In the shifting landscape of global geopolitics and economics, China is deepening its foothold in Africa through a strategic initiative known as the “Health Silk Road.” This term, tied to the larger Belt and Road Initiative (BRI), symbolizes China’s increasing influence in the healthcare and pharmaceutical sectors across the African continent. As Chinese pharmaceutical giants expand their manufacturing capacities in Africa, they are reshaping the continent’s healthcare infrastructure, creating new diplomatic ties, and asserting their role in global health.
Yet, beneath the surface, this burgeoning relationship raises complex questions about security, sovereignty, and economic dependence. Is Africa’s growing reliance on China for its healthcare needs strengthening the continent’s self-reliance, or is it creating new forms of dependency? Moreover, how is this new pharmaceutical partnership influencing the delicate diplomatic dynamics between China and African nations, especially in light of the growing global competition for influence?
The Expansion of Chinese Pharmaceuticals in Africa
China’s Belt and Road Initiative, launched in 2013, has expanded far beyond its original focus on infrastructure development. Under the umbrella of the BRI, Beijing has embraced a multifaceted approach that includes investments in healthcare, particularly through its “Health Silk Road” initiative. One of the primary ways China is strengthening its ties with Africa is through pharmaceutical manufacturing, addressing the continent’s pressing healthcare needs while creating profitable opportunities for Chinese companies.
A notable example of this expansion is Shanghai Fosun Pharmaceutical’s factory near Abidjan, Ivory Coast, which aims to produce antimalarial drugs and antibiotics. Once completed, this facility is expected to produce five billion tablets annually, significantly boosting Africa’s ability to tackle its healthcare challenges, particularly malaria, which accounts for over 95% of global cases in sub-Saharan Africa. With a €50 million (US$54.7 million) investment from the International Finance Corporation, Fosun’s facility promises nearly 1,000 local jobs, signaling both an economic and health benefit for the region.
This facility, and others like it, are part of a broader trend in which Chinese pharmaceutical companies are setting up manufacturing plants across Africa. From Zambia’s new cholera vaccine production factory, built by Jijia International Medical Technology Corporation, to Nigeria’s upcoming US$100 million pharmaceutical plant developed by Fidson Healthcare in collaboration with Chinese partners, these projects reflect China’s growing investment in Africa’s health sector.
In countries like Nigeria, where the HIV/AIDS epidemic remains a major concern, the Chinese-backed pharmaceutical plant in Lagos’ Lekki free-trade zone is seen as a critical step towards ensuring the availability of antiretroviral drugs for the nearly two million people living with the disease. As Western pharmaceutical companies such as GSK and Sanofi exit the African market, China is stepping in to fill the gap, reinforcing its position as a key player in Africa’s healthcare future.
China’s pharmaceutical expansion into Africa offers clear benefits for both parties. For African countries, this partnership presents an opportunity to address critical healthcare challenges while fostering economic growth through job creation and technology transfer. However, this growing reliance on Chinese investments also poses certain security and economic risks that need to be addressed.
Economic Opportunities and Local Capacity Building
For Africa, the most immediate benefit of China’s pharmaceutical investments is the improvement in healthcare delivery. With millions of Africans affected by diseases like malaria, cholera, and HIV, the establishment of local manufacturing facilities ensures better access to life-saving medications at more affordable prices. By producing these medications on the continent, Chinese firms are helping to reduce Africa’s dependence on imported drugs, a key concern for many countries striving to achieve self-reliance in healthcare.
Additionally, Chinese pharmaceutical investments provide a significant boost to local economies. The construction of factories and the subsequent hiring of local workers create employment opportunities and stimulate economic development in regions that often suffer from high unemployment rates. Moreover, the presence of these manufacturing facilities could lead to the transfer of valuable skills and knowledge, helping to develop Africa’s pharmaceutical industry and build long-term capacity.
However, the benefits come with potential risks. Africa’s growing dependence on Chinese pharmaceutical companies for critical medications may limit the continent’s ability to develop truly independent healthcare systems. While China’s investments help fill immediate gaps, they could also create a situation where African nations are reliant on a single foreign power for their medical supplies. This dependence could become problematic if geopolitical tensions arise or if China decides to leverage its economic influence for political gain.
In this context, China’s expanding role in Africa’s healthcare sector could mirror its broader economic strategy on the continent, where Chinese investments in infrastructure have led to concerns about debt dependency. Several African countries, including Zambia and Kenya, have already found themselves heavily indebted to China through large infrastructure loans. A similar pattern in the healthcare sector could weaken Africa’s bargaining power and make the continent vulnerable to external pressures.
Security Implications of Chinese Investments
China’s expanding footprint in Africa’s pharmaceutical industry also carries security implications. The COVID-19 pandemic underscored the strategic importance of healthcare and the production of essential medicines. As countries around the world struggled with supply chain disruptions and shortages of critical medical supplies, the importance of local manufacturing became painfully clear.
By investing in Africa’s pharmaceutical sector, China is positioning itself as a crucial player in the continent’s healthcare security. This, in turn, could give Beijing significant leverage over African countries, especially in times of crisis. As Professor Ernest Tambo of the University of Global Health Equity in Rwanda notes, local production of antimalarial drugs, vaccines, and antibiotics could save lives, particularly among vulnerable populations such as children and pregnant women. However, Africa’s growing reliance on Chinese healthcare infrastructure could also give China greater influence over African governments, potentially affecting their foreign policy decisions.
Moreover, the presence of Chinese pharmaceutical factories in politically unstable regions, such as Mali and Ethiopia, raises concerns about the security of these investments. While China has demonstrated a willingness to operate in conflict zones, the long-term stability of these ventures remains uncertain. Political instability, civil unrest, and armed conflicts could threaten the sustainability of China’s healthcare projects in Africa, potentially leading to disruptions in medical supply chains and exacerbating existing healthcare challenges.
China’s Soft Power in Africa
China’s expansion into Africa’s pharmaceutical industry is not just an economic venture—it is also a key component of Beijing’s broader diplomatic strategy on the continent. The Health Silk Road, like other aspects of the Belt and Road Initiative, is designed to enhance China’s soft power and strengthen its political ties with African nations.
By investing in Africa’s healthcare sector, China is building goodwill and fostering closer diplomatic relationships with African governments. Leaders across the continent have publicly praised China’s efforts to improve healthcare infrastructure and provide much-needed medications. For instance, Zambian President Hakainde Hichilema expressed gratitude to Chinese President Xi Jinping for making Zambia’s cholera vaccine plant a reality, highlighting the positive impact of Chinese investments on the country’s health system.
These expressions of gratitude are indicative of the diplomatic leverage that China gains through its healthcare investments. In exchange for much-needed infrastructure and medical supplies, African countries may feel inclined to support China’s foreign policy positions on the global stage, particularly in international organizations such as the United Nations and the World Health Organization. China’s growing influence in Africa could also lead to greater political alignment between African nations and Beijing, potentially affecting the continent’s relationships with other global powers, including the United States and the European Union.
China’s Competition with Western Powers
China’s growing role in Africa’s healthcare sector also has implications for the broader geopolitical competition between China and Western powers. For decades, Western countries have been the primary providers of aid and investment in Africa, particularly in the areas of healthcare and education. However, China’s Belt and Road Initiative has shifted the balance of power, with Beijing now emerging as a key player in Africa’s development.
The exit of Western pharmaceutical giants like GSK and Sanofi from the Nigerian market underscores the changing dynamics. As Western companies retreat, Chinese firms are stepping in to fill the void, offering affordable medications and investing in local manufacturing. This shift could weaken Western influence in Africa, particularly in the realm of healthcare, where China is rapidly gaining ground.
At the same time, China’s involvement in Africa’s pharmaceutical sector raises concerns about the quality and safety of Chinese-made medications. While Chinese firms are capable of producing affordable drugs, questions remain about whether they can maintain the same quality standards as their Western counterparts. Ensuring the safety and efficacy of Chinese-made medications will be crucial in maintaining trust and goodwill between China and African countries.
China’s investments in Africa’s healthcare sector are part of a broader long-term strategy to deepen its economic, political, and diplomatic ties with the continent. As Africa’s population continues to grow at an unprecedented rate, the demand for healthcare services and medical supplies will only increase. By positioning itself as a key provider of pharmaceuticals and healthcare infrastructure, China is ensuring its continued relevance in Africa’s development trajectory.
China’s investments in Africa’s healthcare sector align with its domestic economic interests. As China’s population begins to decline, the country is facing overcapacity in a variety of industries, including pharmaceuticals. Expanding into Africa allows Chinese companies to tap into new markets, ensuring continued growth and profitability.
In the long run, China’s Health Silk Road could serve as a model for its engagement with other regions of the world. By leveraging its expertise in healthcare and pharmaceuticals, China can strengthen its diplomatic ties with developing countries while simultaneously addressing global health challenges.
Navigating the Future of Sino-African Health Cooperation
China’s pharmaceutical expansion into Africa, under the banner of the Health Silk Road, is reshaping the continent’s healthcare landscape. Through investments in local manufacturing, China is addressing critical healthcare challenges while also fostering economic growth. However, this growing reliance on Chinese firms presents both opportunities and risks for Africa.
As African nations seek to strengthen their healthcare systems and achieve greater self-reliance, they must navigate the complex dynamics of their relationship with China. Ensuring that these partnerships are mutually beneficial—and do not create new forms of dependency—will be crucial in shaping the future of healthcare on the continent.
At the same time, China’s growing influence in Africa’s healthcare sector has broader geopolitical implications. As Beijing strengthens its diplomatic ties with African nations, it is also positioning itself as a global leader in healthcare. How the international community responds to this shift will shape the future of global health and diplomacy in the years to come.
The Health Silk Road is not just a path to better health outcomes for Africa—it is a key battleground in the ongoing competition for influence between China and the West. In this new era of global health diplomacy, Africa’s healthcare future will depend on how well it balances the opportunities and challenges presented by China’s expanding role in the continent.