China’s Health Silk Road in the Middle East

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Author: Passant Mamdouh Ridwan, Fudan University

The launch of the Health Silk Road (HSR) and Digital Silk Road (DSR) in 2015 as part of the Belt and Road Initiative (BRI) demonstrates the expansion of Chinese diplomacy from infrastructure and construction to the health and technology sectors. Several areas of collaboration increase China’s influence and promote the longevity of the BRI framework beyond the COVID-19 pandemic.

The HSR is a continuation of China’s long history of providing medical assistance to different regions. Africa-China medical cooperation dates back to 1963, when China was the first country to send a medical team to Algeria.

The COVID-19 pandemic has ushered in a new phase of medical cooperation with China, investing in healthcare infrastructure and sending medical equipment, workers and pharmaceutical products overseas. The Chinese government is now focusing on what can benefit both recipient and donor countries. It can improve healthcare systems in poor regions and will create new opportunities to increase Chinese healthcare investment in the long term.

Speaking at the 2021 Global Health Summit, President Xi Jinping expressed the need for global cooperation and solidarity to fight the COVID-19 pandemic. China’s ability to contain the virus at home has given China the credibility to take an active role in manufacturing and launching vaccines in Africa and the Middle East.

The use of digital technology to monitor diseases, particularly 5G technology, has enabled remote connection between medical staff and patients. China is translating its domestic experience of accessing rural and remote healthcare into enabling healthcare in poor countries.

In sub-Saharan Africa, the Middle East and Latin America, the BRI plays an important role in enabling access to vaccines and medical supplies earlier than in Western countries. Middle Eastern countries such as the United Arab Emirates and Bahrain were among the first countries outside of China to approve the Sinopharm vaccine, reflecting the Middle Eastern countries’ confidence in modern Chinese medicine.

Egypt was the first African country to manufacture the Chinese Sinovac vaccine. Under a deal with the Chinese pharmaceutical company, a factory in Cairo will produce more than 200 million doses a year and a second factory three million doses a day. This would make Egypt the largest vaccine producer in Africa and the Middle East.

In 2021, China said it had provided two billion vaccine doses to 120 countries and international organizations, more than any other nation, including a total of 180 million vaccine doses for Africa. Egypt, Algeria and Morocco are among the largest recipients.

For Middle East countries looking to transform their economies, the health sector is an increasing reform priority due to the severe impact of the COVID-19 pandemic on economic growth and health care. Attracting investments in the healthcare sector is a major concern. A focus on integrating technology and developing healthcare infrastructure will be critical to this reform.

In recent decades, Egypt, Jordan and Tunisia have emerged as regional hubs due to the perceived high quality of health services provided by their private health sectors. However, despite increased investment in healthcare infrastructure in many countries in the Middle East and North Africa, healthcare spending as a percentage of GDP is still very small. Lebanon, Tunisia and Saudi Arabia spend more of their GDP on health than the rest of the region, but health spending is growing fastest in the United Arab Emirates and Qatar.

According to the Gulf States’ new development vision, the healthcare sector will increasingly rely on imported medicines and finished products, while the healthcare market will play a pivotal role in increasing healthcare investment. China is a key healthcare trade and investment partner in realizing this vision. The Abu Dhabi Vision 2030 considers the pharmaceutical industry as a primary development area due to its future growth prospects, export potential and medium to long-term economic impact.

At a critical juncture of the COVID-19 pandemic, China took the initiative to offer medical aid and vaccines to developing countries. This move further strengthened China-US relations. China took the opportunity to gain more influence in the Middle East and Africa, which are struggling with low vaccination rates, as the United States and the EU are not more engaged.

As the COVID-19 pandemic enters its third year and new subvariants are spreading rapidly, China will not be able to single-handedly win the race to launch vaccines and meet the entire vaccination needs of poor regions. A full global recovery from this health crisis will require the cooperation of all major powers.

Passant Mamdouh Ridwan is a postdoctoral researcher at the Belt and Road & Global Governance Institute at Fudan University

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