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

Published on Pambazuka News, by Li Anshan, July 13, 2011.

Through reference to the history of Chinese medical assistance across the African continent, Li Anshan considers the differences in approaches and understandings behind Western and Chinese ‘aid’ and the scope for potential trilateral (West–China–Africa) 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 t  he case of the China–US–Africa cooperation … //


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


  • 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.


  • 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.


  • 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.


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:


  • 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?


  • 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.


  • 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.


  • 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.

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