Skip to main content

Commentary: What's behind China's controversial Health Silk Road efforts

The idea of a Health Silk Road predates the coronavirus outbreak and is a part of a growing Chinese brand of medical diplomacy, says Ngeow Chow Bing.

China medical
Chinese medics posing for a group photo after landing on a China Eastern flight at Rome's Fiumicino international airport from Shanghai, bringing medical aid to help fight the new coronavirus in Italy. (Photo: STRINGER/ANSA/AFP)

But the concept can be traced back to a document prepared by China’s health authorities in 2015.

The document laid out a three-year proposal to promote the Belt and Road Initiative (BRI) through cooperation in the healthcare sector.

READ: Commentary: China billionaires a force to be reckoned with in global COVID-19 fight - and more


At the first BRI Forum in 2017, a Beijing Communique of the Belt and Road Health Cooperation and Health Silk Road was signed by China, the World Health Organization (WHO), UNAIDS and 30 countries.

A closer look at the Communique suggests that it shared many similarities with the 2015 document.

According to these documents, the main activities under the HSR include: Organising high-level regional forums for health officials, establishing a Belt and Road Public Health Network for coordinated reactions to public health emergencies, and capacity building and professional training.

The documents also emphasise cooperation — for example in monitoring, control and prevention of infectious diseases — between medical science professions in research and development and in the use of traditional medicine.

Chinese foreign minister Wang Yi has said Beijing is open to international cooperation to identify
Chinese foreign minister Wang Yi has said Beijing is open to international cooperation to identify the source of the novel coronavirus. (Photo: AFP/NICOLAS ASFOURI)

READ: Commentary: China's COVID-19 push for global influence

Other initiatives include medical aid and donations, exchanges between different national healthcare systems, maternal and child health projects, trade and investment in the healthcare industry, and the standardisation of health and drug access.


Before the outbreak of COVID-19, the HSR was quietly progressing in some of these areas of cooperation, albeit unevenly.

Regional forums have taken place in the form of the China–ASEAN Health Cooperation Forum, the China–Central and Eastern European Countries Health Ministers Forum and the China–Arab Health Cooperation Forum.

China also established several regional health cooperation projects with its Central Asian and Greater Mekong Subregion neighbours. Networks such as the Association of Sino-Russian Medical Universities and the China–ASEAN Forum on Hospital Management Cooperation were formed.

READ: Commentary: The new wave of Chinese tech champions you never heard of but should know

READ: Commentary: Life in China after COVID-19 lockdown gives normal new meaning

A China–ASEAN Human Resources Training Programme of Health Silk Road aims to train more than 1,000 ASEAN healthcare professionals by 2022.

As is the case with many projects in the BRI, some of these projects predated the conception of the HSR but were all eventually absorbed into it.


The COVID-19 pandemic makes the HSR more relevant. China is facing intense international scrutiny for its initial inadequate handling of COVID-19.

But after mostly containing the spread of the coronavirus in early March 2020, China is now actively exercising medical diplomacy.

China implemented a unique system of “a province for a country”, in which a province is responsible for providing both material medical assistance (masks and protective gears) and health experts to a paired country.

China's Foreign Minister Wang Yi is welcome by Laos President Bounnhang Vorachith before the A
China's Foreign Minister Wang Yi (R) is welcome by Laos President Bounnhang Vorachith before the ASEAN and China emergency meeting on the coronavirus in Vientiane, Laos February 20, 2020. (Photo: REUTERS/Phoonsab Thevongsa)

Since March, China has shipped out billions of masks and millions of pieces of protective gear, though the rushed production resulted in some sub-standard products that Western media were quick to highlight.

In a somewhat low-profile manner, Chinese officials and media have slowly raised the idea of the HSR amid the ongoing outbreak.

President Xi spoke of the concept with Italian Prime Minister Giuseppe Conte in March. The HSR was elevated as a new platform for BRI cooperation and in contributing to global health governance in a People’s Daily commentary that same month.

READ: Commentary: China's tensions could boost Hong Kong's stock exchange

READ: Commentary: Alibaba makes a whopping US$28 billion bet on its next breakthrough act

The Beijing-based Belt and Road Think Tank Alliance organised the first online forum on the HSR in April, where more than 30 scholars and retired foreign statesmen participated. Song Tao, the head of the International Department of the Chinese Communist Party, gave the opening speech to the forum.

Some Chinese commentators are already packaging China’s medical diplomacy activities during the pandemic under the rubric of the HSR.


These are signs that Beijing will slowly and carefully redirect the HSR as a mainstay of the BRI after the COVID-19 outbreak.

Just like the BRI, a highly adaptive venture without a detailed blueprint, the HSR will be strong on rhetoric, the substance of which will be based on the concrete implementation of projects.

Chinese aid is unloaded from a plane in Haiti, one of many shipments of medical supplies by Beijing
Chinese aid is unloaded from a plane in Haiti, one of many shipments of medical supplies by Beijing to combat the coronavirus AFP/Pierre Michel Jean

With this overarching concept, China is repositioning itself as a responsible leader in global health governance and aims to repair its national reputation.

Yet China is also aware this is not the right time to push the concept aggressively, especially in the developed world, when the pandemic is accelerating the deterioration of its relationships with most Western countries.

In contrast, the target audience of the HSR is more likely to be the developing world, where there is generally less ideological scrutiny of how the Chinese government performed during the early stages of the outbreak.

Regardless of the misgivings, China is well positioned to offer substantive assistance. Many developed countries are suffering from the pandemic, due in no small part to the poor performance of their own governments.

The pandemic is also exposing the weaknesses of healthcare infrastructure in many developing countries and the HSR has the potential to help address some of these weaknesses.

LISTEN: How Singapore businesses and workers can thrive in a post-pandemic new normal

READ: Commentary: Embattled China knows its national priority is the economy

But the HSR is not immune to geopolitical competition. The US State Department just launched the US–ASEAN Health Futures initiative.

Southeast Asian (and developing countries in general) do not want to sign up for one initiative to the exclusion of another. Both initiatives should and can be equally welcomed on their own merit.

Both the United States and China have their own respective strengths to offer to the developing world. The major powers must resist treating international healthcare cooperation as a zero-sum game, as they often do in other spheres of rivalry.

LISTEN: Repairing and recycling to reduce e-waste: A pipe dream?

BOOKMARK THIS: Our comprehensive coverage of the coronavirus outbreak and its developments

Download our app or subscribe to our Telegram channel for the latest updates on the COVID-19 outbreak:

Dr Ngeow Chow Bing is Director of the Institute of China Studies at The University of Malaya. This commentary first appeared on East Asia Forum.


Popular posts from this blog

SSG Commando Muddassir Iqbal of Pakistan Army

“ Commando Muddassir Iqbal was part of the team who conducted Army Public School operation on 16 December 2014. In this video he reveals that he along with other commandos was ordered to kill the innocent children inside school, when asked why should they kill children after killing all the terrorist he was told that it would be a chance to defame Taliban and get nation on the side. He and all other commandos killed children and later Taliban was blamed. Muddassir Iqbal has deserted the military and now he is  with mujahedeen somewhere in AF PAK border area” For authenticity of  this tape journalists can easy reach to his home town to interview his family members or   ISPR as he reveals his army service number” Asalam o Alaikum: My name is Muddassir Iqbal. My father’s name is Naimat Ali. I belong to Sialkot divison (Punjab province), my village is Shamsher Poor and district, tehsil and post office  Narowal. Unfortunately I was working in Pakistan army. I feel embarrassed to tell yo

RWR Advisory: Belt and Road at a Glance

This edition covers developments from March 12 - March 26..  Belt and Road at a Glance   Subscribe to the Belt and Road Monitor Top Developments China National Machinery Industry Corporation, commonly known as Sinomach, has agreed to  build  a $845 million, 255-mile railway across  Iran , building upon a sustained period of growth for Chinese investment in Iran that accelerated after Xi Jinping’s state visit to the country in January 2016. The railway will link the cities of Tehran, Hamedan and Sanandaj. China Civil Engineering Construction, a subsidiary of CRCC, is currently also  building  a 263-km railway line from Kermanshah to Khosravi. According to Chinese entrepreneur Lin Zuoru, who  owns  factories in Iran, “Iran is at the center of everything.”On March 23, China’s Ministry of Commerce announced that foreign direct investment by Chinese companies in 50 Belt and Road countries fell by 30.9% year-on-year. While the Ministry stated that this number covers investment across al

CPEC Jobs in Pakistan, salary details

JOBS...نوکریاں چائنہ کمپنی میں Please help the deserving persons... Salary: Salary package in China–Pakistan Economic Corridor (CPEC) in these 300,000 jobs shall be on daily wages. The details of the daily wages are as follows; Welder: Rs. 1,700 daily Heavy Duty Driver: Rs. 1,700 daily Mason: Rs. 1,500 daily Helper: Rs. 850 daily Electrician: Rs. 1,700 daily Surveyor: Rs. 2,500 daily Security Guard: Rs. 1,600 daily Bulldozer operator: Rs. 2,200 daily Concrete mixer machine operator: Rs. 2,000 daily Roller operator: Rs. 2,000 daily Steel fixer: Rs. 2,200 daily Iron Shuttering fixer: Rs. 1,800 daily Account clerk: Rs. 2,200 daily Carpenter: Rs. 1,700 daily Light duty driver: Rs. 1,700 daily Labour: Rs. 900 daily Para Engine mechanic: Rs. 1,700 daily Pipe fitter: Rs. 1,700 daily Storekeeper: Rs. 1,700 daily Office boy: Rs. 1,200 daily Excavator operator: Rs. 2,200 daily Shovel operator: Rs. 2,200 daily Computer operator: Rs. 2,200 daily Security Supervisor: Rs.