,
was based in Beijing, youknow, they also, you know,
(15:22):
you know, talk about, foundthe information suggesting
that government wasseriously considering, right?
The having a, you know,a new strategy, right.
To replace by the zero COVID, you know?
But you know, that still,I did not explain why,
but the change come,came so sudden, right?
(15:45):
With so minimal preparation.
And it seems to be irrational, right?
That the, so, you know, I, I,
I think certainly why in thatsense, the November, you know,
2022, all this protest, right?
In Beijing, Shanghai
and Elsewell played a sort of like,
(16:07):
you know, you know, sort ofa transformative role here.
You know, that when the leaders, you know,
actually might solve, youknow, from the, you know, the,
the, the, the footage rest the,of this pro that, you know,
the, the, the people wereso frustrated, right?
That even, right, thatthere's this sort of like the,
(16:30):
the largest protest, you know,since 1989 in a way, right?
And then there also, right,there's clear, right,
the regime legitimacy implicationsthere from the slogans.
They were enchanting.The, I think, you know,
they were really shockedin my understanding.
(16:51):
And then I think the,
maybe what this, again,
we don't know the exact details there.
Some talk about this like sort
of revenge reopening, youknow, that is that, well, this,
this is what you want, right?
You want reopening, youwant ditch the zero COVID,
(17:11):
you got it, right.
You know? Wow. So it's that kind of,
but we still, again, wedon't have enough information
to make sort of
affirmative conclusion, youknow, on the, the forces
that lead to the change.
(17:32):
- Yeah. And what about whetherCOVID still sits in the
back of people's minds?
I mean, you continue to go back
and forth to China, you doyour research, you, you know,
have friends and, and family there.
I mean, is this somethingthat people still talk about?
Is it raised is, you know,do people say, you know,
should we be concerned aboutanother pandemic of some sort?
(17:55):
How does, how does itplay out do you think,
broadly within society?
- Well, again, officially,right, both state media,
social media, right, thatyou seldom heard, right?
This term COVID, right?
They have those, you know,other terms, you know, replacing
that we call it like duringthe special times, during the,
(18:17):
the mask era, right?
This, the, you know, so clearly
what this still like politicallysensitive issue, taboo,
aerial, you know, that discouragepublic discussion, right?
The, the pandemic, you know,
the state re the governmentresponse to it, you know?
(18:40):
But, but you know, again,the problem is that you have
that many people, right?
Who died by the, during theCOVID, especially by the, during
that maybe 35 days
after the December seven, December 7th,
by 2022.
You know, we, we, we have met people
who lost their loved ones by the, during
(19:02):
that period of time.
You know, they were, you know,
certainly not happy with that.
You know, the, I I, I can tell, right?
That that kind of emotion, right,
that was suppressed, right?
The, there, the one personjust said, you know,
I feel I need to do something,
(19:23):
but in the meantime, Ialso feel like I'm numb.
You know, this kind of numb, you know that
in Chinese, right?
It's so you don't get a clear sense
what exactly people are thinking about.
It's kind of very feeling thatwas difficult to describe.
Maybe it will disappearover time, you know,
(19:46):
but, you know, who knowsif that become part
of the collective memory ofthe society, you know, when
the, you know, social politicalconditions change, you know,
they might, you know, like become
- Part of the process,- Right?
(20:06):
It is just like, you know,they great leap forward, right?
That, you know, they becomeimportant imp, impacters,
you know, for the post more rural reform
- Yeah.
Reform. So that's really interesting.
So you, you mentioned, you know,
one change in Chinesepolicy in terms of reporting
(20:28):
when you know you are sick
or reporting on a potential disease
that people will be rewarded in some way
and not punished
and not punished if itturns out not to be true.
Are there other importantchanges that you think have come
as a result of like,lessons learned from COVID
(20:51):
by the Chinese government issues
around greater transparency,public transparency,
or, you know, differentways that health, you know,
is being monitored in society?
I assume those bracelets areno longer part of, you know,
everyday life in China, is that right?
The ones that we're trackingpeople's, you know, exposure
(21:13):
to COVID, ostensibly,
- Well, COVID is still there, right?
And it's still spreading in,in, in the country, right?
And across the globe, right?
It's just that, you know,
now it's no longerconsidered a public health
threat, you know, a majorpublic health threat, right?
(21:34):
The, if you consider all this, the,
the government actions on chicken Goya
outbreak in Guangdong, right?
That the sort of, thatwas remini reminiscent
of the zero COVID approaches, right?
To a localized outbreak,
which is certainly much,you know, much less federal,
(21:57):
you know, than COVID-19 in 2020.
So we have seen by this, you know,
this revised infectiousdisease law, you know,
that seems to like the, well
after, you know, finally bythe, I thought that there was,
(22:20):
you know, basically littlepublic discussion, right?
Right. What we did, right?
What we did wrong, you know,during, you know, COVID-19,
you know, how do we get,are we going to fix, right?
That this loopholes mightexpose during the system, right?
That, that, you know, the, it seems to be
(22:42):
by, you don't see
that kind of, right.
The scale of,
with this public health investments we saw
after, you know, sas, right?
In 2003, right
after sars, there was,you know, you don't,
there was not just a, likea, you know, transparency,
(23:06):
you know, the sort of this
investment in public health.
In fact, if you visit any ofthe provincial by the CDC,
by those state of art buildings, labs,
they were almost all build,you know, in the wake
of sars, you know, outbreak.
(23:26):
But you don't see thatkind of similar level
of investment, right?
In the post COVID era.That is my impression.
And certainly what that hassomething to do with the local
financial capacity,
because right, we know thelocal government, right?
The debt reading, you know, the
and era economic slow down, right?
(23:49):
That they really didn't havethat much in interest, right?
Incentive right. To investin public health, you know.
But at the central level,we have seen like this, some
of the, like the anti graphiccampaigns, you know, launch
(24:09):
of the healthy China, you know, 20,
30 more state intervention, you know,
like managing people's weight.
But that, that does seems,doesn't seem to have anything
with like a future pandemicpreparedness, you know,
and response.
- So what, what do you, when you say
that the government ismanaging people's weight,
(24:31):
they're not, they're notgoing in there like the family
planning offices, are they?
And actually weighing peopleand, and checking on them.
- No, no, it's not like that.
Well, that's the, but,
but it, it sort of stillreminds me this sort
of like a recurring, right?
This the, is the, the,this biopower, right?
(24:51):
The, you have this sort of more,
it's like a form, you know,as a fail approach, right?
In dealing with sort ofindividual lifestyle diseases,
you know, like, youknow, overweight, right?
The not diseases risk factors, right?
(25:12):
Or this is like obesity.
The, you now you see thegovernment is taking action, right?
In those areas, you know,that clearly show, you know,
that the government, youknow, wants to do more, right?
In this field.
But it also represents sortof like a subtle, right, the
(25:35):
state penetration right to people's lives,
but in order to achieve
by this macro health objectives. Right?
- I see. So, so more informationcampaigns and sort of
- Yeah, health, wellness,education, you know, the,
(25:57):
the campaigns, you know,maybe also provide some
incentives for people to sort of,
you know, exercise constrained, right?
In the, their diet habits,you know, that we are seeing
that there's people validatingin China more concerned
by their weight, this how,you know, this, like this,
(26:20):
you know, the weight reductionby those, the camps become
so, and drugs become sopopular now in China.
- Interesting. Interesting. Okay.
But not, but not in terms
of the government actuallytaking individuals and,
and subjecting them tosort of pressure, right?
It's not at that level. It's a
(26:41):
- Broader, not that kind of,- Yeah.
- The, the, the,- It hasn't
- Gone that zero COVID type of campaign.
- Okay. It hasn't, it hasn'tgone, it hasn't gone that far.
That's, that's a relief, I have to say.
So let me, let me ask you, I wanna,
I wanna talk more about China'srole on the global stage,
but let me just take a beat
and ask you how youdecided to study this field
(27:04):
of public health.
I mean, I think you are, youknow, certainly one of few
in the United States and in the world.
You are one of the top, you know,
experts in this space.
I mean, how did you decide
that this was somethingyou wanted to pursue?
- Well, thank you, Liz. I'lltake this the a, a compliment,
(27:26):
well, why I got hooked onglobal health and China.
Let me, well, certainlybecause I'm a Chinese, right?
That, that naturally, whenyou came to this country,
you wanted to study yourcountry, there's certain right
comparative advantages likelanguage or cultural, right?
(27:49):
But, but let me take youthrough this journey, right?
I started as a China specialist, right?
Diving deep into its policies
and institutions, you know,during my graduate study at
the U of Chicago.
So my dissertation focused onChinese health politics in the
(28:12):
post more era, right?
Essentially look at, youknow, how the state, you know,
tackled health issues
after those massive, you know,
liberal reforms kicked off, right?
So that was my first lovereally, you know, understanding
how China's political institutions shaped
its health policies by, in the mal era.
(28:35):
But when I graduated in 2000,
global health was juststarting to bubble up
as a field, right?
That it was not a huge field.
It was like almost like everybodyknows everybody community,
but it was this passionate community
by talking about health as a global issue,
(28:57):
not just the local one.
And also they talk about it
as a national internationalsecurity challenge,
not just a pure public health concern.
So I was intrigued, right?
It feel like, you know,the perfect bridge, right,
between my China expertiseand the bigger, right.
The award problems, right?
(29:18):
You know, then, you know,we have sars, right?
That hit in 2003,
and that was a wake upcall in highlight, right?
The health as a highpolitics issue, right?
So the outbreak showed
how faster my health crisiscould spew across borders,
and it sort of, you know,
cemented my interestingglobal health governance
(29:41):
and global health security, you know,
and, you know, that isWayne, you know, sitting hall
by the University School ofDiplomacy came calling, right?
That they hired me as aglobal health person, right?
To build their global health program.
You know, that was actuallyone of the first to tie health
to security and foreign policyin the professional school
(30:02):
of international affairs.
And that to me was a dream gig, right?
To shape something new and later, right?
I'm fortunate, I wasfortunate to become affiliated
with the Council on ForeignRelations, you know,
as a senior fellow for global health.
That gave me a bigger platformto blend my China knowledge
(30:23):
with global health challenges.
And also I was really, you know, lucky,
but I was able to work with great minds,
great colleagues like you, right?
On the China side and,you know, Laurie Garrett
and letter tomboy, you on theglobal health side, you know,
from there, by this isbeing a wide ride, you know,
(30:46):
writing books right?
On Chinese health politicstest testifying to Congress
and diving into everything fromChina's environmental health
crisis to its COVID response by, so it's,
it's all about connectingthe dots, you know,
between Chinese politics,Chinese policies,
and the world, the, I mean,the global health issues.
(31:09):
- Yeah. I mean, I, I think, you know,
it's also just you become sucha, such an incredible blend
of both, you know, scholarship, right?
As you said, the, the researchthat you do on the issues,
which is, you know, rigorous research,
but at the same time,there's an ability for you
to contribute to the debates
and sort of policies thataffect, you know, millions, tens
(31:32):
of millions of people globallyby sharing your knowledge
and your ideas.
So it's, it's both, it'slike a, a half academic
and not activist exactly,
but an element, right, ofactivism, of being able
to take your knowledge andreally make it worth something.
I think on the, on thelarger global stage, it's,
I think it's terrific.
(31:53):
So, okay, so a great, agreat career trajectory
that's led you to, Ithink, an important place.
So let's revert now.
Let me just touch on acouple of of final issues.
You know, China, despite,you know, the role
that it played in COVID as the originator,
(32:13):
despite the fact that itwas not as transparent
as should have been, despite the fact
that it used its control overpersonal protective equipment
in sometimes coercive waysto try to get countries,
you know, not to say anything bad about it
or, you know, use it for, for other
reasons has become an importantplayer in the global public
(32:37):
health diplomacy space, I think through
its health, silk Road, for example.
Talk a little bit about, and,
and I will say, you know, one
of the things I've foundinteresting just in some
of my own reading, is that it does seem
as though many countries emerging
and middle income economiesdon't look at China
(32:59):
as bearing the same kind of responsibility
that many European andadvanced economies do.
They have a differentperception of the role
that China played in COVID often
because China was providingthese countries with vaccines
when they couldn't get them,
for example, from the United States.
And notwithstanding the factthat those vaccines were not
(33:19):
as good as, you know, the uss
or, or other countries.
Nonetheless, they were veryappreciative of the fact
that China was selling them.
So talk a little bit about how the role
that China's playing on theglobal stage in terms of health
and health diplomacy, what itsambitions are, do you think,
(33:41):
and then I wanna finish
and talk a little bitabout the US China sort of
cooperation or competitionor how you see that emerging.
But first, let's talk about
how you see China playingon the global stage.
- Well, if you look atthis, it's the response
by toward the, the, the global, the,
(34:02):
the COVID-19 pandemic, right?
The, the people
often, you know, mentioned, right, this,
the vaccine diplomacy, right?
When I was visiting southeastAsian countries, you know,
the meeting with the, the, the scholars,
the government officials there,
(34:24):
but they all mentioned, right,that, that, you know, in the,
at the time in the way,
but the western countries,including United States,
were practicing the, theirvaccine nationalism, right?
Stockpiling the vaccines fortheir own population, right?
It was China, right? Who that
(34:45):
provided the batteryneeded the vaccines, right?
Even though by, you mightsay in terms of the efficacy
by the, maybe safety not
as good by as like the MI vaccines,
although that's debatableto some people, the,
(35:06):
you know, still, right?
The China was the first right
to provide those desperateneeded the medical supplies by
not just the vaccines, bytalking about the masks,
ventilators, you know, sothis is, you know, sort
of broadly defined, the vaccine diplomacy,
you might also call it, you know,
the health diplomacy, right?
(35:26):
The President Xi pledged theChinese vaccine would be a
global public good, youknow, that position China
as a leader, right?
In the global response.
And the countries didappreciate, you know, what
China was doing, right?
You know, survey data showed
(35:47):
that those initial gains, right?
That those 56% of thesurveyed countries, the,
the journalists, right, the, the
observed more positive media coverage
of China following the outbreak.
You, and in Southeast Asia,you know, China was perceived
as the most generous provider of the COVID
(36:10):
assistance, you know,
but those gains, you know, proved fragile
and fleeting, right?
The, especially with the rapid spread
of this highly transmissible, you know,
delta having omicron variants, you know,
we saw actually a steepdrop in the global delivery
of the Chinese vaccines.
You know, they since four, 2021, right?
(36:33):
Then the zero COVID policyinitially was marketed as a proof
of the, the, the effectivenessof the China's solution by
to the global pandemic,essentially, you know,
become a TROs, you know, when,
you know China was lockingdown Shanghai when spring 2022,
while the world moved on, I
(36:57):
this only projected theBrutalness not strength, you know?
And then, so by 20 22, 20 23, much
of that good will had evaporated, right?
The, the pure global attitudesurvey clearly showed by
that even after all thisefforts, by only 28%
of the respondents across 24 countries
(37:19):
say they had the favorable view
of China in spring 23, right?
Compared to 59% for the United States.
You know, but if you look at the, the,
the post COVID era, right?
China's health diplomacy, you know, the,
they have pivoted from emergency response
to institutionalized health engagement,
(37:41):
and they are playing thelong games strategically.
They've pledged 500 million to the WHO,
the World Health Organization
after, you know, Trump,
president Trump announcedthe withdrawal from the
International Health Organization.
They have increased healthrelated development assistance
to lower and middle income countries.
(38:01):
And where we, of course, the Be
and Road Health Sea Roadwas a key framework, right?
Which allowed China continueto invest in hospitals,
pharmaceutical production facilities,
public health capacitybuilding across Africa,
Southeast Asia, Latin America.
Well, these are tangible,visible projects,
(38:22):
but that creates soft power, right?
Dependency in a way simultaneously.
So I think, you know, the, you know,
president Trump's second termis absolutely critical, right?
To the strategist effectiveness, right?
Because it essentially might allow China
(38:46):
to sort of portray itself
as a defend of multilateralism, you know,
global health governance, you know,
China becomes the go-to partner
for countries dependent onforeign aid programs, you know,
and that essentially, right,
the changes the competitivedynamic fundamentally, right?
(39:10):
So, you know, China doesn'thave to significantly,
dramatically increase thishealth related development
systems to fill the void, you know, left
by the United States, right?
There just needs to be present
and why America is absent, right?
That's a much lower bar, right?
In this competition forglobal health leadership.
(39:33):
And so, you know,
you know, I think the, the, the,
you could say
by the current administrationisn't just an opportunity
for China, it's policy, notjust a present opportunity
for trying, it becomesa force multiply, right?
Because Beijing doesn't have
(39:54):
to be particularly goodat right health diplomacy
or significantly
or dramatically increase health related
development assistance.
They just have to be there,you know, when we are not,
you know, I think that shouldworry the United States
because leadership in globalhealth governance isn't just
about altruism,
(40:15):
it's about influence thestandard setting, right?
Agenda setting and shaping, right.
The rules of games forthe next health crisis.
So if we see that space,
we are gonna find it verydifficult to reclaim,
- Right?
Yeah, no, I, you're makinga point. I completely agree.
And, and I, I think aboutthis more broadly in terms
(40:37):
of the development assistance
and the shuttering of U-S-A-I-Dthat, you know, people say,
well, China's gonna fill the vacuum.
I said, it's not gonna fill the vacuum,
it's gonna do just enough.
You know? Exactly. To, because we're gone.
So it doesn't need, exactly as you said,
it doesn't need to do much.
It can go and, and supportthe rural reading program in
Cambodia for a million dollars,
(40:59):
and it's going to receive allsorts of, you know, accolades.
Just Exactly. Exactly.So I, I think we're,
we're very much on, onthe same page there.
And I think the other aspect,
and I'm, I'm curious whetheryou think this is, is accurate,
is that it also gives China all
of this health diplomacygives China the opportunity
to promote its traditionalChinese medicine,
(41:21):
Chinese made medical devices.
It becomes a, an economic play as well,
an export mechanism, right?
As you're saying a force multiplier,
but it, it also multipliesoppor other kinds
of opportunities for China.
When we pull out, I thinkit really enables them
to gain ground in other areaswhere the United States,
(41:41):
you know, may have also had advantages
because of our aid, youknow, linking to, you know,
US made medical devices orWestern made medical devices.
I think it's anotherEntry point for China.
Do you, do you agree with that or, or
- Oh yeah, absolutely, right.
That it is they, becauseif you look at by this,
the COVID diplomacy wherewhen we are, they are
(42:05):
actually exporting, right?
Their vaccines masks ventilators, right?
It's officially claim it'sas a global public good,
but it is not right if with the,
we believe that global publicgood means it's not excludable
by, if it's like, you know, joining is
(42:25):
of supply, right?
That they, you know, anythingbut global public good, right?
Is actually, look, the vaccinesChina shift overseas by
85% of them actually for commercial
or sale, you know, the, right.
So it's, you know, but by,
but by doing so, they're notjust, you know, you know,
(42:46):
expanding its geopolitical influence
and not just projecting soft power,
but also expand it bythe commercial, right.
The influence, right,
- Right.
Commercial influence and,
and opportunities forChinese companies. Right?
- Right.- So, so one last question.
I think, you know, thehealth, health space,
like the environment, whichyou know, I've worked on
(43:08):
for many years, is alwayssort of promoted as an area
for good US China cooperation, right?
Everybody says, well, we can cooperate
and health and the environment.
So in the current context,what do you see there?
Do you see any possibility
for cooperation in particulargiven what's going on in the
health space here in the United States?
(43:30):
I would imagine thatopportunities are much,
much diminished, but,
but maybe things are going onthat, that I don't know about.
- Well, well, Susan, well,
I think this is a great question, right?
That they are, you know, manypeople when we talk about,
you know, US Chinacorporation, you know, they,
this is just naive, right? Given the
(43:53):
- Throwaway a throwaway sortof health environment, right?
- Yeah. Given the geopoliticaltensions, given the lack
of trust, you know, and,
and well, this, one ofthe specific, right?
The, the hurdles is withthat COVID-19 origins, right?
This, this controversy, right?
Basically, many lawmakers heal, right?
(44:15):
That they say, well, you know
that if you want thecorporate US to cooperate
with China health first,let's fix this problem first.
If we, we can't even fix this,
they forget about any corporation, right?
So that is becoming one ofthe biggest hurdles, you know,
for US China Health Corporation. But, but
(44:37):
- I still just so I'm so yen,just so I'm clear by the,
the hurdle is the fact that China won't
acknowledge the actualorigin of the virus,
or what's the hurdle exactly?
- Well, the hurdle isbasically, this is all
what the WHO has been demanding.
I mean, the way this also hassolid, the w o's relationship
(44:57):
with China and the Dr.
Teros, you know, since
July, 2021, you know,
WHO has been requesting China to be trans,
to be cooperative, right?
In the second stage of the,
the investigation amongthe COVID nine, the origins
(45:18):
of COVID-19,
but the first, right, the stage was sort
of like a WHO China jointstudy conducted in the spring
of 2021.
You know, that they launcheda, a, a sort of a, a,
a report in, in end of March,you know, basically accepted,
you know, all the explanationsprovided by the Chinese side.
(45:40):
So, you know, that, you know,sort of actually damaged to
by the reputation, thecredibility in a way of the WHO
and the us right?
And then the, under the Trump 1.0, right?
They essentially also, I believe
that's basically awhitewashed report, right?
(46:00):
The, the want to Chinato be more forthcoming,
to be more transparent, right?
To be more cooperative, right?
In the, the, the original survey,
but, you know, China, sort of the,
the narrative here isthat, you know, a right,
(46:22):
that the, the pandemic
or the outbreak started in Wuhan
doesn't necessarily meanChina is the origin point,
was the origin point of the pandemic.
And second, right, that if, you know, you,
you believe that the lab leaks the problem
that caused the pandemic.
(46:43):
Let's also investigatefor Dietrich, you know,
your military labs herein the us you know, the,
so, you know, indicatingthat US could be a, a,
a origin point of the,the pandemic, right?
So you have that kind
of finger pointing right overthe origin of the pandemic.
That is becoming a, one ofthe biggest hurdles, you know,
(47:05):
for US China Health Corporation.
- Yeah. So no, no real prospect,
I think in the immediate future
for some breakthrough on health
cooperation. Is that fair to say?
- Right. Well, you feel,you know, actually it's,
in a way it's even worse by the,
so beginning 2020, right?
The since the,
(47:31):
the early spring that year, right?
And until
2023 last year,
24 last year, there was no high level
dialogue, you know, public health issues.
There was no, of course,
(47:52):
there was no serious discussionon corporation, right?
During the pandemic, but even
after the pandemic was over, right?
That we have, you know, that that accepted
for last year, right?
That there was a Chinesevice health minister visiting
Washington, you know,meeting his counterpart.
At HHS,
we have essentially no highlevel health dialogue, you know,
(48:16):
and even the, the, at theworking level, you know, now
with under the newadministration, our diplomats,
our health attach, well,
actually there's no formal health attach.
They are now is acting, they were very,
they're very cautious in terms
of reaching out theircounterparts in China.
(48:37):
That is very unusual, I would say,
I would say abnormal, right?
And this shouldn't be thecase, you know, as the,
when I was in Beijing,
a Chinese diplomacy professorat the leading top university
in China said, if there isno cooperation of health,
how could you expect theeffective corporation
(48:58):
in other areas?
It just to shows that dire state of
US China relations, unfortunately.
- Yeah, no, i, I, Itend to agree with you,
and I will say, I think even it was up
until like health diplomacywas up until the, you know,
second to last year, last yearof the Biden administration,
before we had real talkson commercial negotiations,
(49:20):
on military negotiations, the only thing
that was going on was reallythe climate change discussions.
And that was very much a sortof a, a personal, you know,
kind of love affair for, you know,
former Secretary Kerrywho was so committed
to climate change and had the personal
relationship with Shia Genis.
(49:41):
So yeah.
- And unfortunately, buteven that right there,
this walking group now asthe, i I think it is that the
corporation has also stalled,right? Under the numerous,
- Yeah, well, I'm, I'msure since we've pulled out
of the Paris Climate accord,
that there's not gonna be muchcooperation at the national
level on, on climate change.
Okay, last quick, threequestions, just boom, boom, boom.
(50:04):
So first question, whatbook would you recommend
to our viewers book
or article on China
that you think is really justexcellent and people should read?
- Well, I would recommend,you know, a, a book by won ds,
the title, the Breakneck, you know, that's
(50:24):
to have this interestingcomparison, you know, between the,
the governance in the US and China, right?
The, the, well, the, wellChina, according to the authors,
sort of managed by theengineers, the US governed
by lawyers, and they, theybelieve, you know, that sort
of shaped the different governance model
that explain why right now, you know,
(50:47):
China is quickly catchingup in this key, right,
the high tech areas bythe AI biotech, right?
The robotics, you name it,of course for the author want
to claim it's not thechairman leader. No, no,
- No, no.
And his name is, it's his English name.
Just to be clear, is DanWong. So you can Dan Wong.
(51:08):
So it's a little different, but Right.
So Dan Wong, yes, I agree.
It's a great book and I thinkit made it's New York Times
bestseller and I reviewedit for foreign affairs,
I think in the upcoming issue.
And it's really, I agree with you.
It's a great, it's aterrific, terrific read. Okay.
What issue in China, let's putaside public health though.
What issue about China
or in China do you thinkAmericans don't really understand
(51:31):
or need to know more about?
What, what do you know
that other people don'tknow that they should?
- Well, I think whatset aside public health,
I think it was, I, I'm stillsort of puzzled, you know,
by these, you know, sort ofalmost like over the past,
just a couple of years you've seen, right,
(51:53):
the China quickly catching up, right?
In the high tech area, right?
The, well, biotech is avery good example, right?
Just years ago, we are still,
when we talk about China'sinnovation capability,
which says, well, they'remaking good progress,
but it's going to be a longway before they can catch up.
But now guess what? Why?
(52:14):
They're not just catching up,
but in some areas they become,
they're becoming a leader, right?
And in a way, this is creatingsort of the, another kind
of dependence, you know,in addition to the APIs,
active pharmaceutical ingredients,key starting materials,
but this innovative drugs and,
(52:34):
and biosimilar molecules, youknow, they are, you know, like
we are becoming increasinglydependent upon them.
If you look at by the, this,the number of deals by the o of
the, of the licensing, right?
The, the, with the signwith the Chinese companies,
(52:56):
you know, this is, I found itvery, you know, interesting,
especially if you think aboutthis, you know, this era
of economic slow down, right?
Well, you know, unemploymentrate of the use is
so high, right?
That the consumption level is low.
You know, the real industryis like all probably seems the
(53:20):
almost, you know, all like a is
in such a bad shape, you know,how could that happen, right?
- Yeah. No, I think that's, that's great.
And actually I'll do a littleplug for our, our, our next
podcast, which is gonna be with Dr.
Ch Lee, who is a well-known geneticist
(53:43):
and works on biotech issuesand, and on cancer drugs
and goes between Chinaand the United States.
And he's gonna talk to usexactly about innovation
and science and technology,
particularly in the biotech field.
So thank you, thank youfor that leading Yanzhong.
But one last question for you.
If you had a recommendation
(54:03):
for the Trump administration right now,
either thinking in termsof US China competition
or cooperation, what, what would it be?
- Well, I, I would sayprincip support engagement.
I was, you know,
it is interesting when youask this question, just
finish this, the part ofthe, at tribute to our
(54:25):
old colleague Jerry Cohen, right?
He was the person, right?
That I think, you know,
if there's something Iremember the most, in the most,
it was this, I, right?
He's the commitment to,you know, rule of law
and human rights.
So he is the principled person,
but I also had this flexibility, right?
(54:48):
That in dealing with peoplewith opposed views, right?
So that is how he was admired,respected in both sides
of the Taiwan Street, youknow, so, you know, I think,
you know, he, as I I I saidin the tribute, you know, that
this principled engagementjust to show, you know,
(55:09):
that when we are dealingwith, well sort of
give a example, right?
This, the suggestingthat when we are dealing
with like a geopoliticalright rival like China, even,
we disagreed upon many things.
I think engagement
and even cooperation remains
(55:29):
possible and vital.
- And that is a great note to end on.
And, and thank you for the reminder
of our truly wonderfulcolleague Jerry Cohen,
who passed away just recently, you know,
towering figure in the fieldof China, legal studies,
someone who spanned both,you know, the corporate work,
(55:52):
government work, andof course was renowned
for his work on Chinesehuman rights issues as well.
So Yan Jang, thank you so muchfor a really rich discussion.
I expect no less fromyou from one of the best
and top figures in the field,
so I appreciate your takingthe time to speak with us.
(56:12):
- Thank you, Liz.- If you enjoyed today's podcast
and would like to hear moreinformed discussion about China,
please subscribe to theHoover YouTube channel
or your favorite podcast platform.
- Welcome to China
Considered a podcastthat brings fresh insight
and informed discussion to one
of the most consequentialissues of our time,
how China's changingand changing the world.
I'm Liz, Economy, Hargrove Senior Fellow
and co-director of theProgram on the US, China,
and the World at the Hoover Institution at
Stanford University.
Today we're gonna talk aboutChina and public health.
It may seem like a niche issue,
(00:29):
but from everything that theworld has seen with regards
to SARS and then with COVID, we know that
what China does at homehas enormous implications
for the rest of the world.
And to guide us on ourdiscussion, we're very fortunate
to have Yanzhong Huang.
He is a Senior Fellow at theCouncil on Foreign Relations
and a professor at Seton Hall University.
He's also the author most recently
(00:50):
of toxic politics inin-depth exploration into
how China's environmentalproblems contribute
to its health problems.
Welcome, Yanzhong. It's greatto have you with us.
- Well, thank you, Liz, for having me.
- So let's start with what'sgoing on inside China.
You have, I think, followedChina's public health system
(01:11):
for probably longer than almostanybody else in the field.
What kind of changes have youseen over time since you first
began studying, you know,China's public health system?
What has, what has really struckyou most about the changes
and what hasn't changed?
- Well, I think if you just look at the,
(01:33):
the, the public healthsystem in China, right,
that you've seen, right?
The, you know, they are makingsignificant strides, right?
With average life expectancyrising to 78.5 years.
That up, that was up from 77 2020.
They've made so much progressin biotech, you know,
(01:55):
that there is nowbecoming a global leader.
You know, quickly catchingup with the United States.
If you look at the data,you know, 20, 25, 30 7%
of molecules licensed
by major pharma firmsoriginated from China, right?
The, you know, they, youknow, also, you know,
(02:16):
major changes in,
I would say challenges, you know,
that are happening in thepopulation by population.
Aging certainly is acute.
Now, 20% of the population,
we are talking about nearly300 million aged over 60.
(02:36):
They have non-communicablediseases we call NCDs.
And they cause more than 80%of the death in China. That is
- Exactly, what are thoselike, that's like what?
Cancer, obesity, diabetes. These are ncd,
- Yeah.
We call the, the cancer,diabetes, you know,
cardiovascular disease, disease.
But all, all those issues, you know,
(02:58):
like respiratory conditions, you know, so,
and their risk factors youconsider like obesity, right?
Approximately 50% of Chineseadults are overweight
or obese according to a 2020 report.
Smoking continue to be a challenge, right?
Over 50% of the adultmen in Shriners smoke.
(03:21):
And there's, you know,infectious diseases continue
to be a challenge, right?
That is exemplified by the, this year,
by the, in the summer, right?
The, the chi gonia outbreakin Guangdong, right?
That started for Shang, you know, driven
by mosquito boom transmission,you know, raising concerns
(03:42):
for open spread.
You know, there are allthese challenges of problems.
But in the meantime, if you look at the,
the public health infrastructure, right?
Continue to be centrally coordinated
by the National HealthCommission, you know,
that oversees a vast network
of over 1 million healthcare facilities,
including state owned tertiary hospitals,
(04:05):
community health centers,specialized in centers
for disease control and prevention.
They call it also CDC, right?
But, you know, they haveCDCs at national prevention
and local levels, right?
Universal bail,
basic medical insurancenow covers over 95%
of the population.
(04:26):
You know, but you know, the,you know, the benefits varies,
depends on what schemesyou are subscribed.
The, and, you know,
the local government now arefacing in the post COVID year,
all this fiscal challengesin providing, right.
The, the public services, right?
(04:48):
And the, they're trying to fixthe loopholes, you know, left
by, in the post COVID era, right?
The, the public health system,you know, with this, the,
this newly revised infectiousdisease law, you know,
now encouraged for, which Ifound this is very interesting.
(05:08):
Now, finally, by thislaw effective, you know,
this last month encouragedthe individual sharing
and reporting disease relatedinformation by, you know,
mentioning that entities
and individuals will reportin good faith eligible
for rewards and exempt fromliability if the event is
(05:31):
later rolled out.
So, so yeah, we're seeing bothchallenges, you know, changes
and also stability inthe system, essentially.
- I mean, it used to bethe case that, you know,
doctors were not paid well.
So the medical profession, it was hard
to attract people sometimes.
(05:51):
Is that, has that changed?
Has investment, has government investment
in the practice medicine,for example, improved so
that now you're gettingmore and better doctors
and they're getting paid more?
- Well, well, in, in the United States,
but typical that you have,you know, the, the, the, some
of the best brightest people, right?
(06:13):
When go to a medicalschool, you know, that
is not the case in China.
The, although, you know, weare seeing over the past year,
this seems to be improving.
You have more people getinterested, you know,
studying at the medicalschools in top universities.
(06:34):
But I think for those doctors
who work at the, you know, thegrassroots level, you know,
even township health centers still, right?
They, they, there arefew people who trained,
you know, receive formal training, right?
To walk by in at that level, you know,
(06:55):
even though we were assignedto those institutions,
you know, still, right?
That you would try your best
to get into like a countyhospital urban hospital
because the pay is, you know,not good, is you have to,
you know, rely on, you know, basic salary,
which is really small,not attractive at all.
(07:16):
But in those institutions, you know, you,
if you rely on bonus, but the,you have to count on demand,
but the demand for theirservice is really still small.
People would still preferto bypass institutions
for urban health centers.
- Oh, interesting. And that of course,
also prompted anotherchallenge in, in sort
of the public health system,which was corruption, right?
(07:39):
Because you had a system
where the doctorsweren't making any money,
and so people would paythem extra to get seen,
or they would overcharge for medicines.
How, you know, effectively has, you know,
Xi Jinping's ongoingcampaign against corruption.
Now, I think it must be in its 13th year.
How effective has thatbeen in the medical field?
(08:01):
- Well, actually launched a, a,
a anti-corruption campaignin the medical sector in
2023, right after
- Oh, late. Oh, late, okay.
- I, yeah, the end of the, theCOVID pandemic, you know, so
this campaign so far has punished,
I believe over 40,000 people,
including like hospitalmanagers, you know,
(08:23):
the health officials by whoare involved in procurement
and bribes, you know, the,
although that enforcementgaps remain the, you know,
and that campaign continued that there is,
the government has not indicatewhen this is going to end.
I assume that if thatall systematic, you know,
(08:48):
problems, you know, sustained,there's no way to get rid
of all this corruptions in this sector,
- Right?
I mean, I think we've seenthat in many other sectors like
the military where itseems to be a never ending
- Candidate exactly.
- Against corruption.
So perhaps the same willunfortunately be true in
(09:09):
the, in the medical sector.
So let's talk a little bit about COVID
and what you've seen post COVID in terms
of the government's response.
I have to say, I was speaking
at a media round tablethe other day to a bunch
of journalists, and one ofthem asked me whether I thought
that China had been sufficiently punished
(09:32):
or had sufficiently takenresponsibility for COVID.
I wonder how you wouldanswer that question.
I mean, do you think
that China has been heldsufficiently accountable
for its role in COVI and its spread?
- Well, this is the, well,
(09:55):
interesting question, right?
I, I think in a way, like inFebruary, like early February
after Lee Leon died, youknow, the, by the way,
what Leon was the whistle blower, right?
That, you know, right? Theshare the information about the
upcoming, you know, pandemic.
And he was then punished, right?
(10:17):
And then he died from the, the, the, the,
the COVID himself, right?
So at that time whereyou, you have seen, right,
this is sort of like a China'sby noble moment, you know,
people really, you know,
like demanding accountability,you know, the, you know,
(10:37):
the flooded the internet, right?
Showing their dysplasia and frustration.
But I think, you know,
and many people I thought that what leads
to transformative political change, right?
But, you know, instead was followed by,
by the information, youknow, cracked down by more
(11:01):
tightened political control.
And so, you know, this, the, one
of the lessons we've learnedthat there all this major,
you know, crisis not alwaysfollowed by, you know,
liberalization ortransformative political change.
(11:22):
China, it might be the opposite
is true, you know, the, but,
but I think, you know, it's really, I,
I found it really fascinatingwhen I was studying, right?
That there's the, the, thestate response, you know,
to the, the, the pandemic.
(11:42):
You know, it's justthat kind of resilience.
I found very, you could say
impressive, you know, the, you know, if,
if you consider rightthis, this, this swing
between different political modes, right?
(12:04):
This, I think this is themost striking thing, right?
The, it's capacity for sudden
dramatic pivotals without apparent
legitimacy cost, right?
If you think about theshifts we witnessed,
right from initialinaction by December, 2019
and early January, 2020 tothe decisive lockdown of Wuhan
(12:29):
in late January, 2020,you know, then the swing
to overreaction with draconianzero COVID for three years,
but then almost overnightby, in early December, 2022,
there's a complete, there wasa complete reversal, right?
Sudden reopening with minimal preparation,
and then COVID justdisappeared from public
(12:52):
discourse entirely.
Like, you know, nothinghad ever happened, right?
So nobody mentioned it anymore,you know, so, you know, I,
I find, you know, this, this, that kind
of adaptability, or mayberesilience is the better word.
It tells us something profoundabout how the system operates
(13:13):
and maintains control.
- So I think that's really interesting.
Let me ask two follow-upquestions on that.
So first, what's yourexplanation for that?
I think it was a Decemberdecision to just lift the controls
and, you know, overnight,as you said, without thought
(13:34):
to some kind of ensuring thatpeople would be protected
or even the elderlysomehow, that, that, what,
what do you think wasbehind the decision at
that very moment?
And then do you think
that COVID is still anissue in people's heads?
I mean, despite the factthat it's not talked about,
is it still in the minds of, you know,
(13:57):
people in Chinese society?
I mean, presumably many peoplelost loved ones, you know,
to COVID as they did here inthe United States, of course,
you know, is it somethingthat's not talked about, but
nonetheless still has lessons, you know,
that people have taken away?
And what would those lessons be?
(14:18):
- Well, well, first of all,when we talk about the forces
or factors that led toby the reopening, right?
You know, certainly you couldhave, you know, the confluence
of factors, but the influences by the,
but you know, I think, youknow, we still need, right,
the more information, right?
And what exactly happened, right?
(14:39):
In Hai, you know, thatmade, you know, the,
the government leaderto make that decision
to completely right, ditch the zero COVID.
And we could just, you know,list some of the, you know,
the factors we know, right?
That, that, for example,by that time, by, you know,
(14:59):
November, December, 2022, it was clear by
that approach no longer sustainable right?
Diminishing returnsproblems, very clear, right?
And there was also by, according to
the media reports by those reporters,
was based in Beijing, youknow, they also, you know,
(15:22):
you know, talk about, foundthe information suggesting
that government wasseriously considering, right?
The having a, you know,a new strategy, right.
To replace by the zero COVID, you know?
But you know, that still,I did not explain why,
but the change come,came so sudden, right?
(15:45):
With so minimal preparation.
And it seems to be irrational, right?
That the, so, you know, I, I,
I think certainly why in thatsense, the November, you know,
2022, all this protest, right?
In Beijing, Shanghai
and Elsewell played a sort of like,
(16:07):
you know, you know, sort ofa transformative role here.
You know, that when the leaders, you know,
actually might solve, youknow, from the, you know, the,
the, the, the footage rest the,of this pro that, you know,
the, the, the people wereso frustrated, right?
That even, right, thatthere's this sort of like the,
(16:30):
the largest protest, you know,since 1989 in a way, right?
And then there also, right,there's clear, right,
the regime legitimacy implicationsthere from the slogans.
They were enchanting.The, I think, you know,
they were really shockedin my understanding.
(16:51):
And then I think the,
maybe what this, again,
we don't know the exact details there.
Some talk about this like sort
of revenge reopening, youknow, that is that, well, this,
this is what you want, right?
You want reopening, youwant ditch the zero COVID,
(17:11):
you got it, right.
You know? Wow. So it's that kind of,
but we still, again, wedon't have enough information
to make sort of
affirmative conclusion, youknow, on the, the forces
that lead to the change.
(17:32):
- Yeah. And what about whetherCOVID still sits in the
back of people's minds?
I mean, you continue to go back
and forth to China, you doyour research, you, you know,
have friends and, and family there.
I mean, is this somethingthat people still talk about?
Is it raised is, you know,do people say, you know,
should we be concerned aboutanother pandemic of some sort?
(17:55):
How does, how does itplay out do you think,
broadly within society?
- Well, again, officially,right, both state media,
social media, right, thatyou seldom heard, right?
This term COVID, right?
They have those, you know,other terms, you know, replacing
that we call it like duringthe special times, during the,
(18:17):
the mask era, right?
This, the, you know, so clearly
what this still like politicallysensitive issue, taboo,
aerial, you know, that discouragepublic discussion, right?
The, the pandemic, you know,
the state re the governmentresponse to it, you know?
(18:40):
But, but you know, again,the problem is that you have
that many people, right?
Who died by the, during theCOVID, especially by the, during
that maybe 35 days
after the December seven, December 7th,
by 2022.
You know, we, we, we have met people
who lost their loved ones by the, during
(19:02):
that period of time.
You know, they were, you know,
certainly not happy with that.
You know, the, I I, I can tell, right?
That that kind of emotion, right,
that was suppressed, right?
The, there, the one personjust said, you know,
I feel I need to do something,
(19:23):
but in the meantime, Ialso feel like I'm numb.
You know, this kind of numb, you know that
in Chinese, right?
It's so you don't get a clear sense
what exactly people are thinking about.
It's kind of very feeling thatwas difficult to describe.
Maybe it will disappearover time, you know,
(19:46):
but, you know, who knowsif that become part
of the collective memory ofthe society, you know, when
the, you know, social politicalconditions change, you know,
they might, you know, like become
- Part of the process,- Right?
(20:06):
It is just like, you know,they great leap forward, right?
That, you know, they becomeimportant imp, impacters,
you know, for the post more rural reform
- Yeah.
Reform. So that's really interesting.
So you, you mentioned, you know,
one change in Chinesepolicy in terms of reporting
(20:28):
when you know you are sick
or reporting on a potential disease
that people will be rewarded in some way
and not punished
and not punished if itturns out not to be true.
Are there other importantchanges that you think have come
as a result of like,lessons learned from COVID
(20:51):
by the Chinese government issues
around greater transparency,public transparency,
or, you know, differentways that health, you know,
is being monitored in society?
I assume those bracelets areno longer part of, you know,
everyday life in China, is that right?
The ones that we're trackingpeople's, you know, exposure
(21:13):
to COVID, ostensibly,
- Well, COVID is still there, right?
And it's still spreading in,in, in the country, right?
And across the globe, right?
It's just that, you know,
now it's no longerconsidered a public health
threat, you know, a majorpublic health threat, right?
(21:34):
The, if you consider all this, the,
the government actions on chicken Goya
outbreak in Guangdong, right?
That the sort of, thatwas remini reminiscent
of the zero COVID approaches, right?
To a localized outbreak,
which is certainly much,you know, much less federal,
(21:57):
you know, than COVID-19 in 2020.
So we have seen by this, you know,
this revised infectiousdisease law, you know,
that seems to like the, well
after, you know, finally bythe, I thought that there was,
(22:20):
you know, basically littlepublic discussion, right?
Right. What we did, right?
What we did wrong, you know,during, you know, COVID-19,
you know, how do we get,are we going to fix, right?
That this loopholes mightexpose during the system, right?
That, that, you know, the, it seems to be
(22:42):
by, you don't see
that kind of, right.
The scale of,
with this public health investments we saw
after, you know, sas, right?
In 2003, right
after sars, there was,you know, you don't,
there was not just a, likea, you know, transparency,
(23:06):
you know, the sort of this
investment in public health.
In fact, if you visit any ofthe provincial by the CDC,
by those state of art buildings, labs,
they were almost all build,you know, in the wake
of sars, you know, outbreak.
(23:26):
But you don't see thatkind of similar level
of investment, right?
In the post COVID era.That is my impression.
And certainly what that hassomething to do with the local
financial capacity,
because right, we know thelocal government, right?
The debt reading, you know, the
and era economic slow down, right?
(23:49):
That they really didn't havethat much in interest, right?
Incentive right. To investin public health, you know.
But at the central level,we have seen like this, some
of the, like the anti graphiccampaigns, you know, launch
(24:09):
of the healthy China, you know, 20,
30 more state intervention, you know,
like managing people's weight.
But that, that does seems,doesn't seem to have anything
with like a future pandemicpreparedness, you know,
and response.
- So what, what do you, when you say
that the government ismanaging people's weight,
(24:31):
they're not, they're notgoing in there like the family
planning offices, are they?
And actually weighing peopleand, and checking on them.
- No, no, it's not like that.
Well, that's the, but,
but it, it sort of stillreminds me this sort
of like a recurring, right?
This the, is the, the,this biopower, right?
(24:51):
The, you have this sort of more,
it's like a form, you know,as a fail approach, right?
In dealing with sort ofindividual lifestyle diseases,
you know, like, youknow, overweight, right?
The not diseases risk factors, right?
(25:12):
Or this is like obesity.
The, you now you see thegovernment is taking action, right?
In those areas, you know,that clearly show, you know,
that the government, youknow, wants to do more, right?
In this field.
But it also represents sortof like a subtle, right, the
(25:35):
state penetration right to people's lives,
but in order to achieve
by this macro health objectives. Right?
- I see. So, so more informationcampaigns and sort of
- Yeah, health, wellness,education, you know, the,
(25:57):
the campaigns, you know,maybe also provide some
incentives for people to sort of,
you know, exercise constrained, right?
In the, their diet habits,you know, that we are seeing
that there's people validatingin China more concerned
by their weight, this how,you know, this, like this,
(26:20):
you know, the weight reductionby those, the camps become
so, and drugs become sopopular now in China.
- Interesting. Interesting. Okay.
But not, but not in terms
of the government actuallytaking individuals and,
and subjecting them tosort of pressure, right?
It's not at that level. It's a
(26:41):
- Broader, not that kind of,- Yeah.
- The, the, the,- It hasn't
- Gone that zero COVID type of campaign.
- Okay. It hasn't, it hasn'tgone, it hasn't gone that far.
That's, that's a relief, I have to say.
So let me, let me ask you, I wanna,
I wanna talk more about China'srole on the global stage,
but let me just take a beat
and ask you how youdecided to study this field
(27:04):
of public health.
I mean, I think you are, youknow, certainly one of few
in the United States and in the world.
You are one of the top, you know,
experts in this space.
I mean, how did you decide
that this was somethingyou wanted to pursue?
- Well, thank you, Liz. I'lltake this the a, a compliment,
(27:26):
well, why I got hooked onglobal health and China.
Let me, well, certainlybecause I'm a Chinese, right?
That, that naturally, whenyou came to this country,
you wanted to study yourcountry, there's certain right
comparative advantages likelanguage or cultural, right?
(27:49):
But, but let me take youthrough this journey, right?
I started as a China specialist, right?
Diving deep into its policies
and institutions, you know,during my graduate study at
the U of Chicago.
So my dissertation focused onChinese health politics in the
(28:12):
post more era, right?
Essentially look at, youknow, how the state, you know,
tackled health issues
after those massive, you know,
liberal reforms kicked off, right?
So that was my first lovereally, you know, understanding
how China's political institutions shaped
its health policies by, in the mal era.
(28:35):
But when I graduated in 2000,
global health was juststarting to bubble up
as a field, right?
That it was not a huge field.
It was like almost like everybodyknows everybody community,
but it was this passionate community
by talking about health as a global issue,
(28:57):
not just the local one.
And also they talk about it
as a national internationalsecurity challenge,
not just a pure public health concern.
So I was intrigued, right?
It feel like, you know,the perfect bridge, right,
between my China expertiseand the bigger, right.
The award problems, right?
(29:18):
You know, then, you know,we have sars, right?
That hit in 2003,
and that was a wake upcall in highlight, right?
The health as a highpolitics issue, right?
So the outbreak showed
how faster my health crisiscould spew across borders,
and it sort of, you know,
cemented my interestingglobal health governance
(29:41):
and global health security, you know,
and, you know, that isWayne, you know, sitting hall
by the University School ofDiplomacy came calling, right?
That they hired me as aglobal health person, right?
To build their global health program.
You know, that was actuallyone of the first to tie health
to security and foreign policyin the professional school
(30:02):
of international affairs.
And that to me was a dream gig, right?
To shape something new and later, right?
I'm fortunate, I wasfortunate to become affiliated
with the Council on ForeignRelations, you know,
as a senior fellow for global health.
That gave me a bigger platformto blend my China knowledge
(30:23):
with global health challenges.
And also I was really, you know, lucky,
but I was able to work with great minds,
great colleagues like you, right?
On the China side and,you know, Laurie Garrett
and letter tomboy, you on theglobal health side, you know,
from there, by this isbeing a wide ride, you know,
(30:46):
writing books right?
On Chinese health politicstest testifying to Congress
and diving into everything fromChina's environmental health
crisis to its COVID response by, so it's,
it's all about connectingthe dots, you know,
between Chinese politics,Chinese policies,
and the world, the, I mean,the global health issues.
(31:09):
- Yeah. I mean, I, I think, you know,
it's also just you become sucha, such an incredible blend
of both, you know, scholarship, right?
As you said, the, the researchthat you do on the issues,
which is, you know, rigorous research,
but at the same time,there's an ability for you
to contribute to the debates
and sort of policies thataffect, you know, millions, tens
(31:32):
of millions of people globallyby sharing your knowledge
and your ideas.
So it's, it's both, it'slike a, a half academic
and not activist exactly,
but an element, right, ofactivism, of being able
to take your knowledge andreally make it worth something.
I think on the, on thelarger global stage, it's,
I think it's terrific.
(31:53):
So, okay, so a great, agreat career trajectory
that's led you to, Ithink, an important place.
So let's revert now.
Let me just touch on acouple of of final issues.
You know, China, despite,you know, the role
that it played in COVID as the originator,
(32:13):
despite the fact that itwas not as transparent
as should have been, despite the fact
that it used its control overpersonal protective equipment
in sometimes coercive waysto try to get countries,
you know, not to say anything bad about it
or, you know, use it for, for other
reasons has become an importantplayer in the global public
(32:37):
health diplomacy space, I think through
its health, silk Road, for example.
Talk a little bit about, and,
and I will say, you know, one
of the things I've foundinteresting just in some
of my own reading, is that it does seem
as though many countries emerging
and middle income economiesdon't look at China
(32:59):
as bearing the same kind of responsibility
that many European andadvanced economies do.
They have a differentperception of the role
that China played in COVID often
because China was providingthese countries with vaccines
when they couldn't get them,
for example, from the United States.
And notwithstanding the factthat those vaccines were not
(33:19):
as good as, you know, the uss
or, or other countries.
Nonetheless, they were veryappreciative of the fact
that China was selling them.
So talk a little bit about how the role
that China's playing on theglobal stage in terms of health
and health diplomacy, what itsambitions are, do you think,
(33:41):
and then I wanna finish
and talk a little bitabout the US China sort of
cooperation or competitionor how you see that emerging.
But first, let's talk about
how you see China playingon the global stage.
- Well, if you look atthis, it's the response
by toward the, the, the global, the,
(34:02):
the COVID-19 pandemic, right?
The, the people
often, you know, mentioned, right, this,
the vaccine diplomacy, right?
When I was visiting southeastAsian countries, you know,
the meeting with the, the, the scholars,
the government officials there,
(34:24):
but they all mentioned, right,that, that, you know, in the,
at the time in the way,
but the western countries,including United States,
were practicing the, theirvaccine nationalism, right?
Stockpiling the vaccines fortheir own population, right?
It was China, right? Who that
(34:45):
provided the batteryneeded the vaccines, right?
Even though by, you mightsay in terms of the efficacy
by the, maybe safety not
as good by as like the MI vaccines,
although that's debatableto some people, the,
(35:06):
you know, still, right?
The China was the first right
to provide those desperateneeded the medical supplies by
not just the vaccines, bytalking about the masks,
ventilators, you know, sothis is, you know, sort
of broadly defined, the vaccine diplomacy,
you might also call it, you know,
the health diplomacy, right?
(35:26):
The President Xi pledged theChinese vaccine would be a
global public good, youknow, that position China
as a leader, right?
In the global response.
And the countries didappreciate, you know, what
China was doing, right?
You know, survey data showed
(35:47):
that those initial gains, right?
That those 56% of thesurveyed countries, the,
the journalists, right, the, the
observed more positive media coverage
of China following the outbreak.
You, and in Southeast Asia,you know, China was perceived
as the most generous provider of the COVID
(36:10):
assistance, you know,
but those gains, you know, proved fragile
and fleeting, right?
The, especially with the rapid spread
of this highly transmissible, you know,
delta having omicron variants, you know,
we saw actually a steepdrop in the global delivery
of the Chinese vaccines.
You know, they since four, 2021, right?
(36:33):
Then the zero COVID policyinitially was marketed as a proof
of the, the, the effectivenessof the China's solution by
to the global pandemic,essentially, you know,
become a TROs, you know, when,
you know China was lockingdown Shanghai when spring 2022,
while the world moved on, I
(36:57):
this only projected theBrutalness not strength, you know?
And then, so by 20 22, 20 23, much
of that good will had evaporated, right?
The, the pure global attitudesurvey clearly showed by
that even after all thisefforts, by only 28%
of the respondents across 24 countries
(37:19):
say they had the favorable view
of China in spring 23, right?
Compared to 59% for the United States.
You know, but if you look at the, the,
the post COVID era, right?
China's health diplomacy, you know, the,
they have pivoted from emergency response
to institutionalized health engagement,
(37:41):
and they are playing thelong games strategically.
They've pledged 500 million to the WHO,
the World Health Organization
after, you know, Trump,
president Trump announcedthe withdrawal from the
International Health Organization.
They have increased healthrelated development assistance
to lower and middle income countries.
(38:01):
And where we, of course, the Be
and Road Health Sea Roadwas a key framework, right?
Which allowed China continueto invest in hospitals,
pharmaceutical production facilities,
public health capacitybuilding across Africa,
Southeast Asia, Latin America.
Well, these are tangible,visible projects,
(38:22):
but that creates soft power, right?
Dependency in a way simultaneously.
So I think, you know, the, you know,
president Trump's second termis absolutely critical, right?
To the strategist effectiveness, right?
Because it essentially might allow China
(38:46):
to sort of portray itself
as a defend of multilateralism, you know,
global health governance, you know,
China becomes the go-to partner
for countries dependent onforeign aid programs, you know,
and that essentially, right,
the changes the competitivedynamic fundamentally, right?
(39:10):
So, you know, China doesn'thave to significantly,
dramatically increase thishealth related development
systems to fill the void, you know, left
by the United States, right?
There just needs to be present
and why America is absent, right?
That's a much lower bar, right?
In this competition forglobal health leadership.
(39:33):
And so, you know,
you know, I think the, the, the,
you could say
by the current administrationisn't just an opportunity
for China, it's policy, notjust a present opportunity
for trying, it becomesa force multiply, right?
Because Beijing doesn't have
(39:54):
to be particularly goodat right health diplomacy
or significantly
or dramatically increase health related
development assistance.
They just have to be there,you know, when we are not,
you know, I think that shouldworry the United States
because leadership in globalhealth governance isn't just
about altruism,
(40:15):
it's about influence thestandard setting, right?
Agenda setting and shaping, right.
The rules of games forthe next health crisis.
So if we see that space,
we are gonna find it verydifficult to reclaim,
- Right?
Yeah, no, I, you're makinga point. I completely agree.
And, and I, I think aboutthis more broadly in terms
(40:37):
of the development assistance
and the shuttering of U-S-A-I-Dthat, you know, people say,
well, China's gonna fill the vacuum.
I said, it's not gonna fill the vacuum,
it's gonna do just enough.
You know? Exactly. To, because we're gone.
So it doesn't need, exactly as you said,
it doesn't need to do much.
It can go and, and supportthe rural reading program in
Cambodia for a million dollars,
(40:59):
and it's going to receive allsorts of, you know, accolades.
Just Exactly. Exactly.So I, I think we're,
we're very much on, onthe same page there.
And I think the other aspect,
and I'm, I'm curious whetheryou think this is, is accurate,
is that it also gives China all
of this health diplomacygives China the opportunity
to promote its traditionalChinese medicine,
(41:21):
Chinese made medical devices.
It becomes a, an economic play as well,
an export mechanism, right?
As you're saying a force multiplier,
but it, it also multipliesoppor other kinds
of opportunities for China.
When we pull out, I thinkit really enables them
to gain ground in other areaswhere the United States,
(41:41):
you know, may have also had advantages
because of our aid, youknow, linking to, you know,
US made medical devices orWestern made medical devices.
I think it's anotherEntry point for China.
Do you, do you agree with that or, or
- Oh yeah, absolutely, right.
That it is they, becauseif you look at by this,
the COVID diplomacy wherewhen we are, they are
(42:05):
actually exporting, right?
Their vaccines masks ventilators, right?
It's officially claim it'sas a global public good,
but it is not right if with the,
we believe that global publicgood means it's not excludable
by, if it's like, you know, joining is
(42:25):
of supply, right?
That they, you know, anythingbut global public good, right?
Is actually, look, the vaccinesChina shift overseas by
85% of them actually for commercial
or sale, you know, the, right.
So it's, you know, but by,
but by doing so, they're notjust, you know, you know,
(42:46):
expanding its geopolitical influence
and not just projecting soft power,
but also expand it bythe commercial, right.
The influence, right,
- Right.
Commercial influence and,
and opportunities forChinese companies. Right?
- Right.- So, so one last question.
I think, you know, thehealth, health space,
like the environment, whichyou know, I've worked on
(43:08):
for many years, is alwayssort of promoted as an area
for good US China cooperation, right?
Everybody says, well, we can cooperate
and health and the environment.
So in the current context,what do you see there?
Do you see any possibility
for cooperation in particulargiven what's going on in the
health space here in the United States?
(43:30):
I would imagine thatopportunities are much,
much diminished, but,
but maybe things are going onthat, that I don't know about.
- Well, well, Susan, well,
I think this is a great question, right?
That they are, you know, manypeople when we talk about,
you know, US Chinacorporation, you know, they,
this is just naive, right? Given the
(43:53):
- Throwaway a throwaway sortof health environment, right?
- Yeah. Given the geopoliticaltensions, given the lack
of trust, you know, and,
and well, this, one ofthe specific, right?
The, the hurdles is withthat COVID-19 origins, right?
This, this controversy, right?
Basically, many lawmakers heal, right?
(44:15):
That they say, well, you know
that if you want thecorporate US to cooperate
with China health first,let's fix this problem first.
If we, we can't even fix this,
they forget about any corporation, right?
So that is becoming one ofthe biggest hurdles, you know,
for US China Health Corporation. But, but
(44:37):
- I still just so I'm so yen,just so I'm clear by the,
the hurdle is the fact that China won't
acknowledge the actualorigin of the virus,
or what's the hurdle exactly?
- Well, the hurdle isbasically, this is all
what the WHO has been demanding.
I mean, the way this also hassolid, the w o's relationship
(44:57):
with China and the Dr.
Teros, you know, since
July, 2021, you know,
WHO has been requesting China to be trans,
to be cooperative, right?
In the second stage of the,
the investigation amongthe COVID nine, the origins
(45:18):
of COVID-19,
but the first, right, the stage was sort
of like a WHO China jointstudy conducted in the spring
of 2021.
You know, that they launcheda, a, a sort of a, a,
a report in, in end of March,you know, basically accepted,
you know, all the explanationsprovided by the Chinese side.
(45:40):
So, you know, that, you know,sort of actually damaged to
by the reputation, thecredibility in a way of the WHO
and the us right?
And then the, under the Trump 1.0, right?
They essentially also, I believe
that's basically awhitewashed report, right?
(46:00):
The, the want to Chinato be more forthcoming,
to be more transparent, right?
To be more cooperative, right?
In the, the, the original survey,
but, you know, China, sort of the,
the narrative here isthat, you know, a right,
(46:22):
that the, the pandemic
or the outbreak started in Wuhan
doesn't necessarily meanChina is the origin point,
was the origin point of the pandemic.
And second, right, that if, you know, you,
you believe that the lab leaks the problem
that caused the pandemic.
(46:43):
Let's also investigatefor Dietrich, you know,
your military labs herein the us you know, the,
so, you know, indicatingthat US could be a, a,
a origin point of the,the pandemic, right?
So you have that kind
of finger pointing right overthe origin of the pandemic.
That is becoming a, one ofthe biggest hurdles, you know,
(47:05):
for US China Health Corporation.
- Yeah. So no, no real prospect,
I think in the immediate future
for some breakthrough on health
cooperation. Is that fair to say?
- Right. Well, you feel,you know, actually it's,
in a way it's even worse by the,
so beginning 2020, right?
The since the,
(47:31):
the early spring that year, right?
And until
2023 last year,
24 last year, there was no high level
dialogue, you know, public health issues.
There was no, of course,
(47:52):
there was no serious discussionon corporation, right?
During the pandemic, but even
after the pandemic was over, right?
That we have, you know, that that accepted
for last year, right?
That there was a Chinesevice health minister visiting
Washington, you know,meeting his counterpart.
At HHS,
we have essentially no highlevel health dialogue, you know,
(48:16):
and even the, the, at theworking level, you know, now
with under the newadministration, our diplomats,
our health attach, well,
actually there's no formal health attach.
They are now is acting, they were very,
they're very cautious in terms
of reaching out theircounterparts in China.
(48:37):
That is very unusual, I would say,
I would say abnormal, right?
And this shouldn't be thecase, you know, as the,
when I was in Beijing,
a Chinese diplomacy professorat the leading top university
in China said, if there isno cooperation of health,
how could you expect theeffective corporation
(48:58):
in other areas?
It just to shows that dire state of
US China relations, unfortunately.
- Yeah, no, i, I, Itend to agree with you,
and I will say, I think even it was up
until like health diplomacywas up until the, you know,
second to last year, last yearof the Biden administration,
before we had real talkson commercial negotiations,
(49:20):
on military negotiations, the only thing
that was going on was reallythe climate change discussions.
And that was very much a sortof a, a personal, you know,
kind of love affair for, you know,
former Secretary Kerrywho was so committed
to climate change and had the personal
relationship with Shia Genis.
(49:41):
So yeah.
- And unfortunately, buteven that right there,
this walking group now asthe, i I think it is that the
corporation has also stalled,right? Under the numerous,
- Yeah, well, I'm, I'msure since we've pulled out
of the Paris Climate accord,
that there's not gonna be muchcooperation at the national
level on, on climate change.
Okay, last quick, threequestions, just boom, boom, boom.
(50:04):
So first question, whatbook would you recommend
to our viewers book
or article on China
that you think is really justexcellent and people should read?
- Well, I would recommend,you know, a, a book by won ds,
the title, the Breakneck, you know, that's
(50:24):
to have this interestingcomparison, you know, between the,
the governance in the US and China, right?
The, the, well, the, wellChina, according to the authors,
sort of managed by theengineers, the US governed
by lawyers, and they, theybelieve, you know, that sort
of shaped the different governance model
that explain why right now, you know,
(50:47):
China is quickly catchingup in this key, right,
the high tech areas bythe AI biotech, right?
The robotics, you name it,of course for the author want
to claim it's not thechairman leader. No, no,
- No, no.
And his name is, it's his English name.
Just to be clear, is DanWong. So you can Dan Wong.
(51:08):
So it's a little different, but Right.
So Dan Wong, yes, I agree.
It's a great book and I thinkit made it's New York Times
bestseller and I reviewedit for foreign affairs,
I think in the upcoming issue.
And it's really, I agree with you.
It's a great, it's aterrific, terrific read. Okay.
What issue in China, let's putaside public health though.
What issue about China
or in China do you thinkAmericans don't really understand
(51:31):
or need to know more about?
What, what do you know
that other people don'tknow that they should?
- Well, I think whatset aside public health,
I think it was, I, I'm stillsort of puzzled, you know,
by these, you know, sort ofalmost like over the past,
just a couple of years you've seen, right,
(51:53):
the China quickly catching up, right?
In the high tech area, right?
The, well, biotech is avery good example, right?
Just years ago, we are still,
when we talk about China'sinnovation capability,
which says, well, they'remaking good progress,
but it's going to be a longway before they can catch up.
But now guess what? Why?
(52:14):
They're not just catching up,
but in some areas they become,
they're becoming a leader, right?
And in a way, this is creatingsort of the, another kind
of dependence, you know,in addition to the APIs,
active pharmaceutical ingredients,key starting materials,
but this innovative drugs and,
(52:34):
and biosimilar molecules, youknow, they are, you know, like
we are becoming increasinglydependent upon them.
If you look at by the, this,the number of deals by the o of
the, of the licensing, right?
The, the, with the signwith the Chinese companies,
(52:56):
you know, this is, I found itvery, you know, interesting,
especially if you think aboutthis, you know, this era
of economic slow down, right?
Well, you know, unemploymentrate of the use is
so high, right?
That the consumption level is low.
You know, the real industryis like all probably seems the
(53:20):
almost, you know, all like a is
in such a bad shape, you know,how could that happen, right?
- Yeah. No, I think that's, that's great.
And actually I'll do a littleplug for our, our, our next
podcast, which is gonna be with Dr.
Ch Lee, who is a well-known geneticist
(53:43):
and works on biotech issuesand, and on cancer drugs
and goes between Chinaand the United States.
And he's gonna talk to usexactly about innovation
and science and technology,
particularly in the biotech field.
So thank you, thank youfor that leading Yanzhong.
But one last question for you.
If you had a recommendation
(54:03):
for the Trump administration right now,
either thinking in termsof US China competition
or cooperation, what, what would it be?
- Well, I, I would sayprincip support engagement.
I was, you know,
it is interesting when youask this question, just
finish this, the part ofthe, at tribute to our
(54:25):
old colleague Jerry Cohen, right?
He was the person, right?
That I think, you know,
if there's something Iremember the most, in the most,
it was this, I, right?
He's the commitment to,you know, rule of law
and human rights.
So he is the principled person,
but I also had this flexibility, right?
(54:48):
That in dealing with peoplewith opposed views, right?
So that is how he was admired,respected in both sides
of the Taiwan Street, youknow, so, you know, I think,
you know, he, as I I I saidin the tribute, you know, that
this principled engagementjust to show, you know,
(55:09):
that when we are dealingwith, well sort of
give a example, right?
This, the suggestingthat when we are dealing
with like a geopoliticalright rival like China, even,
we disagreed upon many things.
I think engagement
and even cooperation remains
(55:29):
possible and vital.
- And that is a great note to end on.
And, and thank you for the reminder
of our truly wonderfulcolleague Jerry Cohen,
who passed away just recently, you know,
towering figure in the fieldof China, legal studies,
someone who spanned both,you know, the corporate work,
(55:52):
government work, andof course was renowned
for his work on Chinesehuman rights issues as well.
So Yan Jang, thank you so muchfor a really rich discussion.
I expect no less fromyou from one of the best
and top figures in the field,
so I appreciate your takingthe time to speak with us.
(56:12):
- Thank you, Liz.- If you enjoyed today's podcast
and would like to hear moreinformed discussion about China,
please subscribe to theHoover YouTube channel
or your favorite podcast platform.
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