On May 5, 2023, the World Health Organisation (WHO) declared the end of the Coronavirus Disease (COVID-19) as a ‘global health emergency.’ The news represents a significant step towards ending the global pandemic, which began as an outbreak in the Chinese city of Wuhan. The pandemic not only killed millions of people, but it also wreaked havoc on the world economy and health care system.

In Africa, although the health impact of the pandemic has been considerably low compared to other regions of the world, it undoubtedly exposed the deficiencies in Africa’s public health systems and its unpreparedness for contagion viruses despite the continent’s history of infectious disease outbreaks. In the face of a weakened healthcare system and inadequate health infrastructure, the WHO warned about the potential devastation in Africa and urged collective support for African countries.

Africa’s aid partners, including China, quickly developed various support programmes to support and mitigate the pandemic’s potentially ravaging effect on Africa. Since then, China has donated millions of vaccines to African countries, assisted in the construction of the Africa Centre for Disease Control and Prevention (Africa CDC) headquarters, trained thousands of African medical personnel, dispatched hundreds of Chinese medical experts to Africa, and assisted in the establishment of a joint vaccine production facility in Africa with an annual capacity of approximately 400 million doses.

The implication is that China’s role in African public health cannot be overlooked. This article provides insight into China’s contribution to Africa’s public health.

The Promise of Improving Africa’s Public Health Systems

Finding evidence of China’s current commitment to African public health issues is relatively easy. Cooperation on public health has featured consistently in the Forum on China-Africa Cooperation (FOCAC) documents. As an acknowledgment of the importance of public health in China-Africa cooperation within the FOCAC framework, the first Ministerial Forum on China-Africa Health Development was held in 2013.

China’s interest in Africa’s public health was further entrenched in the ‘China-Africa Cooperation Vision 2035’ jointly developed by China and Africa in December 2021. In the policy document, China promised to “support African health policies and help it strengthen the prevention and control system of communicable diseases, improve medical research, vigorously develop traditional medicine, and improve medicine accessibility and affordability.”

This long-term strategy was mutually discussed at the 2021 FOCAC summit in Senegal, with short-term targets outlined to be fulfilled by 2024. At the summit, China and Africa committed to expanding their collaboration and exchanges on public health and healthcare concerns at various levels. Among the specific promises are Chinese pharmaceutical businesses transferring technologies to African countries, establishing China-Africa Friendship Hospitals, and constructing the Africa CDC headquarters.

Furthermore, China made pledges to offer medical Aid to Africa to support preventing and controlling communicable and non-communicable diseases and develop public health capacity.

The FOCAC Action Plan (2022-2024) expressly specified the following public health policy commitments to be undertaken by China for African countries:

  • Support African countries in building national public health institutions and carrying out information sharing and technical cooperation.
  • Donate 600 million COVID-19 doses to Africa and 400 million doses provided through joint production between Chinese companies and African countries.
  • Help accelerate the establishment of the African Medicines Agency, support the program, and help strengthen Africa’s local drug production.
  • Complete the construction of the Africa CDC headquarters, undertake ten medical and health assistance projects, and speed up the building of China-Africa Friendship Hospitals.
  • Support the Catalytic Framework to End AIDS, TB, and Malaria in Africa by 2030 by carrying out anti-malaria projects and sharing success stories with African countries.
  • Help Africa reduce maternal and infant mortality rates and improve the survival and health of pregnant and postnatal women and newborns.
  • Collaborate on drug supervision, support Africa’s public health testing capabilities, and encourage Chinese enterprises to cooperate with African countries.
  • Send about 1,500 Chinese medical personnel and experts to Africa, provide mobile medical services for cataract and heart disease treatment, and create a health cooperation training platform.

China’s Health Aid to Africa

Chinese foreign Aid to Africa has long included health assistance. However, the health component has traditionally been minimal, accounting for less than 3% of total aid packages (e.g., table 1). This historical pattern is rapidly shifting in response to current global health crises such as the Ebola and COVID-19 outbreaks.

For example, China’s third White Paper on Foreign Aid, launched in 2021, mainly focused on health aid in response to global public health challenges. Indeed, as of 2020, most (76%) of China’s humanitarian aid funding to Africa went to public health. Similarly, COVID-related help accounted for 92% of Chinese humanitarian Aid to Africa between 2020 and 2021.

Early Chinese health aid to Africa took the form of medical teams dispatched to African countries. The first team was sent in the early 1960s, and the tradition has persisted until the present day. That health aid has since extended to include physical health infrastructure, medical supplies, and training of health workers, among other things.

Having gained some early experience as the country that was first hit by the pandemic, China’s first action in response to the call for COVID-19 global response in Africa was the delivery of pandemic-related medical supplies to the United Nations’ Humanitarian Response Depot (UNHRD) office in Ghana in April 2020 for onward distribution to 17 other beneficiary African countries.

It has since delivered over 200 million doses of vaccinations to over 30 African countries, and Africa’s joint vaccine manufacturing now has an annual capacity of over 400 million doses. Furthermore, China has dispatched over 1,000 Chinese medical specialists to Africa, where they have taught thousands of local medical and healthcare practitioners.

In terms of infrastructure, China has constructed the Africa CDC headquarters, which was started ahead of time in December 2020. It has also completed most Chinese-aided health infrastructure projects across Africa. Among the examples are the construction of the outpatient facility for infectious diseases at the Grand National Hospital of Mauritania and the renovation of the China-Guinea Friendship Hospital in Guinea.

The Chinese private sector has also highly supported China’s commitment to providing health aid to Africa. For example, the Jack Ma Foundation and Alibaba Foundation gave 20,000 test kits, 100,000 masks, 1,000 medical use protective suits and face shields, 500 ventilators, and other medical supplies to all African countries in 2020.

Concluding Remarks

The preceding sections demonstrate China’s interest in developing Africa’s public health systems, and it has since made significant contributions in providing the necessary health infrastructure and building the capacity of health officials to respond to public health crises across Africa.

China’s commitment and assistance have aided in improving healthcare outcomes and health systems in Africa. As China’s efforts continue, China-Africa public health cooperation has the potential to improve healthcare delivery significantly, address new health challenges, and create a brighter future for Africans.

Written by: Dr. Hagan Sibiri Senior Research Fellow, ACCPA

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