Sinica Podcast

This week on Sinica, I sit down with Dr. Ruby Wang, whose new book, China Cure: The Rise of a Biotech, AI Medicine and Global Health Superpower (Agenda Publishing, out October 31, with a foreword by Kerry Brown), is the explanation general readers have been missing for one of the most consequential and least understood transformations in China today. Ruby is a rare creature in this space: a practicing physician in Britain’s NHS, trained in surgery, who worked London’s hospital wards through the first wave of COVID; the former head of the UK government’s health engagement in China at the British Embassy in Beijing; a former health adviser within the UN system; a onetime medical adviser at AliHealth in Hangzhou; and a Schwarzman Scholar. She now runs the strategy consultancy Lintris Health and writes the excellent China Health Pulse newsletter and podcast, both of which I recommend to anyone trying to follow this space.
Anyone who spent time in a Chinese hospital in the late ‘80s or ‘90s — the pre-dawn queues, the ticket scalpers, the cashier’s window at every step, the IV drips for a head cold — will find the arc of this book hard to believe. Within living memory, China sent barefoot doctors into the countryside with herbal remedies and antibiotics in army-green satchels; last year, Chinese companies signed something like 186 out-licensing deals worth a disclosed $137 billion, roughly half the global total and close to ten times the 2021 figure, with Pfizer, Bristol-Myers Squibb, AstraZeneca, GSK, and Eli Lilly all buying. Since Ruby gave a terrific interview to my friend Kyle Chan on his High Capacity podcast this spring on the apps, data flows, and clinical AI, I deliberately steered elsewhere: to her family — a deckhand grandfather, a father’s crooked splint, a grandmother’s transnational hunt for Gleevec — to the four reinforcing conditions she argues made the transformation possible, to the “China is fast because China is loose” shortcut and what’s actually behind the speed, to BIOSECURE and its successors, to the AI doctor avatars now fielding millions of inquiries a year, and to the burnout and violence that still bedevil the lives of Chinese clinicians.
10:31 – Two family stories from 1970s Zhejiang: a deckhand grandfather and a barefoot doctor’s crooked splint
15:57 – Four reinforcing conditions, part one: demographic pressure and crisis as catalyst (SARS, melamine, fake vaccines)
23:42 – The long view: Healthy China 2030 and why China’s health ministers are technocrats
27:54 – The cultural inheritance: who signs the consent form, and China’s health codes vs. Britain’s billion-pound app
35:26 – Grandma and Gleevec: a family’s transnational hunt for a drug in 2003
40:17 – The reversal: hǎiguī, copycats to first-in-class, and the tenfold surge in out-licensing
42:35 – Is China fast because China is loose? Where China leads (oncology, GLP-1s) and where it lags
50:22 – BIOSECURE, COINS, and BINSA: who loses when politics meets pharma
55:37 – Digital health in three systems, Ant Afu’s AI doctor avatars, and whether the silver generation can keep up
1:08:44 – “A lifetime of eating bitterness”: Dr. Wang of Guangzhou, burnout, and yī nào
Paying It Forward
Yanzhong Huang, senior fellow for global health at the Council on Foreign Relations and professor at Seton Hall — the go-to voice on the geopolitics of China and health, and Ruby’s first port of call.
Afra Wang, writer of the Concurrent newsletter — Ruby admires how she reads the cultural currents beneath technology, and finds it endlessly useful to take those insights to the health-tech angle.
Olivia Plotnick, Shanghai-based founder of Wai Social — on-the-ground work on branding and consumer behavior across some 30 lower-tier Chinese cities, including health and wellness.
Recommendations
Ruby: Deep China: The Moral Life of the Person, edited by Arthur Kleinman with Yunxiang Yan, Jing Jun, Sing Lee, and others — what being sick reveals about society and culture in China: psychiatry, caregiving, and how patients and families have changed as the country has. Kleinman’s The Soul of Care is also worth your time.
Kaiser: Augustus by John Williams — the third of his novels I’ve recommended on the show, and the National Book Award winner: an epistolary novel of imperial Rome told through a crazy quilt of letters and fragments from family, friends like Agrippa, and poets like Virgil and Horace, each given a completely distinct voice. Quiet campus novel, anti-Western, imperial Rome — the range, and the restraint, are astonishing.
Also: Ezra Klein’s conversation with Carnegie’s Matt Sheehan — a masterclass in clarity on AI safety and the U.S.-China relationship, and the best thing to listen to in the wake of Dario Amodei’s “Pacing the Frontier” essay.

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This week I sat down with Gloria Xiong, Assistant Professor of Government at Colby College, and Jessica Chen Weiss, the David M. Lampton Professor of China Studies at Johns Hopkins SAIS, to discuss their new Foreign Affairs essay, "How China Found Its Most Potent Weapon: The Real History of Beijing's Rare Earth Dominance."
The story everyone tells is one of foresight — a master plan hatched by Deng Xiaoping and now coming to fruition. Gloria and Jessica argue the reality was far messier: reform-era export mania, environmental catastrophe, defiant local governments, scarcity anxiety, and a lesson in chokepoint weaponization that Beijing learned from Washington. Getting the story wrong, they argue, feeds an action-reaction spiral that neither side started and neither fully controls — and with the Busan truce expiring in November, the stakes could hardly be higher.
09:31 — "The Middle East has oil, China has rare earths": what Deng Xiaoping actually said, and how a quote got recruited for a story he wasn't telling
12:33 — Why the master plan narrative is so irresistible across the partisan spectrum in Washington
15:40 — The cheap and dirty origins: reform-era export mania, thousands of small mines, and rare earths sold "at the price of cabbage and dirt"
19:06 — The West as co-author of the chokepoint: offshoring the pollution, and the stockpile that was never built
21:53 — Beijing's struggle to control its own industry: quotas, "crime rings," and the partially failed 2002 consolidation
25:13 — September 2010: what really happened with the "embargo" against Japan, and why Beijing may have learned about it from Japanese customs
28:47 — Fans and fire hoses: how bottom-up nationalism can commit Beijing to coercive postures it didn't choose
32:13 — The debate inside China after 2010: protectionists versus Hong Feng's warning against using rare earths as "political chips"
35:44 — The 2015 WTO ruling: China complied — was it a rule-taker, or did it simply lack the tools to do anything else?
38:06 — Learning from Washington: Huawei, the Export Control Law, the China Rare Earth Group, and what distinguishes learning from planning
40:24 — The 2022–2024 ledger: what's the evidence for an action-reaction spiral beyond the timeline?
44:25 — April 2025: coercion or bureaucratic pileup? Thirty licensing officials and a 74% collapse in magnet exports
47:46 — October 2025: the extraterritorial rule that mirrored the Foreign Direct Product Rule, and the Busan truce
52:32 — The countdown to November: hawks in both capitals, "mutually assured disruption," and Xi's coming state visit
55:29 — The limits of leverage on both sides: yttrium, Japan's diversification, and China's own resource insecurity
58:32 — From crime rings to two national champions: has the Wild West been tamed, and are central-local relations "fractured"?
01:02:21 — Prescriptions: positive reciprocity, licensing Chinese technology, and managing interdependence rather than escaping it
01:05:51 — Everyone else: Myanmar, Congo, Australia, and how Beijing thinks about third countries that don't want to choose

Paying It Forward
Gloria name-checked Wendy Leutert of Indiana University, who works on the reform and global expansion of China's state-owned enterprises and, with Isaac Kardon, on Chinese investment in global ports; Ning Leng of Georgetown University, author of the award-winning Politicizing Business: How Firms Are Made to Serve the Party State in China; and Ketian Zhang, who has written extensively on Chinese coercion and maritime disputes.
Jessica first acknowledged the scholars whose research the essay drew on but couldn't cite in Foreign Affairs: Cory Combs of Trivium China, Arthur Kroeber, Henry Farrell, Duleep Singh, and Julie Klinger. She also flagged Jack Zhang, who runs the Trade War Lab at the University of Kansas, and Kyle Jaros and Sara Newland, who are writing a book on subnational economic statecraft — work that has shaped her thinking on disaggregating what the United States wants, not just what China wants.
Recommendations
Gloria: Healing the Heart of Democracy by Parker Palmer — a book she first read in a college writing seminar and returned to as she heads back into the classroom.
Jessica: The Scientist and the Spy by Mara Hvistendahl, which she uses to close her SAIS seminar on Chinese foreign policy as a reminder about proportionality; and Ann Patchett's new novel Whistler.
Kaiser: Wallace Stegner's Angle of Repose, the 1972 Pulitzer winner — a novel about mining camps in the American West and one of the most fully realized characters in American fiction.
Also mentioned: Jessica's recent interview with Daniel Kurtz-Phelan on The Foreign Affairs Interview podcast, and her interview in The Monitor, the newsletter of the Carter Center's U.S.-China Perception Monitor.
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This week on Sinica, I’m joined once again by Ryan Hass, Director of the John L. Thornton China Center at Brookings, former NSC director for China, Taiwan, and Mongolia, and co-host of the Beijing Brief podcast. Ryan has just published two pieces that couldn’t be better timed: a long essay in China Leadership Monitor, “China’s Great Power Vision Comes into Focus,” which argues that the 2020s may be remembered as the decade Beijing finally laid its cards on the table — and a shorter Brookings piece, “Why Beijing Isn’t Taking the Bait with Trump,” on why Xi Jinping has answered an unusually accommodating American president with a poker face, and what that means for Xi’s state visit to Washington later this month.
We start with the perennial question — what does China want? — and Ryan’s own two-decade journey with it, from chasing a supposed secret strategy in Zhongnanhai as a junior political officer to concluding that Beijing’s vision is now legible and consistent: an international political order stripped of its liberal core and rebuilt around sovereign equality and the “global majority.” We talk about “American decline” and “strategic stalemate” in Chinese discourse, the tension between China’s pitch to the developing world and its export juggernaut, the Middle East and Northeast Asia as test cases, and the central riddle of Ryan’s essay: why a country so willing to articulate its ambitions has been so unwilling to pay for them. Then we turn to the summit — constructive strategic stability, escalation dominance, and what will and won’t be on the table when Xi comes to Washington.
03:11 – The “What does China want?” genre — and why Ryan concluded there is no secret plan locked in a Zhongnanhai vault
06:10 – From participant to architect: what actually changed, and whether Beijing is revisionist or, as I cheekily put it, restorationist
09:12 – “American decline” (美国衰落) and “strategic stalemate” (战略相持): reading Beijing’s rhetorical restraint and the Maoist echo
14:34 – Champion of the global majority, or the world’s factory? The $6 toaster problem and the credibility gap on Ukraine and Japan
19:36 – The Middle East as a test case: economic enabler, not security patron — and the good-faith maximalist rebuttal
24:38 – Northeast Asia: why Beijing keeps generating the very encirclement it fears
26:59 – Rhetoric without resources: flat foreign aid, shrinking BRI lending, and the SCO as China’s proving ground
32:28 – The Pew swing that hasn’t materialized, and why Biden may have been America’s last restorationist president
36:01 – Why Beijing isn’t taking the bait: Xi’s poker face, “constructive strategic stability,” and the G2 refusal
41:55 – Confident abroad, anxious at home: the purges, the memory of 2020, economic escalation dominance, and a viewer’s guide to the September summit

Paying It Forward
Ryan flags two women doing important work in China studies, both with books out this fall: Emily Matson of Georgetown, whose China’s Date Debate: How Manchurian Scholars Rewrote World War II examines how the start date of China’s war with Japan was moved from 1937 back to 1931; and Shuxian Luo of the University of Hawaiʻi at Mānoa, whose Simmering Seas: Escalation and De-escalation in China’s Maritime Disputes is forthcoming from Oxford University Press in October. He also gives a shout-out to the engines of the Brookings China Center, research assistants Allie Matthias and Joyce Yang.
Recommendations
Ryan: Barbara Tuchman’s The Guns of August, which he’s late to but found poignant for its eerie echoes of today’s battlefields — and Maggie Haberman and Jonathan Swan’s Regime Change, an inside account of the second Trump administration that he calls harrowing but essential for anyone trying to anticipate the president’s behavior. (He also finally read The Three-Body Problem, and now knows his sophons from his Trisolarans.)
Kaiser: Robert Harris’s Agrippa, published September 1 — the memoir of Marcus Agrippa, the general who won Octavian’s battles and built half of Augustan Rome, and a story about the pivot from republic to empire that feels uncomfortably relevant. And if you’ve read Tuchman, do read Christopher Clark’s The Sleepwalkers: How Europe Went to War in 1914. Not my official recommendation, but astonishing.
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This week on Sinica, I sit down with the writer Pallavi Aiyar — at her own dining table in Beijing, where in recent months I’ve been the lucky beneficiary of her and her husband Julio’s legendary hospitality. Pallavi first arrived in Beijing in 2002 to teach at the Beijing Broadcasting Institute and went on to spend the better part of a decade as The Hindu’s China correspondent — for much of that time, the only Chinese-speaking Indian foreign correspondent in the country. That period produced Smoke and Mirrors: An Experience of China, still one of the very few sustained attempts to look at China through Indian eyes. After 16 years away — years spent in Brussels, Jakarta, Tokyo, and Madrid — she’s back in Beijing, and turning her gaze inward with her latest book, Travels in the Other Place: Pursuing the Self in Eight Acts. She writes the wonderful Substack The Global Jigsaw, which I recommend without reservation.
Our conversation is built around her recent essay for Noema Magazine, “The Real Problem Underlying India-China Tensions,” which argues that the deepest problem in the relationship isn’t the border or the trade imbalance but the distorting lenses through which each side reads the other: China reads India through the lens of colonial subordination, while India reads China through the lens of betrayal. We talk about the ugly etymology of an ethnic slur, the partial historical memories each country mistakes for the whole picture, her serialized interviews with the Chinese India-watcher Mao Keji, the aporia-inducing impossibility of explaining either country to outsiders — and how her answer to the question she first posed in 2008, “Would I rather be born Indian or Chinese?”, has changed, painfully, in the years since.
4:35 – Beijing, 2002: an ad in That’s Beijing, gandhi@hotmail.com, and becoming The Hindu’s correspondent
10:03 – “Beijing and I grew up together”: the aughts as a shared coming-of-age
12:16 – The asymmetry of obsession: why India watches China, but not the reverse
16:39 – The unacknowledged third vertex: Western discursive power in the India-China relationship
18:08 – Back after 16 years: the Liangma River, blue skies, and the panopticon
21:35 – Walks in the park and the “buddy system”: what access looks like now
25:43 – Where did all the foreigners go?
29:59 – The scene at CCG: candor, offense, and the register of truth
33:10 – “Asan”: the etymology of a slur, Sikh policemen, opium fortunes, and China’s colonial lens
40:10 – 1962 and India’s betrayal lens
42:15 – Aporia: the foolhardy task of explaining India or China
47:22 – Shame and indignation: explaining a place you love versus a place you merely know
52:29 – The big question, 2008: born Indian or Chinese?
55:44 – The 2026 answer: “It hurts”
1:00:08 – Kaiser pushes back: cherry-picked comparisons, and can this essay’s very existence complicate its conclusions?
1:04:43 – Twin nations of the exam
1:06:57 – Cognitive empathy: what it would take for ordinary Indians and Chinese to actually see each other

Paying It Forward
Yaqi Li, a young Chinese international relations scholar recently returned to China after a year in Singapore — Pallavi admires the rare self-reflectiveness of his memoir-inflected IR writing on his Substack, New China Literacy, and notes that he makes an interesting case for AI-assisted writing as a way for second- and third-language English speakers to find their voice.

Recommendations
Pallavi: Flashlight by Susan Choi — a novel spanning Japan, the U.S., and North Korea, built around the North Korean abductions of Japanese citizens in the 1970s. Also This Is Where the Serpent Lives by Daniyal Mueenuddin — the first novel from her favorite Pakistani writer, a sprawling, Chekhovian portrait of feudalism and politics in modern Pakistan.
Kaiser: Crossing to Safety by Wallace Stegner — beautiful at the sentence level, painted on a small canvas: two couples who meet as young academics at the University of Wisconsin–Madison, and their friendship across the decades. Emotionally rich despite the absence of grand drama.

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This week on Sinica, I welcome back Evan Osnos of The New Yorker, whose marvelous new essay, “The Future, Made in China,” chronicles a tech-focused return trip to Beijing, where he lived from 2005 to 2013 — first for the Chicago Tribune, then as The New Yorker’s China correspondent. Evan is the author of Age of Ambition: Chasing Fortune, Truth, and Faith in the New China, which won the National Book Award, as well as Wildland: The Making of America’s Fury and The Haves and Have-Yachts.
His essay is far more than another breathless account of China’s advances in robotics and electric vehicles. It’s a meditation on what China’s technological ascent means for the United States, for how both societies are organized, and for the rest of us, whose futures increasingly seem to be wagered by two small circles of powerful men in Beijing and Washington. We talk about the Xiaomi Hyperfactory, “Chinamaxxing,” the export control debate, and the deeper contest Evan identifies: not democracy versus authoritarianism, but humanism versus scientism.

3:04 – Walking Beijing’s streets again: quieter, richer, more surveilled
11:26 – The Xiaomi Hyperfactory: choreography, awe, and what’s actually real
18:10 – Doomed to coexist: Evan’s message for the American reader
24:15 – Schrödinger’s China: joke or juggernaut?
27:16 – The limits of knowability in an increasingly opaque system
31:56 – Threat narratives vs. “Chinamaxxing”: America’s two China conversations
43:20 – “Thank Trump”: America’s self-inflicted wounds
47:29 – Revisiting the Sullivan doctrine and export controls
53:10 – Mankind 2000: humanism, scientism, and rival oligarchies
1:02:48 – Convergence: arriving at dystopia from opposite directions
1:07:21 – Self-strengthening redux: Levenson and America’s meum-verum gap
1:17:53 – The other Sputnik moment: the backlash against tech oligarchy
Paying It Forward
Yi-Ling Liu, author of The Wall Dancers: Searching for Freedom and Connection on the Chinese Internet — Evan admires how her work grapples with the competition between scientism and humanism across national borders.
Chang Che, who writes for The New Yorker and The Guardian — watching China’s technological developments up close, “creating history in real time.”
Recommendations
Evan: How to Rule the World: An Education in Power at Stanford University by Theo Baker — the youngest-ever Polk Award winner on how a rising generation at Silicon Valley’s feeder school perceives its opportunities and obligations. Also True Grit by Charles Portis — splendid, sentence-savoring dialogue.
Kaiser: Butcher’s Crossing by John Williams, author of Stoner — a Western with the same sentence-level craft; for fans of Melville and Cormac McCarthy.

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