VICTORIA, British Columbia — Since the early 2000s, China has become a major player in the international development aid landscape. Health aid has been a significant component of Chinese foreign aid since the 1960s, but its importance to Chinese foreign policy has ramped up in recent years with the introduction of the Health Silk Road. Chinese President Xi Jinping introduced the Health Silk Road in 2016 as an extension of the Belt and Road Initiative (BRI). China launched the BRI in 2013 and is China’s most ambitious and successful foreign policy strategy to date.
China’s ambition with the BRI is to revitalize the ancient Silk Road trading routes by expanding China’s political and economic influence in Europe, Asia, the Middle East and Africa. As of 2021, the BRI has produced an estimated 40% of global economic output and has covered 140 nations. China’s Health Silk Road utilizes the transportation infrastructure and economic relationships established under the BRI to provide health aid to low-and-middle-income countries (LMICs).
The Fight Against Malaria
A major component of China’s Health Silk Road is the transfer of methods and experiences learned from its public health successes. In 2021, the World Health Organization (WHO) announced China’s attainment of malaria-free status, which is the nation’s greatest health success to date. China is now applying its malaria-eradicating technologies and methods to the African context.
Sub-Saharan Africa faces a high burden of malaria compared to the rest of the world. In 2020, the African continent accounted for 95% of the global malaria burden and 96% of malaria deaths worldwide. Since the 1970s, China has developed two pharmaceutical innovations, artemisinin-based combination therapies (ACTs) and long-lasting insecticidal nets (LLINs), which significantly curbed malaria infections in China. The WHO now recommends ACTs as the primary treatment method for malaria and the use of LLINs in Africa prevented 68% of malaria incidences between 2000 and 2015.
China also partnered with the government of Tanzania between 2015 and 2018 to implement the first phase of the China-Tanzania Malaria Prevention and Control Demonstration Project. The project used the Chinese “1-3-7” surveillance model, which proved incredibly successful in China’s malaria eradication efforts, to screen and monitor malaria cases. The model has the potential to reduce malaria cases by more than 80%.
The COVID-19 pandemic further advanced the Health Silk Road as China became the leading supplier of vaccines, personal protective equipment and other medical supplies. Early on in 2020, China was able to contain the spread of COVID-19 within its borders. This allowed the country to advance its leadership position in global health by increasing the presence of Chinese medical supplies in the global market.
In November 2021, the Chinese government committed to delivering 1 billion doses of COVID-19 vaccines to the African continent. China delivered a significant portion of the vaccines as “commercial supplies.” This method of vaccine delivery differs from other major producers of vaccines, such as the United States, which typically offer vaccines as donations. China also constructed “vaccine filling and finishing plants” in the regions of Africa, the Middle East and Asia. China’s use of the market in the delivery of vaccines to Africa has allowed it to far outpace the United States and other Western nations in global vaccine distribution, further advancing the Health Silk Road
What Do Critics Say?
China’s emergence as a leader in global health assistance through the Health Silk Road has differed from that of traditional donors in the West. Traditional health aid from Western donors often comes with conditionalities, wherein recipient governments have to follow certain democratic standards or implement economic reforms to receive aid. However, Chinese health aid often does not have any conditionalities attached to it, leading critics to accuse China of propping up repressive regimes in nations.
Critics have also condemned what they believe to be the economic opportunism of Chinese health aid in Africa. They argue that China uses the Health Silk Road to pursue inroads into African markets for its manufacturing products and to gain access to the continent’s natural resources. China has responded to these criticisms by indicating that it provides aid to many countries in sub-Saharan Africa that are not rich in natural resources. China has also pointed out that its health aid helps fill infrastructure gaps in impoverished rural regions.
China’s emergence as a leader in global health aid through the Health Silk Road has supported many nations in Africa in the fight against infectious diseases. While critics condemn China’s health aid as exploitative, the nation proves to be a partner for LMICs in need of assistance.
– Kaitlyn DeWeerd