The health silk road in China’s governance and multilateralism: towards a role adjustment

Though a late addition to the Belt and Road Initiative (BRI), the Health Silk Road (HSR) is a key corridor, complementing the land, sea, and digital components of the Initiative. Like the BRI, the HSR reflects China-led multilateralism, aiming to establish China as a proactive global health player. This article explores the HSR’s role in Chinese multilateralism, focusing on its response to health challenges. Drawing on role theory, this study aims to bridge a gap in previous research that has overlooked the progress achieved by the HSR in modernising China’s domestic and international capacities for managing public health issues. The analysis aims to answer the following research question: How does the Health Silk Road contribute to adjusting China’s role conception as a global health provider to meet both domestic and external role expectations? We draw on a qualitative methodology complemented by an online survey to measure how the Health Silk Road impacts on the external perceptions of China, and by pre-selected interviews conducted to experts. In this context, we posit that China’s role as a health provider is evolving to meet both domestic and international expectations for a more effective and mature presence in global health governance. In conclusion, the pandemic has tested Beijing’s response and expedited its role adjustment towards becoming a global health player. Despite these changes, China remains hard to define as a revisionist actor in global health governance.