China's Medical Diplomacy
The Chinese hospital ship Peace Ark

China's Medical Diplomacy

 
 

Pending government approval, a group of 35 doctors and nurses based in Shanghai will soon become the nation’s first medical team to join the World Health Organization’s emergency response system, specializing in disaster relief.

It’s a big step, but China is no tenderfoot. Long gone are the days of the chijiao yisheng, or “barefoot doctors,” when farmers with rudimentary training functioned as village physicians. Today, the University of Hong Kong, Peking University and Fudan University boast some of the world’s best medical programs. And, let’s not forget, China has been providing medical assistance to foreign nations since 1963, when it sent a medical team to Algeria after the country’s war of independence. Beijing has since maintained its medical assistance to Africa ever since, renewing its commitment last year to send 1,500 medical professionals to the continent.

Its disaster response résumé is none too shabby either. When an earthquake struck the Pakistan city of Muzaffarabad in 2005, Beijing dispatched a 49-member rescue team. When the 2010 Haiti earthquake ruptured, it sent a 60-member relief team. And after the 2011 Tohoku earthquake, Beijing had a 15-member relief team on the ground within 48 hours.

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Nor is China new to the WHO. In fact, it helped create it. Sze Szeming, who would later be the UN’s medical director, conceived the idea with delegates from Norway and Brazil during a UN conference in 1945. Also, its current director-general, Margaret Chan, is from Hong Kong.

Before we applaud, however, let’s reflect on the fact that, with China’s economy probably limping along for the rest of the year, and its military budget cramping up as a result, Beijing’s hard power influence won’t be burning up the track anytime soon. Consequently, soft power is its new best friend. Moreover, the usual suspects—panda diplomacy, stadium diplomacy, Confucian Institutes—are inadequate. There’s nothing wrong, prima facie, with free stadiums, but Beijing knows these plays don’t work on people who read the news.

“The party needs legitimacy,” Stein Ringen, emeritus professor of political science at the University of Oxford, writes this week in the New York Times. “Being less able to rely on economic growth, it becomes more dependent on ideology.”

The thing about ideology is, it only works within China’s borders; to build legitimacy abroad, Beijing will have to confront criticism concerning its human rights violations and somehow find a way to present itself as humanitarian.

“If legitimacy is Xi’s aim, then human rights should be chief among his concerns,” writes Olivia Enos, a research associate at The Heritage Foundation’s Asian Studies Center. “After all, the true legitimacy of a government is derived from its ability to protect and promote the rights of its peoples.”

Enter medical diplomacy. This term may seem overly cynical, but keep in mind that thinking critically about China’s medical efforts abroad isn’t tantamount to opposing them, any more than looking sideways at panda diplomacy would mean having to dislike pandas. Besides, there’s good evidence that China views health crises first and foremost through a political lens. It suppressed news of the 2003 SARS epidemic, causing far more people to die than otherwise would have, because alerting the public and working transparently with the WHO would’ve compromised the political status quo. For the Party, that’s a bridge too far.

Beijing did later issue an apology for its handling of the SARS outbreak, and now works more openly with the WHO, although again, we would be wise to question whether this volte-face is a moral calculation or a political one. As noted in an April 2010 study, published in PLOS Medicine, “There are signs that China is now using public health as a means to strengthen its diplomatic relations with the developing world, in particular the African continent.”

Of course, real people will see real benefits from China’s contributions to the WHO. If the barons of Beijing wish to serve themselves by saving lives around the world, more power to them. There are certainly more harmful forms of soft power — Japanese soap operas, for example.

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