China’s approach to global health governance and its adherence to multilateralism
During this year’s World Health Assembly in Geneva, China pledged an additional $500 million to the World Health Organization over the next five years. This speaks volumes about its political commitment to global health governance. While politically committed to improving the well-being of its citizens, China increasingly positions itself as an important player in global health governance with its vision of building a global community of health for all.
China takes a two-pronged approach to global health governance. The first prong is bilateralism. In 1963, China sent medical teams to Algeria to help strengthen its broken medical system. Since then, China has normalised its collaboration with African countries by dispatching doctors and training local doctors. That cooperation has significantly promoted health governance in Africa. In the wake of the Ebola crisis in West Africa, China helped the African Union build the Africa Centres for Disease Control and Prevention to bolster the capacity of public health institutions in effectively coordinating disease prevention, surveillance and control on the continent. Africa CDC’s headquarters symbolises the China-Africa bilateral partnership in global health.
That bilateral health cooperation was further highlighted in the Beijing Action Plan (2025–2027), unveiled at the 2024 Forum on China-African Cooperation. China and Africa agreed to host the Health Silk Road Cooperation Conference and the China-Africa Ministerial Forum on Health Cooperation, institutionalise policy dialogue and technical exchanges on public health, establish the China-Africa Knowledge Exchange Center for Health Development Cooperation, and hold a dialogue between Chinese and African think tanks on health cooperation. Health care is clearly a pillar in the strategic partnership between China and Africa.
The Health Silk Road, an integral part of China’s Belt and Road Initiative, is another eminent embodiment of China’s bilateral efforts to promote global health governance. China has partnered with BRI countries in infectious disease prevention and control, public health emergency response, maternal and child health, chronic disease prevention and control, and digital health care. China has been helping upgrade public health capacity through long-term talent cooperation programmes with more than 20 BRI countries since 2013. These efforts have significantly helped them respond to public health threats.
Championing multilateralism in global health
The second prong is multilateralism in global health governance, which China staunchly supports and practices. It has repeatedly voiced its support for the WHO. Indeed, the Global Security Initiative, released in 2023, stipulates that China will “support the World Health Organization in playing a leading role in global governance in public health, and effectively coordinate and mobilize global resources to jointly respond to COVID-19 and other major global infectious diseases”. As the dominant member of the BRICS, China has reiterated its support for the WHO’s central coordinating role in implementing multilateral efforts to protect public health from infectious diseases and epidemics.
China has integrated global health governance into various multilateral organisations. China has motivated the Shanghai Cooperation Organization, of which it is a founding member, and hosted its health ministers’ meeting in April 2025 under the theme of ‘Promoting sustainable health development and sharing a healthy future’. China’s proactive engagement in multilateral health regimes demonstrates its aspiration to be a leader in global health governance.
However, China has encountered problems in achieving its aspiration. Geopolitically, it has faced fierce strategic competition from the United States in recent years. As such, China is likely to marginalise global health issues in its foreign policy in order to pursue other high-profile strategic priorities in the current competitive geopolitical environment. Financially, as its economy has slowed substantially, China has neither the capacity nor the intention to fill the vacuum left by the United States in the long run. Indeed, no specifics have been provided by the Chinese government about the additional $500 million pledged to the WHO. The pledge has not been covered by any domestic state-led media outlets.
Geopolitical competition makes global health issues more politicised. This is detrimental to the coordination of multilateral organisations in global health governance. Therefore, a coordinated multilateral approach to global health crises is greatly needed now. With the US withdrawal from multilateral global organisations such as the WHO and UNESCO, and its disruptive cuts to health programmes abroad, how to achieve the most out of the reduced resources available in global health hinges on coordination among the multilateral players – including international organisations, global public partnerships and civil society organisations. Just as the economic and political reshuffling among powers has potentially irreversibly transformed global health politics, so too are global health regimes subject to fundamental reforms in their financing and governance structures. Multilateralism is the key to reforming global health regimes to meet global health crises successfully.
