In January 2021, China finally published its White Paper on International Development Cooperation. I say finally because – having seen white papers on aid published in 2011 and 2014, some people at least had the expectation that the next in the series would be in 2017! Nevertheless, the 2021 paper generated considerable online buzz, especially amongst development experts like myself. In retrospect, the paper came at a crucial time, with COVID-19 entrenching ruptures in international development cooperation, as around the world countries turned inwards to focus on their own domestic challenges. Ban on exporting protective goods bans on providing PPE via aid, and even the slashing of aid budgets were just some examples we saw over 2020. The vaccine nationalism we’ve seen in 2021 has been even worse, with the African continent has received less than 2% of the world’s vaccinations.
The paper was certainly released at a contested time for development cooperation. But what did it say that was important, especially when it comes to African countries as well as specific sectors like global health? What was all the fuss about? Compared to the 2011 and 2014 documents, this document had two obvious differences – more detail and more signposting of China’s future priorities in development cooperation.
Let’s recap some numbers from the new paper. From 2013 to 2018, Africa received the largest share of Chinese funding of any other region, accounting for 45%. China allocated a total of RMB120.6 billion ($18.25 billion) to African countries, equating to approximately $3 billion per year, including grants of $1.4 billion per year (47%). However, beyond the paper, China’s development cooperation falls behind Africa’s other major development partners, except for France ($2.6 billion). Levels of assistance from all partners are low, as in 2018, China’s assistance equated to just 0.01% of its gross national income (GNI), whilst for the UK, U.S., and France, assistance accounted for only 0.13%, 0.05%, and 0.08%, respectively. Further, development assistance from development partners – except China – has declined over time when measured as a percentage of African GNI.
But can interested African citizens, for instance, tell how China is and will cooperate with African countries on health, or other sectors? Yes and no. One of the reasons for yes is that this white paper is the first since the China International Development Cooperation Agency (CIDCA) was formed in 2018, established to be the central ‘body’ in charge of the strategic direction of development cooperation. The white paper goes into more detail on this. Previous white papers focused on three main sectors – agriculture, infrastructure and training. However, in the 2021 paper, we find a wider focus on climate change, humanitarian assistance, and health. Also, while there is no explicit mention of the African Union’s Agenda 2063, there is an explicit alignment with the UN’s Sustainable Development Goals (SDGs).
In this way, the paper details China’s increasing commitments to global health challenges, some of which have been deployed to specific African challenges. From 2013 to 2018, China implemented 58 hospital projects across the world, with hospital construction projects in seven African countries mentioned. The paper also notes China’s role in addressing public health threats, such as its support to African governments responding to Ebola (which was China’s largest humanitarian aid commitment before COVID-19) providing over $120 million in aid to 12 African countries, alongside deploying 1,200 medical personnel.
We’ve seen this commitment in action with COVID-19. For example, there has been notable private sector support, including medical equipment donations by the Jack Ma Foundation and the Alibaba Foundation during a period when medical supplies were difficult to procure due to worldwide demand. Further, China has provided just over 5 million vaccines to African countries through donations and purchases. Assuming vaccines were priced between $5 to $18 per dose, as Senegal recently paid $18 per dose for Sinopharm procurement, then the equivalent spent so far would equate to $25 million to $90 million.
The White Paper Also Expresses China’s Willingness to Engage in Regional and Multilateral Organizations.
To demonstrate this, the paper pays explicit attention to China’s commitments to donate to initiatives such as COVAX and participating in the G20 Debt Service Suspension Initiative. That said, it is clear these multilateral initiatives need reform, with or without China’s engagement. To date, just 7% of COVAX orders made by African governments have arrived.
There is also signposting regarding health assistance going forward. For example, in terms of COVID-19 assistance to Africa, the paper notes that Beijing will ‘work with Africa to accelerate the follow-ups to the FOCAC Beijing Summit, give greater priority to cooperation on public health…and build an even stronger China-Africa community of shared future’.
Although the paper lacks specificity on what this cooperation will look like, it does suggest this could be negotiated by African leaders through mechanisms such as FOCAC. This point was echoed during our recent interview with His Excellency Mamadou Ndiaye, Senegal’s ambassador to China, who revealed that health will likely a top priority for the upcoming FOCAC 2021 discussions.
So why do I also say the white paper might not tell us much about future cooperation with African countries on issues such as health?
The fact is, development is all about the WHO and the HOW.
- First, this white paper is really notable – especially compared to other development partners – on how much it emphasizes that recipient countries – such as African countries – should have “control”, or in development-speak “ownership” or “localization”. It notes “control” by developing countries in project implementation is required to ensure sustainability, with an emphasis on localizing project management with China playing a supervisor role. This is critical in health. As one of our recent analyses revealed, China has supported capacity building across the continent, through pharmaceutical investment, university-level education, and knowledge exchange. The problem is, despite the laudable intentions, the complexities of the Chinese aid system can be a break on localization. As my colleagues detailed in a primer for recipient countries, Chinese assistance is coupled with a plethora of various state agencies and state actors, each with their own operational remits. In this sense, a country-by-country approach would be beneficial to understand which actors are involved in certain projects.
- Second, while this white paper is more detailed than before, it’s not quite detailed enough for African citizens interested in how much their country gets in “aid” or “development cooperation” from China. The breakdown by sector for the different types of grants is also unclear. For example, we know a certain proportion of aid to Africa is spent on agriculture (e.g. in the form of Agricultural Demonstration Centres and expert training), on health (e.g. in the form of permanent and emergency medical teams, or donations of medical equipment, or building hospitals), and so forth. Therefore, it is challenging to understand whether certain African sectors have received more support from China over time than others. Many African countries do not have the time or staffing resources to keep detailed reporting on Chinese lending practices.
Yet, despite these shortcomings, the paper offers a chance for African policymakers to better understand the opportunities from their relationship with China.
It is an essential document for African policymakers to understand the processes, directions, and priorities of Chinese cooperation. And the stated intention for “control” provides African countries and even regional institutions with additional bargaining power to negotiate on project design, delivery and management.
Going forwards, we hope that China will continue to share more detail, to provide Africans with a more rounded understanding of Chinese international development cooperation, to ultimately save more lives and ensure better wellbeing globally.
Jade Scarfe is an analyst at the Beijing-based development consultancy Development Reimagined.