Fentanyl is poisoning the American people at an unprecedented scale. This year alone, the Drug Enforcement Agency seized enough fentanyl to kill every single American. During his first term, President-elect Donald Trump took a hardline stance on the drug crisis, focusing on Mexico to secure the U.S.-Mexico border and combat Mexican drug cartels. Eight years later, he is ready to crack down again. This time, however, the incoming president should turn his attention to an overlooked and critical source of the problem: China.

The journey of fentanyl begins in China and ends with lives lost across America. Chinese criminal organizations and pharmaceutical companies produce the precursors needed for fentanyl production. These precursors are then funneled to Mexican cartels, who refine them into the lethal drug. Cartels, in turn, lace fentanyl with other substances to mimic prescription opioids or smuggle it in disguised forms, such as nasal sprays, eye drops, and even small candies. Once trafficked into the United States, these drugs expose hundreds of thousands of Americans to a deadly gamble.

The U.S. must impose harsher sanctions on China to curb this crisis. Stronger measures would pressure Beijing to take decisive action against organized criminal networks. They could also bar Chinese pharmaceutical companies complicit in the trade from accessing U.S. financial systems and impose costly penalties on the Mexican cartels that rely on China for their supply chain. Such sanctions could save countless American lives and reduce crime rates tied to the drug trade.

Currently, the U.S.-Mexico Bicentennial Framework for Security, Public Health, and Safe Communities falls short of addressing the nexus between Chinese suppliers and Mexican cartels. Neither China nor Mexico prioritizes meaningful law enforcement coordination with the U.S. In fact, China continues to deny responsibility for its role in fentanyl production, while Mexico’s actions remain inadequate. Both nations seem to view the fentanyl epidemic as America’s problem to solve.

From 2017 to 2020, the Trump administration called on China to tackle its fentanyl production, and the U.S. imposed sanctions under the Kingpin Act against Chinese drug traffickers. Yet these measures have largely failed. China remains the top exporter of illicit fentanyl precursors. To truly address this crisis, the president-elect must take a more aggressive approach by intensifying sanctions against China.

Only sustained and escalated pressure will compel Beijing to act against its drug producers and suppliers. While China’s inclusion of fentanyl on its controlled substances list is a step forward, it is insufficient without additional enforcement. Tougher sanctions could catalyze greater progress.

The implications for Chinese pharmaceutical companies are stark. As a major exporter of pharmaceutical products, China risks losing access to the lucrative U.S. market if it continues to produce illegal substances. Sanctions would also sever their ability to transact with U.S.-backed financial institutions and restrict partnerships with American biotech firms. These measures would deliver a clear message: enabling the production of harmful substances will result in severe economic consequences.

Meanwhile, Mexican cartels—dependent on Chinese precursors—would also face significant disruptions. Cutting off their supply chain would inflate their production and distribution costs, leading to fewer drugs making their way to American streets. The resulting scarcity would likely lower overdose rates and save lives.

While critics argue that sanctions often escalate international tensions, Donald Trump remains a staunch advocate of their use. During his first term, he significantly increased sanctions on China, a strategy he appears poised to revisit. Importantly, escalating sanctions is unlikely to worsen U.S.-China relations further, as Beijing has already begun taking incremental steps to curb illegal fentanyl production. However, these steps must be met with continued U.S. pressure to ensure meaningful outcomes. Should production rates fall to zero, the U.S. could consider easing sanctions as a reward for compliance.

Protecting American lives starts with dismantling China’s role in fentanyl production. Tougher sanctions on China are a necessary step to achieve this goal. Over the next four years, the president-elect has a critical opportunity to safeguard Americans, reduce crime, and foster a healthier, safer future. The path forward is clear: hold China accountable and prioritize the well-being of the American people.