China’s responses to COVID-19 reveal an evolving dynamic of (a) containment and control; (b) limited disclosure; and (c) escalating resistance. These stand against a background of historical grievance against the West and alienation from the international health policy community exemplified by the United States and its European allies with whom China has ongoing disputes over trade, human rights, and security. China’s COVID-19 response involves reaction to conflicting WHO themes of modernization and colonialization that both invite and inhibit participation by developing countries. Proclaiming support for modernization in medical training, equipment, and services, the PRC has also emphasized the role of Chinese Traditional Medicine, while resisting WHO calls for disclosure of raw data, lab records, and case files. China’s posture will require a measure of accommodation in global efforts to contain the pandemic and prepare for future outbreaks, combined with renewed efforts to improve cooperation and transparency.