Speaking Of Asia

Coronavirus: Healthcare BRI can help China redeem itself

Such a project will help Beijing defuse a backlash over the pandemic while meeting the long-term needs of its Belt and Road Initiative partners

ST ILLUSTRATION: MANNY FRANCISCO

On a holiday in Prague last September, my wife and I were led by a tour guide past the John Lennon Wall, a symbol of democracy, and into the inner city.

A car making its way down a pedestrians-only cobblestone road caught his attention, and his good humour vanished. In the vehicle were two Chinese men, barely out of their teens.

Waving and gesticulating, our tour guide ordered them off and returned to curse at rude Chinese people who seemed to be all over the place, blaming his nation's leadership for having so many around in the city.

The young Chinese pair didn't seem to have been deliberately ignoring local rules as much as having taken a wrong turn.

Embarrassed by the unexpected explosion of xenophobia, the Asians in the group, mostly Singaporeans, looked down at their shoes.

Make no mistake: From Italy to Estonia to Serbia, European states this month may be falling over themselves to praise China and gratefully receive the medical experts and supplies Beijing is sending over. But that's for now, when any help is welcome. Who knows what will happen when things settle down.

This week, Spain overtook China in the number of coronavirus deaths and is now second only to Italy.

In Britain, which broke ranks with transatlantic ally the United States to become an early member of the China-led Asian Infrastructure Investment Bank (AIIB), people are shaken after Prince Charles tested positive for the virus and isolated himself in his Scottish castle.

In a nation that stood against massive US pressure to allow the telecommunications giant Huawei to participate in its 5G roll-out, the toll is climbing alarmingly as dozens perish every day.

FALLOUT OF A COVER-UP

China cannot be blamed for the outbreak of the pandemic - that could have happened anywhere. But, whichever way you look at it, Beijing cannot escape a large dose of responsibility for the cover-up that lost the world valuable time in curbing its dastardly spread.

ST ILLUSTRATION: MANNY FRANCISCO

Among the countries affected, most at risk is Pakistan, with which China touts an "iron brotherhood" relationship that is as close as "lips and teeth". Indeed, Prime Minister Imran Khan had refused to evacuate Pakistani students in Wuhan at the height of the outbreak, fearing that to do so would embarrass China.

Next door, Iran - which, too, has close ties with China - is in worse shape, with more than 2,000 deaths and counting.

Can China turn this international setback into opportunity? In small ways, it is already doing so.

Each of 54 African nations, for instance, will receive 20,000 test kits, 100,000 masks and 1,000 protective suits for medical use from the Jack Ma Foundation, raised in the name of China's richest man.

Chinese medical teams are already on the ground in Italy.

But these are, at best, temporary salves that are easily forgotten. What, for instance, are 20,000 test kits and 100,000 masks for a nation the size of Nigeria, which has a population of 200 million?

What's needed is a more sustained effort, and perhaps the route to that would be to build a massive component of public healthcare facilities into China's vaunted Belt and Road Initiative (BRI).

MAKING AMENDS

Since the BRI is President Xi Jinping's signature project, it would, in some ways, have an impact on the way history will view him.

It will also help erase some of the misgivings about BRI as a mercantilist enterprise that condemns recipient nations to debt traps even as it oils the wheels of China's wheezing state-owned enterprises.

Nations, after all, are but the sum of their individuals. There have been instances in history where powerful men have self-corrected and turned to good work.

Remember how former US defence secretary Bob McNamara - who relentlessly threw men, machines and explosives into the Vietnam War in the Kennedy and Johnson administrations - atoned for his actions later by his sincere, committed work as president of the World Bank, an institution whose official name is the International Bank for Reconstruction and Development?

On a national level, the US helped Japan rebuild after destroying it in World War II. Today, the two have one of the tightest relationships in the world.

Japan, for its part, has erased a lot of the bad memories that stem from its aggression in World War II with its overseas development assistance, not to speak of the investment capital that seeded the East Asian economic miracle.

Building healthcare as an integral part of the BRI is an idea that has been around for a while, but I heard its most impassioned exposition from the mouth of the public health expert Priya Balasubramaniam, who was a fellow panellist at a seminar held last October in Guangzhou, organised by the Guangdong University of Technology.

Dr Balasubramaniam argued persuasively that with the rapid pace of globalisation, health problems are no longer issues for a single nation. Collective action by multiple countries is necessary to combat global health crises such as infectious diseases, non-communicable disease lifestyle risks, and health inequity beyond state borders.

BEYOND PANDEMICS

As we are witnessing, disease threats originating from China - after the severe acute respiratory syndrome outbreak in 2003 and the avian influenza pandemic in 2014, we now have Covid-19 - could quickly affect neighbouring countries. China itself has had to confront diseases that spread from elsewhere, such as the 2011 polio outbreak and the Zika virus in 2016.

And that is on top of more permanent diseases, including lifestyle-related ones such as Type 2 diabetes and cardiovascular disease. Today, non-communicable diseases contribute to 62 per cent of Asia's disease burden.

A BRI that builds capacity to handle public health emergencies will need to balance preventive and interventionist methods, as well as training of healthcare professionals.

China has the means to do it. One startling revelation during the onset of the Wuhan outbreak was the presence in the city of hundreds of foreign medical students. In the subsequent stages, the world witnessed China's impressive ability to respond to a health crisis, including the swift ramping up of the manufacture of medical equipment such as ventilators.

It has also been made aware that China is the world's dominant producer of APIs, or active pharmaceutical ingredients, the basic raw material for drugs.

Combine that with its leadership in artificial intelligence and its growing strengths in emerging technologies such as blockchain, and you have a powerful force waiting to be unleashed in everything from disease detection to preventing counterfeit medicine.

To its credit, there are indications that Beijing is beginning to think in this direction. In a recent conversation with Italian Premier Giuseppe Conte, Mr Xi reportedly spoke of a "health silk road".

Recent analyses by the Beijing-headquartered AIIB, which in so many ways complements the BRI but with less diplomatic baggage attached, highlighted a direct correlation between overall infrastructure quality and health security, indicating that infrastructure development is a key part of health security and epidemic preparedness.

The bank says it is poised to announce a number of public health infrastructure financing options for its members in the coming days and weeks.

The trick is not just to make health security a function of good infrastructure but to recognise it as a parallel virtue that could even stand on its own.

Given Asia's demographic trends, the number of Asians aged 65 years and above is projected to nearly double - from 412 million currently to 802 million within 20 years.

In absolute numbers, much of the increase will be driven by China, India, Indonesia, Bangladesh and Vietnam. It is clear that healthcare infrastructure will need to be expanded.

The Covid-19 crisis only makes the case more urgent.

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A version of this article appeared in the print edition of The Straits Times on March 27, 2020, with the headline Coronavirus: Healthcare BRI can help China redeem itself. Subscribe