Security Boundaries and Cooperation Space in China–U.S. Biomedicine
On December 10, 2025, the U.S. House of Representatives passed the reconciled version of the Fiscal Year 2026 National Defense Authorization Act (NDAA). The defense policy bill authorizes approximately USD 901 billion in spending, approaching the USD 1 trillion mark. Congress has passed the legislation for more than sixty consecutive years, maintaining its status as “must-pass act”. More importantly, this year’s NDAA incorporated the institutional framework of the revised BIOSECURE Act. The framework authorizes U.S. federal executive agencies to establish a list of “biotechnology companies of concern” and prohibits federal agencies and their partners from entering into contracts with or providing certain funding to listed entities. In doing so, the framework establishes systematic controls over biotechnology suppliers linked to designated “foreign countries of concern”, including the People’s Republic of China.
China’s Rapid Rise in Biomedicine
U.S. scrutiny and pressure on China’s biopharmaceutical industry largely stem from China’s rapidly growing innovation capacity and expanding international transactions. According to The Economist and its accompanying charts published on November 29, 2025, the number of “innovative drugs under development” in China had reached approximately 25,000 by January 2025, accounting for roughly one-quarter of the global total. The publication’s data also show that, measured by the number of clinical trial initiations, China-based companies increased their global share from single-digit levels in 2009 to nearly 30% in 2024, making China one of the world’s most important centers for clinical R&D activity and one of the fastest-growing countries in the sector.
Biomedicine directly affects national security and economic influence. The United States worries that the outflow of genetic data, critical reagents, and manufacturing capacity could serve military or intelligence purposes, while China regards biomedicine as a key pillar for advancing the “Healthy China” strategy and strengthening national technological capabilities. Research and forecasts from institutions such as IQVIA, Evaluate Pharma, and McKinsey suggest that the global biopharmaceutical and prescription drug markets will expand by hundreds of billions of dollars over the coming years, with innovative medicines serving as the primary growth driver. Whoever leads the next generation of key technologies and products will gain strategic advantage in this new phase of global competition. The United States increasingly views China’s rapid rise in biomedicine as a challenge to its long-term dominance, accelerating the trend of “securitizing” biomedicine within the broader framework of national security and geopolitical competition.
Despite growing tensions, China and the United States remain highly complementary in biomedicine. The United States possesses the world’s largest pharmaceutical market and leading basic research capabilities, while China offers unique advantages in clinical trial speed, cost efficiency, and patient scale.
Major U.S. pharmaceutical companies continue to show strong demand for cooperation with Chinese innovative drug firms. According to The Economist, in May 2025, Pfizer paid USD 1.25 billion to Chinese biotech company Akeso to secure manufacturing and commercialization rights outside China for an experimental cancer drug. In the same month, British pharmaceutical giant GSK reached a USD 500 million agreement with China’s Hengrui Pharmaceuticals to jointly develop a treatment for pulmonary diseases. Including options for up to nine additional drugs, the total value of the transaction could reach USD 2 billion. These cases demonstrate an ongoing transition from simple licensing arrangements toward joint development and globally coordinated commercialization models.
The Global Biopharmaceutical Landscape Will Be Reshaped
These complementary industrial realities will inevitably create diverging attitudes toward China between the U.S. pharmaceutical industry and the U.S. government. A key question is how to leverage this complementarity to prevent the United States from fully incorporating biomedicine into a securitized framework of geopolitical competition.
The major transactions between pharmaceutical giants such as Pfizer and GSK and Chinese companies highlight how commercial logic can offset political pressure. Ultimately, the balance will depend on the interaction between strategic rivalry and market demand: one side pushes for decoupling and industrial restructuring, while the other seeks to preserve channels of cooperation. This dynamic will reshape the global biopharmaceutical landscape, push China to accelerate industrial upgrading and strengthen indigenous capabilities, and test whether global scientific collaboration can move beyond zero-sum thinking and avoid undermining human health and well-being.
Xu Anlong: Dean, Professor and Chief Scientist of Sun Yat-sen University Institute of Advanced Studies Hong Kong; a member of the National Committee of the Chinese People’s Political Consultative Conference; Director of the Teaching Guidance Committee for Integrated Chinese and Western Medicine under the Ministry of Education; Vice President of the Chinese Society for Immunology; Vice President of the China Association of Chinese Medicine; former President of Beijing University of Chinese Medicine; former Vice President of Sun Yat-sen University; and holds a PhD in Molecular Immunology from the University of Illinois.
Liu Yu: Research Fellow / Young Scientist at Sun Yat-sen University Institute of Advanced Studies Hong Kong and holds a PhD in History from The Chinese University of Hong Kong.
