As Western donors retreat, many fear that China will fill the gaps and disrupt the global health order. But in practice, China offers fresh, alternative tools, and the Global South is listening.
Thank you Ruby for this careful, analytic and comprehensive article. You point out many important issues and facts that the mainstream media simply does not cover. I hadn't known that Britain, too, had slashed aid funding. Something else that didn't make the msm. the final part about recognising the importance of traditional medicine is a very important factor, considering how China has successfully integrated TCM into treatment protocol across the country.
Thanks for this interesting article, a nice comparison of potential differences in approach. A few comments below.
"Whatever comes next, whether China-led, Western-led, or otherwise, care must actually reaches the people who need it."
Wholeheartedly agree, hopefully whatever disagreements exist between various stakeholders this principle can be a starting off point on which we can all find common ground.
“many in the Global South are readily shaking China’s hand: rising up against dependency, speaking up for agency, and welcoming the USAID/Western donor gap not as a vacuum, but as an opportunity for change.”
Many may be doing so, but the 'global south' or even individual countries within the global south are pretty heterogeneous. There are also a lot of voices warning of catastrophes who would like to see a continuation of programs like PEPFAR.
I don't object to talk about 'opportunity' per se, or think that we should embrace 'doomerism', but if we're going to talk about opportunity and new ways of doing things, we should be clear about the costs involved in abandoning established programs (that perhaps represent the old way of doing things). Some estimates put potential deaths at over 10 million over the next five years, and perhaps many millions more will suffer from preventable diseases. I imagine that those who have lost access to lifesaving medical care for themselves and their children aren't thinking about what a wonderful chance this is to break free from "aid dependency".
Given the success of PEPFAR and other USAID programs over the last 20 years, I can't help but wonder if we might not be more cautious of embracing an "out with the old, in with the new" mindset or insist on "rewriting the playbook", and instead give careful consideration to the successes of the past few decades and how they might be built upon.
"By now, China is well known for building infrastructure, extremely quickly and efficiently, in developing nations."
The controversy in DRC over the past few years over the Sicomines deal and over infrastructure investments elsewhere raises questions about this claim, as well as about the role of private companies in aiding development.
Along similar lines, to what extent can the "brothers" claim be maintained when people notice that the senior management of these companies is almost exclusively Chinese? Can we honestly frame the Chinese approach in opposition to "paternal" approaches when we hear the patronizing way that most managers talk about their local employees?
PS small correction "Western-trained scientists and policymakers, myself included, aren’t not naturally taught to see this clearly. " 多了一个 n't
Excellent summary. I feel the cross-border diseases is the Achilles heel, especially given China’s reticence to investigate the origins of Covid. To me, it’s very clear there is a national and strategic interest in surveilling diseases, famines, and droughts. These western-led model acknowledges this reality in a way I do not see the Chinese leadership doing.
China of course has its own contradictions with this given the death of Li Wenliang and its scientists who published the genome of COVID within days on public sites.
Raising this to a broad view and getting a bit philosophical, the four horseman in Revelation were war, pestilence, famine, and disease. International aid and health address 3 of those. It would be foolish to underinvest in programs that monitor this.
Regurgitation of the US narrative which is never investigated by mainstream media. Over 1.5 million Americans and a quarter of a million Brits dead under questionable mishandling.
A comprehensive covid timeline you won't have seen in the MSM.
"A huge part of the problem in understanding what China wants, as my policy friend and I discussed with each other, is that most China watchers do not spend enough (or any) time in China." - fantastic statement.
Interesting text. In my perspective, it's important to consider that Tradicional Chinese Medicine has been integrated into the higher education system since 1956 and has been modernizing since, at least, 1986. Nowadays, it uses research tools such as OMICS, systems biology, network pharmacology and nanopharmacology. In conclusion, in China, tradition is compatible with modernity and modernization is not the same as westernization. This can also serve as model for other developing countries.
Have read earlier today that Trump regime is now going hard after Cuba’s Medical Doctors overseas programs. I’m wondering how this is going to ripple through the whole world system along with the loss of funding, particularly in Africa and South America.
Thank you Ruby for this careful, analytic and comprehensive article. You point out many important issues and facts that the mainstream media simply does not cover. I hadn't known that Britain, too, had slashed aid funding. Something else that didn't make the msm. the final part about recognising the importance of traditional medicine is a very important factor, considering how China has successfully integrated TCM into treatment protocol across the country.
Thank you Debbie for such kind words, I am keen to write about TCM specifically in a future post, the intersection and paradox is fascinating
Thanks, Ruby. Bookmarked.
Excellent blog. A must read for folks interested in global health.
Thanks so much for your support Dr Singer!
Thanks for this interesting article, a nice comparison of potential differences in approach. A few comments below.
"Whatever comes next, whether China-led, Western-led, or otherwise, care must actually reaches the people who need it."
Wholeheartedly agree, hopefully whatever disagreements exist between various stakeholders this principle can be a starting off point on which we can all find common ground.
“many in the Global South are readily shaking China’s hand: rising up against dependency, speaking up for agency, and welcoming the USAID/Western donor gap not as a vacuum, but as an opportunity for change.”
Many may be doing so, but the 'global south' or even individual countries within the global south are pretty heterogeneous. There are also a lot of voices warning of catastrophes who would like to see a continuation of programs like PEPFAR.
I don't object to talk about 'opportunity' per se, or think that we should embrace 'doomerism', but if we're going to talk about opportunity and new ways of doing things, we should be clear about the costs involved in abandoning established programs (that perhaps represent the old way of doing things). Some estimates put potential deaths at over 10 million over the next five years, and perhaps many millions more will suffer from preventable diseases. I imagine that those who have lost access to lifesaving medical care for themselves and their children aren't thinking about what a wonderful chance this is to break free from "aid dependency".
Given the success of PEPFAR and other USAID programs over the last 20 years, I can't help but wonder if we might not be more cautious of embracing an "out with the old, in with the new" mindset or insist on "rewriting the playbook", and instead give careful consideration to the successes of the past few decades and how they might be built upon.
"By now, China is well known for building infrastructure, extremely quickly and efficiently, in developing nations."
The controversy in DRC over the past few years over the Sicomines deal and over infrastructure investments elsewhere raises questions about this claim, as well as about the role of private companies in aiding development.
Along similar lines, to what extent can the "brothers" claim be maintained when people notice that the senior management of these companies is almost exclusively Chinese? Can we honestly frame the Chinese approach in opposition to "paternal" approaches when we hear the patronizing way that most managers talk about their local employees?
PS small correction "Western-trained scientists and policymakers, myself included, aren’t not naturally taught to see this clearly. " 多了一个 n't
Excellent summary. I feel the cross-border diseases is the Achilles heel, especially given China’s reticence to investigate the origins of Covid. To me, it’s very clear there is a national and strategic interest in surveilling diseases, famines, and droughts. These western-led model acknowledges this reality in a way I do not see the Chinese leadership doing.
China of course has its own contradictions with this given the death of Li Wenliang and its scientists who published the genome of COVID within days on public sites.
Raising this to a broad view and getting a bit philosophical, the four horseman in Revelation were war, pestilence, famine, and disease. International aid and health address 3 of those. It would be foolish to underinvest in programs that monitor this.
Thanks for your perspective!
Regurgitation of the US narrative which is never investigated by mainstream media. Over 1.5 million Americans and a quarter of a million Brits dead under questionable mishandling.
A comprehensive covid timeline you won't have seen in the MSM.
https://annachenwrites.substack.com/p/covid-timeline-vs-trump-spin-110
Thanks for sharing your piece Anna!
"A huge part of the problem in understanding what China wants, as my policy friend and I discussed with each other, is that most China watchers do not spend enough (or any) time in China." - fantastic statement.
Thanks so much Paul!
Interesting text. In my perspective, it's important to consider that Tradicional Chinese Medicine has been integrated into the higher education system since 1956 and has been modernizing since, at least, 1986. Nowadays, it uses research tools such as OMICS, systems biology, network pharmacology and nanopharmacology. In conclusion, in China, tradition is compatible with modernity and modernization is not the same as westernization. This can also serve as model for other developing countries.
Thanks for your thoughts Diogo. I will be writing about TCM in a later post - as you say, a fundamental part of China’s health
Have read earlier today that Trump regime is now going hard after Cuba’s Medical Doctors overseas programs. I’m wondering how this is going to ripple through the whole world system along with the loss of funding, particularly in Africa and South America.