This report presents the hearing record of a vital Commission investigation conducted on July 31, 2019, and has been professionally converted for accurate flowing-text e-book format reproduction. The hearing assessed China's role in global health, pharmaceuticals, and medical products. In addition, it examined the activities of Chinese health and biotech firms in the United States, and U.S. access to China's health market. Finally, the hearing considered the implications for U.S. public health and national security of growing U.S. dependence on Chinese health products.

Contents: 1. Opening Statement of Senator Talent * 2. Panel I: Administration Views on Chinese Pharmaceutical, Medical Product, and Biotechnology Development and Sourcing * 3. Christopher Priest, Chief of Staff, Defense Health Agency Operations Directorate (J-3) * 4. Panel II: China's Role in Global Health and Activities in the United States * 5. Rosemary Gibson, Senior Advisor, Hastings Center, Author, "China Rx" * 6. Ben Westhoff, Author, "Fentanyl, Inc." * 7. Dr. Jennifer Bouey, Tang Chair in China Policy Studies, RAND Corporation; Associate Professor, Georgetown University's School of Nursing and Health Studies * 8. Dr. Mark Kazmierczak, Scientist and Associate, Gryphon Scientific LLC * 9. Panel III: U.S.-China Links in Health and Medical Products: Risks and Opportunities * 10. Benjamin Shobert, Director of Strategy for Health Business Strategy, Microsoft; Senior Associate, National Bureau of Asian Research * 11. Katherine Eban, Author, "Bottle of Lies" * 12. Dr. Yanzhong Huang, Senior Fellow for Global Health, Council on Foreign Relations; Professor, School of Diplomacy and International Relations, Seton Hall University * 13. Craig Allen, President, US-China Business Council * 14. Mark Abdoo, Associate Commissioner for Global Policy and Strategy, Food and Drug Administration

China has emerged as the second largest pharmaceutical market in the world by revenue only behind the United States. There are several factors contributing to China's attractiveness as both a market and a production site including the low cost of production, a large consumer base, and a deep talent pool. And as China's market power continues to expand, U.S. consumers are becoming increasingly reliant on drugs sourced from the country which presents economic and national security risks. As the largest source of fentanyl, China also plays a key role in the on-going U.S. opioid epidemic. Beijing's weak regulatory and enforcement regime allows chemical and pharmaceutical manufacturers to export dangerous controlled and uncontrolled substances.

What is the quality and safety of those products and what is our exposure? Should the public be concerned? Should they have more information? Are the regulatory standards sufficient to protect their interests, and how are the facilities being inspected? These are important questions, but they just touch the surface of bilateral health sector relationships between the U.S. and China.