In a landmark bilateral initiative, the United States and China agreed to join forces against the fentanyl epidemic—a move that signals a potential thaw in fraught relations. Yet few know what the agreement entails, whether it will be effective, or what it signals for cooperation on other issues.
U.S. President Joe Biden and Chinese President Xi Jinping agreed to the talks last November. China had previously limited its cooperation with the U.S. following former Speaker of the House Nancy Pelosi’s 2022 visit to Taiwan.
The opioid epidemic is devastating the U.S., with fentanyl, a powerful synthetic opioid, at the root of the chaos. Introduced in the 1960s for pain management, fentanyl has become a lethal street drug. Infamously addictive, the drug is often used to "cut" more expensive substances like cocaine, posing dangerous risks to unsuspecting users. In 2022, over 107,000 Americans died of fentanyl overdoses, roughly twice the U.S. death toll from the Vietnam War.
Most of the precursor chemicals used to make fentanyl are manufactured in China by small chemical and pharmaceutical companies. These companies sell to cartels in Mexico, who turn them into fentanyl they then smuggle into the U.S.
China lacks an immediate economic incentive to crack down on fentanyl production — they profit from the cartels’ business. Their cooperation, instead, reflects longer term political and economic objectives. Chinese officials saw other benefits to this agreement: relief from broad U.S. sanctions against 32 Chinese companies blamed for fentanyl production or mistreatment of the Uyghurs. When Xi refused to begin talks without Biden first lifting the sanctions on the China’s Public Security Ministry’s Institute of Forensic Science, the U.S. agreed.
The U.S. gained bargaining power from Chinese economic tumult. Economic decline began in 2021 due to COVID-19 restrictions but recently worsened, reflecting weaknesses in the housing sector, stock market, and domestic consumption. These economic challenges increase U.S. leverage to ensure the fentanyl agreement has real impact. China needs to remediate U.S. relations to attract foreign capital and increase exports. Should China fail to constrain fentanyl exports, the U.S. might reinstate sanctions and threaten trade between the countries.
But creating an enforceable deal is challenging. Drug manufacturing's clandestine nature makes regulation difficult. Fentanyl is particularly difficult to regulate because manufacturers create new analogs so frequently that regulatory agencies can not keep up.
Some urge the U.S. and China to engage in a multilateral approach, pointing to China’s successful collaboration with Australia under “Taskforce Blaze.” The 2015 collaboration successfully reduced illegal methamphetamine trafficking that was devastating Australia. Versions of this already exist: the Biden Administration established the Global Coalition to Address Synthetic Drug Threats in July 2023, which more than 80 countries joined (though not China). U.S. and Chinese leaders could find multilateral efforts easier to embrace given bilateral frictions and mutual mistrust.
At a minimum, successful efforts should include Mexico, which is central to the problem but absent from the conversation. While the U.S. heavily criticizes China for its inability to control the flow of fentanyl out of its country, Mexico shares blame for its failure to police and control its powerful drug cartels.
Finally, many note America’s failures in responding to the threat of fentanyl. Both China and Mexico have condemned the U.S. for focusing exclusively on supply without addressing American demand for the drug. Furthermore, Mexico struggles to control its drug cartels because they possess military-grade automatic weapons – most of which were imported from the U.S. And U.S. inability to control domestic demand for fentanyl ensures rich profits for those Mexican and Chinese entities making and selling the drugs. Journalist Sam Quinones wrote America must “step up to curtail the southward supply of assault weapons… that ensure traffickers can produce the drugs killing so many Americans.”
The U.S.-China pact is a make-or-break moment in the battle against this epidemic. If they fail, the grim reality is more lives lost and tensions heightened.
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