International partnerships developed by Beijing in the realm of health can be evaluated as part of a strategy that extends beyond humanitarian aid to gain a voice in global governance, export its development experience, and reinforce its international legitimacy. As globalization has inextricably intertwined economic, social, and political relations among states, health has ceased to be merely a component of national public policies, transforming instead into a strategic subject at the intersection of international security, development, and diplomacy. Epidemics, disparities in health infrastructure, capacity differentials in pharmaceutical and vaccine production, and issues surrounding access to healthcare services tangibly demonstrate the interdependent structure of the international system. In this context, health diplomacy can be regarded as a foreign policy tool that enables states not only to utilize their knowledge, technology, human resources, and financial capacity in health for cross-border cooperation, but also to build trust and legitimacy in international relations. The fact that health is a universal human need renders economic interests insufficient to explain cooperation in this domain; it places normative elements such as humanitarian responsibility, the right to development, and international solidarity at the center of the debate.[i]
China’s initiatives to strengthen international health partnerships constitute a striking example of this transformation. The activities conducted by Chinese medical teams in countries such as Benin, Seychelles, and Zimbabwe are examined through emergency surgical interventions, the training of local medical personnel, clinical capacity building, and the development of hospital infrastructure. Over approximately six decades, China has dispatched 31,000 medical personnel to 77 countries and regions, providing services to roughly 300 million patients. These figures are based on data from the National Health Commission of China and should not be equated with an independent impact assessment. Nevertheless, these examples demonstrate that China attempts to move its health assistance beyond periodic humanitarian interventions by integrating it with long-term professional training and institutional capacity-building activities.[ii]
To comprehend China’s initiatives in international health, it is necessary to focus on the concept of the “Health Silk Road”, developed within the framework of the Belt and Road Initiative (BRI). Since 2016, the Health Silk Road has been associated with Beijing’s objectives of enhancing cross-border health cooperation, facilitating access to medical resources, and supporting the health systems of partner countries. The initiative can be evaluated as the healthcare extension of the international network of relations China has built through economic connectivity and infrastructure investments. Activities such as training health personnel, fostering hospital-to-hospital cooperation, combating epidemic diseases, manufacturing pharmaceuticals, and transferring medical technology indicate that development diplomacy does not rely solely on physical infrastructure. However, the success of the Health Silk Road depends on the sustainability of healthcare services in partner countries, the independent capacity of local institutions, and measurable changes in access to care, rather than the mere volume of activities undertaken.[iii]
The significance of the Health Silk Road within international relations literature is also linked to China’s quest to transfer its development experience to countries with differing social and economic conditions. Considering that Western development models were long regarded as the primary benchmark for the modernization of health systems, China’s sharing of its expertise in public health, epidemic surveillance, and medical production through international cooperation increases the visibility of non-Western development approaches. Nevertheless, concluding that the Chinese model is universally applicable would be inaccurate. Health systems differ substantially in terms of financing structures, demographic characteristics, professional standards, legal frameworks, and local needs. Therefore, China’s experience gains international value not through direct replication, but through adaptation to local conditions and the active participation of partner countries in decision-making processes.[iv]
When evaluated within the framework of Joseph Nye’s soft power approach, health diplomacy does not measure a state’s influence over international actors merely through its economic or military capacity; influence can also be enhanced through the ability to build trust, foster cooperation, and project a positive image. Because healthcare services directly impact people’s quality of life, they possess the potential to create tangible social experiences beyond diplomatic rhetoric. Medical teams serving in a country which is sharing knowledge with local staff, enhancing the clinical capacity of hospitals, or contributing to the fight against preventable diseases can shape how the donor country is perceived. For China, these activities offer an opportunity to support its discourse of development partnership and international solidarity through concrete applications. However, it should not be assumed that health assistance automatically translates into soft power. For this impact to become lasting, it depends on the experiences of recipient societies, the quality of services provided, and whether the cooperation generates mutual benefits.[v]
In this framework, China’s health diplomacy necessitates a re-evaluation of the relationship between humanitarian aid and strategic interests. It is customary for states to pursue economic, political, and normative goals simultaneously in their foreign policies; hence, defining China’s health partnerships purely as altruistic aid or as a tool for geopolitical influence remains analytically incomplete. Relations established in healthcare can contribute to China building long-term ties with local partners, facilitating the international circulation of its medical technology and products, and enhancing its visibility within international organizations.
Global health governance features a multi-layered structure in which issues that states cannot resolve individually are addressed through international organizations, national governments, research institutions, and other actors operating in the field of health. The World Health Organization (WHO) assumes an essential role within this structure in terms of developing technical standards, monitoring diseases, and ensuring international coordination. However, the implementation of global health policies relies not merely on material power, but also on financial resources, the political will of states, and the legitimacy of international institutions. China’s expansion of its health diplomacy is therefore more than a matter of bilateral aid relations. This diplomacy holds importance for the future of international health institutions and the provision of global public goods. Achieving influence in health requires contributing to financing, research, data sharing, and the establishment of international standards alongside technical capacity.
A 2026 study published in the journal Globalization and Health examines China’s health diplomacy conducted through the World Health Organization and the shifting institutional relations in the post-COVID-19 era. The study reveals that although China maintains its rhetoric of multilateralism, bilateral relations and pragmatic interests retain their significance in its international health activities. Accordingly, China seeks to secure a more influential position in global health governance. In this context, Beijing may capitalize on shifts in the financing, representation, and decision-making mechanisms of international institutions. This demonstrates that health diplomacy is not detached from great-power competition, yet it does not eliminate areas where states can cooperate in line with shared interests.[vi]
One indicator concretizing the scope of China’s health diplomacy is its healthcare delivery and professional capacity-building activities in African countries. According to data published in Chinese state media, 28 Chinese medical teams comprising a total of 662 personnel have served in Benin since 1978, contributing to the establishment of 26 core clinical specialty centers through partner hospitals. In Zimbabwe, over 180 local healthcare workers were reported to have been trained within a single year in the fields of respiratory diseases and intensive care. These indicators reveal that China’s health diplomacy is not an assistance model based solely on direct patient treatment but encompasses long-term activities such as professional knowledge transfer and clinical capacity building. However, the number of health personnel, the scope of training activities, or the total number of established centers are insufficient on their own to measure the impact of these initiatives on health systems. The genuine success of these activities must be evaluated alongside indicators such as whether local healthcare workers continue to provide post-training services, whether the clinical centers established are financially and technically sustainable, and whether healthcare services reach broader segments of society. In this regard, the degree to which China’s health partnerships create permanent capacity in local institutions is as important as their quantitative scale.
China’s influence in global health is not limited to dispatching medical personnel and hospital partnerships; it is also evident in the fight against infectious diseases and the sharing of health policies at an international level. In this context, malaria serves as a prominent example of how China’s nationally developed practices are linked to global health governance. According to World Health Organization data, approximately 240 million people in Sub-Saharan Africa are reported to have benefited from artemisinin-based combination therapies. Meanwhile, China’s “1-3-7” approach—developed for malaria case detection and response—is based on the principles of reporting cases within one day, conducting epidemiological investigations within three days, and completing necessary interventions within seven days. The integration of this approach into international technical guidelines highlights China’s ability to translate its domestic health expertise into international norms and practices. However, interpreting the figure of approximately 240 million people as an impact generated solely by China is not possible. National health systems, international organizations, research institutions, and pharmaceutical supply networks jointly play a role in combating malaria. Therefore, while this example renders China’s contribution visible, it also highlights the multi-actor nature of global health outcomes.
When evaluating the long-term results of China’s health diplomacy, an analytical distinction must be drawn between output indicators and outcome indicators. Dispatched medical personnel, established clinical centers, organized training programs, and patient consultations conducted are output indicators that illustrate the scale of cooperation. Conversely, reductions in mortality rates from preventable diseases, expanded access to primary healthcare, alleviation of local healthcare worker shortages, and self-sustaining operation of health infrastructure without external aid represent more comprehensive outcome indicators. The sustainability of China’s activities under the Health Silk Road should also be examined through this second group of indicators. In addition to its potential regarding global health governance and the Sustainable Development Goals, the Health Silk Road also presents challenges such as fragmented regulatory frameworks, the recognition of medical qualifications, and the harmonization of standards. These challenges demonstrate that international cooperation in health cannot rely solely on resource transfers; it demands legal alignment, institutional coordination, transparency, and the active involvement of partner countries in decision-making processes. Within this framework, the impact of China’s health diplomacy depends less on the volume of aid provided and more on how well it aligns with local needs and contributes to the sustainable continuation of healthcare services even after cooperation concludes.
Current indicators regarding China’s international health diplomacy demonstrate that Beijing is moving its health activities beyond temporary humanitarian assistance, transforming them into a more comprehensive foreign policy tool aimed at strengthening its position in global governance. Medical personnel deployments sustained for nearly sixty years, clinical centers established in African nations, training programs for local health workers, and the international visibility gained by malaria control practices indicate that China’s presence in this field has acquired institutional continuity.
The provision of healthcare services and the development of local capacity afford China the opportunity to build long-term relationships with partner countries, contribute to the formation of international standards through technical knowledge and practice sharing, and enhance the global visibility of its development experience. Measuring the diplomatic return on these activities solely through aid volume would be misleading. The primary determinant is whether the support provided creates lasting capacity in the health systems of partner countries and the extent to which it contributes to perceiving China as a reliable partner. This distinction is crucial for understanding the relationship between the material dimension of China’s health diplomacy and its capacity to generate international legitimacy.
When evaluated in terms of power distribution in the international system, China’s health diplomacy emerges not as an attempt to completely replace the existing global health order, but rather as a strategy to expand its representation, operational room, and norm-shaping capacity within it. Beijing’s pursuit of enhancing its relations with multilateral institutions such as the World Health Organization alongside bilateral health partnerships forms two complementary dimensions of its quest to become a more influential actor in global health governance. While bilateral partnerships provide China with opportunities to establish direct cooperation, tailor projects to specific needs, and foster long-term diplomatic ties, activities conducted through multilateral organizations enable these relationships to reach a broader sphere of influence within the framework of international standards and institutional legitimacy. A more decisive development is that China seeks to be more than a mere executor or funder in determining international health policies. China strives to be recognized as an actor that contributes to defining problems, formulating solution methodologies, and setting technical standards. Thus, Beijing’s strategic gain lies less in replacing existing institutions and more in securing a greater voice in their operation while raising the visibility of its own priorities in international policy processes.
Existing data demonstrates that this policy has acquired continuity and established an institutional dimension, particularly through relations developed with African nations. Consequently, China’s international health diplomacy will continue to support its pursuit of a greater voice in global governance in line with current trends. However, whether this influence transforms into lasting international legitimacy will depend on the consistency between rhetoric and implementation, as well as the concrete results achieved in partner countries. Thus, China’s health diplomacy can be addressed as a process through which global power relations are reshaped via knowledge, healthcare capacity, and international institutions. In this process, the most critical strategic gain for Beijing will be to become an indispensable partner in defining and solving global health challenges, rather than supplanting other actors.
[i] Martinez, E., Rosskam, E., Aslanyan, G., Baines, L., Komatsu, R., Darabos, N., … & Nordstrom, A. (2026). Preparing current and emerging health leaders: An innovative competency-based framework for health diplomacy. PLOS Global Public Health, 6(9), e0004974.
[ii] “Bridging medicine and care: How China is strengthening international health partnerships”, CGTN, https://news.cgtn.com/news/2026-10-14/How-China-is-strengthening-international-health-partnerships-1ReccUx51GE/p.html, (Date of Access: 14.10.2026).
[iii] Wang C, Huang S, Lassi N and Zhang X (2025) A decade of China’s health silk road: policy review for global health governance and SDG partnerships. Front. Public Health 13:1676960. doi: 10.3389/fpubh.2025.1676960
[iv] “CHINA-WHO Country Cooperation Strategy 2022–2026”, World Health Organization, https://iris.who.int/server/api/core/bitstreams/74d363e7-eef0-4a5d-9585-eeb8f2890d3f/content, (Date of Access: 14.10.2026).
[v] Nye, J. S. (2004). Soft power: The means to success in world politics. Public affairs.
[vi] Shang, Z., Huang, Y. China’s global health diplomacy through the World Health Organization: a qualitative study. Global Health 22, 25 (2026). https://doi.org/10.1186/s12992-025-01165-w
