Abstract
BackgroundThere is a growing recognition of China’s role as a global health donor, in particular in Africa, but there have been few systematic studies of the level, destination, trends, or composition of these development finance flows or a comparison of China’s engagement as a donor with that of more traditional global health donors.MethodsUsing newly released data from AidData on China’s development finance activities in Africa, developed to track under reported resource flows, we identified 255 health, population, water, and sanitation (HPWS) projects from 2000–2012, which we descriptively analyze by activity sector, recipient country, project type, and planned activity. We compare China’s activities to projects from traditional donors using data from the OECD’s Development Assistance Committee (DAC) Creditor Reporting System.ResultsSince 2000, China increased the number of HPWS projects it supported in Africa and health has increased as a development priority for China. China’s contributions are large, ranking it among the top 10 bilateral global health donors to Africa. Over 50% of the HPWS projects target infrastructure, 40% target human resource development, and the provision of equipment and drugs is also common. Malaria is an important disease priority but HIV is not. We find little evidence that China targets health aid preferentially to natural resource rich countries.ConclusionsChina is an important global health donor to Africa but contrasts with traditional DAC donors through China’s focus on health system inputs and on malaria. Although better data are needed, particularly through more transparent aid data reporting across ministries and agencies, China’s approach to South-South cooperation represents an important and distinct source of financial assistance for health in Africa.
Highlights
There is a growing recognition of China’s role as a global health donor, in particular in Africa, but there have been few systematic studies of the level, destination, trends, or composition of these development finance flows or a comparison of China’s engagement as a donor with that of more traditional global health donors
We identified 255 HPWS projects that were allocated to 46 individual African countries or regionally
African countries require additional funding to meet the Millennium Development Goals, achieve Universal Health Coverage, and other global health priorities, and given that aid flows from traditional donors have plateaued in recent years, there is a need to find new sources of funding for these additional resources [31]
Summary
There is a growing recognition of China’s role as a global health donor, in particular in Africa, but there have been few systematic studies of the level, destination, trends, or composition of these development finance flows or a comparison of China’s engagement as a donor with that of more traditional global health donors. Poverty reduction and health improvements in China, which represents over one fifth of the world’s population, heavily influence global measures of disease burden as well as progress towards human development goals. While China’s engagement as a global health donor is not new – it dispatched its first medical team to Algeria in 1963 – its modalities appear to be changing and growing more prominent in Africa [2]. China hosted the first-ever Ministerial Forum on China-Africa Health Development, which was held in Beijing in August 2013 and timed to commemorate the 50th anniversary of the first Chinese medical team. China’s President Xi Jinping heralded a “new era” of China-Africa cooperation on health and noted that “human development is at the core of development”, which notably includes health [8]
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