Just outside 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.

就在离上海不远的无锡市，中国正在打造自己的医药业未来——一个蓬勃发展的、由大量工厂与实验室组成的生物技术中心。在这里，全球制药公司可以比其他任何地方更快、更便宜地开发和生产药物。

Amid the Trump administration’s tariffs on China, I figured manufacturing hubs like this one would be racked 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.

在特朗普政府对中国加征关税之际，我原以为这样的制造业中心会充满焦虑。但今年4月我走访无锡时，政府官员坚称当地的研究中心方兴未艾。他们自豪地向我介绍那些一直在茁壮成长的明星实验室和企业。今年1月以来，中国生物技术类股票飙升逾60%，似乎也印证了他们的说法。这座城市的研究人员无疑有望在未来几十年里都保持忙碌状态。

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.

在打破美国生物技术领域主导地位的过程中，中国不见得就是想着在美国擅长的领域击败美国。美国生物技术产业以孵化尖端疗法和治愈手段闻名，中国的创新路径则主要聚焦于加快制造速度和降低成本。其理念并非在诸如CRISPR基因编辑技术等领域取得突破性进展，而是让本国药品和医疗产品的研发、测试及生产变得更高效且成本更低。

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.

因此，中国的生物技术产业能以低得多的价格向客户提供药品和其他医疗产品，包括价格低廉的仿制药。这些或许并不能够改变世界，却是全球成百上千万人每天赖以生存的治疗方法。随着中国影响力的扩大，世界很快将不得不正视生物技术领域出现的这位新领军者，并决定如何应对。

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 companies 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.

药明康德就是体现中国生物技术发展路径的一家公司。它是制药研发的一站式服务提供商，简化了从早期药物发现到青年科学家招聘和药品生产的所有流程。据估计，这家公司参与了美国四分之一的药品的相关工作，其中包括重要的抗癌药物，其客户既有信达生物、江苏恒瑞等中国企业，也有辉瑞、葛兰素史克、阿斯利康等欧美制药商。

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 much 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.

尽管中国政府会与国内外制药企业进行强硬的谈判，以合理价格换取市场准入，但中国消费者能享受低价归根结底是因为中国生物技术企业的药品测试和生产速度远超美国同行。到目前为止，美国生物技术巨头似乎并不介意这种竞争，因为借助药明康德这类公司，他们能将更多资金投入突破性研究。

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.

但这种情况可能很快就会改变。凭借政府的大力支持、不断壮大的科学家队伍、庞大的患者群体、高效的医疗体系以及与外国企业（包括美国企业）的合作，中国生物技术产业或许很快就能赶上美国——美国领导人也意识到了这一点。4月，一个国会两党委员会建议未来五年至少向生物技术领域投资150亿美元，以便与中国竞争。另外还在考虑联邦层面的立法，例如去年众议院通过的《生物安全法案》，该法案将禁止联邦机构及接受联邦资金的机构与药明康德等中国生物技术承包商合作。

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.

然而，美国研究领域的严峻形势可能会让这类政策落空。美国联邦政府对医学研究的资助远高于中国，这在很大程度上要归功于美国国立卫生研究院等联邦机构提供的资金。但这些机构数十亿美元研究拨款的持续不确定性将使美国生物技术产业更难维持其本土主导地位。美国大公司将越来越依赖中国提供的成本优势和优秀的年轻工程师。

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.

许多人将中国崛起的生物技术产业视为威胁，但是这一点我并不确定。约80%的美国人认为处方药价格过高。特朗普总统正试图解决这一问题，部分措施是迫使制药公司将处方药价格降至与其他高收入国家相当的水平。这或许能在短期内缓解美国消费者的不满，但对美国制药和生物技术公司的冲击可能只会加速中国企业超越美国同行的进程。

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 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.

反过来将中国视为解决方案的一部分或许更为合理。增加对中国新生产药品的获取渠道能让美国人在应对糖尿病、癌症、心脏病等日益增多的各种疾病时有更多廉价药物和治疗方案可供选择。与美国生物技术巨头形成更多竞争有助于压低美国产药品的价格。这种竞争或许还能激励太平洋两岸（及其他地区）的企业加大对创新药物研发的投入，从而降低糖尿病、心脏病、失智症和癌症的发病率，延长寿命——或者可能进一步开展合作。

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.

需要明确的是，中国的生物技术产业并没有带来什么健康天堂。在中国约5亿农村人口（约占其总人口的35%）中，许多人难以获得可靠的医生和医疗服务；民间智慧认为，有病就多喝热水。中国的全民公费医疗制度被称为“医保”，覆盖范围十分有限。尽管中国能以更快的速度生产和销售药品——有时仅需16个月——但在研发新药的前沿科学领域仍存在短板。中国的医生、政府机构和金融家仍将美国科学视为黄金标准（尽管这一标准正面临越来越多的不确定性）。北京大学生物学家饶毅告诉我，中国尚未建立起能与美国国立卫生研究院相匹敌的、能支持生命科学发展的国家机构。

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 promoted in 2015 as a strategic industry under the country’s Made in China 2025 plan.

然而，中国在过去十年左右的时间里取得的进步令人惊叹。2002–2003年的非典疫情促使中国更加重视生命科学。过去二十年里，中国大力投资生物技术研究，建设监管基础设施，并培养了一批年轻科学家。2015年，在“中国制造2025”规划中，生命科学被列为战略性产业。

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.

这一投资在很大程度上也是为了应对中国日益老龄化的人口。到2035年，预计中国65岁以上人口将达4亿。2022年，中国有近500万人被诊断出癌症，超过250万人死于癌症。目前，中国约有1.48亿糖尿病患者；心脏病导致的死亡人数超过300万。中国的医疗支出仅占国内生产总值的7%左右，但这一比例肯定会上升。

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.

中国政府几乎无力承担以美国价格购买美国制造的药品（按照特朗普的说法，美国人也承担不起）。但中国也不能承受让公民死于可治愈疾病的政治后果。这导致中国政府面临巨大压力，不得不通过国家支持的风险投资基金等方式，培育和投资本土生物技术龙头企业。

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 cheaply as a Chinese one.

据亚洲协会称，这些企业利用了中国的药品审批流程——其招募临床试验患者的速度是美国的两到三倍。中国国家药品监督管理局近期的改革缩短了临床试验审批等待时间，并使临床试验操作成本比美国低约30%。由于中国在保持低成本的同时注重扩大生产规模，没有一家西方公司能像中国企业那样以低廉的价格提供生物医药产品。

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.”

在担任国务卿之前、还是参议员的时候，鲁比奥的办公室曾在一份2024年的报告中写道：“中国在多个领域都有能力开展高价值研究，既包括其擅长的生产领域，也包括美国曾轻松领先的理论领域。”

Mr. Rubio and others are alarmed not 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.

鲁比奥等人感到担忧的不仅是其经济和产业影响，还有地缘政治影响。中国的生物技术产业是本世纪其在全球扩大软实力的一部分。中国正增加对东南亚国家的药品出口。在新冠疫情期间，康希诺和科兴等中国企业研发并向发展中国家出口了大量新冠疫苗。

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 as 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 went back to China, it could supercharge the country’s efforts.

该产业的崛起也培养了中国强大的生命科学人才储备。中国科学院和中国主要大学每年培养的医学毕业生数量是美国的四到五倍。《自然》杂志近期对美国科学家进行的调查显示，75%的人表示正考虑离开美国。一位中国风险投资家告诉我，如果这75%的人中有华裔回到中国，可能会极大推动中国在该领域的发展。

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.

尽管中国的生物技术产业可能专注于大幅压低药品价格，但这些人才也为中国实现创新性突破奠定了基础。以中国的立康生命科学公司为例，其新型癌症疫苗采用mRNA编辑技术，正在接受美国食品药品监督管理局的审批。这种疫苗旨在激活患者的免疫系统，瞄准并攻击其特定的癌细胞。它正在快速通过中国的监管流程，最近已在海南省部分地区向特定患者开放使用。

The kicker? Likang is planning to offer this product for around $21,000 — a small fraction of the price that Western companies like Merck or Moderna would offer for similar products. (For its part, the United States 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.

更要命的是，立康计划将这款产品定价约2.1万美元——仅为默克、莫德纳等西方公司同类产品价格的一小部分。（而美国刚刚取消了近5亿美元用于针对呼吸道感染的联邦mRNA疫苗研究经费。）我采访的一位立康投资者对该公司的疗法能否进入美国市场并不乐观，因为当前美国对中国企业及其产品持敌对态度（看看《生物安全法案》、TikTok面临的不确定性，以及华为、比亚迪等公司被限制在美开展业务就知道了）。立康可能需要将这种药物授权给美国制药公司，而这会抬高价格，迫使美国癌症患者支付溢价。

To American officials, these obstacles are essential to stymieing 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.

在美国官员看来，这些障碍对于遏制中国崛起至关重要，因为中国崛起不仅威胁到美国的经济主导地位，还有可能使中国的技术创新超越美国。许多人对新冠疫情仍记忆犹新，他们认为疫情源于中国的实验室泄漏，并指责中国政府加剧了危机。中国推进更大胆的研究和实验的前景，让许多美国领导人感到恐惧。

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 any American really choose to forgo a cheap cancer vaccine that could save a dying mother in the name of national security?

但西方从中国购买廉价药品和治疗手段的压力只会越来越大。想想资金常年短缺的英国国家医疗服务体系。如果中国为英国等国家提供了一种负担得起的方式来照顾其老龄化人口，他们会拒绝吗？难道真的会有美国人为了国家安全放弃能拯救垂危母亲的廉价癌症疫苗吗？

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.

美国可以听从国家安全鹰派的逻辑，彻底禁止中国药物；也可以像中国从美国创新中获益那样，从中国的创新中受益。

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 past 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.

美国人需要克服的最大障碍之一是几十年来形成的固有印象——认为中国的质量和安全标准低于美国，尤其是在药物和医疗手段方面。过去十年的一些例子包括：给婴儿接种的狂犬病疫苗生产存在安全违规；一款在美国销售的心脏药物因被发现含有致癌物而召回；2019年，一家中国企业向医院销售被HIV污染的血浆（无人被感染）。甚至中国消费者也对本国企业可能为降低药物价格而在质量和安全上偷工减料感到愤怒。

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 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.

但这里存在一种讽刺：如今的中国体系在很多方面都建立在复制美国最佳实践的基础上。许多中国最优秀的科学家都曾在美国接受培训。如果中国的生物科技产品能满足14亿中国公民的需求，那么只要通过透明的监管审查，它们就应该能达到全球标准。中国始终是中国制药产品的最大市场。我们可能使用的任何中国企业生产的药物都是中国能为其本国人民提供的最好产品。

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.

中国的成功仍常被视为美国的失败，但事实未必如此。美国医疗体系仍受困于不平等和低效，美国不妨从中国的成功中汲取灵感——中国在优化药物研发流程、为民众提供更廉价且易获取的治疗方面成效显著。中美两国都在竞相让人活得更长久、更健康。但如果中国找到了更快、更廉价地实现这一目标的方法，美国人不应因政治因素而落在后面。