Just outside of Shanghai, in the city of Wuxi, China is building its future of medicine — a booming biotechnology hub of factories and laboratories where global pharmaceutical companies can develop and manufacture drugs faster and cheaper than anywhere else.
Amid the Trump administration’s tariffs on China, I figured manufacturing hubs like this one would be wracked with anxiety. But when I visited Wuxi in April, government officials insisted that its research hub was flourishing. They were proud to tell me about their superstar labs and companies that are continuing to thrive. The fact that Chinese biotechnology stocks have surged over 60 percent since January seems to bolster this claim. The city’s researchers certainly seemed positioned to be busy for decades.
In its quest to dethrone American dominance in biotech, China isn’t necessarily trying to beat America at its own game. While the U.S. biotech industry is known for incubating cutting-edge treatments and cures, China’s approach to innovation is mostly focused on speeding up manufacturing and slashing costs. The idea isn’t to advance, say, breakthroughs in the gene-editing technology CRISPR; it’s to make the country’s research, development, testing and production of drugs and medical products hyperefficient and cheaper.
As a result, China’s biotech sector can deliver drugs and other medical products to customers at much cheaper prices, including inexpensive generics. These may not be world-changing cures, but they are treatments that millions of people around the world rely on every day. And as China’s reach expands, the world will soon have to reckon with a new leader in biotech and decide how it wants to respond.
One such company that embodies the Chinese approach to biotech is Wuxi AppTec. It’s a one-stop shop for pharmaceutical research and development, streamlining everything from early-stage drug discovery to young scientist recruitment and medication production. The company, whose clients have included Chinese firms like Innovent and Jiangsu Hengrui, as well as American and European drugmakers like Pfizer, GlaxoSmithKline and AstraZeneca, was involved in, by one estimate, a quarter of the drugs used in the United States, including blockbuster cancer drugs.
Though the Chinese government bargains hard with both foreign and domestic pharmaceutical companies to provide products at the right price in exchange for market access, the low prices that Chinese consumers pay are ultimately the result of Chinese biotech companies’ ability to test and manufacture drugs at a pace far faster than their American counterparts. So far, American biotech giants don’t seem to mind the competition, since their own use of companies like Wuxi AppTec allows them to dedicate more of their money to breakthrough research.
That may soon change. Armed with aggressive government support, an expanding cohort of scientists, a large patient pool, a streamlined health care system and collaborations with foreign businesses (including American ones), the Chinese biotech sector may soon catch up to America’s — and U.S. leaders know it. In April, a bipartisan congressional commission recommended investing at least $15 billion in biotech over the next five years to compete with China. Federal legislation is being considered, such as the Biosecure Act, which passed the House last year and would prohibit federal agencies and recipients of federal funds from contracting with Chinese biotech contractors like Wuxi AppTec.
The dire state of the American research landscape may render such policies moot. U.S. federal funding for medical research is significantly higher than China’s, thanks in great part to funding provided by the National Institutes of Health and other federal sources. But the ongoing uncertainty of billions of dollars in research grants from these agencies will make it more challenging for America’s biotech industry to maintain its homegrown dominance. Big American companies will be ever more dependent on the cost advantages and bright young engineers that China offers.
While many see China’s rising biotech sector as a threat, I’m not sure that I do. About eight in 10 Americans think prescription drug costs are too high. President Trump is attempting to rectify the issue in part by forcing pharmaceutical companies to slash prescription drug prices to levels comparable with those in other high-income countries. That may help solve American consumers’ gripes in the short term, but the hit to American pharma and biotech companies might only help accelerate Chinese companies’ race to surpass their U.S. counterparts.
Instead it would make more sense to consider China as part of the solution. Increasing access to new Chinese-made medications could give Americans more options for cheaper drugs and treatments for a whole range of diseases on the rise, including diabetes, cancer and heart disease. Creating more competition with U.S. biotech giants could help drive down American-made-drug prices. That same competition might also spur companies on both sides of the Pacific (and elsewhere) to invest more in the development of innovative medicines that chip away at rates of diabetes, heart disease, dementia and cancer to lengthen people’s lives — or perhaps further link up on collaborative efforts.
To be clear, China’s biotech industry hasn’t ushered in some sort of health paradise. For many of the approximately 500 million Chinese who live in rural communities (around 35 percent of the population), doctors and health care services are unreliable or difficult to reach — just drink hot water for what ails you, the folk wisdom goes. China’s universal public system, known as Yibao, doesn’t cover very much. Though China can manufacture and distribute drugs at heightened speeds — sometimes in as little as 16 months — it still has trouble with frontier science for developing new drugs. Chinese doctors, government agencies and financiers still regard American science as a gold standard (albeit one that is facing increasing uncertainty). Yi Rao, a neurobiologist at Peking University, told me that China had yet to build a federal apparatus to support the life sciences that was capable of rivaling America’s National Institutes of Health.
And yet the progress China has made over the last decade or so has been staggering. The 2002-03 SARS outbreak spurred the country to take the life sciences more seriously. Over the past two decades China has invested heavily in biotech research, building out regulatory infrastructures and developing a pipeline of young scientists. Life sciences were officially promoted in 2015 as a strategic industry under the country’s Made in China 2025 plan.
Much of this investment was also driven by the need to address the country’s increasingly aging population. By 2035, 400 million Chinese are projected to be over age 65. Nearly five million Chinese were diagnosed with cancer in 2022, and more than 2.5 million died of it. Currently, about 148 million Chinese have diabetes; heart disease contributes to over three million deaths. China spends only about 7 percent of its gross domestic product on health care, but that’s sure to creep upward.
China’s government can hardly afford to pay American prices for American-made drugs. (To hear Mr. Trump tell it, neither can Americans.) But China also can’t afford the politics of letting its citizens die of curable diseases. That has led to intense pressure for the Chinese government to create and invest in Chinese biotech champions, including through the use of state-backed venture capital funds.
These companies have taken advantage of a drug approval process that recruits patients for clinical trials two to three times as fast as in the United States, according to the Asia Society. Recent reforms by China’s National Medical Products Administration have reduced wait times for clinical trial approval and have made trial operations an estimated 30 percent less expensive than in the United States. And thanks to its focus on scaling up manufacturing while keeping costs low, no Western company will offer biomedical products as cheap as a Chinese one.
As Marco Rubio’s office wrote in a 2024 report when he was a senator, before he became secretary of state, “China is capable of high-value research in a variety of fields, related to both production, where it excels, and theoretical fields, where the United States once enjoyed a comfortable lead.”
Mr. Rubio and others aren’t alarmed simply by the economic and industrial implications but also by geopolitical ones. China’s biotech industry is part of its expansion of soft power around the world this century. The country is increasing pharmaceutical exports to countries in Southeast Asia. During the Covid-19 pandemic, Chinese enterprises like CanSino and Sinovac developed and exported large quantities of Covid vaccines to the developing world.
The rise of this industry is also fueling a very strong bench of life sciences talent in China. The Chinese Academy of Sciences and major Chinese universities produce four to five times as many medical graduates annually than the United States does. And when Nature polled American scientists recently, 75 percent said they were considering leaving the United States. A Chinese venture capitalist told me that if the ethnically Chinese among those 75 percent came back to China, it could supercharge the country’s efforts.
And while China’s biotech industry may be focused on making drugs ultracheap, that talent is laying the foundation for the country to achieve innovative breakthroughs, too. Consider Likang Life Sciences, a Chinese company whose new cancer vaccine, which uses mRNA editing, is undergoing clinical trials for F.D.A. approval. The vaccine is designed to activate patients’ immune system to target their specific cancer and attack it. It is swiftly moving through the Chinese regulatory process and has recently become available to select patients in part of Hainan Province.
The kicker? Likang is planning to offer this product for around $21,000 — a fraction of the price that Western companies like Merck or Moderna would offer for similar products. (For its part, the United States also just canceled nearly half a billion dollars of federal funding for mRNA vaccine research targeting respiratory infections.) An investor in Likang that I spoke to isn’t optimistic that the treatment will be made available to Americans, given the current U.S. hostility toward Chinese businesses and their products. (Look no further than the Biosecure Act, the uncertain status of TikTok and existing restrictions that companies like Huawei and BYD face when attempting to do business in the United States.) Likang might need to license the drug to an American pharmaceutical company, which would jack up the price and force American cancer patients to pay a premium.
To American officials, these obstacles are essential to stymying a Chinese ascendancy that not only threatens U.S. economic dominance but also presents the potential for Chinese technological innovation to eclipse America’s. The Covid-19 pandemic is still fresh in the minds of many who believe it began thanks to a lab leak in China and blame its government for inflaming the crisis. The prospect of China pushing forward with bolder forms of research and experimentation frightens many in U.S. leadership.
But the pressure on the West to purchase cheaper drugs and treatments from China will only dial up. Consider Britain’s National Health Service, perpetually short of money. If China offers countries like Britain a way to affordably take care of their aging populations, will they say no? Would Americans really choose to forgo a cheap cancer vaccine that could save a dying mother in the name of national security?
The United States could follow the logic of national security hawks and ban Chinese medicines outright. Or it could seek to benefit from Chinese innovations, much as the Chinese have from America’s.
One of the biggest hurdles Americans would need to overcome is the decades-long reputation that the quality and safety standards in China are lower than America’s, especially when it comes to drugs and medical treatments. Some recent examples over the last decade include safety violations in the manufacturing of a rabies vaccine given to infants, the recall of a heart drug sold in the United States after it was discovered to be tainted with a carcinogen and the 2019 case of a Chinese company selling hospitals blood plasma contaminated with H.I.V. (no one was infected). Even Chinese consumers are angry that Chinese companies may be cutting corners on quality and safety to make their drugs cheaper.
But there’s some irony here: In so many ways, the Chinese system of today has been built on replicating American best practices. Many of China’s most impressive scientists were trained in the United States. If China’s biotech products are good enough for its own 1.4 billion citizens, they should be good enough to meet global standards — provided they pass transparent regulatory scrutiny. China is and always will be the biggest market for Chinese pharmaceuticals. Any medicines that we might use from Chinese companies are the best China can do for its own population.
Chinese success is still often perceived as America’s loss, but it doesn’t have to be. The U.S. health care system continues to be stressed by inequalities and inefficiencies, and the United States would do well to take inspiration from China’s success in streamlining drug discovery and development to provide more affordable and accessible treatments to Americans. Both countries are racing to make people live longer and healthier lives. But if China finds ways to achieve this goal more quickly and cheaply, Americans shouldn’t be left behind because of politics.
Jacob Dreyer is a writer and editor who has lived in Shanghai for most of the past 17 years.
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