The Health Silk Road: A Double-Edged Sword? Assessing the Implications of China's Health Diplomacy

The Health Silk Road (HSR) of the Belt and Road Initiative (BRI) of China aims to enhance public health and foster international cooperation in the healthcare sector. HSR objectives include strengthening healthcare infrastructure, expanding China's global health leadership, and enhancing international health cooperation. The aim of this study was to examine the HSR and its implications for global health and international relations by using expert opinion analysis on known major HSR initiatives. We analyzed the objectives of HSR, including improving healthcare infrastructure, enhancing global health cooperation, and expanding China's global health leadership. Additionally, as a case study, an in-depth analysis of the China-Pakistan collaboration on healthcare under the China-Pakistan Economic Corridor (CPEC) was conducted. This research posits that the HSR has a mix of positive and negative implications. Positive impacts of HSR include improved healthcare services, infrastructure, and capacity-building in participating countries. The main challenges include the quality and sustainability of the infrastructure and services provided, debt sustainability, transparency of projects, and China's geopolitical influence. This research identified five motives behind China's HSR: economic interests, diplomatic influence, reputation building, regional stability, and health security. The summary centers on CPEC and the WHO/Global collaboration. This research contributes to a nuanced understanding of the HSR's multifaceted impacts and underscores the importance of open dialogue, cooperation, and the sharing of best practices among stakeholders. By assessing the motives, implications, and concerns of the HSR, this study offers valuable insights for policymakers, global health practitioners, and scholars, highlighting the significance of international collaboration.