{"id":2568,"date":"2025-06-25T20:15:19","date_gmt":"2025-06-25T19:15:19","guid":{"rendered":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/?p=2568"},"modified":"2026-02-16T11:31:09","modified_gmt":"2026-02-16T11:31:09","slug":"how-will-chinas-health-aid-react-to-the-changing-international-development-landscape","status":"publish","type":"post","link":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/","title":{"rendered":"How will China\u2019s health aid react to the changing international development landscape?"},"content":{"rendered":"

By David Bishai[1]<\/sup> and Austin Strange[2]<\/sup><\/strong><\/p>\n

[1] The University of Hong Kong School of Public Health
\n[2] The University of Hong Kong Faculty of Social Sciences Department of Politics and Public Administration<\/p>\n

Background<\/strong><\/p>\n

The halt of the United States Agency for International Development (USAID)<\/a> as a major source of health assistance ($16 billion annually) will trigger re-examination of balance and scope in foreign assistance around the world. For the remaining roughly 100 donor countries<\/a>, urgent questions remain about how these governments will seek balance between aid\u2019s developmental and strategic functions, and whether and who will step up to fill an imminent void, particularly in global public health.<\/p>\n

Eyes are now on China amidst USAID\u2019s funding uncertainties. Will China\u2019s government alter the nature and scope of its bilateral health assistance, long an important pillar of its international development cooperation? Will its engagement in and contributions to multilateral assistance be accompanied by shifts in its global health strategy? Reviewing recent goals and trends in China\u2019s foreign health assistance can inform answers.<\/p>\n

China and International Development<\/strong><\/p>\n

Throughout the post-World War II international development regime, donors and lenders have viewed aid\u2013including that aimed at public health and other highly visible issue areas\u2013as an important tool for health equity as well as building goodwill<\/a> among foreign elite and public audiences<\/a>. There is abundant scholarly evidence that aid is effective at doing this. China\u2019s government has maintained a foreign aid program since shortly after its founding. Over the past seven decades it has invested in a diverse set of highly visible overseas development activities<\/a>, from sponsoring thousands of physical and now digital infrastructure projects, to dispatching over 30,000 medical professionals<\/a> across the Global South and providing vaccines and medications. These \u201chard\u201d and \u201csoft\u201d initiatives have important socioeconomic objectives, but they are also valuable for China\u2019s international image and relationship-building at local and national levels.<\/p>\n

By pausing most of USAID\u2019s funding<\/a> and operations, Donald Trump and Elon Musk sent a loud signal about America\u2019s lack of consistent commitment to supporting development around the world. The Department of Government Efficiency (DOGE)\u2019s impact on USAID is particularly jarring because the Agency has been a world leader in demonstrating how to support global public health while simultaneously building goodwill. US annual aid was only about 1% of the federal budget in recent years, even after significant increases to war-stricken partners such as Ukraine, but accounted for a large share of global humanitarian aid, making it a rather unique resource in America’s foreign policy toolkit<\/a>. Over 20% of USAID funding was devoted to health activities and has supported some of America\u2019s most successful<\/a>\u2013from both a public health and public relations viewpoint\u2013initiatives, such as PEPFAR.<\/p>\n

Chinese development finance includes both hardware investments like cellphone towers, roads, and hospitals and software investments like training and policy advice, but is known for placing a greater emphasis on the former. Yet while debt-financed infrastructure now represents the bulk of Chinese development cooperation, China\u2019s international development cooperation features a diverse mix<\/a> of concessional aid and commercially-oriented financing that supports an extremely wide span of projects<\/a> across transportation, energy, industry, agriculture, education, health, and other sectors.<\/p>\n

China’s growing investments in health aid offer an important example of how China’s diverse overseas development activities serve both developmental and relational goals. Between 2000 and 2017 China\u2019s government committed over 1,300 health projects worldwide, roughly 13% of its total aid portfolio, and these projects were spread across services<\/a> such as specialty equipment and tertiary services (37%), basic medical services and drugs (19%), and basic health infrastructure (13%). A more recent study estimates Chinese global health and population aid totalled nearly US$30 billion<\/a> over the same period. China has prioritized health aid across Asia and Africa, and has invested heavily in sectors not already well-covered by Organization for Economic Cooperation and Development Assistance Committee donors including medical services and basic health infrastructure. During the COVID-19 pandemic, the Chinese government provided over US$4.6 billion in pandemic aid, the most of any donor. In short, China\u2019s global health assistance is large, growing, and multidimensional, and delivers hundreds of visible interventions<\/a> in the form of services, products, and infrastructure at both local and national levels in Global South countries. China also contributes to various multilateral organizations that provide development assistance and have long relied on USAID support, such as the World Food Programme of the United Nations.<\/p>\n

The spillovers from USAID\u2019s woes may produce unforgettable lessons for China as it thinks about the priorities of aid partners. For aid recipients, the long term dependability of bilateral assistance from any single donor will be questioned. Aid packages will be scrutinized for the potential mayhem they could cause if funding suddenly stopped. \u00a0China will find a warmer welcome for co-designing health assistance\u2014both software and hardware\u2014that accelerate a receiving partner\u2019s capacity to meet their own needs by building local institutions. A donor like China will need to bring even more field knowledge of the science of socioeconomic development and public health into crafting investments. This shift will trigger China\u2019s higher education institutions to do more training of a workforce ready for careers in development policy and the systems science of global public health.\u00a0 We predict a mirror image of what is happening in US right now where careers are ending and student interest in these fields is fading rapidly. For example, the applications from mainland China for the University of Hong Kong<\/a>\u2019s Masters in Public Health and Bachelors in Global Health and Development have increased by 26% and 80% respectively compared to 2024.<\/p>\n

Conclusion<\/strong><\/p>\n

Whether Chinese health aid will shift further into software investments like those historically developed by USAID depends on Beijing, which already has a longstanding approach to global public health in place. We believe that recipient countries will want to have more assurance than ever that their partnership with a donor will not backfire. They will need more participation in seeing how each investment serves their development and is shielded from vagaries of a donor\u2019s internal politics. We predict that China and other Asian and \u201cemerging\u201d donors will be called upon to fill global coverage gaps, both bilaterally and multilaterally, amidst major changes in the international politics of development. The composition of Chinese health assistance should not be expected to resemble nor replicate what was lost with the drawdown of USAID funding.<\/p>\n","protected":false},"excerpt":{"rendered":"

By David Bishai[1] and Austin Strange[2] [1] The University of Hong Kong School of Public…<\/p>\n","protected":false},"author":576,"featured_media":2570,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[29],"tags":[24269,77893],"class_list":["post-2568","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-funding","tag-china","tag-usaid","odd"],"yoast_head":"\nHow will China\u2019s health aid react to the changing international development landscape? - Health Policy and Planning Debated<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"How will China\u2019s health aid react to the changing international development landscape? - Health Policy and Planning Debated\" \/>\n<meta property=\"og:description\" content=\"By David Bishai[1] and Austin Strange[2] [1] The University of Hong Kong School of Public...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/\" \/>\n<meta property=\"og:site_name\" content=\"Health Policy and Planning Debated\" \/>\n<meta property=\"article:published_time\" content=\"2025-06-25T19:15:19+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-02-16T11:31:09+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/files\/2025\/06\/Capture-1024x605.png\" \/>\n\t<meta property=\"og:image:width\" content=\"1024\" \/>\n\t<meta property=\"og:image:height\" content=\"605\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"phpunsal\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"phpunsal\" \/>\n\t<meta name=\"twitter:label2\" content=\"Estimated reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/\"},\"author\":{\"name\":\"phpunsal\",\"@id\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/#\/schema\/person\/28a4efb1d1010ffde9ce165ad9dd7e97\"},\"headline\":\"How will China\u2019s health aid react to the changing international development landscape?\",\"datePublished\":\"2025-06-25T19:15:19+00:00\",\"dateModified\":\"2026-02-16T11:31:09+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/\"},\"wordCount\":1071,\"image\":{\"@id\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/files\/2025\/06\/Capture.png\",\"keywords\":[\"China\",\"USAID\"],\"articleSection\":[\"Funding\"],\"inLanguage\":\"en-GB\"},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/\",\"url\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/\",\"name\":\"How will China\u2019s health aid react to the changing international development landscape? - Health Policy and Planning Debated\",\"isPartOf\":{\"@id\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/files\/2025\/06\/Capture.png\",\"datePublished\":\"2025-06-25T19:15:19+00:00\",\"dateModified\":\"2026-02-16T11:31:09+00:00\",\"author\":{\"@id\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/#\/schema\/person\/28a4efb1d1010ffde9ce165ad9dd7e97\"},\"inLanguage\":\"en-GB\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-GB\",\"@id\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/#primaryimage\",\"url\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/files\/2025\/06\/Capture.png\",\"contentUrl\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/files\/2025\/06\/Capture.png\",\"width\":1084,\"height\":640},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/#website\",\"url\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/\",\"name\":\"Health Policy and Planning Debated\",\"description\":\"\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-GB\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/#\/schema\/person\/28a4efb1d1010ffde9ce165ad9dd7e97\",\"name\":\"phpunsal\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-GB\",\"@id\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/0eb8024050dfb79188ec632b3c126b21503861881ec0932af76989917471a5d0?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/0eb8024050dfb79188ec632b3c126b21503861881ec0932af76989917471a5d0?s=96&d=mm&r=g\",\"caption\":\"phpunsal\"},\"url\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/author\/phpunsal\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"How will China\u2019s health aid react to the changing international development landscape? - Health Policy and Planning Debated","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/","og_locale":"en_GB","og_type":"article","og_title":"How will China\u2019s health aid react to the changing international development landscape? - Health Policy and Planning Debated","og_description":"By David Bishai[1] and Austin Strange[2] [1] The University of Hong Kong School of Public...","og_url":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/","og_site_name":"Health Policy and Planning Debated","article_published_time":"2025-06-25T19:15:19+00:00","article_modified_time":"2026-02-16T11:31:09+00:00","og_image":[{"width":1024,"height":605,"url":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/files\/2025\/06\/Capture-1024x605.png","type":"image\/png"}],"author":"phpunsal","twitter_misc":{"Written by":"phpunsal","Estimated reading time":"5 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/#article","isPartOf":{"@id":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/"},"author":{"name":"phpunsal","@id":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/#\/schema\/person\/28a4efb1d1010ffde9ce165ad9dd7e97"},"headline":"How will China\u2019s health aid react to the changing international development landscape?","datePublished":"2025-06-25T19:15:19+00:00","dateModified":"2026-02-16T11:31:09+00:00","mainEntityOfPage":{"@id":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/"},"wordCount":1071,"image":{"@id":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/#primaryimage"},"thumbnailUrl":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/files\/2025\/06\/Capture.png","keywords":["China","USAID"],"articleSection":["Funding"],"inLanguage":"en-GB"},{"@type":"WebPage","@id":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/","url":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/","name":"How will China\u2019s health aid react to the changing international development landscape? - Health Policy and Planning Debated","isPartOf":{"@id":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/#website"},"primaryImageOfPage":{"@id":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/#primaryimage"},"image":{"@id":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/#primaryimage"},"thumbnailUrl":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/files\/2025\/06\/Capture.png","datePublished":"2025-06-25T19:15:19+00:00","dateModified":"2026-02-16T11:31:09+00:00","author":{"@id":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/#\/schema\/person\/28a4efb1d1010ffde9ce165ad9dd7e97"},"inLanguage":"en-GB","potentialAction":[{"@type":"ReadAction","target":["https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/"]}]},{"@type":"ImageObject","inLanguage":"en-GB","@id":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2025\/06\/25\/how-will-chinas-health-aid-react-to-the-changing-international-development-landscape\/#primaryimage","url":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/files\/2025\/06\/Capture.png","contentUrl":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/files\/2025\/06\/Capture.png","width":1084,"height":640},{"@type":"WebSite","@id":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/#website","url":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/","name":"Health Policy and Planning Debated","description":"","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-GB"},{"@type":"Person","@id":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/#\/schema\/person\/28a4efb1d1010ffde9ce165ad9dd7e97","name":"phpunsal","image":{"@type":"ImageObject","inLanguage":"en-GB","@id":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/#\/schema\/person\/image\/","url":"https:\/\/secure.gravatar.com\/avatar\/0eb8024050dfb79188ec632b3c126b21503861881ec0932af76989917471a5d0?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/0eb8024050dfb79188ec632b3c126b21503861881ec0932af76989917471a5d0?s=96&d=mm&r=g","caption":"phpunsal"},"url":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/author\/phpunsal\/"}]}},"_links":{"self":[{"href":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/wp-json\/wp\/v2\/posts\/2568","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/wp-json\/wp\/v2\/users\/576"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/wp-json\/wp\/v2\/comments?post=2568"}],"version-history":[{"count":4,"href":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/wp-json\/wp\/v2\/posts\/2568\/revisions"}],"predecessor-version":[{"id":2574,"href":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/wp-json\/wp\/v2\/posts\/2568\/revisions\/2574"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/wp-json\/wp\/v2\/media\/2570"}],"wp:attachment":[{"href":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/wp-json\/wp\/v2\/media?parent=2568"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/wp-json\/wp\/v2\/categories?post=2568"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/wp-json\/wp\/v2\/tags?post=2568"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}