Can the US and China cooperate on African health priorities?
With heightened tension and eroded trust between the United States and China, it may seem futile to seek new avenues for bilateral cooperation. In such times, it may be even more important to maintain open channels of communication and identify common goals.
One area where Washington and Beijing might make common cause is support for African public health systems, in particular the African Union (AU) project to develop an African Medicines Agency (AMA).
The African Union adopted a treaty in 2019 to launch the AMA to provide regulatory oversight to facilitate the local production of quality, safe, efficacious and affordable medicines for African citizens.
Despite U.S.-China competition in Africa, U.S-China cooperation on the African Medicines Agency would not be the first time that great powers in conflict have helped achieve breakthroughs in global health.
In 1958, at the height of the Cold War, the Soviet Union called for a global effort to eradicate smallpox. In 1966, the U.S. took up the cause and the U.S. and the Soviet Union — with the support of 58 other member states — cosponsored a resolution at the World Health Organization’s 19th annual assembly, launching the world’s most successful campaign to eradicate a contagious disease.
The USSR and U.S. went further, as they successfully exchanged scientific information and constructive critiques in areas outside smallpox. The U.S. surgeon general pointed out flaws in a Soviet overseas vaccine production facility, resulting in Moscow’s robust reformation of its vaccination programs abroad.
Despite current tensions, the United States and China have enjoyed constructive relations on public health in the past. The U.S. played an important role in helping China set up the Chinese Center for Disease Control and Prevention, including collocating specialists from the U.S. CDC within the fledgling Chinese agency.
Both countries have invested significantly to support African countries’ efforts to improve their own public health systems. The phenomenally successful U.S. President’s Emergency Program for AIDS Relief (PEPFAR) stemmed the HIV pandemic in Africa, and Beijing increasingly refers to its own “Health Silk Road” programs which have mounted hospitals and, more recently, distributed vaccines and other COVID-related materials throughout Africa.
The U.S. played a leading role in the establishment of the African Centres for Disease Control and Prevention, now based in Ethiopia. China provided a headquarters building for the agency.
The AMA is the logical next step and an AU priority.
The U.S. could invite, or challenge, China to join U.S. efforts to support the AMA. The countries could approach the AU together to identify specific projects. Washington and Beijing could commit to help individual African states develop domestic vaccine production capacities so that, come the next pandemic, they are not once again excluded from global health solutions. The U.S. and China could also cosponsor a resolution at the next World Health Assembly session urging other countries to join the endeavor.
We should not underestimate the challenges. The U.S. and China have competed in Africa, including on public health. We should not assume China would accept the invitation or that terms of collaboration would easily be agreed. When one of the authors served as U.S. ambassador to Zambia and proposed to his Chinese counterpart collaboration on health projects there, the Chinese ambassador politely declined. And U.S.-China cooperation on Africa CDC has, at times, been problematic.
Moreover, throughout the COVID-19 pandemic the U.S. and China have openly sparred on public health. China’s obstruction of coronavirus origin investigations eroded international trust of Beijing, while former President Trump’s aggressive name-calling further exacerbated tensions as both countries’ leaders engaged in an ugly publicity battle.
But COVID-19 is an urgent reminder of our shared interests in ensuring distant countries can conduct effective surveillance of disease outbreaks and respond with local resources when possible. It is in American and Chinese interests to fortify those capacities, including in Africa where opportunities for improvement abound.
The U.S. and China have different but potentially complementary strategies to support African health systems. The U.S. emphasizes technical support; China provides health infrastructure and commodities.
If both take a constructive approach, U.S.-China collaboration could improve public health capacity in Africa based on African Union priorities. Constructive U.S.-China collaboration could boost international trust in both countries and bolster U.S. standing on the continent, where it has recently flagged. China might benefit from working with the United States to help make its own public health aid in Africa more responsive to the needs of African countries themselves.
U.S. Secretary of State Antony Blinken has said that the “United States’ relationship with China will be competitive where it should be, collaborative where it can be, adversarial where it must be.”
Tensions between the world’s two largest powers will persist. But collaborative health projects in Africa could build bridges, advance shared goals and strengthen African countries’ health systems, ultimately benefitting the safety and security of the entire international community.
Georgia Nichols has worked in Senegal to combat trafficking in persons, is a Department of Education African languages fellow, and a master’s degree candidate in international affairs at the Frederick S. Pardee School of Global Studies at Boston University.
Mark C. Storella is professor of the practice of diplomacy and director of the African Studies Center at the Frederick S. Pardee School of Global Studies at Boston University. Storella is a former U.S. ambassador to Zambia, serving as a U.S. diplomat for three decades.
Source: TEST FEED1
