China's Expanding Engagement in Global Health Dennis Van Vranken Hickey (bio) For most of the nineteenth and much of the twentieth century, China was called, "the sick man of Asia (东亚病夫, dong ya bing fu)."1 But those days are over. As President Xi Jinping observed, "China has bid farewell to the problems that plagued its people for thousands of years, including hunger, shortages and poverty" (Yu 2019, 19). As described below, China is now one of the world's top economic, political and military powers. China: An Economic Power By the late 1970s, China had lived through more than a century of turmoil. Key drivers of the chaos included imperialist encroachment, the Sino-Japanese War (1937–1945), the Chinese Civil War between the Chinese Communist Party (CCP) and the Chinese Nationalist Party (Kuomintang or KMT), a series of natural disasters and the unsound economic policies embraced by Chairman Mao Zedong after "liberation" in 1949. All of this changed after Deng Xiaoping became the supreme leader in the People's Republic of China (PRC) in the late 1970s and launched the so-called "reform era." But the country's economy did not really take off until after Deng made his landmark journey south to Shenzhen in 1992 and accelerated the "reform and opening up" process.2 Figure 1 (below) shows China's astounding gross domestic product (GDP) growth from the early 1990s onward. Since the 1990s, China has experienced a transition from a largely agrarian society with a planned socialist economy into a global economic powerhouse. The CCP calls the new approach "market socialism" or "socialism with Chinese characteristics" and bristles at suggestions that it strongly resembles capitalism. Whatever one calls it, the transformation has enabled China to become the second largest economy in the world—enjoying a double-digit annual growth rate from 2000 to 2010 [End Page 327] and roughly 7 percent since then. In the past decade, millions of Chinese have joined the middle class which now numbers roughly 400 million and is expected to exceed 550 million by 2022 (Iskyan 2016). The exploding middle class is playing a part in a governmental strategy that is expected to help the country's economy transition away from dependence on exports and toward domestic consumption (Zhang 2019). It appears that China is well on its way toward achieving the CCP's stated goal of creating a "moderately well-off society" by 2021. Click for larger view View full resolution Figure 1. China's GDP Growth in Current US Dollars Source: World Bank national accounts data, and OECD National Accounts data, https://data.worldbank.org/indicator/NY.GDP.MKTP.CD?end=2017&locations=CN&start=1961&view=chart. China: A Political Power As China's economy has exploded, the country's political influence has likewise grown. To be sure, economic partnerships seem to have largely paved the way. The PRC has surpassed the United States as the largest trading partner of numerous countries in the global south—particularly those in Africa and Latin America. And the country is "expected to spend over US$1 trillion on its "Belt and Road" initiative (BRI)—seven times the size of the Marshal plan in real dollars" (US Global Leadership Coalition 2018). [End Page 328] This ambitious project will integrate the economies of 65 countries that include 70 percent of the world's population, 30 percent of the GDP, and 75 percent of the earth's energy reserves. The land-based version of the new Silk Road consists of a series of economic corridors connecting the PRC with nations in Central and Western Asia, the Middle East, and Europe. The sea-based Silk Road will traverse the South China Sea, the Indian Ocean, the Mediterranean and eventually connect China to Central Asia, Africa and Europe. China has pledged not to transform itself into a "global hegemon" that "bullies" other countries (Yu 2019). Still, some suspect Beijing's motives as the government's leadership has increasingly pointed to the Chinese approach to development as an alternative pathway for states in the global south to follow. It has even established alternative international organizations—most notably the Asian Infrastructure Investment Bank (AIIB)—to help the...
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