Despite heightened tensions between China and the U.S., sub-national diplomacy remains a critical channel for fostering collaboration. However, rising security concerns in the U.S. and differing priorities in China pose challenges, underscoring the need for transparency, trust, and a focus on mutual interests to sustain these efforts.

In an era of growing tensions between the United States and China, Roberta Lipson brings a valuable perspective shaped by decades of experience across the two cultures. As an American who has spent nearly half a century in Beijing building a network of 11 hospitals and 25 clinics, Lipson understands the complex interplay between business, healthcare, and international relations. In this conversation with KJ Kerr of China-US Focus on the sidelines of the U.S.-China Hong Kong Forum in November, she speaks about her remarkable journey and offers thoughtful analysis on the future of bilateral relations amid uncertain political times.

China must see to its own domestic affairs and promote all-around socioeconomic progress. Externally, it must walk the path of peaceful development without wavering, adhere to an independent foreign policy of peace and hold fast to multilateralism to foster solidarity with other nations. Only in this way can we overcome the severe challenges that are coming our way.

Trump 2.0 is expected to be more mature than it was in Round 1. He will likely place greater emphasis on leadership and earning respect from other countries. If both sides commit to communication, managing differences and deepening cooperation, relations can find a new balance in a complex international environment.

The two major powers should go beyond their differences and work together to advance global industry and offer even greater joint contributions — finding new ways to secure a peaceful, mutually beneficial relationship.

As the impacts of climate change intensify, the U.S. and China must shift focus to adaptation, with opportunities for cooperation through subnational partnerships and a competitive model to assist vulnerable nations. This approach offers a path forward for both countries to lead global efforts in climate action.

Recent developments signal a potential thaw in U.S.-China space cooperation, as NASA’s outreach sparks cautious optimism but also draws sharp political criticism from China, highlighting both the promise and the challenges of collaboration amidst broader tensions.

The election of Donald Trump to a second term signals that the United States will temporarily step back from the next wave of globalization. As a consequence, Japan’s future security will lie in its deep integration into the processes of globalization and regional integration. This raises an opportunity for improving China-Japan relations.

The recent prisoner swap and forward movement on illicit drugs by China and the United States demonstrates that the two powers can make stabilizing progress together when they put their minds to it. But more uncertainty is on the way, as Donald Trump returns to the White House.

There are no winners in war — either shooting wars or technology wars. The scope of the new agreement between China and the United States is narrower after revisions, yet it’s still good for both sides because it preserves contacts and exchanges at many levels.