A number of initiatives over the last ten years have explored collaboration with China on international development or global health. DFID’s China-UK Global Health Support Programme is the most important and is a key source of learning on how to work together.
COVID-19 has underlined challenges to global governance and the need for global collaboration to support health and development. Solving the problems of the first half of the twenty-first century, such as the current pandemic, will require widespread collaboration, including with ‘rising powers in development’ such as China.
China’s changing global engagement
The changing role of China is at the centre of current discussions of global governance. The country has been a major beneficiary of globalisation and its weight in the global economy has changed utterly in the short twenty years since its WTO accession. With that has come calls for China to play a greater role in the provision of global goods – whether as a provider of development finance, as a greater contributor to the governance of major global issues such as climate change, or as an increasingly important player in research and development, with the potential to contribute to solving global challenges.
China’s domestic development trajectory has led the country to increase its overseas engagement. Starting in the early 2000s, China’s drive to ‘go out’ has seen Chinese companies engage more overseas, both in developed and developing economies. From the 2010s, meanwhile, China has framed its overseas engagement in terms of the BRI (Belt and Road Initiative), a drive to promote connectivity across much of Asia and into Africa, based on infrastructure roll-out and increasing integration of supply chains. This has led to structural changes in the patterns of China’s overseas investment and greater support for infrastructure development in developing countries. Inevitably, there is much discussion over the amounts of money and investment actually flowing, how this will affect the world, and how growth can be translated into welfare and support the sustainable development goals.
The BRI is part and parcel of an ongoing process of China rethinking its place in the world. For much of the late twentieth century, China’s government, companies and intellectuals were intently focused on the country’s domestic development. ‘Development cooperation’ with other countries and the multilateral system was about support to China and solving China’s domestic problems. This is now changing. The government has pushed for institutional innovations to support a greater role for China in global development. The Asian Infrastructure Investment Bank, the New Development Bank, and the China International Development Cooperation Agency are the most obvious examples. This reorientation is pushing Chinese government and intellectuals to find new ways of framing the country’s global engagement, notably around the notion of a ‘community of shared destiny’ and, more recently, a ‘community of shared health’.
The Global Health Support Programme: a new role for China
In the early 2010s, the UK Department for International Development (DFID) started to rethink its cooperation with China. China was becoming too rich to warrant direct bilateral support, but simultaneously too important to ignore as a potential partner in global development. Building on DFID’s collaboration within China, a suite of programmes was developed to think through how to work with China globally. The most significant of these was the GHSP (Global Health Support Programme).
The GHSP supported the exploration of a new role for China in global health and how the UK and China could work together to support common priorities. The programme supported collaboration with a number of key Chinese agencies to think through China’s current role and ways to work more effectively, as well as building the capacity of Chinese institutions and providing a platform for a small number to pilot health interventions in third countries. The programme has provided invaluable learning at a time of rapid change in the global system and when there is a need to figure out how to work on the pressing issues of the twenty-first century.
Starting in 2014, an Itad and IDS team followed the GHSP, tracking its development and providing a platform for learning about the challenges to greater and more effective Chinese engagement, as well as the challenges to more substantive UK-China cooperation. The evaluation viewed components of the project as ‘probes’ into different aspects of the complex process of ‘capacitating’ actors and institutions (in China, the UK and international organisations) to manage China’s rapidly changing engagement in global health. For each probe, we asked about the kind of learning generated, whether it is used and by whom.
The GHSP had a number of important achievements at a defining time. However, it also showed many of the constraints to be overcome as the Chinese government and technical agencies seek to transform their roles as the country looks for its new global role.
Globally, we are at a time of strain – arising from the proximate effects of COVID-19, the economic and social fall-out and the stresses these issues are placing on current arrangements for global governance. Major issues of the first half of the twenty-first century – and longer – will not be solved by countries acting in isolation. As we look forward to the challenges of tackling and mitigating the effects of human-induced climate change or antimicrobial resistance, for example, it is clear that finding solutions will require widespread collaboration, including with ‘rising powers in development’ such as China.
The GHSP has provided some initial exploration in one important area. All sides recognise that China could play an increased role and that there is a need for greater cooperation in global health. There is now a need for rapid learning on how to work together and develop mechanisms in China, partner countries and agencies to support deeper and broader collaboration, in global health and beyond.
Read the articles sharing the key findings of the GHSP evaluation and reflecting on the implications:
- The China-UK Global Health Support Programme: looking for new roles and partnerships in changing times – sharing the findings of the evaluation.
- Understanding China’s growing involvement in global health and managing processes of change – reflects on how the GHSP and China’s exploration of a new global role in health draw on China’s tradition of experimentalism in policy making and discusses some implications for how we think about the management of complex and rapid change processes