China-US constructive strategic stability can preserve continuity, humanity and agency in global health

Editor's Note: In this article, Wu Yanni and Zhou Qing'an, researchers from the Global Development and Health Communication Center under Tsinghua University, examine the implications of China-US strategic stability for global health. Drawing on the countries' recent agreement to build a constructive relationship based on respect, fairness and reciprocity, they argue that this stability can preserve continuity in a fragmented geopolitical landscape, humanity as technology advances, and agency for the Global South. They emphasize that major-power cooperation is a necessity for maintaining cumulative health systems, preventing technological fragmentation, and ensuring that countries can access diverse sources of knowledge without being forced into mutually exclusive blocs.

The next pandemic will not wait for geopolitics to become less complicated. Encouragingly, at a moment when world leaders were gathering at the United Nations for the second High-Level Meeting on Pandemic Prevention, Preparedness and Response (PPPR) on September 25, 2026, China and the United States, two of the world's most consequential powers, agreed to build a constructive relationship of strategic stability based on respect, fairness and reciprocity.

For global health, the value of China-US strategic stability extends beyond the bilateral relationship. It lies in three things it can help preserve: continuity in a fragmented geopolitical landscape, humanity as technology advances, and agency for the Global South.

First, China-US strategic stability could generate a positive demonstration effect for global health cooperation.

"Cooperation is a necessity, not an ideal." WHO Director-General Tedros Adhanom Ghebreyesus made the point plainly during PPPR. In an interconnected and interdependent world, no country can protect the health of its people by acting alone. Yet this is also a time of growing fragmentation, when geopolitical divisions can make sustained cooperation harder to maintain.

The agreement between China and the US to build a constructive relationship sends an important signal. It may demonstrate that major powers can manage differences while keeping channels for cooperation open. As two countries with substantial scientific, technological and health-system capacities, their ability to maintain dialogue and cooperate where interests overlap may give other countries greater reason to view international cooperation as viable and worth sustaining.

This particularly matters because global health cooperation is cumulative. Disease surveillance systems, research partnerships, laboratory networks, health-worker exchanges, supply chains and multilateral mechanisms take years to build and depend on continuity long before a crisis emerges. Preserving that continuity is itself a contribution to collective capacity.

Second, how China and the US manage their AI competition could shape whether AI becomes a force for shared global health capacity or another source of fragmentation.

Competition between China and the US in AI is a reality. If managed responsibly, competition can push researchers and companies to move faster, improve technologies, and lower costs. In global health, that could mean better tools for disease surveillance, diagnosis, drug discovery, and health-system management that reach more people more quickly.

The risks rise when competition becomes a race to shut others out. If data, models, expertise and infrastructure become locked into separate systems, the world could lose opportunities to share knowledge and build on one another's advances through scientific exchange, commercial applications, technology transfer and capacity-building. For health threats that cross borders, fragmented technological ecosystems can create consequences far beyond the countries where those technologies were developed.

China and the US are both at the forefront of AI development. While the two sides do not need to have identical views on AI governance, they have agreed to establish a dialogue mechanism to discuss the risks and benefits of AI, creating a practical basis for shared risk management. Such mechanisms can help address risks whose consequences extend beyond national borders, including those affecting health, while keeping technological development oriented toward human needs.

Third, China-US relations matter for whether the Global South can continue to draw on diverse sources of knowledge and experience.

Countries across Africa, Asia and Latin America should be able to assess and adopt global health solutions according to their needs and evidence, regardless of where those solutions originate. China and the US are both major sources of scientific knowledge, health technologies and practical experience. Solutions from either country, when adopted elsewhere, should be assessed on the basis of their effectiveness, affordability and suitability to local conditions, rather than the geopolitical alignment of one camp or another.

China and the US will continue to compete, and countries will inevitably make different choices about the technologies and partnerships they use. The concern is whether geopolitical competition will make those choices narrower by turning technological and knowledge ecosystems into mutually exclusive blocs. Agency means retaining the space to evaluate, adapt and combine different approaches according to local needs.

Finally, this also places weight on how the US assesses the durability of the China-US relationship. Given Washington's role in global health, its shifts in global health engagement and its evolving policy toward China, US policy choices can reshape the wider environment for international health cooperation. If the sustainability of the relationship is judged primarily through the lens of strategic rivalry, global health stability becomes harder to maintain.

The world cannot predict when another pandemic will occur. But we can shape the conditions in which we would meet such a pandemic. China-US strategic stability can help preserve the conditions for global health cooperation to remain possible.

The next pandemic will test all these conditions. It will test whether the relationships built before a crisis can withstand geopolitical pressure, whether technological advances can be translated into practical health benefits, and whether countries retain enough room to determine their own responses. What matters, ultimately, is what remains connected, what remains human, and what remains possible.