Photo by Ousa Chea on Unsplash

A Biomedical Truce for the United States and China: Governance of a Global Scientific Enterprise

By Sophia Lugo

Harvard University | Schwarzman Scholar, Tsinghua University

The views expressed are her own and do not necessarily represent the views of The Carter Center or its associates.

Cancer on the Front Lines

As one of the most revolutionary scientific endeavors of the 20th century, the Human Genome Project (HGP) ushered in a new era of open, international scientific collaboration, reaffirming shared ownership over the “code of life” common to all humans, regardless of status or nationality. The US had originally sought a program of intense collaboration in genetics with Japan immediately after World War II as an object of Cold War geopolitical and economic strategy. However, the scale, importance, and urgency of the project, bolstered by the clear benefits of linking the efforts and resources of laboratories across the world, soon brought several countries on board. When Craig Venter’s Celera Genomics entered the scene, it demonstrated the speed of private enterprise but included in its purpose potentially commercializing the genome. Heads of state including Bill Clinton and Tony Blair quickly released statements encouraging open scientific collaboration in the name of “reduc[ing] the burden of disease, improv[ing] health around the world, and enhanc[ing] the quality of life for all humankind,” in context, juxtaposing the importance of these outcomes against privatizing and commercializing life for economic gain.[1] Meanwhile, Chinese scientists seized this opportunity to step onto the global stage of scientific research, “proving ourselves that we can do [what] others are able to do.”[2] Thus, in 1999, China became the only developing country to join the Project, committing itself to sequencing, assembling, and analyzing about 1% of the human genome.

The HGP has been historicized as a lasting example of the importance of a culture of open, transnational scientific collaboration, working in the name of shared human interests. Its utility has been couched in language alluding to shared commitments to biological understanding and universally distributed benefits. Before the 10th strategic meeting for HGP scientists, held in Hangzhou, China, Chinese President Jiang Zemin reaffirmed the ethos underlying the mega collaboration: “owned by all, done by all and shared by all.”[3]  With active support from scientists around the world, especially proposals submitted to UNESCO by Chinese scientists, the United Nations Millennium Declaration included the promise, as a part of an ethic of conservation and stewardship, “To ensure free access to information on the human genome sequence.” [4] Upon completing sequencing of the human genome, the heads of governments of the USA, UK, Japan, France, Germany, and China issued a joint proclamation reaffirming these values:

“[A]ll the chapters of the instruction book  of human life…[are] now freely available to the world without constraints via public databases…from which revolutionary progress will be made in biomedical science and in the health and welfare of humankind… an important step toward establishing a healthier future for all the peoples of the globe, for whom the human genome serves as a common inheritance.[5]

In this way, the HGP resulted in the creation of a new field, genomics, whose scientific communities and research were inherently transnational and diverse, fostering a string of international mega projects and boosting China’s reputation in scientific prowess on the global stage.

Other international collaboration projects, such as the International Space Station, CERN, the International HapMap Project, and SESAME, have similarly staked their claims to success on principles of inclusion, openness, and shared responsibility. Among scientific communities, international collaborations abound, informally organized by scientists meeting at conferences or symposiums, virtually reviewing and identifying complementary projects, and reaching out to share expertise, access, equipment, and resources. These informal scientific networks have formed the backbone of transnational “lab” spaces, co-produced and validated by institutions that provide funding, workforce and academic mobility, and public acknowledgement. That is, as these networks have grown in value, they have influenced funding institutions to validate the nature and purpose of their work through joint initiatives, such as the US-China Collaborative Biomedical Research Program, implemented in 2010 by the US National Institutes of Health (NIH) and National Natural Science Foundation of China. Programs have been developed that explicitly seek to use science diplomacy as a means of strengthening international ties while solving complex problems, such as the Obama administration’s US Science Envoy Program, through which “eminent US scientists and engineers leverage their expertise and networks to forge connections and identify opportunities for sustained international cooperation.”[6]  Awards recognizing and further validating preferred means for scientific accomplishment have also increasingly favored collaborative projects. For example, in 2015, the Breakthrough Prize in Fundamental Physics went to the 1,377 physicists who collaborated on the neutrino oscillation experiments.[7] As commented by one of the Breakthrough Prize’s founders, “[S]cience is a much more collective effort than it was 100 years go. It is international, it is diverse, it involves lots of people.”[8]

However, recent events would betray this history of open scientific collaboration, placing scientific research, including biomedical research, and innovation on the frontlines of an economic battle between the US and China. In the US, an effort is underway by the US NIH and the FBI to expose scientists who have allegedly stolen “not military ideas, but scientific ideas, designs, devices, data and methods that may lead to profitable new treatments of diagnostic tools.” [9]  In April, 2019, the renowned MD Anderson Cancer Center terminated 3 ethnically Chinese senior researchers for allegations related to ties with China. Other ethnically Chinese faculty and researchers at the cancer center have also been interrogated by the FBI, including the director of the Center for Public Health and Translational Genomics, who ended up taking a new job in China .[10] No formal charges had been levied, but months of investigation left her “branded an oncological double agent,” even though her collaborations with China had originally been encouraged by MD Anderson in efforts to advance the fight against cancer.[11] In fact, only four years prior, MD Anderson had received the PRC’s International Science and Technology Cooperation Award for “important contributions to China’s bilateral or multilateral scientific and technological cooperation,” in a ceremony attended by President Xi Jinping and Premier Li Keqiang. When receiving the award,  the MD Anderson representative remarked, “Cancer is a significant challenge worldwide… China in particular offers tremendous opportunities for saving lives through joint cancer research with top scientists and the government’s commitment to fighting cancer.”[12] Nevertheless, the US government and the NIH continue to pursue actions endangering collaborative research  and rebranding those who participate as traitors.  As of late 2019, 180 individual cases of potential IP theft remain underway—an accusation of “economic espionage” as China vies for a position as a world leader in innovation and technology.[13] 

In response, the scientific community has rebuked incursions of nationalism and exclusion of the scientific community’s input. On September 4, 2019, in response to these increasing restrictions on international (particularly, Chinese) collaborators, sixty leading American science, engineering, and international education organizations signed onto a letter to the heads of the National Science Foundation (NSF), NIH, and the Office of Science and Technology Policy. While “recogniz[ing] the need to maintain a balance between an openly collaborative scientific environment and protecting our [American] economic and national security,” they warned of the “unintended effect of harming the scientific enterprise.” Furthermore, the letter stressed how the US’s scientific leadership, and its related economic outputs, “have been vastly accelerated by bringing international minds together and has helped to drive innovation and discoveries” across various fields vital to health, development, and sustainability. Finally, asking the government to reconsider new policies relevant to foreign-born science collaborators, the letter asked for a “wide range of stakeholder perspectives,” including, most importantly, input from the scientific community itself.[14]

Nevertheless, the Trump administration has only stepped up its attacks.  On a May 29, 2020 press briefing, Trump terminated the US’s relationship with the World Health Organization, claiming it to be under Chinese control, and accused China of stealing manufacturing opportunities and jobs, destroying American industries, trade violations, and intellectual property theft.[15] Following this, the US White House released a proclamation prohibiting entry into the US to Chinese graduate students “identified as potential security risks.” The proclamation accused “PRC authorities [of using] some Chinese students, mostly post‑graduate students and post-doctorate researchers, to operate as non-traditional collectors of intellectual property…[and therefore] determined that the entry of certain nationals of the PRC…pursuant to an F or J visa to study or conduct research…would be detrimental to the interests of the United States.”[16] Later, in June, Harvard University Professor Charles Lieber was indicted on counts of false statements to federal authorities about a contract he held with China’s Thousand Talents Program to set up a research lab in Wuhan, “amid concerns that the program is a facade used by China to steal American intellectual property.”[17]

While transnational, mega science collaborations have become normative in scientific culture, and preferred by associations of scientists in the United States, trends in nationalism and the ongoing US-Sino power negotiation have proven these informal networks to be vulnerable to sabotage. Even structures based on loose commitments negotiated by nation-states, such as the WHO, have been insufficient to counteract attacks on transnational collaboration to meet universal needs. In what follows, this essay will attempt to show the importance of transnational scientific collaboration, particularly for the US, for whom limiting collaboration with China will come at the expense of its own scientific leadership.  

Furthermore, in creating a body to safeguard shared goals of scientific enterprise, we shall see how nation-states—particularly the US and China—as dominant actors of global governance are ill-suited to solve global challenges and protect universal public goods. To counteract rising nationalism, an international body regulating and setting guidelines for collaboration spearheaded by Chinese and American scientists, but allowing for an inclusive, transparent, multi-stakeholder led model of governance, can protect and promote shared interests in the realms of public health and medicine, despite political tensions. 

Checkmate: Chinese Scientific Centrality Threatens US Hegemony

As explained by hegemonic stability theory, the US as the hegemonic power since the Second World War, with its military and economic resource superiority, has acted as the lynchpin in creating and stabilizing the liberal international world order. This order has promoted its own interests, while providing international public goods and promoting cooperation. International science collaborations, like the HGP, have both highlighted and promoted the US’s science preeminence, while providing political support for US global leadership.[18] It was under this construct that, in 1972, US President Nixon and Chinese Premier Zhou Enlai agreed to state-sponsored scientific exchanges that would promote mutual understanding and Chinese modernization.[19]

However, actions from the Trump administration cast a doubt as to continued US interest in the liberal international order, such as US withdrawal of support from the Paris Climate Accord, Trans-Pacific Partnership,Iran nuclear deal, World Health Organization, and others. Instead of promoting collaboration and stabilization of liberal world order, the US and other Western countries have seen strong trends away from globalization and towards protectionist policies and immigration restrictions, with mounting attacks on multilateral institutions.  

To further destabilize the status quo, this rise in economic nationalism and backlash against international institutions is happening at the same time as the US is engaged in negotiation of power with China as the alternative hegemon. In science and technology, China no longer appears to be in “catch up” mode. Rather, its scientific networks, technologies, international companies, universities, and funding contributions (including pledging an additional $50M in funding in 2020 to the WHO after US withdrawal of support) have quite publicly campaigned for China as an alternate scientific and technological leader. Several Chinese technological initiatives and state targets have fueled narratives of a new biotech arms race, that challenge US hegemony in a way reminiscent of the Cold War nuclear arms race. These include Made in China 2025 (China’s plan to avoid the middle-income trap by becoming the world leader in high-tech industries, providing for more high value-added jobs and increased economic independence), as well as the race to develop world-dominating AI, quantum computing, 5G, and now COVID-19 vaccine production capabilities.

The negotiation of power has thus spread to the scientific realm, where mounting evidence (as shown by Science and Engineering Indicators produced by the US’s NSF) shows China a very near threat to a previously uncontested US leadership in science. Part of the blame for the US’s slipping stance has been declining domestic commitments to basic science and engineering (S&E) research. Notably, for all four years of his presidency to date, Trump has proposed budget cuts for the NIH, NSF, the Department of Energy, and NASA.[20] His February 2020 proposal argued for a $3 billion USD (7%) cut in biomedical research.[21] Even before the Trump administration, NIH funding had fallen by 22% from 2003 to 2015, given budget cuts, sequestration, and inflationary losses.[22] Additionally, in terms of workforce capacity, the US education system continues to lag behind other advanced economies in STEM education, with little improvement over the past decade: US eighth graders ranked in the middle of countries assessed for math and science skills.[23]

Furthermore, much of the success of the American scientific enterprise, both in private industry and academia, can be attributed to foreign-born contributions.  In 2017, temporary visa holders made up 34% of US S&E doctoral degrees. More than half of these came from China, India, and South Korea, with the number of Chinese graduate students increasing between 2016 and 2018.[24]  Studies have also shown increases in international faculty in the US, as well as higher research productivity for international versus domestic American faculty.[25]  Foreign-born scientists and engineers also account for almost a third of the US S&E workforce.[26]  83% of Chinese doctorate recipients who studied in the US had stayed in the US for work by 2017 (albeit, showing a decline from 93% in 2013), suggesting that Chinese-born scientists contribute greatly to the skilled workforce fueling American scientific enterprise.[27]

On the other hand, China and its leaders have, since China’s Reform and Opening, placed significant focus on becoming a leading power in science and innovation. Indeed, China has employed scientism and an explicit strategy of informal international collaboration to achieve preeminence since Deng Xiaoping’s reforms, the “Four Modernizations” (agriculture, industry, science, and military).  Launched in October 10, 1978, the vision—which stated, “Carry out the policy of opening to the outside world and learn advanced science and technology from other countries” –saw science as critical for modernization, state power, national security, and self-determination:

“After World War Two, the desire for Chinese self-empowerment emerged in the near feverish pursuit of science… Deng Xiaoping’s reforms were a continuation of a historical need for foreign technology…. The idea was to utilize scientific methods and foreign technology to “pull China up by its bootstraps” militarily, in turn providing political leverage and stability.”[28]

In 2016, Xi Jinping renewed this commitment by setting the target for China to become a leader worldwide in science and technology by 2049, the PRC’s 100th anniversary, declaring that “Great scientific and technological capacity is a must for China to be strong and for people’s lives to improve.”[29]  In this goal, China has indeed made great progress.  After explosive growth, China now accounts for 23% of global domestic R&D expenditures, closely trailing the US’s 25% contribution and exceeding that of the European Union.[30] In peer-reviewed S&E research publications, China’s global contribution has grown from 5% in 2000, to 21% in 2018, lagging only behind the EU (US is in third place, with 17%).[31] China has also shown to be the leading inventive force in the world by share of patent families granted to inventors in 2018, making up 49% of patents worldwide, compared to the US’s 6.8% share.[32]

China’s centrality and leadership in global scientific collaboration networks has also improved dramatically. China contributed to 20.7% of all internationally-produced, highly cited scientific publications in 2017, up from 5.7% in 2008. Of these 2017 papers, 64.3% listed Chinese researchers as first or corresponding authors (a position indicating leadership in a study).[33] A 2018 trend analysis using the Scopus database of abstracts and research showed that in terms of field-weighted citation impact, given China’s increasing research impact and the US’s declining impact, China may catch up to the US by 2025.[34]

Additionally, as foremost collaborators, Chinese and American successes are certainly linked to and corroboration of the benefits provided by international collaboration. Over time, as tremendous challenges of global scale have emerged, scientific projects have continued to become larger and more complex, and the benefits of scale have been made empirically clear.[35]  Transnational collaboration provides greater access to capital and reduce risks and costs of research through synergies, while providing greater access to critical expertise, data, and high-cost, high-tech equipment. This can lead to greater research productivity, citation impact, and speed of innovation critical to scientific fields and gains in health and quality of life.[36] Studies have shown that international collaboration has a higher positive correlation with research impact (measured by citation index) than public funding does, with countries offering scientists more mobility (to immigrate and emigrate) producing the most impactful research. [37],[38]  American and Chinese scientists have particularly enjoyed these benefits. The Nature Index, which tracks contributions to research articles in 82 high quality natural science journals, shows that US and China occupy first and second places, respectively, in research output overall and in share of contributions to articles with international collaborators for March 2019 through March 2020.[39]Furthermore, the US and China were each other’s top collaborators in this time period—with US involvement factoring into 42% of Chinese research outputs with international contributions and Chinese involvement in 20% of American ones.[40],[41] When only considering studies where US and Chinese institution-affiliated scientists collaborated, using an aggregated fractional share of authorship, more authors were Chinese than American—52%, edging out authors affiliated with US institutions at 48%.[42],[43]

Furthermore, evidence points to the US having more to lose than gain by limiting collaboration with China, in both access to funding and research output. A 2019 study from the University of Arizona quantified the benefit that Chinese institutions provided to American research output from 2014 to 2018: (1) In funding of research including Chinese and American collaboration, Chinese institutions provided funds for 3.5 times the publications than American institutions, increasing by 188% per annum, versus US funding institutions’ 46% increase. (2) In terms of publication growth, US publications in S&E grew by almost 3% if including research co-published with Chinese institution-affiliated authors; however, if excluding publications with Chinese contributions, American publication output declined by about 2%. On the other hand, Chinese-institution affiliated publications grew about 28% without US contribution, and 30% with US contribution. [44] In other words, while Chinese and American institutions’ successes were co-dependent, the US stands to lose significant funding and output from non-collaboration.

The empirical evidence makes clear that international collaboration—particularly, US-China collaboration—in sciences is a positive-sum game. The US benefits in both economic output and scientific prowess by collaborating with Chinese scientists both domestically and internationally. However, as the US-Sino conflict appears primarily political, rather than economic, and as Washington continuously employs nationalist rhetoric and policy, a new framework must be concocted to safeguard potential economic, technological, and health gains against the towering threat of rising nationalism.

Nationalism as Barrier to Shared Commitments

Times have changed; whereas before, scholars predicted that globalization would continue to spread, today, we face a global retreat towards nationalism, with no end in sight.[45] The liberal world order, formerly promoted by Western elites, has found resistance from rising actors, like China, but also by those who crafted it—most notably, the US. The struggle has revealed the nation-state as actor on the global stage to be ill-suited to foster multilateralism and “universal” public goods.

Part of this can be explained by the appeal of nationalism over other political-isms, particularly, more vaguely defined universalisms. Nationalism, in post-industrial societies, has often been found to arise as a result of perceived uncertainty or marginalization.[46] Nationalistic candidates often use perceived attacks on a “national” identity and culture to create a fear of the “other.”  Rhetoric targeting immigrants and foreign cultures both helps increase feelings of camaraderie between national communities and explains real or perceived economic decline in terms of relative “unfairness” perpetrated by outsiders. For Trump voters, a majority believed that there had been a decline in American ways of life and that the American identity and culture was being lost.[47]

In his book Imagined Communities, Anderson describes the historical and sociological rise of nations as powerful cultural units. Against the backdrop of Western Europe’s Enlightenment period and other contemporary cultural systems, nationalism rose as an eternal entity providing meaning to suffering and mortality during a time of rising rationalist secularism. Since then, in nationalism’s name, thousands of lives are sacrificed each year, revolutions are fought, sports are played, and value sets are forged. In describing the immense power of the idea of a nation, Anderson provides the story of the Indochina War, Vietnam invaded Cambodia, then China invaded Vietnam regardless of their alliance as revolutionary Marxist countries in the international arena. Here, these young countries’ national-isms superseded the shared identity derived from other political-isms, namely Marxism, and revolutionary history.[48]  He writes of nations as imagined political communities (in that no member will ever meet or see most other members but nevertheless feels communion with them) with finite boundaries and sovereign powers.[49]

As the liberal order is destabilized and uncertainty increases, nationalisms—particularly in their current expression—have hijacked current political discourse and attempts at delineating “universal” values. By definition, nationalistic expression cannot extend to all mankind; it must concoct values or images that separate members of their ilk from others. Even the Universal Declaration of Human Rights, adopted by the United “Nations,”has been criticized by scholars for actually being a set of globalized localisms negotiated, then exported as normative by certain “winning” entities, namely, countries best able to leverage geopolitical power and influence.[50]  Regardless of the UN’s or other intergovernmental organizations’ purposes to ensure international peace and stability, the nation-state is inherently vulnerable to nationalistic discourse, threatening multilateral efforts among nation-states. Many country representatives rely on their national identities and national positions rather than rational debate to negotiate at the international level. As non-Western, non-liberal countries contest Western hegemony, many “universalisms” have been unmasked as efforts to align the global stage with national priorities.

While China and the US maintain different approaches to global governance, both have often approached international agreements as fits their national agendas, modulating their interactions with multilateral organizations in a way that prioritizes their state sovereignty and “exceptionalism.” As concerns its relationship with international organizations since World War II, the US, though charged with upholding the liberal world order, has historically engaged in multilateral cooperation insofar as it has promoted objectives of the incumbent administration. Given the US’s hegemonic power, non-cooperation from the US, versus other actors, has been met with little backlash.[51] The Trump administration has gone farther than this in his “America first” approach to foreign policy and trade, emphasizing since his inauguration that “it is the right of all nations to put their own interests first.”[52] China has, despite concessions made for a seat at the WTO and UN Security Council,  similarly been amenable to compliance in transnational legal spaces insofar as its political sovereignty, economic growth programs, and long-term interests of its people—who are the foundation of socialist political ideology—are not violated. The country’s rapid rise and unprecedented economic success reinforces that domestic policy and institutions are working well and should have the liberty to determine state foreign policy.[53]

As these two countries rise in power on the global stage, instead of discussing principled and shared interests, negotiations on the international stage have become positional debates between relatively fixed interests. In order to protect shared global interests, such as health and creation of intellectual capital, that have become too large for nation-states to independently handle, a new model of global governance must move away from the narrative of nation-state as dominant actor in global institutions. This is particularly true for the transnational scientific realm, dominated by China and the US, whose identities on the global stage have prioritized sovereignty and nationalistic ideals.

A Governance Model “Owned by All, Done by All, and Shared by All”

While the downstream products of science-making with direct economic value—intellectual property—have protections codified into the WTO’s TRIPS agreement (Article 27), basic guidelines and regulations for upstream scientific activity have largely gone ignored, both in treaty inclusion and as a subject of study.[54] Momentum for such an international collaboration that would allow for harmonizing norms and regulations has been building for years, as the impacts of scientific activity have entered public discourse—particularly for the biomedical sciences. [55] While the COVID-19 crisis will likely lead to continued de-globalization in economic spheres, the opposite has been true for globalization of research and innovation:

“The rapid mobilization of so many actors across the world to collaboratively develop and test new therapies and vaccines has been remarkable. Unprecedented international knowledge creation efforts are engaging multiple stakeholders such as hospitals, private companies, research institutes, government at various levels, and civil society.”[56] 

Here again, the Human Genome Project—which, despite its early origins as an object of American geopolitical strategy, became a prime example of international collaboration towards a shared goal—offers insights for an inclusive governance structure geared towards shared biomedical interests, where nation-states are replaced by more direct stakeholders as primary decision-makers. Three aspects contributing to the HGP’s success should be incorporated into the creation of an international scientific institution.

1. Multi-stakeholder, interdisciplinary collaboration

In debating the feasibility and logistics of the project, the HGP involved multiple stakeholders: university administrators and academics, scientific committees, the nascent biotech industry, Congress, the NIH, Department of Energy (DOE), and the National Academies of Science. During the project, the HGP not only promoted transnational collaboration, but also brought together scientists from multiple disciplines, from computer scientists, to biologists, physicists, mathematicians and engineers. Additionally, 5% of its budget was allotted to understanding social, ethical, and legal implications. In gathering requisite support and funding, it employed a consortium model where various trusts, funding sources, and scientific associations from all over the world came together to mobilize action.[57]

Here, while “boundaries” were drawn between contributors by scientific specialty or academic institution—with differing cultural customs, frameworks for knowledge acquisition, jargon, and technical capabilities—representations and discourse drew on professional identities as scientists and problem solvers, rather than their nationalities. A common goal was clearly delineated from the beginning (to completely and accurately sequence the entire human genome), as were key performance indicators (e.g., timelines, commitments per delegation, and accuracy), setting the stage for principled debate based on shared interests and objective contributions towards the goal.  Even the name of the project—Human Genome Project—recalls a shared identity and sense of purpose, setting foundation for working towards mutual gains.

A global institution for science should similarly adopt an approach where identities and representations are labeled in a way that reinforces objective, principled contribution as to shared stakes and impacts of scientific activity. A multi-stakeholder approach, including participation from a broad range of stakeholders impacted by the activities of science—from scientists, to bioethicists, healthcare providers, regulators, politicians, private industry representatives, and concerned citizens via civil society organizations—could redirect supranational dialogue away from negotiations based on relatively fixed and political interests of nations. Rather, by representing communities whose identities are based on shared commitment to solve problems (e.g., scientists, bioethicists, healthcare providers), debate can focus on how rights, ethical guidelines, standards of practice, and shared data affect the ability of scientists to innovate and work ethically. Civil society organizations could represent risks to lived realities, as well as provide democratic legitimation. Private industry could focus on effective capital allocation, fair competition, and goods distribution. Including participation of national academic associations would provide a vehicle for implementation of harmonized standards and ethics of practice through funding allocation and communication of regulations, as well as an interface between scientists and policymakers.

2. Transparency

Instrumental to rallying support for the HGP was clearly communication of its urgency throughout and in several media. Upon hosting the several strategic meetings, and at the completion of the project, public representatives communicated its progress and successes to the public. Likewise, transparency in information, activities, and decisions (including pending decisions and actions towards public input), consistently using rhetoric that recalls shared commitments and urgency, would help to build public awareness and support for an international body. Additionally, virtually inviting public viewership and discourse into global lab networks and activities could help rally support for a truly inclusive scientific enterprise.

3. Creation of open data-sharing structures

 The HGP introduced the idea of making genetic sequencing data immediately public and easily accessible, through databases like GenBank and the UCSC Genome Browser. Additionally, it promoted the use of open-source software to create communities interested in optimizing shared programs.[58] Most importantly, these structural components of collaboration launched a cultural transformation through adopting a modus operandi of joint stewardship of biological problems, and universal collaboration.

Similarly, the institution, divided into special interest groups, should help set up pooling of datasets throughout biomedical disciplines. Harmonizing regulations, standards of practice, and ethics would lay the foundation for enhanced collaboration across borders, as well as create mutually adopted frameworks for issues of privacy, security, and commercialization of life.  Additionally, creation of open databases and joint patient registries, integration of food and pharmaceutical regulations, and joint epidemiological efforts, should be part of the agenda.  


For the US, maintaining its hegemonic power over the global scientific enterprise has become a highly politically charged objective, inextricably intertwined with narratives of economic patriotism, national security, and American exceptionalism (“America First”).  As part of what US FBI Director Christopher Wray calls a “whole-of-society” response to the “Chinese threat,” the approach to deterring Chinese science hegemony has become multi-fold: limit China’s technological and scientific influence abroad through attacks on markets and China’s credibility, and directly oppose China’s strategy of scientific internationalism. In the face of highly visible, ongoing public health emergencies with universal impact, collaboration in realms as critical as cancer research have taken on a connotation—in many cases, explicit accusations—of espionage and conspiracy. As scientific advancement and public health become a battleground of the US-China trade war, health-oriented private and public partnerships, investments, student exchanges, and market access are at risk. Collaborative norms in the production of science are at risk. Of greatest importance, potential gains in human health well-being are at risk. 

In cutting off collaborations, the US scientific enterprise stands to lose. A new, stabilized global scientific order will require a governance model that can withstand nationalistic attacks—one that is committed to inclusivity, transparency, openness, and to truly solving challenges for the sake of humanity. Naturally, cultural and social differences based on national boundaries may inform implementation and perceptions of rights. Therefore, getting Chinese and American affiliates to the negotiating table will first require shifting focus to principled shared interests, versus positional bargaining through national identities.

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[2] Xiaoling Wang et al., “The International Human Genome Project (HGP) and China’s Contribution,” Protein & Cell 9, no. 4 (April 2018): 317–21,

[3] Xinhua News Agency, “Chinese President Hails Genome Project,” August 28, 2001,

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[8] Merali.

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[10] Mara Hvistendahl, “Exclusive: Major U.S. Cancer Center Ousts ‘Asian’ Researchers after NIH Flags Their Foreign Ties,” Science | AAAS, April 19, 2019,

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[13] Kolata, “Vast Dragnet Targets Theft of Biomedical Secrets for China.”

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[21] Mervis.

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[27] National Science Foundation and National Center for Science and Engineering Statistics.

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[31] National Science Foundation and National Center for Science and Engineering Statistics.

[32] National Science Foundation and National Center for Science and Engineering Statistics.

[33] Zhihui Zhang, Jason E. Rollins, and Evangelia Lipitakis, “China’s Emerging Centrality in the Contemporary International Scientific Collaboration Network,” Scientometrics 116, no. 2 (August 1, 2018): 1075–91,

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[35] Stefano Lami, “Challenges and New Requirements for International Mega-Science Collaborations,” Science & Diplomacy, June 27, 2017,

[36] Tianwei He, “International Scientific Collaboration of China with the G7 Countries,” Scientometrics 80, no. 3 (2009): 571–82; Lami, “Challenges and New Requirements for International Mega-Science Collaborations.”

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