Global health security must be multiplayer

China should promote health partnerships with both state and innovative non-state actors

The cross-border spread of infectious diseases has become a major threat to all countries, and global health security has already become an integral part of national security strategies and diplomacy. However, it takes more than one country to safeguard global health security. Research and development of key drugs and vaccines, guaranteeing drug and vaccine availability, the joint prevention and control of infectious diseases, and strengthening underperforming national public health systems are all key challenges requiring multilateral cooperation for an effective response.

The participation of innovative non-state actors has been changing the face of global health governance, highlighting the need for multilateral health cooperation and galvanizing it in the process.

In recent years, the global health arena has witnessed the rise of an increasing number of nongovernmental organizations, private businesses, charitable organizations and civil unions of all shapes and sizes that work alongside traditional actors such as sovereign states and the United Nations. These non-state actors are playing an ever-expanding role with a direct stake in the formulation of health policy standards and the development of public health systems. For example, among the non-state actors that have been working on creating tools to respond to infectious diseases are the Bill& Melinda Gates Foundation, the Global Fund, the Coalition for Epidemic Preparedness Innovations (CEPI) and the Global Alliance for Vaccines and Immunization (GAVI). In light of the novel coronavirus outbreak, they have quickly mobilized resources, and pooled together leading global institutions and professionals around the world to take action to respond to the pandemic. Non-state actors have also played important roles in the fight against numerous global health challenges, such as HIV/AIDS, malaria and polio.

International development cooperation in health has long been serving the purpose of diplomacy, in terms of showing goodwill, deepening bilateral ties and showcasing positive country image through soft capacities. In this case, previous international cooperation in health highlights bilateral channels. As China and the international community have become more interdependent, multilateral cooperation has become an increasingly salient theme in global health governance. If China holds to the concept that health cooperation should serve diplomacy and sticks to the related bilateral cooperation, it will add difficulties for the country to make full use of its potential and to play a unique role in the process of global health governance reform.

In light of this, China should reflect deeply on the relationship between national security and global health security, and regard health security as a priority in its diplomacy, focusing on a result-oriented approach to objectively evaluate its comparative advantages and bottlenecks in this regard. China should build partnerships with other governments and non-governmental actors on an equal footing and with an open and inclusive mindset to strengthen multilateral health cooperation. These partnerships could drive reforms in health governance toward building a global health security architecture.

China is ramping up its multilateral health cooperation. On multiple major occasions, China's leaders have stated the country's commitment to supporting multilateralism, safeguarding the rule-based international order, and strengthening the role of the UN system as the core platform for global governance.

In this vein, China has been stepping up its financial contributions to international organizations, increasing its budget by nearly five times from 2011 to 2019, from 5.4 billion yuan ($763.1 million) to 25.1 billion yuan. Aside from paying membership quotas, China has also provided support to international organizations through donations, assessed contributions to peacekeeping, as well as equity and capital injection. Besides the UN system, nongovernmental organizations such as GAVI and the Global Fund have also benefited from China's health-related donations. But generally speaking, China places a premium on the unique role of multilateral organizations, especially traditional, official entities such as the UN.

The COVID-19 pandemic has served to bring the importance and the urgency of multilateral health cooperation into sharp relief and China should undertake effective measures-in the form of short-term response and long-term planning-to promote multilateral cooperation.

First, China should strengthen its commitment to multilateral arrangements to stem the global spread of the novel coronavirus. It should take the initiative to implement the G20 Statement on COVID-19 and strengthen the role of the World Health Organization in coordinating the global response to the pandemic. China should take actions to fill the funding gap in the WHO's COVID-19 Strategic Preparedness and Response Plan (SPRP), contribute to the COVID-19 Solidarity Response Fund, CEPI and GAVI, and prioritize support for the joint research and development of vaccines to enable breakthroughs. China should also strengthen cooperation with the WHO in supporting the implementation of global initiatives on pandemic preparedness.

Second, China should take multilateral cooperation as an important channel to contribute to the reform of the global health governance system. Global health security should become the goal of foreign policy, not just as a tool for closer relations between nations and the display of national images. This should be a starting point when formulating the international health development cooperation policies, with refined and quantified cooperation objectives made and the division of the bilateral and multilateral health cooperation clarified. In addition, within the overall framework of the international health development cooperation policies, a five-year vision plan should be formulated separately, gathering and mobilizing the resources from both domestic institutions and foreign partners, to promote understanding and form consensus in the process of discussing multilateral cooperation ideas together.

Third, China should pursue parallel partnerships with traditional, intergovernmental organizations as well as innovative, nongovernmental entities. On the one hand, China should step up its core quota contributions to traditional multilateral organizations such as the WHO and the UN International Children's Emergency Fund to help them strengthen their institutional capacity, while facilitating policy dialogue and cooperation on development projects such as helping vulnerable countries strengthen their public health systems and safeguard maternal and child health. On the other hand, in choosing among the numerous creative, non-traditional multilateral agencies to work with, China should give precedence to those such as the Bill & Melinnda Gates Foundation, the Global Fund, CEPI and GAVI that share the same priorities. To do this, it is necessary to identify partner institutions at home and put in place periodic coordination and communication arrangements and respond to health financing plans in an orderly manner. Cooperation should prioritize the research and development of key drugs and vaccines and work on expanding drug availability. At the same time, China can also encourage domestic scientific research institutes and private sector entities to participate in these efforts.

The author is director and research fellow of the Institute of International Development Cooperation at the Chinese Academy of International Trade and Economic Cooperation at Ministry of Commerce of China. The author contributed this article to China Watch, a think tank powered by China Daily. The views do not necessarily reflect those of China Daily.