Barefoot Doctors Research Articles

Solve the Plight of Rural Healthcare Talent from the Success of the Barefoot Doctor Period

The Barefoot Doctors (BDs) have contributed tremendous strength to the protection and promotion of the health and well-being of vast farmers in China, and the country’s three-tiered medical and preventive healthcare network of counties, townships, and villages is widely acknowledged as a valuable experience in providing rural healthcare in developing nations. In the twenty-first century, China’s rural health care is facing new opportunities and challenges in terms of talent issues. In order to provide a new avenue for the survival and advancement of rural health care workers in the twenty-first century, this paper addresses the predicament of the current workforce and incorporates an interview with Ms. Song, a former barefoot doctor, to distill the successful experience and propose a solution to the current predicament.

Diagnostic outcome of pro bono neurogenetic diagnostic service in Sri Lanka: A wealth creation

The inherited disease community in Sri Lanka has been widely neglected. This article aimed to present accumulated knowledge in establishing a pro bono cost-effective national, island-wide, free-of-charge molecular diagnostic service, suggesting a model for other developing countries. The project provided 637 molecular diagnostic tests and reports free of charge to a nation with limited resources. We pioneered the implementation of mobile clinics and home visits, where the research team acted as barefoot doctors with the concept of the doctor and the researcher at the patient’s doorstep. Establishing pro bono, cost-effective molecular diagnostics is feasible in developing countries with limited resources and state funding through the effort of dedicated postgraduate students. This service could provide an accurate molecular diagnosis of Duchenne muscular dystrophy, Huntington’s disease, Spinocerebellar ataxia, and Spinal muscular atrophy, a diagnostic yield of 54% (343/637), of which 43% (147/343) of the patients identified as amenable for available gene therapies. Initiated human resource development by double doctoral degree opportunities with international collaborations. Established a neurobiobank and a national registry in Sri Lanka, a rich and unique repository, wealth creation for translational collaborative research and sharing of information in neurological diseases, as well as a lodestar for aspiring initiatives from other developing countries.

Barefoot Doctor: A Novel, by Can Xue. Translated by Karen Gernant and Chen Zeping. New Haven and London: Yale University Press, 2022

Barefoot Doctor: A Novel, by Can Xue. Translated by Karen Gernant and Chen Zeping. New Haven and London: Yale University Press, 2022

People vs. ‘god of plague’: Socialist China’s anti-zoonotic campaign media as environmental media

This article cross-pollinates environmental media studies with socialist China’s anti-snail fever campaign media, including two 1965 science education films, a 1961 song book, all entitled ‘Song wensheng’ (‘Sending away god of plague’), and a 1970 Chijiao yisheng shouce (‘The handbook for barefoot doctors’). Through studying popular audio-visual and print media produced to support the socialist state-sponsored campaign against snail fever – the longest anti-zoonotic campaign in China – I adopt a cross-media approach to campaign media. Unpacking the environmental unconscious in campaign media, I advance the concept of compost media to intervene in environmental media studies by going beyond critiquing the Capitaloscene, and revealing socialist campaign media as quintessential to environmental media.

ANTI-INFLAMMATORY ACTIVITY OF DEINBOLLIA PINNATA LEAVES WITH ISOLATION OF TRITERPENOIDS

Inflammation is the secondary signal from tissue/cell injury or damage. Most often have increased temperature, and blood flow and are characterized by pain, coloration and swelling. Leaves of Deinbollia pinnata have been into use for anti-inflammatory diseases in rural populated areas of African countries by barefoot doctors. The leaves of D. pinnata investigated showed higher anti-inflammatory with methanol, ethyl acetate and n-hexane in order of (80%, 50% and 14%) at 50 µL for bovine serum albumin assay; and methanol, ethyl acetate and n-hexane (85%, 57%, and 20%) at 40 µL using egg albumin assay. The result showed that the methanolic fraction with less quantity of yield has the highest anti-inflammatory potential compared to other fractions indicating the presence of polar unidentified compounds. Seven (7) known triterpenes were reported using combined chromatographic separation from ethyl acetate fraction which showed the highest yield of extract. These include squalene (1) stigmasterol (2), stigmasta-5,22-diene-3-ol acetate (3), ?-sitosterol (4), lupeol (5), taraxasterol (6), and betulinic acid (7) from aerial parts. Their structures were elucidated using HR-ESIMS, 1D NMR compared with existing data which confirmed their uses in African traditional medicine as anti-inflammatory and antioxidant.

Validez y legitimidad de las medicinas tradicionales americanas: el caso de la asociación Médicos Descalzos de Chinique, Guatemala

El objetivo de este artículo es identificar las formas de legitimación que emplean las medicinas tradicionales para defender su persistencia y desarrollo. La investigación se centra en el caso de la Asociación Médicos Descalzos (MeDes) de Chinique, Guatemala, una organización autogestiva de medicina maya k’iche’. Se realizó un trabajo de campo de cinco semanas de duración, utilizando principalmente el método etnográfico y el análisis de documentos históricos y contemporáneos. La contribución del artículo es la tipificación del proceso de sistematización y validación de conocimientos de medicina maya k’iche’ realizados por MeDes e ilustrados en la descripción de la labor de las comadronas.

Chapter Five: Farewell to the God of Plague

Abstract In the light of biopolitical production, socialist China's medical practice was marked by a heavy reliance on the creativity of the masses and a rejection of the technical bureaucracy. The anti-epidemic campaign exemplified a popular and grassroots medicine for the people and by the people. In films Withered Trees Meet Spring and Spring Sprouts, the political mobilization of the peasantry, the raising of political consciousness, and mass participation in the prevention of diseases project a vision of healthcare for the people. The biomedical movement targeted an increasingly privileged health program skewed in favor of elites and urbanites and divorced from the wellbeing of ordinary people. The medicine of the “barefoot doctor” entails the ecological understanding of the human body in sync with nature and is rooted in affective labor in healing the rifts between humans and nature.

Barefoot doctors: A solution to the dilemma of COVID-19 prevention and control in rural areas of economically underdeveloped countries.

Barefoot doctors: A solution to the dilemma of COVID-19 prevention and control in rural areas of economically underdeveloped countries.

Development of China's health care system in the time of COVID‐19: Challenges, opportunities, and call for actions

Development of China's health care system in the time of COVID‐19: Challenges, opportunities, and call for actions

Public financing for primary health care is the key to universal health coverage and strengthening health security

Public financing for primary health care is the key to universal health coverage and strengthening health security

문화대혁명 시기(1966-1976) 기층 의료 현장의 국가-사회관계 - 베이징(北京) 교구 농촌의 ‘맨발의 의사[赤脚医生]’를 중심으로 -

This article explores the state-society relationship during ten years of the Cultural Revolution(1966-1976), focusing on the activities of barefoot doctors(赤脚醫生) in the rural areas of Beijing suburbs. Meeting rural residents directly, these doctors practiced disease treatment and prevention either at no cost or for minimal fees supported by the Cooperative Medical Systems(CMS). They contributed to the vital improvement of rural healthcare despite the scarcity of national medical institutions and personnel. <BR> From an institutional view, overall barefoot doctor programs, including the recruitment of barefoot doctors, the administration of medical education, and the provision of remuneration and supervision, were operated by the people

Was Maoist China a Clone of the Soviet Union?

Was Maoist China a Clone of the Soviet Union? Felix Wemheuer Lucien Bianco, Stalin and Mao: A Comparison of the Russian and Chinese Revolutions, translated by Krystyna Horko. 448 pp. Hong Kong: Chinese University Press, 2018. ISBN 978-9882370654. $65.00. Elizabeth McGuire, Red at Heart: How Chinese Communists Fell in Love with the Russian Revolution. 462 pp. Oxford: Oxford University Press, 2018. ISBN 978-0190640552. $34.95. It has become fashionable in Western China studies to write about transnational entanglements between the People's Republic (PRC) and the Soviet Union or to compare the development of both countries. The similarities of Stalin's Soviet Union and Mao's China are obviously many, making it impossible to cover them all in a single text. Two new books approach this comparison from different angles. Lucian Bianco looks at the great leaders and macropolitics in Stalin and Mao: A Comparison of the Russian and Chinese Revolutions, while Elizabeth McGuire uses a focus on personal relations and microhistory in Red at Heart: How Chinese Communists Fell in Love with the Russian Revolution. This review discusses the two monographs within the larger context of Western China studies and with attention to paradigm shifts in Sino-Soviet relations. Paradigm Shifts in Western China Studies Since the mid-1930s, Western scholarship regarding the impact of the Soviet Union on the Chinese Revolution and later the PRC underwent several paradigm shifts. During World War II and under the alliance of the United States and China against the Japanese Empire, Chinese Communists were often considered anti-imperialists and nationalists. The bestseller Red Star over China, written by the American journalist Edgar Snow, contributed to [End Page 442] the view of Mao Zedong as a grassroots revolutionary. The lives of communist leaders in the revolutionary base area in Yan'an were presented by Snow as simple and egalitarian. Therefore, Snow saw Chinese communism as an alternative to bureaucratic state socialism in the Soviet Union.1 When the Chinese Communist Party (CCP) took power in 1949, the Cold War had already started. Anticommunist hardliners in the McCarthy era blamed "liberals" of the former Roosevelt administration and scholars in China studies for underestimating the communist threat and causing the "loss of China." In the 1950s, the newly founded PRC was often seen in the West as a "Soviet satellite state" and "totalitarian dictatorship." Western perception started to change significantly due to the rise of the Anti–Vietnam War movement and the New Left around 1968. Activists and many scholars then saw Maoist China through the lenses of anti-imperialism and Third World liberation movements.2 The New Left considered the Cultural Revolution (1966–76) an experiment in mass participation and rural based-development strategies. Western media reports about the horrors of the Cultural Revolution were often ignored as "anticommunist propaganda"; violence was rationalized, because "revolution is not a dinner party," as Chairman Mao had said. The guerilla fighter and the "barefoot doctor" became poster children for an alternative development model to Western and Soviet modernity. CCP criticism of "Soviet revisionism," and in part Western scholarship, emphasized the "Chinese way" of building socialism.3 From the 1930s until the early 1990s, the history of the CCP was often written as step-by-step emancipation from domination by the Comintern and the Soviet Union. The departure from revolutionary Maoism in China after "Reform and Opening" in 1978 destroyed many dreams and illusions. However, it was only after the collapse of the Soviet Union and the opening of the archives of the Comintern and CPSU (Communist Party of the Soviet Union), that the history of the Chinese Revolution was rewritten again. The new findings from archives deconstructed the myths that the CCP had taken an independent path from the Soviet Union. Stalin's guidance and Soviet support had played [End Page 443] a crucial role in creating the second United Front with the Nationalists (GMD) against Japan in 1937 and in bringing the CCP into power in 1949.4 Archival documents show that Soviet advisers influenced the development of the political and economic system in China in the early 1950s based on the Stalinist model. In the fields of culture, education, agriculture, and policies...

Mass Vaccination: Citizens' Bodies and State Power in Modern China by Mary Augusta Brazelton

Reviewed by: Mass Vaccination: Citizens' Bodies and State Power in Modern China by Mary Augusta Brazelton Wayne Soon Mary Augusta Brazelton. Mass Vaccination: Citizens' Bodies and State Power in Modern China. Studies of the Weatherhead East Asian Institute, Columbia University. Ithaca, N.Y.: Cornell University Press, 2019. 258 pp. Ill. $47.95 (978-1-5017-3998-9). Mary Augusta Brazelton has written an impressive history of vaccination in twentieth-century China. Through a sophisticated analysis of English, French, and Chinese archival materials, correspondences, scientific reports, consular documents, and speeches, Brazelton argues that mass vaccination was central in constructing the modern Chinese citizen. Not only did immunization campaigns entail collective participation as a means of identity building, but they also established the expectation that Chinese people would subject their bodies to the dictates of the state. This process accelerated during the Second World War between 1937 and 1945, when Yunnan province in Southwest China emerged as a critical site for vaccine experiments and the development of vaccination ideas and techniques. Scientists and physicians affiliated with the Chinese Nationalist Party (Kuomintang, KMT) and their local allies led wartime expansion of immunization. Their efforts left critical legacies for the post-1949 Chinese Communist Party–led People's Republic of China (PRC) utilization of vaccination for state building and medical diplomacy. [End Page 533] Chapter 1 highlights how Chinese physicians were limited by the financial and logistical limitations of prewar public health administration, even as they accumulated knowledge and experiences from fellow microbiologists around the world. Arriving in wartime Yunnan, Chinese doctors, as chapter 2 shows, encountered medical systems shaped by competing French, British, and Chinese forces. Chapter 3 describes how Chinese physicians finally received the support needed to enact mass vaccination from multiple health care organizations that emerged during the Second World War. These institutions were backed by a variety of overseas patrons, such as the League of Nations. Chapter 4 delineates how the Chinese government prioritized the production and dissemination of vaccination in wartime Kunming. They sometimes used coercive methods to compel immunization and thereby expanded the power of the state. Chapter 5 shows how the KMT and local government officials shifted their attention from disseminating cholera vaccines in wartime Southwest China to promoting Bacille Calmette-Guerin (BCG) vaccination in coastal China to combat tuberculosis during the Civil War period from 1945 to 1949. Chapters 6 and 7 show how the PRC state used vaccination to improve China's rural public health in the 1950s, setting the stage for touting its success in its global medical diplomacy in the 1960s and 1970s. Mass Vaccination, curated carefully from diverse sources, illustrates the negotiations over vaccination on the ground. We encounter officials in Yunnan who insisted on receiving bribes from custom duties on imported drugs and medical supplies before allowing them into the province (p. 61). We meet cafeteria workers who did not want injections because they were too painful (p. 94). We see mothers who rejected vaccination on the grounds they were too occupied with child-rearing (p. 139). We shudder that a prominent microbiologist committed suicide in 1958 after being hounded for being an "anti-rightist" by the PRC government (p. 168). One wonders if these cumulative acts of resistance and failure effectively challenged the expansion of state-led biopolitics (pp. 7–9). Or were they merely casualties of an unstoppable modern Chinese state, bent on inoculating patients at will for the sake of the greater good? In light of the global race to develop an effective COVID-19 vaccine quickly in 2020, one wonders too whether vaccinators resisted the Chinese state's calls to rapidly develop new vaccines. It is critical to ask if mass immunization (as opposed to barefoot doctors or commune-style healthcare) really underpinned the PRC's rural health advances, as these claims later formed the basis of international experts' promotion of the PRC model in resolving global health issues. As Brazelton points out, underpinning this global desire for the PRC's model is a much more complex history, ironically, that began with its principal rival, the KMT, which sought to immunize its way to victory against the Japanese during the Second World War. This book will undoubtedly...

Changing Narratives and Persisting Tensions: Conflicts between Chinese and Western Medicine and Professional Profiles in Chinese Films and Literature, 1949-2009.

This paper analyses the shifting images of Chinese medicine and rural doctors in the narratives of literature and film from 1949 to 2009 in order to explore the persisting tensions within rural medicine and health issues in China. Popular anxiety about health services and the government's concern that it be seen to be meeting the medical needs of China's most vulnerable citizens - its rural dwellers - has led to the production of a continuous body of literary and film works discussing these issues, such as Medical Practice Incident, Spring Comes to the Withered Tree, Chunmiao, and Barefoot Doctor Wan Quanhe. The article moves chronologically from the early years of the Chinese Communist Party's new rural health strategies through to the twenty-first century - over these decades, both health politics and arts policy underwent dramatic transformations. It argues that despite the huge political investment on the part of the Chinese Communist Party government in promoting the virtues of Chinese medicine and barefoot doctors, film and literature narratives reveal that this rustic nationalistic vision was a problematic ideological message. The article shows that two main tensions persisted prior to and during the Cultural Revolution, the economic reform era of the 1980s, and the medical marketisation era that began in the late 1990s. First, the tension between Chinese and Western medicine and, second, the tension between formally trained medical practitioners and paraprofessional practitioners like barefoot doctors. Each carried shifting ideological valences during the decades explored, and these shifts complicated their portrayal and shaped their specific styles in the creative works discussed. These reflected the main dilemmas around the solutions to rural medicine and health care, namely the integration of Chinese and Western medicines and blurring of boundaries between the work of medical paraprofessionals and professionals.

Beyond the Barefoot Doctors: Using Community Health Workers to Translate HIV Research to Service.

Miami-Dade leads the nation in new HIV infections, and its Black communities experience the greatest disparities in outcomes. Our prior research found that street-based HIV testing facilitated by community health workers improved access to testing and care among Black adults in a controlled trial setting. Herein, we describe our efforts translating this CHW-led intervention into a community service for diverse Blacks in Miami. From December 2016 through August 2017, CHWs educated 1672 individuals about HIV transmission, prevention methods, and risk factor modification; 529 received HIV testing and/or linkage to care services. Approximately 5% of participants (n = 26) had rapid reactiveresults. This efficacious and culturally-acceptable model represents a powerful change in the delivery of HIV care and demonstrates how public health leaders can foster community engagement in the transition from research to service.

Utility of Theory to Explain Village Doctors’ Willingness to Treat People Living with HIV in Rural China

Stigma against people living with HIV in China is common, not only among the general public but also among Chinese health-care providers, impacting their ability to provide quality HIV treatment and care. HIV stigma may be particularly common in rural areas of China, where village doctors (i.e., “barefoot doctors”) have limited medical training yet are charged with providing frontline care for much of China’s rural population. Therefore, the present study aims to use communication and behavioral theory to better understand Chinese village doctors’ beliefs about HIV, including their willingness to become involved in HIV treatment and care. In collaboration with the Behai Centers for Disease Control, we surveyed 228 village doctors in rural China to learn about their experiences in providing HIV treatment and care. We then applied a hybrid theoretical model, combining variables from the Situational Theory of Publics and the Theory of Reasoned Action, to explain providers’ communication, attitudes, and behaviors. Findings suggest that enhanced information activity about HIV may increase providers’ self-efficacy in caring for HIV patients and yield more positive attitudes towards caring for people living with HIV. Theoretical and practical implications are discussed.

Maternal and child health workforce profile and density in China since 1949: a systematic review

BackgroundRoutine sources of information on the maternal and child health workforce in China are without clear definition and categorisation. The aim of the study was to systematically review all the evidence on China's maternal and child health workforce profile (ie, level of education, training, qualification, and professional title), and determine the density of the maternal and child health workforce. MethodsWe did a systematic review by searching six English (Embase, MEDLINE, CENTRAL, EconLit, Global Health, and Web of Science) and two Chinese (Wanfang and China National Knowledge Infrastructure) databases, from 1949 onwards, using a combination of the search terms “human resources for health”, “maternal and child health services”, and “China” with both thesaurus and free text words. We included studies either describing the profile of the maternal and child health workforce or providing data allowing us to calculate the density of the maternal and child health workforce. FindingsWe included 58 studies: 43 reporting profiles of the maternal and child health workforce, and 19 reporting density of the maternal and child health workforce, four of which covered both. 51 (88%) of the 58 studies were done after 1990. The maternal and child health workforce in China covers an array of professions, including obstetricians, gynaecologists, neonatologists, paediatricians, nurses, midwives, general physicians, specialised public health workers, vaccinators, barefoot doctors (ie, farmers who go through short-term medical training), and traditional birth attendants. Definitions of who qualifies as a maternal and child health provider are not clear (eg, the term midwife was used in six studies, and covered a range of training, including clinical medicine, maternal and child health care, nursing, and midwifery). Two studies reported that 7% (24 of 321) and 48% (650 of 1364), respectively, of the maternal and child health workforce at county-level facilities or below held no certificate for maternal and child health care. Only one study reported the density of the maternal and child health workforce at a national level, which was 0·6 health professionals per 1000 population in 2011. The density of the maternal health workforce was between 1·6 and 6·5 times higher than the child health workforce in the same population. The ratio of obstetric nurses to obstetricians ranged from 1·3:1 to 2·0:1, which was higher than the overall nurse-to-doctor ratio at a national level of 1·1:1 in 2017. The ratio of paediatric nurses to paediatricians ranged from 1·1:1 to 1·7:1, which was higher than the national ratio of 1·1:1. InterpretationThe density of the maternal and child health workforce in China is lower than the minimum desired level of 2·3 health professionals (physicians, nurses, and midwives) per 1000 population, as recommended in the World Health Report 2006. The maternal and child health workforce in China is characterised by varied personnel with diverse training backgrounds, a larger maternal health workforce than child health workforce, and more nurses than doctors. A strength of the study is the conceptual understanding of the maternal and child health workforce over the entire period of contemporary China. A limitation of the study is that various data sources prevented us from synthesising the available evidence together. FundingChina Medical Board.

Xiaoping Fang, Barefoot Doctors and Western Medicine in China, Rochester, New York: University of Rochester Press (Rochester Studies in Medical History), 2015, xii &amp; 294 pp., with figures, tables and maps.

Xiaoping Fang, Barefoot Doctors and Western Medicine in China, Rochester, New York: University of Rochester Press (Rochester Studies in Medical History), 2015, xii &amp; 294 pp., with figures, tables and maps.

Between Party, People, and Profession: The Many Faces of the 'Doctor' during the Cultural Revolution.

During the Chinese Cultural Revolution (1966-76), Chairman Mao fundamentally reformed medicine so that rural people received medical care. His new medical model has been variously characterised as: revolutionary Maoist medicine, a revitalised form of Chinese medicine; and the final conquest by Western medicine. This paper finds that instead of Mao's vision of a new 'revolutionary medicine', there was a new medical synthesis that drew from the Maoist ideal and Western and Chinese traditions, but fundamentally differed from all of them. Maoist medicine's ultimate aim was doctors as peasant carers. However, rural people and local governments valued treatment expertise, causing divergence from this ideal. As a result, Western and elite Chinese medical doctors sent to the countryside for rehabilitation were preferable to barefoot doctors and received rural support. Initially Western-trained physicians belittled elite Chinese doctors, and both looked down on barefoot doctors and indigenous herbalists and acupuncturists. However, the levelling effect of terrible rural conditions made these diverse conceptions of the doctor closer during the Cultural Revolution. Thus, urban doctors and rural medical practitioners developed a symbiotic relationship: barefoot doctors provided political protection and local knowledge for urban doctors; urban doctors' provided expertise and a medical apprenticeship for barefoot doctors; and both counted on the local medical knowledge of indigenous healers. This fragile conceptual nexus had fallen apart by the end of the Maoist era (1976), but the evidence of new medical syntheses shows the diverse range of alliances that become possible under the rubric of 'revolutionary medicine'.

Offline: Towards a Pax Sinica?

One's immediate impression on meeting China's new Minister of Health, Ma Xiaowei, is his sense of humour. Laughter frequently punctuates his sentences. He discusses his love of Agatha Christie. Minister Ma has worked in the National Health Commission (Ministry of Health) for two decades. He knows the job and understands its enormous responsibilities. We met on what he pointed out was his 1-month anniversary in the role. Now is “a very critical period” for the health of the Chinese people. He identified two priorities. First, to improve accessibility to medical services. To meet this objective will require a high-performing primary health-care system, something China currently does not have. Second, to reduce the poverty-inducing health costs caused by expensive medicines. He would like to see closer collaboration between Chinese health experts and their international counterparts. And he welcomed independent external assessment of the progress of China's health reforms. He intends to accelerate the pace of those reforms. Time magazine last week named President Xi Jinping one of its “100 most influential people” in the world. It concluded its citation by arguing that, “Pax Americana is finished, and Xi will have a say in whatever comes next.” Today, there are escalating political and economic tensions between America and China. Yet last week signalled a modest but, in the difficult geopolitical circumstances, a not unimportant historic moment. Peng Gong, who heads the Department of Earth Systems Science at Tsinghua University in Beijing, led a team of 45 scientists in publishing a wholly Chinese-led Lancet Commission on unlocking the power of cities for a healthy China. The Commission set out the challenges for Chinese cities as the foundation for Xi's notion of an ecocivilisation: unprecedented expansion, an epidemic of non-communicable diseases, the threat of newly emerging infections, an ageing population, rising health costs, and growing health inequities. Although most policy makers accept that the health sector alone cannot solve these problems, there are few incentives for intersectoral collaboration. Peng and his team wrote a manifesto for urgent action not only by the Chinese Government but also by Chinese society. In line with President Xi's vision for a Healthy China 2030, health must be incorporated into every government policy. Greater public participation in producing healthy cities is needed. Some cities, such as Shanghai, are already putting health at the centre of their thinking. Fan Wu explained how Shanghai has seen life expectancy rise through multisectoral collaboration, community self-management, employer engagement, healthy schools, better care for the urban elderly, and tobacco-free policies. Ling Li put part of reason for the government's unusual focus on health down to President Xi's experience as a barefoot doctor early in his career. But part of the reason is also fear. In 2003, SARS shocked China out of what had been complacency concerning the state of its health system. Healthy China 2030, inaugurated in 2016, aims to achieve three goals. First, to improve population health. Second, to connect health to the country's broader socioeconomic development, emphasising the quality as well as the quantity of development. And third, to provide a platform for China to take a greater role in global health leadership. Foreign affairs specialists often talk about the Thucydides Trap. They mean the moment when one power threatens to displace another. When Athens rose, Sparta saw danger. War followed. Historians say that of 16 episodes of similar power transitions, 12 have ended in war. As America concedes power to China, is conflict inevitable? China interprets America's initiation of a trade dispute as proof that President Trump seeks to check China's rise. Writing in the China Daily last week, Huang Qunhui from the Chinese Academy of Social Sciences charged that the US, “wants to maintain its hegemony to deprive China's development rights.” President Xi has committed China to a new phase of “opening up”. That is certainly the policy of China's health community. The country's medical scientists crave global engagement. The Thucydides Trap is not inevitable. Indeed, there is every reason to believe that if the cooperative spirit of China's medical community could be replicated across China's Government, the future could be peaceful and productive. A new era of Pax Sinica.