Understanding China's shifting priorities and priority-setting processes in development assistance for health

Area of Science:

• Global Health
• International Development
• Health Economics

Background:

• China has emerged as a significant donor of development assistance for health (DAH) over the past two decades.
• Factors influencing China's DAH priority-setting remain underexplored.
• Understanding these priorities is crucial for global health initiatives.

Purpose of the Study:

• To analyze trends in Chinese DAH priorities.
• To compare Chinese DAH priorities with those of OECD Development Assistance Committee (DAC) donors.
• To explore factors influencing China's DAH priority-setting.

Main Methods:

• Comparative analysis of DAH data (AidData, CRS) from 2000-2017.
• Analysis of Chinese medical aid exports pre- and post-COVID-19.
• Qualitative review of Chinese policy documents using Walt and Gilson's framework.

Main Results:

• China is a major DAH donor, particularly to Africa and Asia, with significant project values.
• China prioritizes subsectors like medical services and basic health infrastructure, diverging from DAC donor priorities.
• Chinese medical aid exports surged post-COVID-19; attention shifted towards Asia, eye diseases, and infectious diseases, while malaria aid decreased.

Conclusions:

• China's DAH priorities have evolved, influenced by global health events (SARS, Ebola, COVID-19) and initiatives (Belt and Road).
• Multilateral processes play a significant role in shaping Chinese DAH priorities, challenging the 'lone wolf' donor stereotype.
• China's distinct approach to DAH, focusing on specific health areas and regions, warrants continued monitoring.