“China’s Health Silk Road: Vaccine Diplomacy and Health Governance” Gerald Chan (2024).

Gerald Chan (2024). China’s Health Silk Road: Vaccine Diplomacy and Health Governance. Edward Elgar Publishing Limited, Cheltenham, United Kingdom.

In China’s Health Silk Road, the main emphasis is on critically analysing China’s vaccine diplomacy during the COVID-19 pandemic. Chan employs the concept of "geo-developmentalism" to examine China's role in shaping global healthcare during the COVID-19 pandemic. He explores how China's infrastructure development strategy underpins its emergence as a leading exporter of vaccines. The book comprises eight chapters, each providing insightful perspectives on various approaches to the development of China's Health Silk Road and its overarching diplomatic policy towards COVID-19 pandemic.

In the first chapter the writer focuses on exploring China's accomplishments and potential contributions to enhancing global public health. He introduces China’s Health Silk Road (HSR) as a foreign medical assistance program that gained prominence during the COVID-19 pandemic and played a significant role in Chinese foreign policy under the Belt and Road Initiative (BRI). It encompasses more than aid; it involves trade, industry, and development. While some view the HSR as a comprehensive global health policy, others see it merely as a marketing strategy for the BRI. The author discusses various scholars who have employed different theoretical perspectives, including mercantilism, geopolitics, and Chinese exceptionalism, to analyse the BRI’s impact globally. Notably, Chan introduces "geo-developmentalism" as his analytical framework for examining the HSR's role within the BRI. Through this lens, China’s Health Silk Road serves both developmental and geopolitical goals. Examples from Africa and other developing regions highlight the impact of geo-developmentalism, while competition from Western initiatives underscores China’s global influence.

The second chapter, “Building Silk Roads: Land, Sea, Digital, Health,” discusses the BRI as a cohesive initiative comprising the overland Silk Road, maritime Silk Road, digital Silk Road, and health Silk Road. The author illustrates China’s progress both globally and domestically by integrating these four components. While China focuses on developing infrastructure to foster economic growth, the West emphasizes promoting democracy. The author notes that progress in one area often influences the others; for instance, advancements in the HSR accelerated during the COVID-19 pandemic and in turn bolstered the other three components (land, sea, digital). The chapter also explores the choice of the name "Silk Road" for China’s foreign policy, linking it to China's historical significance as a grand civilization. Additionally, it highlights the development of telehealth in China, including internet hospitals, which aims to improve global healthcare distribution through digital health technology.

In chapter three, the author examines the global context of China's HSR initiative, considering the evolution of modern capitalism, Western influence, and the legacies of imperialism and neoliberalism. The chapter further analyses how the global health system operates and situate China's health policies within this framework. The author emphasizes the global public health issues, like infectious diseases, are shaped significantly by the global political economy. This indicates that trade policies, economic inequalities, and political decisions among nations significantly influence how health issues are managed globally. By applying structural realism in International Relations, he highlights how power dynamics and structural factors influence health policies worldwide. The author argues that China has consistently sought to reshape the global political-economic landscape, including the public health system, to its advantage since the early 21st century.

Chapter four, "China's Health Policy in COVID-19 Times," focuses on China’s response to the COVID-19 pandemic, domestically and internationally. The author explores the challenges within China's health system and its dual approach of integrating traditional Chinese medicine with modern treatments. He examines the factors contributing to China’s emergence as the "pharmacy of the world," highlighting its role in global health and efforts to meet evolving healthcare demands both domestically and internationally. Additionally, government financial support, along with investments from private equity firms, has played a significant role in China’s rise in the pharmaceutical sector. Furthermore, government policies have been crucial in establishing a foundation for China’s emergence as the pharmacy of the world.

The fifth chapter, “China's Vaccine Diplomacy and Health Governance,” discusses China's vaccine diplomacy; particularly its impact on Africa. It highlights the involvement of the private sector in these initiatives, noting that China has provided medical assistance to Africa since the 1960s by deploying the medical teams. Alongside infrastructure projects like roads and railways, healthcare has become a vital component of China's development assistance.

In the sixth chapter, "Patient Rights vs. Patent Rights," the author addresses the ongoing debate between advocates of patient rights and those defending patent rights, which has intensified during the COVID-19 pandemic. He argues that China's growing influence on global health adds complexity to this discussion. China appears to favour patient rights for both developmental and ideological reasons, viewing them as human rights and aligning with many developing nations and the World Health Organization (WHO).

Chapter seven delves into the "Sino-US Rivalry: The Politics of Health". Despite the decline in their bilateral relationship, both China and the US recognize global health as an area for potential cooperation that could yield mutual benefits. The chapter highlights the challenges posed by ongoing rivalries, including differing perceptions and underlying structural issues that strain their relationship. The BRI's health component complicates matters, positioning China's global health efforts at odds with US interests. In response to US pressure, China has adopted a "dual circulation" economic strategy to safeguard its economic resilience and sovereignty.

The concluding chapter synthesizes the findings from earlier chapters, focusing on the challenges and potential of the Health Silk Road. It assesses how effectively geo-developmentalism explains the HSR's impact. The author suggests that the HSR could play a crucial role in assisting low-income countries in recovering and enhancing their medical infrastructure, particularly in the face of future pandemics. As China emerges from three years of lock down due to its zero-COVID policy and expands the BRI to include the Global Development Initiative, there is hope for reducing the wealth gap and fostering peace. Developing countries in the Global South are eager to access global public goods, whether from traditional neoliberal states or emerging economies like China. This shift in development dynamics may lead to structural changes in the existing world order, as an alternative China-led order emerges alongside smaller regional frameworks, while the Western-dominated liberal international order remains intact.

Throughout the book, the author examines the complex relationship between China's health diplomacy and its broader geopolitical objectives, particularly through the lens of the Health Silk Road. Chan emphasizes the HSR's potential to address significant health challenges in developing countries, especially in light of the COVID-19 pandemic. This book focuses thoroughly on China’s point of view. A comparative analysis of different nations' health diplomacy efforts may have made it more interesting. This book is recommended for readers interested in global health, international relations, and China's growing influence. It offers important perspectives for policy analysts, scholars, and professionals to explore China’s health diplomacy as a tool of soft power and its impact on global governance and public health.

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