Ebola and the Power Vacuum: How China Stepped In as America Stepped Back

471 confirmed cases. 84 deaths. No vaccine available. As the Bundibugyo strain of the Ebola virus ravages Mambasa in the Democratic Republic of Congo (DRC), a New York Times report from June 6 shifted the focus away from the virus itself and toward great-power rivalry: the United States is "playing a sharply diminished role," leaving China "less competitive pressure to step up". On the frontlines of the outbreak, a quiet handover of global health leadership is already underway.

From "Leader" to "Absentee": America's Strategic Retreat

This assessment is not without basis. It is grounded in a series of concrete American withdrawals and aid cuts — and in a stark contrast that has played out over the past decade. During the 2014 West Africa Ebola outbreak, the Obama administration mounted a large-scale humanitarian and public health response, deploying thousands of US troops to affected regions. 

China, too, launched the largest overseas public health aid operation in the history of the People's Republic — providing humanitarian assistance worth over US$100 million to affected countries and dispatching organized medical teams en masse to West African outbreak zones. A decade later, the same virus. A very different script.

In January 2025, shortly after returning to the White House, Donald Trump signed an executive order announcing America's withdrawal from the World Health Organization. The Trump administration subsequently shut down the United States Agency for International Development (USAID) and drastically cut foreign aid programs. 

The consequences landed hard in Africa: aid volumes collapsed, the number of medical personnel stationed on the continent fell sharply, and organizations that had relied on American funding for outbreak preparedness training and medical services were left crippled — severely hampering the response to the current Ebola outbreak.

At this moment, the treatment center in Mambasa is facing critical shortages of equipment, medicines, and basic supplies. The lack of diagnostic tools has made it even harder to slow the spread of the Bundibugyo strain. There is currently no approved vaccine or treatment for the virus driving this outbreak.

A Systemic Presence: China's Swift Response

Consider this: while American media were still pointing fingers from behind their keyboards, China had already answered the call of a major power through concrete action — and it is built on years of deep, institutionalized engagement across Africa，not the "tentative first step" or "out of economic interests" posture that some American commentary has insinuated. 

Following the outbreak, the 24th Chinese Medical Team assisting the DRC — already stationed in the country — immediately mobilized and shifted into emergency operations mode. At the time, the Kinshasa contingent was carrying out mobile medical missions in remote areas including Muanda, while the Lubumbashi sub-team was conducting routine medical work at partner hospitals. 

The entire team activated its emergency response at once: conducting targeted inspections of food hygiene and environmental disinfection at each mobile clinic site and Chinese enterprise bases, simultaneously initiating stocktaking and coordinated supply allocation, refining emergency response plans, and organizing cross-regional simulated emergency drills.

The medical team held firm on the clinical frontline, ensuring the ongoing medical needs of local communities were met. The team enforced strict disinfection protocols for incoming patients, implemented comprehensive prevention and control measures, conducted contact tracing, and ensured a safe clinical environment. Between May 17 and 29 alone, the Kinshasa and Lubumbashi sub-teams together treated over 100 local patients.

In the early hours of June 2, the first group of Chinese anti-epidemic medical experts departed Beijing for the DRC to support Ebola prevention and control efforts. The expert team members all possess extensive epidemic response experience and bring together expertise in public health as well as both Chinese and Western medicine. 

They will work alongside the existing Chinese Medical Team in the DRC to support local Ebola control efforts and advance cooperation with Congolese medical and disease control institutions.

Technical Empowerment: From Manpower to Standard-Setting

An even deeper strategic shift is evident in the technological dimension. China's contributions have moved beyond traditional material and human support into a new phase of "technical empowerment."

Sonjelle Shilton, who oversees access to diagnostic tools at Médecins Sans Frontières (Doctors Without Borders), noted that China is at the forefront of rapid diagnostic technology. This includes adaptive machines capable of screening for multiple diseases and point-of-care pathogen identification devices that can be used directly at a patient's bedside. 

For a country like the DRC, where samples must travel hundreds of miles through conflict zones to reach central laboratories, this is nothing short of revolutionary — eliminating the dangers involved in such transport altogether.

Furthermore, according to a recently published peer-reviewed article in the Proceedings of the National Academy of Sciences of the United States of America (PNAS), Chinese scientists are developing an mRNA vaccine designed to provide cross-protection against hemorrhagic fever viruses, including Ebola. 

This work, however, remains at an early stage. These technological capabilities mean that China's assistance is not merely an emergency response — it carries with it forward-looking solutions.

The Quiet Transfer of Global Health Power

Chinese Foreign Ministry Spokesperson Lin Jian explicitly pledged that the Chinese government has decided to provide emergency humanitarian assistance to the DRC and will dispatch a dedicated medical expert team to deliver medical services and support. 

Beyond bilateral aid, China will provide assistance to the African Union Commission, engage in epidemic prevention cooperation, support the Africa Centers for Disease Control and Prevention (Africa CDC) in its control efforts, and jointly enhance Africa's capacity to combat outbreaks.

China's 45 medical teams — comprising over 900 personnel deployed across 44 African countries — are at this very moment fighting alongside African people on the anti-epidemic frontline. It is a systemic, institutionalized presence that forms the solid foundation of China's response, not a hastily assembled task force.

WHO Director-General Tedros Adhanom Ghebreyesus stated that the outbreak is spreading rapidly. The international community must act faster and more effectively to help affected countries bring the outbreak under control and assist neighboring countries in their preparedness efforts.

Lin Jian also noted that going forward, China will maintain close communication with the DRC and other African countries, as well as with the WHO, the African Union, and other bodies — continuing to provide assistance to the best of its ability in line with the evolving outbreak situation and the needs of the African side. 

China also calls on the international community to take more concrete and substantive actions to help the DRC and other African countries overcome the epidemic as soon as possible.

A Replacement of Rules

Viewed through a strategic lens, this outbreak response has become a microcosm for observing shifts in great-power global influence. America's choices reflect the strategic retreat of an "America First" doctrine — a transition from global public health leader to absentee. 

China's actions, by contrast, clearly outline its steadily advancing global positioning: this is not merely about fulfilling the responsibilities of a major power or cultivating a moral image, but about using public health as a key strategic fulcrum to deepen the practical realization of the "China-Africa Community with a Shared Future."

As America chose "America First" and closed the door, China — with 900 permanently stationed medical personnel, point-of-care pathogen detection devices, and a promise to "continue providing assistance to the best of our ability as the situation develops" — is redefining what it means to be a "global health leader." One should view it as a replacement of the rules, instead of merely "filling a void".

East Stratos

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China made its move on May 2. The Ministry of Commerce issued an announcement built around a nine-character directive — “不承認、不執行、不遵守“ （not to be recognised, not to be enforced, not to be complied with”） — in response to the US decision to place five Chinese companies on the Iran-related SDN list. On the surface, this “Blocking Order” is a legal document; in substance, an asymmetric strike at a soft spot in the US sanctions system. It shows how the strategic contest has moved beyond tariffs and technology into the less visible arena of law, finance and rule-making.

Start with the force of US long-arm jurisdiction. Washington does not need to personally choke off every transaction; by leaning on the US dollar clearing system and the global financial network, it can place a target on the SDN list and push banks, insurers and shipping firms worldwide to cut ties out of fear of compliance risk. A low-cost precision strike built on one brutal logic: America designates, and the world follows.

China’s tactical brilliance lies in changing the cost formula rather than striking the US government head-on. By invoking the Rules on Counteracting Unjustified Extraterritorial Application of Foreign Legislation and Other Measures, Beijing denies the effect of the relevant US sanctions within China’s legal order.

More importantly, Article 9 gives harmed Chinese parties the right to sue in Chinese courts and seek compensation from any person or organisation that injures their lawful interests by complying with a blocked foreign law.

That changes the calculation for multinational banks and shipping companies. In the past, once an entity landed on the SDN list, the safest move was to terminate services and absorb only US compliance risk; now those firms must also consider the risk of civil damages in China if they cancel contracts with a sanctioned Chinese company solely in the name of complying with US sanctions. The cost of sanctions is no longer borne by Chinese companies alone; it is shared with, and may even be pushed back onto, the third parties trying to enforce them.

The second edge of this “trump card”: precision. It does not aim at the brain of the US sanctions system — the decision-making bodies — but at the neural network and capillary circulation that keep it alive: the third-party intermediaries that sit at critical junctions of global commerce.

Take the sanctioned Chinese refining companies. Their real problem is often not production itself, but the risk of becoming commercial islands after losing access to financial settlement, cargo insurance, vessel chartering and similar services. The “Blocking Order” is designed to build a legal firewall around them inside China, protecting their channels for RMB financing, supply-chain cooperation and judicial relief, while telling multinationals operating in China or doing close business with it that improper foreign extraterritorial sanctions cannot be treated as a self-evident excuse to damage the lawful interests of Chinese parties.

That puts the key nodes of the global commercial network under real strain. Multinationals that neither want to offend Washington nor can afford to leave the Chinese market can no longer execute US directives mechanically; they must weigh the risk of losing US dollar access against the risk of losing the Chinese market and facing Chinese legal liability. The result is more friction and more uncertainty for the US sanctions machine, turning what was once a low-cost, high-efficiency weapon into a double-edged sword that can trigger legal conflict and commercial blowback.

Can other countries do the same? Probably not easily, because the country with both the capability and the nerve to make this move is, in all likelihood, China. Any legal instrument draws its real force from the national power behind it, and China’s “Blocking Order” rests on the support of a strong real economy, complete industrial chains and a vast market.

China is the world’s largest trader in goods, its most important manufacturing hub and one of the consumer markets with the greatest growth potential. For many multinationals, revenue and market share in China are central to their global strategy, so if complying with US sanctions brings legal risk, commercial losses or even barriers to market access in China, the balance of corporate decision-making inevitably starts to shift. The logic is the same as in the trade war: China’s countermeasures work by turning unilateral US pressure into real costs that US companies, supply chains and consumers must bear.

The “Blocking Order” carries that logic into the legal and financial arena. It shows that China can do more than retaliate in goods trade; it is now using domestic law and market leverage in a more systematic way to push back against US dominance in areas such as financial compliance. The growth of the Cross-Border Interbank Payment System, or CIPS, and the continued opening of China’s financial markets are giving this kind of legal tool a firmer infrastructure base.

The first “Blocking Order” signals a new phase in Sino-US competition. The contest is moving from direct clashes of hard power into a deeper struggle over rules, institutional strength and soft power, marking China’s counter-sanctions framework moving from institutional reserve to real-world operation, and from passive defence to more active rule-setting.

The force of this non-kinetic weapon does not lie in instantly destroying anything. Its strength lies in changing the rules of the game and increasing the cost and complexity of using the other side’s preferred tools. It may not force the United States to abandon sanctions at once, but it ensures that every new designation must now account for the chain reactions and counter-blows it could unleash. For China, which is determined to defend its development interests and challenge unilateralist hegemony, that makes this a pivotal move with both offensive and defensive value in a complex strategic contest.

Future rivalry between major powers will increasingly play out on this invisible battlefield of shaping rules, defining compliance and influencing global commercial expectations. China’s “Blocking Order” is a heavyweight piece placed squarely on that new board.