The Health Silk Road (HSR) is the health-cooperation pillar of China's Belt and Road Initiative (BRI). The concept was first articulated by Chinese President Xi Jinping in 2016 during a visit to Uzbekistan and was formalized in a memorandum of understanding signed between China's National Health and Family Planning Commission and the World Health Organization in January 2017.
The HSR encompasses a broad agenda: building hospitals and clinics in partner countries, training medical personnel, exporting traditional Chinese medicine, supplying vaccines and pharmaceuticals, and coordinating responses to infectious-disease outbreaks. Early projects concentrated on Africa, Central Asia, and Southeast Asia, often layered onto existing BRI infrastructure corridors.
The initiative gained significant prominence during the COVID-19 pandemic, when Beijing used HSR framing to organize donations of masks, ventilators, test kits, and later vaccines (notably Sinopharm and Sinovac) to dozens of countries. Critics in Washington, Brussels, and New Delhi described this as "mask diplomacy" or "vaccine diplomacy," arguing it was designed to deflect criticism of China's early handling of the outbreak and to expand geopolitical influence. Chinese officials countered that the HSR demonstrated a commitment to a "community of common health for mankind" (人类卫生健康共同体).
Key features delegates should note:
- Bilateral rather than multilateral structure: most HSR cooperation runs through state-to-state agreements rather than the WHO or other multilateral bodies, though Beijing has also used WHO platforms to legitimize the framework.
- Linkage to industrial policy: HSR supports the internationalization of Chinese pharmaceutical, medical-device, and biotech firms.
- Normative dimension: Chinese officials promote HSR as evidence that development assistance need not carry Western political conditionality.
For IR researchers, the HSR is a useful case study in how great powers fuse public goods provision with strategic positioning, and in the contested boundary between global health governance and geopolitical competition.
Example
In March 2020, China dispatched medical teams and supplies to Italy and Serbia under the Health Silk Road banner, with Serbian President Aleksandar Vučić publicly thanking Xi Jinping while criticizing EU export restrictions on medical goods.
Frequently asked questions
Xi Jinping introduced the concept in 2016, and it was formalized in a January 2017 memorandum of understanding between China and the World Health Organization.
Keep learning