The pros and cons of China’s health role in Africa

## Summary
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. African researchers gain access to equipment and infrastructure, and Chinese scientists gain access to large and diverse data sets — an invaluable resource for working on shared health challenges, such as cancer and antimicrobial resistance. “For Chinese scientists, especially in public health, tropical medicine and vaccine development, conducting research in Africa provides irreplaceable real-world settings to study disease-transmission dynamics, drug efficacy under diverse conditions and host–pathogen interactions,” says Liangman Gao, director of the Center for Sub-Saharan African Studies at Tsinghua University, Beijing. Article PubMed Google Scholar Download references Related Articles Can China keep up its extraordinary research growth? Nature Index 25 MAR 26 Why China’s philanthropists are digging deep for research Nature Index 25 MAR 26 A guide to the Nature Index Nature Index 25 MAR 26 The surprising science behind red-light therapy — and how it really works News Feature 25 MAR 26 CRISPR makes enhanced cancer-fighting immune cells inside mice News 18 MAR 26 Autism in older adults: the health system must recognize its effects Correspondence 17 MAR 26 Jobs Postdoctoral Fellow A postdoctoral fellow position is available at NIH for translational research on neural mechanisms of frustration/irritability in mice and humans Bethesda, Maryland (US) National Institute of Mental Health, National Institutes of Health Junior Professorship (W1) for „Public Child Mental Health“ (f/m/d The Medical Faculty Mannheim of Heidelberg University invites applications for the Junior Professorship (W1) for “Public Child Mental Health” (f/...

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Chinese medical teams are working with health-care workers on the island nation of Comoros to implement malaria-control programmes. Credit: Wang Guansen/Xinhua/Alamy
Since 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 allocations
1
.
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.
During the Ebola outbreak of 2014–16, in addition to sending a medical team to Sierra Leone to train staff and treat patients at local hospitals, China fast-tracked the construction of the Sierra Leone–China Friendship Biological Safety Laboratory, or Jui Lab, in Freetown to be completed within three months
2
. With continued support from China, the lab has expanded its testing capacity to include a range of pathogens and is the
only high-containment facility of its kind in the country
. In early 2020, Jui Lab was appointed the national testing site for the SARS-CoV-2 virus.
Source: Nature Index
The COVID-19 pandemic itself prompted several initiatives from China to strengthen Africa’s response to the virus. As well as donating 240 million vaccine doses and other supplies to African hospitals and medical centres, China helped to establish vaccine production facilities in Africa, and
accelerated the construction of the Africa CDC headquarters
in Addis Ababa, Ethiopia. Completed in 2023, the Chinese-built facility is now a prominent symbol of
African-led public-health leadership
.
These efforts reflect a broader strategic shift from China. Since sending its first medical team to Algeria in 1963, Beijing has provided support to African countries when needed. Now, rather than relying on Chinese teams to manage disease responses from within the continent, China is investing in systems that can operate independently on the ground.
There are advantages for both sides in this approach. African researchers gain access to equipment and infrastructure, and Chinese scientists gain access to large and diverse data sets — an invaluable resource for working on shared health challenges, such as ca

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## Expert Analysis

### Merits
- Early success was achieved in Comoros, an archipelagic country off the east coast of Africa, following the widespread administration of artemisinin-piperaquine, a Chinese-made malaria treatment, in 2007 7 .
- Although China’s approach has been shifting towards working with African researchers on the ground rather than sending its own teams, certain challenges are slowing progress.
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### Areas for Consideration
- Cheng agrees that the Chinese government’s involvement in research partnerships has made things more difficult than when countries keep such arrangements strictly at the institutional level. “Chinese engagement is always done through official channels,” he says.

### Implications
- Without our modernization, there will be no global modernization,” Xi said.
- 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?
- As a result, China has increasingly focused on strengthening local surveillance and outbreak-response systems across the continent.

### Expert Commentary
This article covers china, health, africa topics. Notable strengths include discussion of china. Areas of concern are also raised. Readability: Flesch-Kincaid grade 0.0. Word count: 2141.