The outbreak of the Coronavirus crisis at the end of 2019 has led to a surprise acceleration and expansion of the HSR and a boom in studies of this topic by global financial press, think tanks and universities. The team from China Investment Research (CIR), Grisons Peak, a London based consultancy focused primarily on emerging markets with a specific focus on the BRI, and the Shanghai Institutes for International Studies (SIIS), a leading foreign policy think tank based in Shanghai, collaborate for the third time in contributing our parts to this rich topic by leveraging our comprehensive data from the 1st quarter of 2019 through the 3rd quarter of 2020 for comprehensive data and through year end 2020 for selected other data.

This report (Click here to read the report)represents a story of how quickly, and with considerable focus, the world’s most populous country and 2nd largest economy, controlled a virus and then proactively used its firepower to re-launch the Health Silk Road (HSR). During the month of February 2020, many countries, including the EU and its member states, sent tonnes of medical aid to China. By March, China had gripped the virus. Once gaining control of the pandemic, China began aggressively re-launching and re-defining its HSR. We know from President Xi’s Keynote Speech at the Opening Ceremony of The Third China International Import Expo that as of 20th October, China had provided assistance to 150 countries and seven international organizations and exported over 179 billion masks, 1.73 billion protective suits, and 543 million testing kits.

The Health sector was an integral part of the Belt and Road Initiative (BRI) that was launched in 2013, while the term HSR was formally coined by the Chinese Health authority in 2015 together with a 3-year action plan. Compared to the hard infrastructure pillar of the BRI, the HSR was intended to forge closer people-to-people connection. Despite a much lower profile, the HSR was already in quite a good shape before the COVID-19 broke out, based on the decades of Chinese own experiences in fighting infectious disease and the development of healthcare system at home and well-established tradition in helping other developing countries in this area. Highlights include helping with the building of hospitals and health infrastructure, sending medical workers and doctors abroad for knowledge-sharing, and working together with the World Health Organization (WHO) and other health-related international organizations.

Our report will be presented to readers in the following structure and path: First, we will introduce the origin and background of HSR, and then discuss China’s ability and role in leading and guiding a global health community, China’s foreign medical assistance to combat COVID-19 epidemic, and followed by discussion on international cooperation mechanism for building HSR, data-based annual performance analysis, and vaccine diplomacy. Readers will see several different components of data underlying the conclusions. This paper sets out details on each of these –primarily financial- components. This paper therefore develops each of these components, and plots them on a series of quarterly maps, commencing Q3 2019 and continuing through to Q3 2020. Compared with the existing publications as of today, our data are unique in the following aspects: stocktaking of official and private assistance in various forms; detailed coverage of HSR-related commercial activities by both Chinese and international companies, including their performance in Chinese capital market; full calculation of Foreign Direct Investment (FDI) and other investments below the 10% threshold of FDI and/or below US$ 10 million; focused documentation of COVID-19 vaccination development and testing by Chinese medical entities. Detailed notes, references and visualized tables and maps are provided for reference.

Our major findings include the following: Firstly, China had already significantly scaled up medical assistance in various forms and secured the operation of medical supply chain for the world. Secondly, Chinese companies accelerated “going out” in both volume and value in the health sector while the aggregate outbound investment has been declining. Thirdly, bio-tech and bio-pharma companies also became the most active components in Chinese capital market, which dwarfed many FDI inbound sector amounts. Strong developments in capital, technology and markets have enabled China to play a bigger role in maintaining global health. Fourthly, China provides vaccines around the world in a "public product" manner and has played an integral role in global vaccine development and distribution.