China’s Health Silk Road

China is at the center of international finger pointing over the global spread of the corona virus or COVID-19. Wuhan in Hubei province is the ground-zero, and some media reports suggest that a female shrimp seller is the patient-0. As of writing this piece, no new cases have been reported in Wuhan and the city is limping back to normalcy albeit with strict monitoring. Elsewhere in the world, United States, several EU countries such as Italy, Spain, France, Germany, andTurkey and Iran are reeling under the pandemic. The rate of new infections and deaths continues to rise amid fears that many more countries may now be under ‘community spread’.

Soon after COVID-19spared in Wuhan, China augmented its medical infrastructure including repurposing many other medical facilities and production/manufacturing units. Among these the most notable was the makeshift Huoshenshan Hospital in Wuhan set up in 10 days. This 1,000-bed facility was built on a 269,000-square-foot piece of land with prefabricated material. It is similar to the Xiaotangshan Hospital in Beijing which was raised in a similar emergence during SARS outbreak in 2003.

There was an exponential demand for personal protective equipment (PPE) such as medical masks, gowns, face shields, and shoes and other medical gears such as respirators. China is the largest producer of such medical gears and supplies nearly half of the world’s demand of masks. At that time, China’s maskproduction capacity was estimated to be nearly 20 million pieces per day which was increased to 116 million by February 29. The government moved with swiftness and ordered expansion and ordered state-owned enterprises to start producing masks in wartime-like production mode. It also offered subsidies, lower taxes, interest-free loans, fast-track approvals to other companies to supplement production. Even Chinese oil and Gas Company Sinopec and Chengdu Aircraft Industry Group which manufactures J-20 stealth fighter repurposed some production lines to produce masks. The above are marvels of the Chinese production adaptability and capacity.

While China went through a harrowing time containing the spared of COVID-19, it did not miss the opportunity to promote its soft power through health diplomacy. The Ministry of Foreign Affairs has stated that over 80 countries, the WHO and the African Union were receiving Chinese medical assistance including the services of doctors, equipment and materials. China supplied medical equipment (through purchase orders and free) to the United States, Italy, Spain, The Netherland, Czech Republic,Turkey and Pakistan to name a few, to supplement requirements. Although some countries have complained about substandard test kits supplied by China, the demand forPPEs continues. China has in the past undertaken similar initiatives. For instance, it provided medical support in West Africa during the Ebola pandemic. It sent over thousand medical experts and provided US$ 120 million for capacity building of local medical workers.

This Chinese initiative is now being labelled as the ‘Health Silk Road’ or HSR diplomacy. In fact HSR has been part of Chinese Belt Road Initiative (BRI) since 2017. In 2016, China identified health as one of the national policy priorities and promulgated “The Healthy China 2030” plan. In 2017, China hosted the “Belt and Road High-Level Meeting for Health Cooperation: Towards a Health Silk Road” and signed a Memorandum of Understanding with the World Health Organization (WHO). DrTedrosAdhanomGhebreyesus, the Director-General of the WHO, acknowledged the importance of the HSR and stated that it could be the “stimulus needed to drive our united activities towards universal health coverage (UHC) and that it contains the necessary fundamentals, such as infrastructure building, access to medicines, and human resources, needed to build a platform for sharing experience and promoting best practices”.

Over 30 countries participated in the 2017 meeting and delegates from the Joint UN Programme on HIV/AIDS (UNAIDS), the Global Fund, the Global Alliance for Vaccines and Immunisation (GAVI) were present at the event. The participating countries also signed the Beijing Communiqué and expressed willingness to join the HSR initiative.

China sees the HSR as a tool to showcase its ‘political commitment to mobilise all resources for better health in the world’.It aims to promote cooperation in the ‘prevention and control of communicable diseases’ through ‘healthcare capacity building, staff training and exchange, traditional medicine, and health education as well as disaster relief, aid, and poverty reduction.

The ongoing Chinese Covid-19 crisis diplomacy has attracted criticism and has been labelled as a ‘struggle for influence’ through ‘politics of generosity’. This comes at a time when a variety of conspiracy theories about COVID-19 are being peddled. Also, China has been accused of lack of transparency by not sharing details of the pandemic,which led to a blame game and President Donald Trump labeling the coronavirus as ‘Chinese virus’ and a Republican senator hinting (without evidence) that the virus could be a ‘bioweapon created by the CCP”, much to the discomfort of the Chinese government. China also blocked Estonian proposal for a discussion in the UN Security Council over transparency in the corona pandemic. The world is infuriated with China but global leaders have met and discussed the pandemic at the extraordinary virtual G20 Leaders’ Summit and expressed solidarity to fight the pandemic, but there was concern over continued US sanction against Iran. But on 31 March, the UK, Germany and France have announced sale of Euro 500,000 of medicines to Iran under Instex a bartering mechanism set up to bypass US sanctions.

Dr Vijay Sakhuja is Consultant with Kalinga International Foundation, New Delhi.

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