This essay analyses China’s health policies before and after the outbreak of COVID-19. It discusses how the problem broke out with emphasis on mistakes made by Wuhan authorities and sketches out the subsequent response of the Chinese government to stop the contagion and share practices. The essay also presents different narratives used by China, the US and the EU in dealing with the pandemic and considers multilateralism a key to address world problems. In so doing, it attempts to explore whether Sino-European partnerships could emerge in a period of rising uncertainty.

  • Local authorities in Wuhan can be criticized for not providing information about the virus on time and for failing to block the exit of citizens from the city before the lockdown. But measures adopted subsequently by the Chinese government have been rather efficient and useful for other countries.
  • The Sino-American antagonism overshadows the need of deeper international cooperation in dealing with COVID-19.
  • China, the US and the EU have each attempted to shape the narrative about COVID-19.
  • The hostility of the Trump administration towards multilateralism opens opportunities for new synergies between China and the EU on health governance.
  • China’s Health Silk Road reflects continuity as it was first proposed in 2016.
  • The post-COVID-19 landscape might portend both risks and opportunities to China.

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The study of China’s development has been a difficult task for Western scholars in the 21st century. The complexity of the Sino-American relationship requires a prudent management of differences. Leadership remains the key of success because a potential confrontation will entail negative consequences for both countries and the world.[1] But rising tensions since the beginning of 2017 have fueled concerns about serious risks for international stability. For Niall Ferguson, for example, Cold War II has already started.[2] The outbreak of the COVID-19 rather confirms pre-existing tendencies than prompts a joint response. While it remains possible for China and the US to cooperate and sideline mutual suspicion, the question is how this might be better achieved. The EU, envisaging to become strategically autonomous, can perform a balancing act, function as a stability pillar and preserve the principle of multilateralism.


“After SARS, the Chinese government took measures to improve public health services by launching a series of reforms to prevent the spread of diseases

From SARS to COVID-19

On 24 June 2003 the World Health Organization (WHO) removed its recommendation that people should postpone all but essential travel to Beijing in order to minimize the international spread of SARS.[3] Beijing was the last area in the world to which this advice still applied, eight months after the virus, a new and unique member of the coronavirus family, had first emerged in southern China. The subsequent question was how SARS would not return and such a problem would not be repeated in the future. The Chinese government took measures to improve public health services by launching a series of reforms to prevent the spread of diseases. Among other things, it started to show a more proactive attitude towards AIDS.[4]  China fostered ‘coordinated development’ as former Prime Minister Wen Jiabao said in an interview with the Washington Post.[5] The aim was to improve imbalances between urban and rural areas and fight poverty in order to create better living conditions for its citizens in line with UN guidelines.

Following years of action, the Healthy China 2030 blueprint was announced in 2016. Based on innovation, scientific development, justice and equity it exhibited the country’s interest in responding to the implementation of the 2030 UN Sustainable Development Goals.[6] China relied on multilateralism and cooperated with the US, the EU and other countries such as Russia. Undertaking responsibilities in global health governance it contributed to the fight against international diseases. Following the Ebola breakout in Western Africa in 2014, for example, it sent financial aid, technical assistance and medical experts. Moreover, China joined the Global Health Security Agenda, an effort to build countries’ capacities to prevent, detect, and respond to infectious disease threats. Other states included the US, the UK, France, Germany, Italy, Spain and others.[7] In 2016 it signed with the WHO the Country Cooperation Strategy 2016-2020, defining their collaboration in health policies, planning, technology and human resources.[8]

China’s contribution to world health has been also linked to the Belt and Road Initiative. Addressing the Uzbek Parliament on 22 June 2016, President Xi Jinping spoke about the need of deepening cooperation in medical care and health as well as the alert for communicable diseases, infection prevention and control, medical assistance and traditional medicine. He proposed to build a Silk Road for health promotion.[9] On 18 January 2017, the WHO agreed to jointly implement a Belt and Road Initiative that focuses on health.[10] The memorandum of understanding was co-signed between then WHO Director General Margaret Chan and President Xi. A few months later, in August 2017, WHO’s new Director General Tedros Adhanom Ghebreyesus gave a speech in Beijing considering the Chinese concept ‘visionary’.[11]

Despite progress, the outbreak of a new disease in the Chinese city of Wuhan in Hubei Province in December 2019 revived dramatic memories. In particular, on 31 December, the WHO China Country Office was informed of cases of pneumonia of unknown etiology in Wuhan. On 11 and 12 January 2020 WHO received further detailed information from the National Health Commission of China that the outbreak was associated with exposures in one seafood market of the city. The Chinese authorities identified a new type of coronavirus, which had been isolated on 7 January. On 12 January 2020 they shared the genetic sequence of the novel coronavirus for countries to use in developing specific diagnostic kits.[12]  Eleven days later, on 23 January Wuhan was locked down in an unprecedented effort to curb the spread of the virus.[13] The Chinese government also responded by building hospitals in only a few days.[14] And it used new technologies to trace infected and quarantined citizens. As result the virus was placed under control a few weeks later and China started to elaborate on the prevention of a second wave.

The outbreak of the new disease exposed problems in China’s prevention and management capacity before Wuhan’s lockdown. President Xi has urged to work on shortcomings.[15] These primarily refer to the late response of local authorities and experts from the Chinese Centre for Disease Control and Prevention to fully disclose the seriousness of the situation and act before 23 January to block the exit of residents from the city. Several Chinese citizens were travelling during this period to celebrate the 2020 Lunar New Year. It is estimated that 5 million people had already left Wuhan before the quarantine.[16] Western criticism has largely focused on the case of ‘whistleblower’ doctor Li Wenliang. Li Wenliang tried to issue one of the first warnings about the deadly coronavirus in social media but was reprimanded by the local police in Wuhan and later died.[17] Chinese media have also reported about the late doctor.[18]


Whereas increased Sino-American cooperation on global health – for example on the management of the Ebola crisis –was one of the results of SARS,  such was not the case with the ongoing pandemic

Different Narratives

The public debate about COVID-19 has been largely politicized outlining the intensifying antagonism between China and the US. Whereas increased Sino-American cooperation on global health – for example on the management of the Ebola crisis – [19] was one of the results of SARS,  such was not the case with the ongoing pandemic. Name-calling has been a critical problem.[20] US President Donald Trump portrayed the coronavirus the ‘Chinese virus’ causing ire in Beijing.[21] For his part Chinese Foreign Ministry spokesperson Zhao Lijian tweeted in his personal account that it could have been the US army bringing the virus to Wuhan in October 2019.[22] The Department of State summoned the Chinese Ambassador to the US Cui Tiankai to protest against this comment.[23] A few weeks later Ambassador Cui acknowledged in a New York Times piece that there was ‘unpleasant talk’ between the two nations about this disease and called for closer collaboration.[24] Following the G20 virtual summit of 26 March, Presidents Trump and Xi had already pledged to cooperate to place the virus under control.[25]

Following the G20 virtual summit of 26 March, Presidents Trump and Xi had already pledged to cooperate.”

In contrast to the US public attitude vis-à-vis China, the EU preferred to employ a milder approach reflecting its interest in playing an active role. High Representative Josep Borrell talked about a ‘global battle of narratives’ and insisted on the necessity of global solutions with Europe ‘at the centre of the fight’.[26] On the same wavelength, President of France Emmanuel Macron defended Western democracies, refrained from linking different governance models to an allegedly successful management of the pandemic and expressed his belief in the cooperation with China.[27] For her part, Chancellor Angela Merkel has avoided – at the writing – to join the public debate about China. Speaking on the phone with Xi on 25 March they agreed on close collaboration on the virus.[28] And German Foreign Minister Heiko Maas criticized both China and the US for their response and said that neither system ‘can be a model for Europe’.[29]

A highly debatable issue during the pandemic has been the medical assistance provided by Western countries to China and vice-versa. While the first phase passed relatively unnoticed and was limited to acknowledgments by the Chinese government, the second is being scrutinized in the public discourse. The US, the UK and several EU countries such as France, Germany, Italy and Spain received medical equipment.  Some commentators believe that the Chinese Communist Party sought to repair its international image by demonstrating solidarity.[30] And some governments have complained about the quality of important products from Chinese companies[31] whereas alleged disinformation narratives are analysed by both the US and the EU.[32]  In spite of criticism the medical equipment shipped from China has been crucial in the global fight against the virus. New York Governor Andrew Cuomo talked about a ‘big deal’ making a ‘significant difference’ when he accepted ventilators from Chinese donors.[33] Similarly, the President of the European Commission Ursula von der Leyen expressed her gratitude for China’s support reminding that the EU had already delivered 56 tons of equipment to the country in February.[34]


In Search of Multilateralism

In the view of Henry Kissinger, the COVID-19 pandemic ‘will forever alter the world’.[35] In a period of uncertainty that did intensify with new norms introduced to international affairs by Trump, the role of China naturally becomes more important. Multilateralism matters and the country traditionally upholds the principle. There are scholars who already see that China is moving quickly and adeptly to take advantage of the opening created by US mistakes, filling the vacuum to position itself as a global leader.[36] Secretary of State Mike Pompeo asserts that Washington’s leadership can hardly be contested. In a relevant statement he said that the US continued to lead the world’s public health and humanitarian response to the pandemic.[37] The statement serves American pride in difficult times. But contempt for multilateralism remains a problem. Trump’s, announcement to halt funding to the WHO confirms the tendency.[38] The UN Secretary General António Guterres  China, the EU and Russia have criticized this decision.

It is not in the interest of China to currently lead or challenge the US because it remains preoccupied with domestic economic problems.

The American presidential election of November 2020 will be critical for the scope of international cooperation and global governance. It is not in the interest of China to currently lead or challenge the US because it remains preoccupied with domestic economic problems.  Its general policy mirrors a willingness to preserve the international status quo that facilitated its development and add Chinese characteristics to it. The question is whether China will come closer to other powers such as the EU in a period during which Washington undermines the transatlantic partnership. Searching for autonomy in world affairs, the EU will perhaps find more cooperation opportunities with China by expanding –  in this case –  partnerships in the health sector. Contrary to the US, the EU is determined to rely on the WHO.[39] In January, the EU also defied the US pressure and refrained from banning Huawei on 5G.  Acting a pillar of stability the EU needs occasionally to navigate between the US and China in search of multilateralism and calmness in world affairs. More optimists and believers in the European dream can envisage mediation initiatives by Europe in fostering Sino-American dialogue.


As a matter of principle China counts on stability and continuity. The ongoing pandemic reverses this logic and generates risks.


Projections about the future are premature as long as the vaccine against COVID-19 has not yet been found. As a matter of principle China counts on stability and continuity. The ongoing pandemic reverses this logic and generates risks. The impact on the national economy cannot be safely assessed although the Chinese government had immediately taken measures to support it by using fiscal and monetary tools. Losses are recorded as exports have dropped but economic windfalls are also observed due to the fall in energy prices.  Additionally, the realization of infrastructure works in the context of the Belt and Road Initiative might also face some financing risks and delays in the short and medium-term.[40] Also, some changes in the supply chain are expected. Multinationals could reconsider their reliance on China and look for alternatives for their production base. Japan, for example, is allocating some funds in helping Japanese companies alter the location of their hubs.[41] Even before the COVID-19 crisis, the US administration had started to employ a similar approach with the ‘America First’ policy.

A December 2018 McKinsey study shows that China’s exposure to other countries has declined, while the world’s exposure to China has increased.[42] Notwithstanding existing constraints for a Western disengagement from China, the country is making preparations for the worst, the so-called decoupling scenario. Although Beijing will – according to its new foreign investment law – promote more openness and create a friendlier business environment to prevent this from happening, it can partly rely on a self-sufficient supply chain for almost all products and a vast domestic consumer market. The adoption of original business strategies in parallel with forming new partnerships as it has started to occur during the pandemics will be the next steps. In a globalization with digital and online features states technologically advanced and innovative in artificial intelligence, big data, cloud computing, blockchain, and 5G will have the upper hand.

China is entering the new era well equipped but also being in the storm eye.




[1] See comments made by Robert, D, Blackwill during a CFR discussion on ‘China’s Role in the World and US-China Relations’, available at:, 16 April 2020 (accessed April 2020).

[2] Niall Ferguson, ‘The New Cold War? It’s With China, and It Has Already Begun’, available at:, 2 December 2019 (accessed April 2020).

[3] ‘World Health Organization Changes Last Remaining Travel Recommendation for Beijing, China’, available at:, 24 June 2003 (accessed April 2020).

[4] Shaoni Bhattacharya, ‘SARS Spurs China to Act on AIDS’, available at:, 13 July 2004 (accessed April 2020).

[5] Interview with Chinese Premier Wen Jiabao, available at:, 21 November 2003 (accessed April 2020).

[6] Xiaodong Tan, Xiangxiang Liu and Haiyan Shao, ‘Healthy China 2030: A Vision for Health Care’, available at:, 2017, pp. 112-114 (accessed April 2020).

[7] Bonnie Jenkins, ‘Now Is the Time to Revisit the Global Health Security Agenda’, available at:, 27 March 2020 and Global Health Security Agenda website, available at: (accessed April 2020).

[8] China-WHO Cooperation Strategy 2016-2020, available at: (accessed April 2020).

[9] ‘President Xi Calls for Building Green, Healthy, Intelligent and Peaceful Silk Road’, available at:, 23 June 2016, (accessed April 2020).

[10] An Baijie, ‘WHO, China Sign Pact Establishing Health Silk Road’, available at:, 19 January 2017 (accessed April 2020).

[11] WHO Director-General, Dr Tedros’s Speech at the Belt and Road Forum for Health Cooperation: Towards a Health Silk Road, available at:, 18 August 2017 (accessed April 2020).

[12] Novel Coronavirus (2019-nCoV) Situation Report -1, available at:, 21 January 2020 (accessed April 2020). For information about the COVID-19 discovery see also updates of the Pasteur Institute available at: (accessed April 2020).

[13] Xinhua website, ‘Xinhua Headlines: In Unprecedented Move, China Locks Down Megacity to Curb Virus Spread’, available at:, 23 January 2020 (accessed April 2020).

[14] Amy Qin, ‘China Pledged to Build a New Hospital in 10 Days. It’s Close’ available at:, 7 February 2020 (accessed April 2020).

[15] Xinhua website, ‘Interview: Three Reasons Why World Should Be Confident in China’s Tackling of COVID-19 – Kuhn’, available at:, 20 February 2020 (accessed April 2020).

[16] Ashley Collman, ‘5 million People Left Wuhan before China Quarantined the City to Contain the Coronavirus Outbreak’, available at:, 27 January 2020 (accessed April 2020).

[17] BBC website, ‘Li Wenliang: Coronavirus Kills Chinese Whistleblower Doctor’, available at:, 7 February 2020 (accessed April 2020).

[18] Global Times website, ‘Probe Findings on Li Wenliang Mark Start of Reflection, Holding Accountability’, available at:, 20 March 2020.

[19] Callie Aboaf, ‘US-China Collaboration in Combating the 2014 Ebola Outbreak in West Africa’, available at:, The Carter Centre Africa-US-China Trilateral Cooperation Research Series No. 3, 2019 (accessed April 2020).

[20] George N. Tzogopoulos, ‘Coronavirus and the Western Media’, available at:, BESA Perspective Paper No. 1,492, 19 March 2020 and ‘Playing a Critical Role’, available at:, 1 April 2020 (accessed April 2020).

[21]  Maegan Vazquez and Betsy Klein, ‘Trump again Defends Use of the Term China Virus’, available at:, 19 March 2020 (accessed April 2020).

[22] Global Times website, ‘US Sparks Word War against China on COVID-19’, available at:, 14 March 2020 (accessed April 2020).

[23] Humeyra Pamuk and David Brunnstrom, ‘US Summons Chinese Envoy over Beijing’s Coronavirus Comments’, available at:, 13 March 2020 (accessed April 2020).

[24] Cui Tiankai, ‘China and the US Must Cooperate against Coronavirus’, available at:, 5 April 2020 (accessed April 2020).

[25] Karen Leigh, ‘President Trump and China’s Xi Pledge to Cooperate to Fight Coronavirus after Phone Call’, available at:, 27 March 2020 (accessed April 2020).

[26] ‘EU HRVP Josep Borrell: The Coronavirus Pandemic and the New World It Is Creating’, available at:, 24 March 2020 (accessed April 2020).

[27] See the transcript of Emmanuel Macron’s interview with FT, available at:, 17 April 2020 (accessed April 2020).

[28] Reuters website, ‘Germany’s Merkel, China’s Xi Agree Close Cooperation on Coronavirus’, available at:, 25 March 2020 (accessed April 2020).

[29] Christiane Hoffmann und Christoph Schult, ‘Foreign Minister Heiko Maas on the Coronavirus: I Find It Appropriate that Every Member State First Acted Nationally’, available at:, 10 April 2020 (accessed April 2020).

[30] Oded Eran and Galia Lavi, ‘China and COVID-19: From Crisis to Opportunity’, available at:, INSS Insight No. 1290, 1 April 2020 (accessed April 2020).

[31] Euronews website, ‘Netherlands Recalls Hundreds of Thousands of Defective Chinese Face Masks’, available at:, 29 March 2020 (accessed April 2020).

[32] Betsy Woodruff Swan, ‘State report: Russian, Chinese and Iranian disinformation narratives echo One Another’, available at:, 21 April 2020 (accessed April 2020).

[33] Kaelan Deese, ‘Cuomo: New York Will Take 1,000 Ventilators from Chinese Government’, available at:, 4 April 2020 (accessed April 2020).

[34] European Civil Protection and Humanitarian Aid Operations website, ‘Coronavirus: Aid from China to the EU Delivered to Italy’, available at:, 6 April 2020 (accessed April 2020).

[35] Henry A. Kissinger, ‘The Coronavirus Pandemic Will Forever Alter the World Order’, available at:, 3 April 2020 (accessed April 2020).

[36] Kurt Campbell and Rush Doshi, ‘The Coronavirus Could Reshape Global Order’, available at:, 18 March 2020 (accessed April 2020).

[37] Michael R. Pompeo, ‘Continuing US Leadership in the Global COVID-19 Response through Additional US Foreign Assistance’, available at:, 8 April 2020 (accessed April 2020).

[38]Betsy Klein and Jennifer Hansler, ‘Trump Halts World Health Organization Funding over Handling of Coronavirus Outbreak’, available at:, 15 April 2020 (accessed April 2020) .

[39] Nathalie Tocci, ‘How Coronavirus Will Upturn the Global Order’, available at:, 9 April 2020 (accessed April 2020).

[40] Plamen Tonchev, ‘The Belt and Road after COVID-19’, available at:, 7 April 2020 and Wendy Wu and Catherine Wong, ‘How China’s Coronavirus Response May Shape the Future of its Flagship Belt and Road Initiative’, available at:, 21 March 2020 (accessed April 2020).

[41] Kenneth Rapoza, ‘Japan Ditches China In Multi-Billion Dollar Coronavirus Shakeout’, available at:, 9 April 2020 (accessed April 2020).

[42] Jonathan Woetzel, Jeongmin Seong, Nick Leung, Joe Ngai, James Manyika, Anu Madgavkar, Susan Lund, and Andrey Mironenko, ‘China and the World: Inside a Changing Economic Relationship’, available at:, December 2018 (accessed April 2020).