Feature Economic development

Rise of a new superpower: health and China’s global trade ambitions

BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k595 (Published 09 February 2018) Cite this as: BMJ 2018;360:k595
  1. Flynn Murphy, freelance correspondent
  1. Sydney, Australia and Beijing, China
  1. flynnpmurphy{at}gmail.com

Massive foreign infrastructure projects are designed to increase China’s economic and political influence—for example, opening up new markets to Chinese drugs and tobacco. The “belt and road initiative,” writes Flynn Murphy, the country’s enigmatic policy backed by huge investment, could have profound implications for local and global health

A public hospital in copper-rich Zambia quadruples its capacity to 800 beds. A Chinese cigarette manufacturing plant near Bucharest prepares to start exporting to the Balkans. A Kazakh medical student on a scholarship to Beijing begins specialty training in neurosurgery. A Jiangsu man flies to Beijing for treatment for the yellow fever he contracted while working in Angola. These disparate events are connected by a Chinese foreign policy with profound implications for global health.

China’s leaders have pledged hundreds of billions of dollars—some say more than a trillion1—in planned projects as part of the country’s “belt and road initiative” (BRI). It’s ostensibly a push to revive and strengthen ancient trade routes between China, Africa, and Europe—“to bring everyone, literally and physically, into China’s economic orbit,” says Peter Cai, a non-resident fellow at Australia’s Lowy Institute think tank and an expert on the policy. Cai says that China wants to grow its global economic and political influence using its most potent weapon: infrastructure building expertise.

Currently that means furnishing Africa, Asia, and Europe with roads, bridges, ports, high speed railways, airports, power plants, and oil and gas pipelines. Broadly, these will wind overland along a “silk road economic belt” that stretches as far as Scandinavia and Portugal, and a sea route through Asia and around the east coast of Africa along a “21st century maritime silk road.” China says at completion the initiative will connect 65% of the world’s people and 35% of its finances.2

Confusion, scepticism, and distrust

Some 70 nations have …

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