Assembling Chinese health engagement in Africa: structures, strategies and emerging patterns

Employing the assemblage perspective, the paper examines the relations of exteriority, heterogeneity and fluidity in the development of global health cooperation 'with Chinese characteristics'. Through the case of Chinese health engagement in Africa, the paper (1) reviews the shifting imperatives of China's involvement in global health; (2) identifies the major approaches, institutions and actors in the design and implementation of overseas health projects; and (3) evaluates the linkages among diplomacy, politics and economics in shaping Chinese health cooperation. The findings demonstrate how public health emergencies such as Ebola and COVID-19 have served as catalysts to push forward new developments in the assemblage of China–Africa health cooperation. In particular, the last decade has witnessed a rescaling of the Chinese state to lead international health initiatives on the one hand and to incentivise diverse sub-state and non-state actors to engage in various health-related trade and investment activities on the other. The COVID-19 pandemic has accelerated the move from a state-guided process of health cooperation to a collective project pursued by multiple official and enterprise actors. The pandemic offers an opportunity to strengthen the links between health and non-health imperatives, hence further deepening China–Africa interdependence.