From ‘how could’ to ‘how should’: The possibility of trilateral cooperation

Recently, there has been an increasing call from the West for a so-called ‘trilateral cooperation’, e.g., West–China–Africa cooperation. I was invited to several conferences, seminars or workshops on the issue, especially on aid, such as ‘China’s emerging global health and foreign aid engagement’, held in Beijing (25 May), the international symposium ‘Styles of foreign assistance’ in Seoul (26–28 May) and China–DAC policy symposium on ‘Economic transformation and poverty reduction: How it happened in China, helping it happen in Africa’ in Beijing (8–9 June). All these workshops are focused on the aid issue. The High-level International Conference on ‘Aid effectiveness’ will be held in Korea in November 2011. There is a doubt on the traditional aid regime and a strong tendency of transforming ‘aid effectiveness’ to ‘development effectiveness’ among developing countries. During this important time, what does the trilateral cooperation indicate? How should China face this new situation? I would like to express my opinion in the case of the China–US–Africa cooperation.

In the workshop co-organised by CSIS-CIIS Conference on ‘China’s emerging global health and foreign aid engagement’, I was assigned to write on the subject ‘How should US and China launch the pilot project in Africa?’ According to the subject-title itself, the presumption is that there is a possibility for US–China cooperation in assistance to Africa. However, to turn that possibility into reality needs a lot of work. The reason is simple: how could two parties discuss an important issue concerning the third party without the third’s knowledge? How could the two parties carry out this kind of cooperation without the third party’s participation at the very beginning? How could we start the cooperation without much understanding, let alone agreement, of each other’s concept of the issue?

The conventional experience indicates that the starting point of cooperation is to understand each other first. What is the concept and principle of cooperation or aid? What is the history of cooperation or aid between one and the other? What are the forms of cooperation and aid? Only by knowing each other – and by acknowledging the difference and similarity of bilateral cooperation – can the trilateral cooperation be smoothly carried out and achieve a better result.

This article intends to provide some background knowledge of China–Africa medical cooperation. The argument is that only by settling the issue of ‘how could’ can we start to get down to the business of ‘how should’. It is divided into five parts: concepts and principles of China–Africa relations; the history of China–Africa medical cooperation; forms of cooperation; key questions regarding trilateral cooperation; and the steps to launch the so-called ‘pilot project’.

CONCEPTS AND PRINCIPLES

The concepts and principles are the basis for China–Africa cooperation. First, how should we look at Africa, in a positive view or negative view? If we take a historical perspective, we will find that Africa is not a backward continent. Rather, it has made a great progress since independence. I would like to name just a few things, namely, integration, human rights, border wars and nation-building. We notice that the African Union is now making some progress and Africa is the only continent that gives one voice regarding the big issues in international affairs. As for human rights, Africa has produced its own female ministers, a UN chair, Nobel Prize winners and even presidents in only about 50 years, which other continents can hardly compete with.[1] Compared with many border wars in modern history in the European continent,[2] there have been much fewer border wars in Africa, which is more impressive considering that the border is mainly the product of imperialist participation or colonial occupation.[3] Nation-building is another great achievement. Modern nation-building is a difficult process for any nation.[4] There are problems in the continent for sure, yet for many African nations it goes rather smoothly.

Secondly, the relationship between China and Africa is equal, which is quite unique considering that equality has never been mentioned in the international arena. China has never used the concept of ‘donor-recipient’ to describe China–Africa relations, with ‘partner’ used instead. China believes that assistance is not unilateral, but mutual. The status of China and Africa is equal, not a relation of superior and inferior. Although the relation is strategic, it is equal and friendly. Both China and Africa appreciate each other and cooperate with each other. It is noticeable that the ‘donor-recipient’ notion reflects a philanthropic idea; the donor has a condescending attitude while the recipient is humble and obedient. With a ‘if-you-don’t-I-will’ attitude, donors are unable to take ‘recipients’ as their equal partners. On the contrary, they always want to be a ‘preacher’ and usually threaten to withdraw the aid if they are not satisfied with what happens in the recipient countries. Therefore, no matter what aid they offer, they are not appreciated by the recipients owing to their arrogant manner.

Thirdly, China takes Africa as a promising rather than ‘hopeless continent’. This attitude can be tested from the Chinese investment in Africa in recent years. According to Western media, ‘Luanda is changing fast. A few years after the end of a devastating civil war, cranes are crowding the skyline of Angola’s capital… Last year Angola’s economy grew by an estimated 15.5%, the fastest on the continent … the rest of Africa has also been doing well: a recent report by OECD estimates that Africa’s economy grew by almost 5% last year, and is expected to do even better this year and next… Is Africa, often dubbed the hopeless continent, finally taking off?’[5] We can also notice recent published facts:

- Rwanda is this year’s top reformer, the first sub-Saharan African country to be named top reformer
- The growth rate of construction is 128 per cent in emerging economies, with Nigeria at the top
- From 2000 to 2008, GDP (gross domestic product) in Africa has an average increase of 4.9 per cent, occupying third place in fastest-growing parts of the world.

With various advantages such as human resources, natural resources and cultural heritage, why should Africa be poor and hopeless?

The principles guiding China–Africa relations can be summarised as equality and mutual respect, bilateralism and co-development, no-political strings attached and non-interference of domestic affairs, and stress on the capability of self-reliance.

As early as 1963–64, Chinese Premier Zhou Enlai put forward the Eight Principles of Development Assistance: 1) aid should not be considered as a unilateral grant, but mutual help; 2) neither conditions nor privileges should be attached to the aid; 3) to reduce the burden of the recipient countries, a no-interest or low-interest loan can prolong the time limit if necessary; 4) the purpose of aid is to help recipient countries develop independently; 5) to increase the income of recipient countries, the programmes should produce quicker results with less investment; 6) China would provide the best equipments and materials for the recipient countries, and promise to change them if the quality is not as good as the agreement permits; 7) to guarantee the recipient countries to master the relevant technology when technical assistance is provided; and 8) experts from China should never enjoy any privileges and should receive the same treatment as the local experts in recipient countries. If we carefully analyse these principles, it is quite obvious that they are a kind of obligation and discipline on China’s side, e.g., what China should do and what the Chinese should avoid. The first principle is very important, guiding China–Africa cooperation for decades.

The best example of this development assistance is the building of the Tanzania–Zambia Railway (TAZARA), ‘one of the lasting monuments to its former presence’. China helped Tanzania and Zambia build the railway of 1,860km for US$500 million during 1968–86 with about 30,000 to 50,000 Chinese involved (64 people died). As Jamie Monson points out: ‘… the Chinese had articulated their own vision of development assistance in Africa throughout the Eight Principles of Development Assistance … these principles reflected China’s efforts to distinguish its approach to African development from those of the United States and the Soviet Union. Several of these principles had direct application to the TAZARA project.’[6]

After the 12th party congress, the Chinese Communist Party started its new policy of development assistance. During his visit to Africa in 1982, Zhao Zhiyang put forward four principles regarding China–Africa economic cooperation, e.g., equal bilateralism, stress on effectiveness, various forms and common development. Although equality is a principle in Western ideology as well as an important content in the humanitarian tradition, there is never mention of this principle in international relations. China and Africa have similar historical experiences, and they both cherish the value of mutual respect and the sense of equality. State–state relations are like person–person relations; only equality and mutual respect can endure any difficulties. After the Canadian oil firm Talisman decided to sell its interest in a Sudan consortium that also involved Chinese and Malaysian firms, the China National Petroleum Corporation wanted to purchase the interest, but Khartoum turned down the Chinese offer and awarded the shares to an Indian firm instead. The deal by no means troubled relations between China and Sudan, which shows that China and Sudan are equal partners, and they each make decisions to guard their national interests independently. As Mkumbwa Ally, deputy managing editor of Tanzania Standard Newspapers stated: ‘The cooperation between China and Africa including Tanzania is based on mutual-benefit, that's not the “Power matters the most” policy by some western countries but the way to cooperate with others.’

No-political strings and non-interference in domestic affairs has been another important principle of China’s diplomacy since the 1950s. China and African countries have similar colonial experiences and they put great emphasis on national sovereignty. In order to make a good decision, China always refers to the UN and the African Union’s stand. What’s more, international affairs show clearly that external interference can seldom settle the problem but instead worsens the situation. As Deborah Brautigum observed recently, ‘Where the West regularly changes its development advice, programs, and approach in Africa … China does not claim it knows what Africa must do to develop. China has argued that it was wrong to impose political and economic conditionality in exchange for aid, and that countries should be free to find their own pathway out of poverty. Mainstream economists in the West today are also questioning the value of many of the conditions imposed on aid over the past few decades.’[7]

China’s assistance policy also puts the stress on self-reliance. This is an experience from China’s own development. With help from China, Sudan has turned from being a net oil importer to an oil exporter. Recent collaboration between China and Nigeria to launch a communications satellite, NigSat I, is a groundbreaking project where China has provided much of the technology necessary for launch and on-orbit service and even the training of Nigerian command and control operators. While Nigeria acquired satellite technology, China also gained from the collaboration by burnishing its credentials as a reliable player in the international commercial satellite market.[8]

Western aid does not work properly, a fact which was pointed out by New York University Professor William Easterly’s work ‘White Man’s Burden: Why the West’s Efforts to Aid the Rest Have Done So Much Ill and So Little Good’, and ex-World Bank employee Robert Calderisi’s book ‘The Trouble With Africa: Why Foreign Aid Isn't Working’. Dambisa Moya, a Zambian scholar who also worked for the World Bank, published a book entitled ‘Dead Aid: Why Aid is Not Working and How There is Another Way for Africa’, criticises the aid regime severely. She termed aid as a ‘silent killer of growth’ and made the statement, ‘Africa’s development impasse demands a new level of consciousness, a greater degree of innovation, and a generous dose of honesty about what works and what does not as far as development is concerned. And one thins is for sure, depending on aid has not worked.’ She called for a stop of aid, and she used a chapter entitled ‘The Chinese are our Friends’ to praise China’s way of development assistance to Africa.

Though China’s aid to Africa is not as large as that of the West, why is it workable? The reason, in my opinion, can be attributed to China’s foreign assistance philosophy, which regards partner countries as equal and believes assistance should be mutually beneficial. China and Africa have both been colonised or semi-colonised, experiences that have provided them with similar norms of conducting international relations: mutual respect and an equal footing.

HISTORY OF CHINA’S MEDICAL COOPERATION IN AFRICA

Generally speaking, China–Africa medical cooperation started from 1962. In July 1962, after the victory of the liberation movement and the withdrawal of French medical staff, the Algerian government called on the international community for medical assistance. The Chinese government received the message through two channels, the Red Cross and the Algerian minister of health. In January 1963, China was the first to express its willingness to provide medical assistance to Algeria, marking the beginning for China to provide medical aid other countries.[9] Since then, Hubei Province has been in charge of the dispatch of the Chinese Medical Team (CMT) to Algeria. Up to 2006, Hubei had sent out more than 3,000 medical personnel/times (p/t) to Algeria and Lesotho. The latter started to receive CMT in 1997.

CMT is dispatched on the basis of one province for one or more African countries. During the 1960s, seven medical teams were sent to six African countries – Somalia, Congo-Brazzaville, Mali, Mauritania, Guinea and two to Tanzania, Zanzibar and Tanganyika respectively. During their visit to Algeria, Premier Zhou Enlai and Vice-Premier Chen Yi met the CMT members there as an encouragement. The assistance was rewarded with great support from African countries, especially in the occasion of UN Assembly in 1972, when 26 African countries voted yes to the revival of the legitimate status of PRC (People’s Republic of China) in the UN.

For the past 48 years, China has implemented cooperation with Africa, dispatching CMT to provide free medical service. Together with CMT, China has also offered free facilities and medications, trained African medical personnel and built hospitals in various African countries. Unique in international relations, the practice of CMT aroused interest from abroad. David H. Shinn, the former US ambassador to Ethiopia and Burkina Faso, once commented that ‘Chinese teams offer an array of medical specialties in addition to traditional medicine. The most recent team of 27 to arrive in Mauritania included specialists in scanning, orthopaedics, epidemiology, gynaecology, surgery, ophthalmology, water chemistry, bacteriology, and virology. They often serve in rural areas, something that many African doctors do with great reluctance.’[10]

Entering the 21st century, China has strengthened its international medical cooperation with Africa. Since 2002, more than 40 agreements were signed. Up to 2010, China has sent 21,000 CMT p/t to 69 countries – most of them are in Africa and have served 210 million patients.[11] According to a source from the Ministry of Health, by the end of 2010 China had sent a total of 17,000 medical workers since the dispatch of the first CMT to Africa, and the total cases treated reached 200 million.[12] Besides CMT, the China–Africa cooperation is expressed in other fields, such as the provision of medication and medical facilities, running training courses and training African medical specialists in China. Most important, China started to set up anti-malaria centres in African countries, as promised by President Hu at the 2006 summit.

As medical cooperation is concerned, CMT has contributed a great deal to the service of Africans, the improvement of health systems and the raising of the standard of local medical services.

FORMS OF CHINA–AFRICA MEDICAL COOPERATION

China–Africa relations are equal, which is quite unique considering that equality has never been mentioned in the international arena. China has never used ‘donor-recipient’ (a philanthropic idea) to describe China–Africa relations, with ‘partner’ used instead. China believes that assistance is not unilateral, but mutual. Both China and Africa appreciate each other and cooperate with each other. The principles guiding China–Africa relations include equality and mutual respect, bilateralism and co-development, no-political strings attached and non-interference of domestic affairs, and stress on the capability of self-reliance. China–Africa medical cooperation generally includes the following ways.

1. To serve Africans in a Chinese way

To serve the people is the fundamental aim of a public heath system, which Chinese doctors try their best to contribute to. In Algeria, CMT spread its 16 treatment stations to 21 provinces and cities, covering more than 10 medical specialties, and became the biggest and most influential one among CMTs in Africa. The great advantage of CMT is the Chinese traditional medical treatment, especially acupuncture. The reputation of CMT has spread to neighbouring countries. In Mali, while the climate and living conditions cause many cases of rheumatism, arthritis and psoatic strain, acupuncture is the most effective cure for the cases. CMT in Niger treated 57,330 patients, 5,120 by acupuncture and several ministers were treated by Chinese medicine and acupuncture. The same thing occurred in Tunisia, Cameroon, Benin, Sierra Leone, Tanzania and Mozambique. In order to praise Chinese medical teams for their service, African governments awarded about 600 CMT members with various medals for their services to humanitarian cause.

2. To improve the local medical system

In order to help improving local public health systems, China has cooperated with African countries in various ways, such as building hospital and medical facilities, providing free medications and transferring Chinese medical techniques. In the Republic of Congo, the hospital for gynaecology and obstetrics was a small one in the 1960s. Now it is the third biggest comprehensive hospital in Brazzaville; it holds 23 Chinese doctors who play a significant role in the hospital. The department or specialty of acupuncture has appeared in Tunisia, Cameroon, Lesotho, Namibia and Madagascar. The cooperation also promoted the institutional innovation in the African medical system. The establishment of the Centre of Acupuncture and the department of acupuncture in Biserta Hospital in Tunisia is an example. The course on acupuncture started at universities in various countries, such as Conakry University in Guinea, Universidade Eduardo Mondlane in Mozambique and Madagascar State Public Health School.

3. To help raise local medical standards

Chinese doctors have also tried to transfer medical techniques to local doctors. When Prime Minister Zhou Enlai visited Zanzibar in 1965, he told CMT there: ‘CMT will sooner or later return back home. We should train Zanzibar doctors and help them to work independently. Therefore to leave a medical team which would never go away … Our assistance is to make the country able to stand up. Just like to build a bridge, so you can cross the river, and without a staff. That would be good.’[13] CMT usually help local doctors by offering free lectures, training courses and operation-teaching. In Tanzania, in order to train local medical staff to learn acupuncture, CMT members used their own body for the local doctors to practice, directly teaching them to grasp the technique. By this way, they trained a large number of medical specialists. CMT also made the best use of local media to publicise medical knowledge. In Algeria, CMT held more than 20 training courses, more than 30 lectures and trained more than 300 personnel, who have become the backbone of local medical institutions. Liberia suffered from war for a long time, resulting in many patients. CMT’s service was noticed by David Shinn, the US former ambassador to Ethiopia and Burkina Faso. He said: ‘China received praise in Liberia for its medical teams because they prioritise the transfer of knowledge and technology. They sent specialists and general practitioners, who upgraded and built the professional skills of local heath workers. In the case of war-torn Liberia, this is a critical medical need.’[14]

4. To fight against malaria in Africa

China adopted several measures such as CMT, training programmes, anti-malaria projects, free facilities and drugs, and anti-malaria centres. Anti-malaria is a major task for CMT, who usually distribute free medications to patients. Cotecxin, the most effective anti-malaria drug produced in China, and acupuncture have won a great reputation in Africa. In certain areas, life habits and the abuse of medication cause serious disease. In Mali, malaria is very common and people have to take Quinine for treatment and many people suffer from limb hemiplegia caused by the overuse of Quinine. Chinese acupuncture experts cured the cases by silver needle. CMT also compiled booklets for training of local medical workers. China holds training programmes at home and in Africa to provide anti-malaria training for African specialists and officials. In 2002 Jiangsu Center for Verminosis Control and Prevention (JCVCP) was designated as a base for international assistance. Since then, the centre has run six programmes for African medical staffs and officials, offering training to 169 officials and special technicians from 43 countries. In 2003, two anti-malaria programmes ran in Madagascar, Kenya and Cameroon to train medical staffs from 35 African countries, to carry out the anti-malaria project is another way. In Moheli island of Comoros, villages are seriously affected by malaria. In 2007, a joint project started between Moheli island and Guangzhou University of Traditional Chinese Medicine (GUTCM) in China. To combat against malaria, the drug is of vital importance. When a delegation of senior African government officials visited a Shanghai-based pharmaceutical company in 2005, they called on Chinese companies to set up branches in Africa for medicine production. DihydroArtemisinin, or ‘Cotecxin’, was first developed by Beijing Holley-Cotec in 1993. It was approved by the WHO (World Health Organisation) as an effective anti-malaria drug. In 1996, the Ministry of Health designated Cotecxin as the required medicine for CMT. It is also chosen many times as aid materials to Africa, either by the government or pharmaceutical companies. Another important measure is the setting-up of anti-malaria centres in Africa, a direct result of the 2006 summit.[15]

5. Other forms of medical cooperation

Besides the above-mentioned forms, there are others as well. China is now one of the countries to dispatch soldiers to join the UN peace-keeping force in Africa. Some of the Chinese soldiers are medical doctors. Chinese civil society also takes an active part in medical cooperation with Africa. For example, the ‘China-African Brightness Action’ is a project carried out by multilateral efforts. As the news media reported, the African initiative is part of the Journeys Bring Light Programme of the National Organisation for the Prevention of Blindness and Beijing Tongren Hospital, financed by companies such as Hainan Airlines in 2010, while the second one was co-organised in March 2011 by the National Committee of Blindness Prevention (NCBP), China Association for Promoting Democracy, the Chinese People's Association for Friendship with Foreign Countries (CPAFFC), HNA Group Co., Ltd, Anhui Foreign Economic Construction (Group) and Beijing Tongren Hospital.[16]

QUESTIONS CONCERNING POSSIBLE TRILATERAL COOPERATION

Before we move to the next step, we have to ask three key questions concerning the essence of cooperation and aid.

QUESTION ONE: SHOULD WE PROVIDE OUR HELP TO AFRICAN COUNTRIES WITH CONDITIONS?

As we know, the US has its own policy regarding its relations with Africa. Different from China’s above-mentioned concepts and principles, the US put a great emphasis on conditionality in terms of aid. For example, in order to contribute to global development, the US Millennium Challenge Cooperation (MCC) offers financial aid to developing countries with certain conditions. There are selection criteria, which include 17 indicators.[17] Only those countries which can meet the criteria are qualified to receive aid. I sometimes ask my American colleagues, ‘If any country can meet your conditions, does it need aid any more?’ If the criteria are the pre-conditions, the cooperation can hardly go on to next step.

QUESTION TWO: CAN WE DECIDE THE ISSUE FOR AFRICANS?

On 3 May this year, three of my graduate students went to the International Poverty Reduction Centre in China last month to attend a seminar on ‘To promote African development through agriculture and social protection’, given by officials and experts from the US government, USAID and British consultant agency. Four topics covered different aspects of African food security, hunger and development, and guarantee of the provision of food in the future. Two of my students are Africans. Although the content was interesting, two of my African graduates complained when they were talking about their assistance to Africa that there was no African present except the two of them. This situation is by no means particular. I have attended some of the workshops with the same peculiar characteristic: talking about important African issues without Africans’ participation. Can we decide the issue for others? That is the key question.

QUESTION THREE: CAN WE DECIDE WHAT AFRICANS NEED?

The other days, two officials from the Department of West Asia and Africa of Ministry of Commerce visited our centre and we discussed China–Africa relations. One of them, Mr Chen, told me a story offered by a World Bank official who exchanged views with the Ministry of Commerce. The World Bank official asked the official of the ministry, ‘Do you know why you Chinese are more successful in the aid issue?’ The answer was negative. Then the World Bank official explained. ‘Let me tell you why. It’s just because we know what aid we can provide in Africa while you don’t know. Since you are not clear, you ask the Africans about this and they told you what they exactly need. That is the reason you are more successful.’ Can we decide what others need? This is another key question.

These three questions bring us back to the concrete issue: how could the US and China launch a pilot project in Africa without Africans’ knowledge and participation?

We really have to answer the three key questions first before starting anything else. If the answers to the three questions are no, then we can move on to discuss the following steps. Frankly speaking, without African involvement and participation, any trilateral cooperation or agenda concerning African would become a political show or a joke.

HOW SHOULD WE START TRILATERAL COOPERATION

With rapid economic growth in China, cooperation between China and Africa is also strengthened. Chinese officials promised to expand medical cooperation with developing countries, including those in Africa in various occasions. The US has a long history of aid to Africa and now it has also speeded up its engagement in Africa, including medical aid. There exists the possibility for cooperation.

What I suggest here are the following steps.

First, to reach an agreement in understanding ‘cooperation’ in the Chinese term, or ‘aid’ in the American term, is of vital importance in the cooperation process. As mentioned above, China has its own philosophy of cooperation, and so does the US. In China, the cooperation is no-conditional strings attached, while the US has about 17 requirements in their MCC aid project. What should both sides do in the cooperation in terms of different philosophy? My African students have expressed some doubt on the issue. ‘China and the US are totally different on the issue, so how could they cooperate in Africa?’ Can we solve this problem first?

Second, there would be a need to choose a proper project once the agreement is reached. There are countless projects undergoing in Africa; some are successful and some not. Some are beneficial towards ordinary Africans, some not necessarily so. In my view, ‘Bring brightness to Africa’ (cataract extraction) might be a good one, since it is a popular one and can directly serve ordinary people. Just think in Malawi alone there are 70,000 people blinded by cataracts! What is more, Chinese doctors have some good experiences and have done this successfully twice in African countries.

Third, choose an African country as a partner. Since China and the US have different views on many issues, they have accordingly different relations with African countries. On the whole, China has fairly good relations with all African countries except the few without diplomatic relations with China. The African country should be one which keeps good relations with both. Only first requested and then agreed by the country, the pilot project can get started. Otherwise, no project can be successful without the host country’s cooperation.

Fourth, who should be responsible for and get involved in the pilot project? There are several ways to do this. Under the government’s guidance, the ministry in charge of the medical issues or cooperation takes the responsibility in organising and performing the project. This is a government’s sponsored project. The second way is that NGOs or GNGOs could take charge of this and decide the issue step by step. The government could sponsor an NGO or GNGO to carry out the project. The third way may be a good way to start once we have settled the ‘how could’ issue. What I suggest is the third one, with both the government’s efforts and civil society’s participation combined.

BROUGHT TO YOU BY PAMBAZUKA NEWS

* Li Anshan is a professor at the Centre for African Studies, Peking University, China.
* Li is a contributor to 'Chinese and African Perspectives on China in Africa', published by Pambazuka Press.
* Please send comments to editor[at]pambazuka[dot]org or comment online at Pambazuka News.

NOTES

[1] It is common knowledge that women in Europe won universal suffrage after a long-time struggle in modern history. Women got their right for election in 1918 in Germany, 1928 in Great Britain, 1945 in France, 1946 in Italy and 1948 in Belgium.
[2] For border wars during the modern time in Europe, see T.C.W. Blanning (ed), ‘The Nineteenth Century: Europe, 1789–1914’, Oxford: Oxford University Press, 2000; Stefan Berger (ed), ‘A Companion to Nineteenth -Century Europe: 1789-1914’, Malden: Wiley-Blackwell, 2009.
[3] According to a Russian Africanist, 44 per cent of borders in Africa were determined by latitude and longitude, 30 per cent by geometrical methods and only 26 per cent by natural border lines such as mountains, rivers and lakes.
[4] For example, after more than 80 years of independence, the US undertook a civil war to prevent the secession of the nation, resulting in about 620,000 soldiers’ deaths (Drew Gilpin Faust, This Republic Suffering: Death and American Civil War, New York, 2008).
[5] The Economist, 24 June 2006.
[6] Jamie Monson, ‘African freedom railway: How a Chinese development project changed lives and livelihoods in Tanzania’, Indiana University Press, 2008, p.148.
[7] Deborah Brautigam, ‘Dragon’s Gift: The real story of China in Africa’, Oxford University Press, 2009, p. 308.
[8] ‘China launched satellite for Nigeria’, Xinhua News Agency, 14 May 2007.
[9] ‘Chinese medical team went to Algeria’, People’s Daily, 7 April 1963.
[10] Ambassador David H. Shinn, ‘Africa, China and health care’, in AISA, no.s 3 and 4, October–December 2006, pp. 14–16. See also Drew Thompson, ‘China’s soft power in Africa: From the “Beijing Consensus” to health diplomacy’, China Brief, 2005, 5 (21), pp. 1–4.
[11] Foreign Aid Division of the Ministry of Commerce, ‘Providing sincere and selfless assistance to promote the construction of a harmonious world’, China Economic and Trade Herald, 2010, issue 15.
[12] ‘China commits to expanding medical aid in Africa’, http://english.peopledaily.com.cn/90001/90776/90883/7288562.html
[13] Jiangsu Provincial Health Bureau (ed), ‘Glorious Footprint: In Memory of Fortieth Annivesary of Jiangsu Province to Dispatch Medical Team Abroad’, Nanjing: Jiangsu Science and Technology Press, 2004, p. 3.
[14] Ambassador David H. Shinn, ‘Africa, China and Health Care,’ Inside AISA, Number 3 & 4 (October/December, 2006), p.15.
[15] For a more detailed history, see Li Anshan, ‘Chinese Medical Cooperation in Africa: With special emphasis on the medical teams and anti-malaria campaign’, Uppsala: Nordic African Institute, 2011.
[16] Huang Yiming, ‘Seeing eye to eye’, http://www.chinadaily.com.cn/life/2010-12/08/content_11668467.htm; ‘2011 China–Africa Brightness Action' Launched in Beijing’, http://biz.yahoo.com/prnews/110318/cn67615.html?.v=1
[17] For MCC indicators, see http://www.mcc.gov/pages/selection/indicators