- COVID-19 has exacerbated pre-existing trends in global trade and geopolitics, including China–US rivalry.
- The pandemic has impacted global supply chains and global political cooperation. It has also weakened regional and multilateral cooperation in favour of nationalism.
- China and the US compete in regions like Africa and Latin America. In Africa the US has built on existing health initiatives, especially the Presidential Emergency Plan for AIDS Relief (PEPFAR).
- In both Africa and Latin America, China has drawn on multiple state and non-state actors to promote its health diplomacy outreach.