The United States will officially leave the World Health Organization in January 2026, creating a significant shift in global health governance. Beyond immediate financial concerns, like a $260 million funding gap and staff reductions, a deeper structural change is underway.
As the U.S. steps back, China is not just taking its place; it’s reshaping global health aid. We’re seeing a move away from the traditional “donor-recipient” model towards one focused on “infrastructure investment.” This change could offer stability, but it also risks fragmentation.
For years, Western countries, particularly the U.S. and countries in the EU, approached global health through charity. They donated funds to multilateral organizations to deliver critical services, such as vaccines and treatments, to developing nations. This was primarily about “delivery.”
In contrast, China’s approach, especially through its Health Silk Road strategy, emphasizes “development.” Recent projects, like building insulin production facilities in Nigeria and antimalarial factories in West Africa, reflect this. Instead of merely providing medicines, China is investing in the infrastructure to produce them locally.
This model appeals to developing countries tired of the often paternalistic conditions tied to Western aid. China’s approach, framed as “South-South cooperation,” emphasizes sovereignty and partnership rather than dependency.
By viewing health security as an issue of industrial capacity, China offers a solution that the West has overlooked—the ability for nations to produce their own healthcare solutions.
Some suggest that China is the new “stabilizer” of global health, which is partially true. China’s financial contributions to the WHO, such as its $500 million pledge at the World Health Assembly in May 2025, show commitment. However, “stabilization” implies maintaining the existing system, which China is not doing. Instead, it is evolving the system in ways that align with its own governance style.
As the WHO faces budget cuts and reduced operations due to U.S. withdrawal, China’s leadership focuses on bilateral agreements. This could lead to a dual system: a struggling WHO setting standards while China directly engages with countries to implement health solutions. The risk here isn’t just about Chinese influence; it’s about global fragmentation. If health standards diverge, collaboration during pandemics could become more challenging.
The U.S. exit also represents a loss of ideological influence. By stepping back, the U.S. allows China to define “global public goods,” a narrative it has actively pursued during the COVID-19 pandemic by distributing over 2.3 billion vaccine doses. Now, China is focusing on health infrastructure as part of its global strategy.
China is embedding its personnel within health ministries across various nations, which is a unique approach to global health. While Western nations debate aid in their parliaments, China deploys state-owned enterprises to implement health policy directly, making it a more agile player in global health diplomacy.
The landscape of global health is changing. With the U.S. withdrawal being a new reality, health leaders must adopt a pragmatic approach. The future might not simply be about choosing between Western or Chinese systems but creating a hybrid model. Countries may adopt Western health standards when convenient but rely on Chinese-made infrastructure.
The global health community should rethink its view of China’s rise. While the Health Silk Road does extend Beijing’s influence, a drug production facility in Nigeria saves lives, no matter who built it. Instead of dismissing China’s contributions, Western powers need to better invest in local health capacities to compete effectively.
As it stands, China isn’t just filling a gap—it is laying down a new path in global health, and with the U.S. stepping back, this road may very well be the only one available.
Y Tony Yang is an Endowed Professor at George Washington University in Washington, DC.
Source link
America First Retreat,Belt and Road Initiative,Block 2,Chinese vaccines,Global Health,Health Silk Road,South-South Cooperation,US-China rivalry,World Health Organization
