GoKawiilSince launching the Health Silk Road in 2017 as part of its Belt and Road Initiative, China’s engagement in African health has shifted from short-term aid missions towards more complex, long-term collaborative projects.
Beyond continued support for African hospitals, health-care workers and rural medical services, China’s expanding involvement in African health includes building joint hospitals and medical centres and strengthening its relationships with pan‑African health and regulatory bodies, including the Africa Centres for Disease Control and Prevention (Africa CDC) and the African Medicines Agency.
China is also investing in African pharmaceutical and vaccine production. Chinese company Shanghai Fosun Pharmaceutical is developing a €50 million (US$58.8 million) facility near Abidjan, Côte d’Ivoire to produce antimalarial and antibacterial medicines, for example, and Jijia International Company of China, a Beijing-based medical equipment firm, is working with Zambia to establish the country’s first cholera vaccine plant.
Nature Index 2026 China
At the 2024 Summit of the Forum on China–Africa Cooperation (FOCAC) in Beijing — the largest gathering of African and Chinese leaders in the capital since 2018 — Chinese President Xi Jinping emphasized China’s commitment to “jointly advance modernization that is open and win–win” through its partnership with Africa across health and other sectors. “China and Africa account for one-third of the world population. Without our modernization, there will be no global modernization,” Xi said.
This deepened commitment to Africa coincides with a sharp decline in US support for aid programmes in low‑ and middle‑income countries, including for health and collaborative research in Africa. In March 2025, the US government announced that 83% of programmes run by the US Agency for International Development (USAID) would be cancelled. Sub‑Saharan Africa was USAID’s largest recipient region in 2024, receiving an estimated $12.3 billion of the agency’s roughly $35 billion in total allocations1.
China cannot replace US contributions in Africa, says Han Cheng of the Max Planck Institute for the History of Science in Berlin, who studies China’s global engagement. “If you think about the scale and scope of US aid on the ground, China can’t match that.”
But the shift does raise the question: will China’s collaborations with Africa bolster local health systems at a moment of acute need? Or will challenges around transparency, diplomacy and long-term support undermine efforts to establish locally driven priorities?
Renewed commitment
Like many nations, China tracks disease outbreaks in regions where its bilateral trade, travel and population flows are strongest. With an estimated 500,000 Africans living in China and between 1 million and 2 million Chinese people living in Africa, the control of diseases such as Ebola, mpox and Lassa fever is a strategic priority. As a result, China has increasingly focused on strengthening local surveillance and outbreak-response systems across the continent.
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