CHINA’S SOFT POWER IN AFRICA

CHINA’S SOFT POWER IN AFRICA:
FROM THE “BEIJING CONSENSUS” TO HEALTH DIPLOMACY

China Brief: Volume 5, Issue 21 (October 13, 2005)
By Drew Thompson

China’s relations with Africa have stead ily deepened and stre ngthened since the
founding of “new China” in 1949. Evolving from ideologically-driven interactions
during the Cold War, today’s China-Africa relations combine pragmatic economic and
political means to achieve China’s objective of establishing a world order that is
peaceful and conducive to continued economic growth and stability at home. In the
1960s and 1970s, China supported liberation mo vements in several African countries,
gave aid to socialist nations to build stadiums, hospitals, railroads and other
infrastructure, and cemented relations through a steady stream of expert engineers,
teachers, and doctors. Today, Chinese officials travel to Afri ca accompanied by
bankers and businesspeople, promoting political and economic commerce that
expands China-Africa ties in a sustainable fashion. While trade and diplomacy are
driven by China’s newfound economic strength and subsequent demand for raw
materials, China continues to support longstanding prog rams that deliver aid to
underserved African citizens, such as sending teams of doctors and providing
medicines. Following the framework set out by the first China-Africa Cooperation
Forum in 2000, China-Africa relations are set to advance through a combination of
traditional financial aid and technical suppo rt programs, along with rapidly growing
bilateral trade and investment.

China is an appealing partner for many African countries for a variety of reasons.
China’s approach to bilateral relations and economic development, characterized by
Joshua Cooper Ramo as the “Beijing Co nsensus,” provides an alternative to
development and political economic reforms espoused by “the West” and typified by
the “Washington Consensus” of the World Bank and IMF. Beijing’s consistent respect
for other nations’ sovereignty and steadfast refusal to criticize or involve itself in the
internal affairs of African nations earns it the respect of leaders and elites who have
benefited from poor governance and opaque political systems and are reluctant to
implement painful economic or political reforms demanded by the West. African
leaders’ embrace of the Beiji ng Consensus reflects perhaps what is most attractive
about Beijing’s “soft power:” a long-standing history of friendly ties, provision of
appreciated, “no-strings-attached” financial and technical aid to both elites and the
most needy, and growing commerce between the world’s largest developing nation
and the continent with the most developing nations.

China’s Soft Power and th e “Beijing Consensus”

“Soft power,” following Joseph Nye’s formulation, includes a country’s culture,
political values, foreign policies, and economic attraction as essential components of
national strength, providing the capacity to persuade other nations to willingly adopt
the same goals. While China’s culture prevailed for centuries from the Tang Dynasty
through the mid-Qing, it no longer competes with cultural icons emanating from the
United States. Undeterred, Chinese leaders and businesspeople have leveraged
China’s strengths, which include a pragmatic approach to international relations
based on the principle of non-interference in domestic affairs. China’s economic
development model, the Beijing Consensus, refutes Western notions of political
liberalization or economic reforms as indispensable for long-term, sustained
development. China has effectively exported its notion of economic development
with Chinese characteristics to its African trading partners, encouraging them to
develop their economy through trade and investment in infrastructure and social
institutions, without dictating terms for political or economic reforms. With an
expanding manufacturing sector, China’s growing need for raw materials, energy and
new markets for cheap consumer goods make its economy relatively complementary
to many African ones. While the light industrial manufacturing sectors in many
African nations are suffering from grow ing imports from China, the dominant
extractives industries are benefiting from Chinese capital investment as well as a
seemingly bottomless market. China’s respect for national sovereignty is attractive
not only to Zimbabwe’s Mugabe, but scores of other African nations that are
reluctant to implement economic and political reforms considered necessary by
Western donor institutions and countries.

The principle of non-interference does no t mean that China r ejects political and
economic reform per se in Africa. Indeed, China is careful to support African-led
efforts to develop sound governance and sustainable development throughout the
continent. Recognizing that good governance and political reforms are vital to the
long-term development of African nation s, 19 nations have joined the “New
Partnership for Africa’s Development” (NEPAD), a consensus framework of the
member countries to promote sustainable development, good governance, poverty
reduction, and stop the marginalization of African economies in an increasingly
globalized world. While China supports NEPAD, it repeatedly stresses that it does so
through the framework of the China-Africa Cooperation Forum, thereby avoiding the
potentially awkward position of having to support the key structural elements that
are ultimately necessary for NEPAD’s succe ss: transparency, democracy, free press,
civil society, independent judiciary, and rule of law—all areas where China has
resisted substantial reform and has relatively little to contribute technologically.

The strength of China’s Afri can relations and the source of much of its soft power
stems from more than just the relatively recent growth in trade and investment.
Throughout its history of cooperation with African nations, China has emphasized
that it has “given what it could” in terms of financial aid and technical support and it
continues to do so even as its abilit y to promote relations through economic
incentives—primarily trade, tourism, and investment—has grown. Technical support,
without political “strings attached” (other than affirmation of a “one China policy”)
has remained a significant aspect of Chin a’s support for African states. Under the
auspices of the China-Africa Cooperation Forum, China has committed to contributing
to the development of human resources in Afri ca by establishing a fund that is jointly
administered and used by various Chinese ministries (Foreign Affairs, Commerce,
Education, Science and Technology, Agriculture and Health) in order to train African
personnel. As of 2003, over 6,000 Africans had been trained as part of the program
(Beijing Review, January 20, 2005). Scholarships for over 1,500 African students are
annually awarded by China, while many Chinese universities have established
relationships with African institutions (Xinhua, Decemb er 16, 2003). These programs
create enduring bonds between Chinese an d African institutions and individuals.
While university scholarships promote closer ties between China and African elites,
China has also promoted “health diplomacy” with African partners, establishing a
relationship between Chinese doctors and millions of ordinary Africans, and earning
the gratitude of many African leaders eage r to be seen providing public goods to
their citizens.

Medical Teams and Health Diplomacy as Soft Power

China has a long history of conducting active “heath diplomacy” programs with
African and Middle Eastern co untries. China’s early relations with many African
nations included significant aid in the form of infrastructure, scholarships for African
elites to study in Chinese universities and the deployment of teams of doctors. Today,
these institutions remain, either as direct government support or under the auspices
of the China-Africa Cooperation Forum. While China’s growing trade and
infrastructure investments in Africa have been the subject of increasing discourse,
there has been little discussion of a long standing and still influential segment of
China’s soft power in Af rica: health diplomacy.

Today, China regularly conducts cooperation in the field of health, including
numerous ministerial visits with African leaders to facilitate the regular exchange of
medical teams and training for medical professionals. Chin a also provides medicine
and medical equipment free of charge to several African countries, and has active
programs to jointly prevent and treat infectious diseases including malaria and
HIV/AIDS. In 2002, the Chinese Ministry of Health conducted a two-part
international training course in techniques for the prevention and treatment of
malaria and tropical diseases, in which 30 students from 17 African countries
participated (1st International Training Course on Malaria Control, September 10,
2002). That same year, as part of the China-Africa Cooperation Forum, China
convened a Sino-African forum on traditional medicine and pharmaceuticals which
was attended by participants from 21 Afri can countries (World Health Association,
October 31, 2002).

China deployed its first medical team in 1964 at the invitation of the Algerian
government. Since then, China has cumula tively sent over 15,000 doctors to more
than 47 African countries and treated appr oximately 180 million African patients In
2003, China deployed a total of 860 medical personnel in 35 teams to 34 countries
(Xinhua, December 16, 2004). Chinese doctors that are part of the medical teams,
known as yiliaodui, normally spend up to two years in-country. Many doctors have
served on medical teams more than once . Additionally, Chinese military medical
units have been deployed on UN Peacekeeping operations in Africa, providing
medical assistance to other peacekeepers (many of whom are from African nations),
as well as civilians. The PLA Navy’s number 401 hospital in Qingdao has also sent
medical teams to Zambia in the past. Civilian medical cooperation is institutionalized
with the health bureaus of individual Chinese provinces, thus maintaining long-term
commitments to provide medical workers and aid to specific countries (see table
below).

This long term medical cooperation builds person-to-person relations between
Africans and Chinese, and brings benefits to both sides. Like the many sports
stadiums, highways, and other infrastructu re such as the Tanzania-Zambia Railway
built in 1976 (and refurbished this year) by the Chinese, the medical teams are
publicized by both Chinese and African leaders as a tangible public good. Yet China’s
capacity to send large numbers of medical doctors to Africa is limited, and the
program faces an uncertain future over the long term. Many provincial budgets are
increasingly stretched by a shrinking tax base since rural tax reforms have been
implemented. The health needs of many Chinese are also not being met and
government doctors are increasingly called upon to deal with public health issues at
home. Additionally, given that the Chinese medical system is increasingly privatized,
more doctors are less inclined to accept a two-year posting in Africa, particularly
because they currently subsidize their meager governme nt stipend with income
generated through patient fees and medicine sales. Medical bureaus in some wealthy
provinces have reportedly been forced to recruit doctors from inland provinces in
order to fulfill their yilaodui obligations.

African support for the program remains strong, however, as evidenced by the
willingness of participating countries to sign bi-annual treaties that invite the teams
and settle the terms of the mission. According to the treaties negotiated between
China and the countries receiving medical teams, all but the poorest of the recipient
countries pay the medical team’s expenses, such as international airfares, doctor and
support staff stipends (including Chinese cooks!), as well as the cost of some
medicine and equipment that is brought by the team. For the poorest countries,
China covers the costs of the team’s travel and the equipment and medicines that
the teams import with them, permitting the hospitals where they work to sell the
drugs to help the countries cover the cost of hosting the medical teams. Granted,
while many countries offset the costs of paying the expenses and salaries of the
medical teams with grants and loans from China or other donor nations, host nations
repeatedly demonstrate their appreciation by continuing the program and covering
the expenses of the team out of national budgets. Medical teams are also regularly
given national awards in Africa and China fo r their contribution.

China’s influence and sound relationships in Africa are the result of many years of
investment in building relations through aid, trade, and cultural and technical
exchange—not just the byproduct of Chin a’s recently booming economy and soaring
demand for African raw materials. China’s strong sense of national sovereignty and
willingness to conduct commerce without political “strings” certainly contribute to its
success. The ability to “see no evil” is a convenient aspect of the “Beijing
Consensus,” and its rejection of unpalatable aspects, such as economic “shock
therapy” or political reform, make China all the more welcome in many African
capitals. China’s approach to Africa, including the way it conducts business and the
provision of aid, technical support, and th e dispatch of medical teams, are all key
components of China’s influence on the continent.


Table:
Chinese Provincial Health Bureau Medical Team Cooperation with African Countries*


*Tibet, Xinjiang, Guizhou and Hainan do not dispatch medical teams abroad. Other
Chinese provinces not listed here dispatch medical teams to other developing
countries outside of Africa.

Drew Thompson is Assistant Director at the Freema n Chair in China Studies, Center
for Strategic and International Studies in Washington, DC.Thompson worked in
Beijing, Nanjing and Shanghai for 7 years in the 1990s,and studied at the Hopkins-Nanjing Center in 1992.