China’s Health Silk Road Is a Dead-End Street

The pandemic has given China a chance to assert global leadership.

Medical staff in Wuhan, China, during the coronavirus pandemic
A medical staff member holds a newborn at an isolation ward for expectant mothers infected by the coronavirus in Wuhan, China, on March 7. STR/AFP via Getty Images

With little fanfare, the National People’s Congress—the annual convening of China’s top legislature and the country’s premier political event—rubber-stamped a $1.4 trillion infrastructure six-year spending plan on May 28, with fifth-generation (5G) wireless networks as its backbone. Undeterred by the devastation that the pandemic has wrought on China and countries globally, the Chinese Communist Party (CCP) has stepped up with full force—by way of its tech champions—with a vision of what a post-pandemic world powered by 5G could look like.

On Jan. 25, as China was still reeling from COVID-19, China Mobile launched 5G base stations to provide the world a high-definition live broadcast of the construction of the Huoshenshan hospitals at the epicenter of the outbreak in Wuhan. It was an act of deft public diplomacy, as Chinese-state media platforms such as People’s Daily telegraphed the content overseas. The livestream garnered more than 490 million views online, as many marveled at the hospital almost completely built in just 10 days.

Huoshenshan hospital staff then used 5G networks to connect front-line health care workers and patients to medical experts in Beijing’s remote consultation platforms, while 5G-enabled robots took patients’ vitals to minimize human contact. Beyond the walls of the hospital, an army of hundreds of driverless vehicles sanitized the streets of Wuhan. Meanwhile, 5G-powered drones dispatched face masks in Beijing. While it is unclear the extent to which these technologies actually aided the government’s response to the crisis, the resulting visuals were compelling and bolstered a narrative of Chinese technological leadership.

Dominating global 5G networks is a long-standing pillar of the CCP’s technological ambitions, made all the more urgent as the party seeks off-ramps from the economic stumble caused by the pandemic. On March 4, the Politburo’s Standing Committee called for “accelerating the construction of new infrastructure such as 5G networks and data centers.” Again, on May 22, at the opening of the 13th National People’s Congress, Premier Li Keqiang emphasized the need to step up “develop[ing] next-generation information networks and expand 5G applications.”

COVID-19 is no doubt a test of Chinese President Xi Jinping’s ironclad authority. But it has also emerged as a golden opportunity for the CCP to leverage critical emerging technologies to tout its superiority to Western models of governance and to advance its narrative of total control.

The Chinese government is pushing this narrative globally in a concerted and well-resourced fashion, drawing in China’s tech champions to do its bidding in countries around the world. While the United States initially floundered in its efforts to contain the virus’s spread and distribute personal protective equipment (PPE) to medical professionals, Alibaba co-founder Jack Ma donated 500,000 coronavirus testing kits and 1 million masks to the United States, documenting evidence of the massive shipment in a tweet captioned “All the best to our friends in America.”

Meanwhile, Huawei—which seeks to dominate 5G wireless network deployments around the world—launched its own public-relations campaign. Huawei sent thousands of masks and respirators to the United States and countries across Europe while offering artificial-intelligence-powered diagnostic technologies to Ecuador and the Philippines for free or at discounted prices. The tech giant even donated a large stock of masks and respirators to Canada, where its chief financial officer Meng Wanzhou remains under house arrest awaiting extradition to the United States on charges of fraud. And in Italy, a country that has felt the brunt of China’s heavy-handed online influence operations, Huawei launched several 5G test beds in a bid to build out the country’s networks.

These efforts are part of a complex global messaging choreography, as Beijing has cynically recast itself as a leader in combating the very pandemic it failed to contain. Chinese diplomats took their case to Twitter using a wide repertoire of formats—including crudely doctored or staged video clips featuring citizens in Italy, Angola, and countries across Asia expressing gratitude to China for their provision of medical goods—to favorably portray Beijing’s handling of the outbreak.

The Chinese Foreign Ministry’s Information Department also sought to muddy the waters on the very origins of the virus by floating various conspiracy theories suggesting that COVID-19 was a U.S.-developed pathogen introduced to Wuhan by U.S. servicemen participating in a military athletic event, or that a strain of the virus was already spreading in Italy well before the outbreak in Wuhan. Several U.S. political leaders and commentators unintentionally bolstered this playbook by countering that the virus was man-made in a Wuhan lab. While the efficacy of Beijing’s disinformation tactics remains an open question, if its ultimate goal was to sow some doubt—and more importantly, to distract from the facts and shift the narrative—it was successful.

Meanwhile, seeking to cement perceptions that China can nimbly and capably solve the world’s most pressing problems, Chinese tech companies such as Hikvision and Dahua have opportunistically pitched their latest products to countries around the world. Leading surveillance companies and entrepreneurs alike have raced to develop thermal imaging technologies, with start-ups such as the Hangzhou-based company Rokid angling to sell thermal imaging glasses in the United States.

China has, historically, demonstrated ingenuity in advancing strategic initiatives—such as its Belt and Road Initiative—designed to advance its interests globally while concealing its internal economic and demographic weaknesses.

In this case, the revival of its concept of a “Health Silk Road” has given Beijing strategic cover to assert global leadership—in contrast to an inward-looking United States that has faltered in its own response to the crisis—while also seeking to generate new momentum in its bid for global 5G dominance. In 2015, China’s National Health and Family Planning Commission unveiled a three-year plan to establish “health cooperation networks” across Belt and Road countries and to bolster China’s role in multilateral health governance. The Chinese government’s strategic planning proved prescient. COVID-19 emerged as a prime opportunity for China to execute these ambitions on an accelerated timeline.

Beijing has systematically used bilateral connections and multilateral institutions to advance its model of technologically empowered health care—predicated on China’s claimed technological supremacy—while the United States and countries across Europe, the Middle East, and Asia have taken on water. In a Feb. 28 call with Italy’s foreign minister, Chinese Foreign Minister Wang Yi expressed his hope that their collaborative effort against COVID-19 would catalyze the creation of a “Silk Road” of health care, alluding to Xi’s hallmark Belt and Road economic strategy.

China has also turned to the World Health Organization in the United Nations, drawing on its growing clout within the agency, to advance its cause. China had floated its Health Silk Road model in the WHO well before the pandemic. Back in 2017, WHO Director-General Tedros Adhanom Ghebreyesus touted the Belt and Road’s role in advancing access to health care and parroted Beijing’s call for the Health Silk Road to promote China’s high-tech health care model in Belt and Road countries. When the United States froze its funding to the WHO in April 2020, China stepped up its contributions and announced just weeks later that it would donate $2 billion  over two years to help other countries respond to the pandemic and would continue to develop hospitals and health infrastructure in countries across Africa.

China is now using the Health Silk Road and its mask diplomacy playbook to increase its leverage over developing countries in the throes of the pandemic. Most concerning is the deployment of telecommunications and surveillance infrastructure. This provides China’s technology companies a stronger foothold, opens the door to widespread data collection, and sets the table for greater repression and social control in countries with little resilience to creeping authoritarianism.

The United States and its allies should adopt a three-part strategy in response to China’s attempt to rewrite history and using the pandemic crisis as a means to bolster its global influence. First and most immediate is countering Beijing’s narrative of its role in vanquishing the virus and superior governance by providing much-needed aid around the world. Top of the agenda should be maintaining pressure on China for an independent international investigation into the origins and spread of the virus.

At the same time, the world’s liberal democracies should form a united front on responding to Beijing’s propaganda by noting the highly successful actions in handling the pandemic in South Korea, Taiwan, and New Zealand, among others; pointing out that much of the “donated” PPE was in fact sold and often comprised counterfeit items of poor quality; counter the disinformation spread by Chinese diplomats; and call out the risks of sharing health data of national populations with China.

Another needed move is doubling down on the effort to keep Huawei out of allied 5G networks in North America, Europe, and Asia. There is renewed energy in this regard in the wake of the United Kingdom’s recent decision to eliminate Huawei from its networks completely by 2023 and growing interest in forging a consortium of democracies to support alternative suppliers of telecommunications equipment, as well as other solutions such as 5G network architecture based on open interfaces.

These secure networks could form the foundation for a new electronic health consortium among the allies to facilitate disease detection, study, and treatment, along with vaccine development. The international consortium of labs, research institutes, and universities pooling supercomputing resources to study the spread of coronavirus is an example of what such collaboration could look like.

Finally, these like-minded countries should work together to secure and diversify supply chains for medical equipment and pharmaceuticals. None of the world’s leading democracies wants to rely on China for these critical goods going forward. At the same time, no one country can be fully self-sufficient in these areas. Instead, emphasis should be on ensuring that sufficient manufacturing resilience and surge capacity exists among them, and that access to critical inputs such as active pharmaceutical ingredients is secured.

The CCP’s resurgent Health Silk Road effort is a key facet of Beijing’s design on shaping the post-pandemic world to its advantage. Deliberate, collaborative action by liberal democracies around the world will be necessary to effectively counteract China’s strategy of exploiting the fissures between them, be better prepared for future health crises, and counter China’s usurpation of international institutions. Doing so will help to ensure that the Health Silk Road ultimately leads nowhere.

Kristine Lee is a research associate with the Asia-Pacific Security Program at the Center for a New American Security.

Martijn Rasser is a senior fellow at the Center for a New American Security. He is a former CIA officer and AI start-up executive.

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