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US-China health cooperation reaches back to the signing of the bilateral Science and Technology Umbrella Agreement, their first agreement after normalization of diplomatic relations in 1979. Bilateral cooperation has shaped the China Center for Disease Control and Prevention (China CDC) and produced some of the world's finest epidemiological research over the last thirty years. US-China research and technical cooperation has covered the full range of health-related topics, with no area given more attention than research and technical cooperation on emerging infectious diseases. In the wake of the outbreak of severe acute respiratory syndrome (SARS), the United States ramped up the staff presence of its Center for Disease Control (CDC) in China. Although this changed in the Obama years, as China's epidemiological capacity developed rapidly, the dramatic shift occurred with the Trump administration, whose cuts, just as COVID-19 arose as the largest epidemiological threat to the world in a century, left only a skeleton staff in place, and the US government without eyes and ears on the ground. Nonetheless, there is a reservoir of mutual respect and willingness to cooperate among the health professionals in both countries. If there is political will, this could become the foundation for a next-phase bilateral health relationship.