CHINA’S HEALTH SILK ROAD REIMAGINING GEOPOLITICAL INFLUENCE THROUGH THE MEDICAL DIPLOMACY IN THE MIDDLE EAST

This research article extensively examines the various aspects of the relationship beyond the limited scope of economic cooperation. The Belt and Road Initiative (BRI) of China includes the Health Silk Road HSR, which is intended to improve public health and promote global collaboration in the healthcare industry. The purpose of this article is to analyze the different aspects of the relationship between China and the Middle East. These aspects include cultural exchange, education initiatives, technological partnerships, partnerships in healthcare, infrastructure development, environmental sustainability efforts, and exchanges of diplomacy. Additionally, it will explore the importance of interpersonal interactions, tourism, academic exchanges, and cultural understanding in nurturing a strong connection between China and the Middle East. HSR aims to improve global collaboration in health, increase China's leadership in health around the world, and fortify the healthcare infrastructure. We thoroughly examined the goals of HSR, which encompass the improvement of healthcare infrastructure, the promotion of collaboration in global health, and the expansion of China's leadership in global health. Furthermore, we conducted a thorough examination of the healthcare collaboration between China and Pakistan, which is part of the Economic Corridor between China and Pakistan (CPEC). This is an instance of research. Our findings suggest that HSR has both beneficial and detrimental ramifications. On the ideal side, HSR has led to enhanced medical services and infrastructure, as well as developing capability in the participating nations. But there are also big obstacles to overcome, such as making sure the infrastructure and services are sustainable and of high quality, controlling the sustainability of the loan, encouraging openness in project execution, and dealing with China's geopolitical influence. Five drivers drive China's HSR, according to the report: financial gain, power in diplomacy, enhancing one's reputation, maintaining regional stability, and health security. The WHO Global Collaboration and CPEC are the


Introduction
The National Health Commission of China, formerly known as the Commission on National Health and Family Planning, coined the phrase "Health Silk Road" with the purpose of aiding the central government in fulfilling its responsibility to promote the execution of the Belt and Road Initiative (BRI).President Xi Jinping officially introduced the idea of the Health Silk Road during his trip to Uzbekistan in 2016.One year later, Beijing and Beijing pledged to assist the Health Silk Road effort and enhance healthcare results in countries taking part in the Belt and Road effort (BRI) in a memorandum of agreement signed by the World Health Organization (WHO).This innovative approach aims to not just redefine collaboration in world-wide health care but, furthermore, transform China's position in international health, revealing a complex interaction of diplomatic, political, and economic elements.
Considering that the HSR progresses, it is crucial to further explore the motivations, feasible consequences, and additionally urgent obstacles linked to this apparently harmless health diplomacy endeavor.Through an analysis of the cooperation between China and Pakistan in the area of medical services within the China-Pakistan Economic Corridor (CPEC), this study uncovers the diverse effects of the Health Silk Road (HSR) initiative.It emphasizes that the impacts of the HSR cannot be easily classified as solely favorable or negative.Instead, the HSR represents a delicate equilibrium, offering crucial healthcare support to participating nations while also bringing up issues with transparency, geopolitical impact, and the sustainability of debt.Moreover, this research article aims to illuminate the more extensive effects of the HSR on worldwide health management.The possibility of ramifications concerning China's expanding impact on the medical field industry, taking into account the challenges that the participating countries may face when navigating the complex terrain of the Health Silk Road (HSR), It is critical to comprehend the potential effects of the Health Silk Road on development, international relations, and global health governance.As it grows more powerful in the healthcare industry, China has the ability to change institutions, attitudes, and practices related to health.This is evident when examining several aspects of HSR, such as its objectives, strategies, successes, and issues.The Health Security Reform (HSR) may change power dynamics and lead to reliance, even though it has the ability to enhance infrastructure and healthcare results in participating countries.It is significant because this research might evaluate how well China is using public diplomacy tactics and reveal the underlying goals of its efforts in health diplomacy.The significance of this topic stems from the consequences China's increasing dominance in the global health industry has for power dynamics and the future of international cooperation.Moreover, this method can foster increased cooperation and adaptability in the case of future global health catastrophes by assisting in the creation of more potent health diplomacy strategies.This is a strong opportunity to explore how health diplomacy may serve both humanitarian and strategic goals, with implications for global health governance and advancement (Lo, C. 2022).

Advancing Healthcare Infrastructure
The Health Silk Road (HSR) is a global initiative aimed at improving healthcare infrastructure in countries to improve health results and general growth.The HSR involves capital expenditures made in new facilities, updating the current infrastructure, and providing supplies and equipment for medical care.The growth of medical laboratories, telemedicine, hospitals, and other key aspects of healthcare infrastructure, public health surveillance, as well as training institutions.China has funded and built several hospitals in partner countries, such as Pakistan, Cambodia, and Laos, to improve their healthcare structures.The HSR highlights the importance of resources for research in medicine and labs in fields like vaccine development, infectious disease management, and digital health solutions.China has collaborated with companion nations to build a framework for e-health and telehealth, such as the Papua New Guinea government and Huawei.The HSR also focuses on public health infrastructure, investing in disease monitoring systems, and public health in partner nations.The Malaria Control Project in Cameroon, supported by China, aims to establish a national center for malaria control and improve training facilities and medical schools.The HSR project also aims to build health-related human resources, such as the Zimbabwean nursing professionals' founding of the China-Zimbabwe Friendship Hospital School of Nursing, which provides instruction.

Strengthening International Collaboration for Global Health Advancement
The Health Silk Road (HSR) is a global initiative aimed at fostering cooperation in various healthrelated fields, including medical research, public health policy, illness prevention and control, and healthcare technology development.China and the Middle East have been working together to combat the HSR, infectious illnesses, and other risks to public health.Launched in 2015, the China-Central and Eastern European (CEE) Programme for Infectious Diseases enables China and 17 CEE nations to collaborate more effectively in capacity building, laboratory testing, and epidemiological monitoring.The 2018 Africa-China Collaboration in the Health Sector Plan emphasizes cooperative efforts against HIV/AIDS and malaria.
The HSR also encourages policy debates and technical exchanges in various fields, such as the growth of the health workforce, health funding, and health system strengthening.Collaborative medical research initiatives are also crucial for international health cooperation.The Global Health Support Programme (GHSP) between the United Kingdom and China is centered on mental health, non-communicable illnesses, and health systems in low-and middle-income nations.The goal of the China-Brazil Center for Disease Control and Prevention (CDC) is to enhance cooperation in epidemiological research, monitoring, and laboratory testing.China is aggressively promoting international cooperation in the field of medicine through the HSR by organizing and hosting conferences and discussions on health.For instance, health ministers from China and Africa can debate public health policies, exchange ideas, and more during the yearly China-Africa Health Ministers' Conference.and find possible areas of cooperation in areas like medical research, health system development, and disease prevention and control (Bliss, K. E. 2013).

China's Rapid Expansion in Global Health and Leadership
China's Health Silk Road (HSR) is a significant tool for strengthening its global health policy.It involves active participation in international health conferences, financial aid, technical support, and capacity-building assistance, as well as strategic alliances.China's HSR policy has been instrumental in addressing various health issues in low-and middle-income nations, such as the Ebola outbreak from 2014 to 2016, where it quickly and extensively executed its HSR policy.China surpassed the efforts of other OECD countries by donating assistance packages worth over $5.5 million to Guinea-Bissau and the three Ebola-affected countries.China has also increased its financial support for international health groups such as the Global Fund to Fight (AIDS), Tuberculosis, and Malaria, the Vaccine Alliance, Gavi, and the World Health Organization (WHO).This demonstrates China's commitment to global health finance and its readiness to participate in international health cooperation.China has been sending medical groups to nations in Africa since the 1960s to provide healthcare activities along with knowledge about regional health personnel.The HSR effort has furthered this project, with thousands of Chinese medical professionals serving in more than 50 nations across the globe.China has also demonstrated its expanding leadership in global health by offering medical supplies, knowledge, and financial support to impacted nations in the wake of the COVID-19 epidemic.
By taking part in global health forums and initiatives like the World Health Assembly and the G20 Health Ministers' Meetings, China can strengthen its status as a leader in health diplomacy and influence worldwide health policy.To address issues related to global health, it actively seeks alliances and partnerships with governmental bodies, businesses, and international organizations (Zeng, W., Ding, M., & Liu, H. 2023).

Consequences and Outcomes of (HSR)
It is crucial to research the consequences, ramifications, and issues surrounding the HSR for a number of reasons.Its ability to affect participating nations' healthcare systems and global health outcomes is a major factor.Policymakers, researchers, and healthcare professionals can determine the advantages and disadvantages of the HSR by comprehending its influence.Future global health programs and policies may be designed and implemented with this information in mind.In addition, evaluating the HSR's effectiveness aids stakeholders in pinpointing areas that require improvement.This leads to more focused investments, efficient use of resources, and enhanced collaboration between China and its allies.Risk mitigation strategies might be developed to ensure that, by assessing potential drawbacks and issues, the HSR helps to achieve sustainable global health.Additionally, studying the HSR provides valuable insights into China's global health practices, ambitions, and aspirations.It also makes clear any potential impacts on international relations and the administration of global health.A detailed examination of the HSR can yield lessons learned and best practices for researchers and policymakers.These may subsequently be used in additional global health efforts and partnerships, leading to more successful, efficient, and long-lasting programs in the end.Finally, researching the HSR encourages communication and collaboration across stakeholders in global health as well as between China and other nations.This encourages collaborations that advance global health as a whole (Târik, M., 2021).Improved Infrastructure for Healthcare: Health outcomes in partner nations have improved as a result of the HSR's dedication to world health collaboration and infrastructure advancement for healthcare.The HSR has been instrumental in lowering death rates, lowering the burden of disease, and enhancing general community medical care through improved medical services, state-of-the-art medical technologies, and effective disease prevention and control strategies.Building clinics, hospitals, and medical research facilities in partner countries has notably expanded access to high-quality healthcare, potentially improving critical health metrics including life expectancy and maternal and child health (Pramudia, P. S. 2022).

Encouragement of Health Collaboration
By putting in place measures to increase capacity, encouraging information exchange, and investing in healthcare infrastructure, the (HSR) has made a substantial contribution to the improvement of the medical systems of the participating countries.The efficacy, resilience, and accessibility of healthcare services in partner countries have been effectively increased by the (HSR) through the upgrading of healthcare facilities, training of healthcare staff, and promotion of the use of cutting-edge healthcare technology.For example, the (HSR) has actively supported the development and modernization of healthcare facilities, given local healthcare workers training and technical assistance, and facilitated the implementation of e-health and telemedicine solutions to ensure improved access to healthcare services in remote and underserved areas (Sun, Y., & Yu, B. 2023).

Leading Global Health
HSR, or the Health Silk Road, has been instrumental in improving cooperation among China and participating nations in a number of fields, including research in medicine and public health policies, illness prevention and control, and the advancement of medical technology.Through collaborative efforts, technical support, and information sharing, Health and Safety Research (HSR) has successfully allowed nations to tackle shared health issues, advance optimal practices, and gain insights from the observations of one another.The Health Silk Road HSR's promotion of collaboration in joint medical research initiatives, infectious disease surveillance and response, and the advancement and dissemination of medical care technology are prime examples of this.The worldwide effort to address pressing health challenges, including non-communicable illnesses, antibiotic resistance, and infectious diseases, has greatly benefited from these initiatives.China's proactive and responsible leadership in the field of global health is solidified by the HSR, which demonstrates China's commitment to international health cooperation and the expansion of global health policies and practices.Through financial support to multilateral health organizations, technical assistance and aid for building partner countries' capacities, and active participation in global health forums and initiatives, China has successfully increased its influence and leadership in global health governance.China's greater engagement in global health has allowed it to influence health policy, advance its development model, and bolster its soft power internationally (Sun, Y., & Yu, B. 2023).

Diplomacy with a Debt Trap
Health Security Review (HSR)-related investments in healthcare infrastructure typically depend on loans from international finance sources, banks for worldwide growth and development, or Chinese policy banks.Concerns have been raised by this funding strategy about the participating nations' ability to continue repaying their debt, particularly those with heavy debt loads or restricted repayment capacities.Unsustainable debt levels have the potential to undermine the HSR projects' future benefits by causing partner nations to experience budgetary limitations, economic instability, and a reduction in their capacity to implement policies.Thus, to guarantee the financial sustainability of this endeavor, investors must properly evaluate and control the debt risks associated with HSR expenditures.China's financing of the development of the Hambantota port in Sri Lanka serves as a prominent illustration of the ramifications of debt issues.As a result, Sri Lanka had serious financial problems and was forced to give a 99-year port lease to a state-owned Chinese corporation.This example serves as a reminder of the possible concerns related to debt sustainability for large-scale infrastructure projects financed by China, even if they are not directly related to HSR (Jiang, M. 2022).

Problems With Governance and A Lack of Transparency
Concerns exist about the reliability, robustness, and security of the services and infrastructure made available by the HSR.Strict respect for norms in maintenance, construction, and management is necessary to guarantee that the investments provide long-lasting improvements in healthcare systems.The safety, efficacy, and sustainability of HSR projects can be compromised by issues like poor construction, inadequate maintenance, or inadequate education among healthcare personnel.This limits the projects' possible effects on the general public's health.To tackle various issues, a strong guarantee of quality systems must be put in place, and HSR projects must be continuously monitored and assessed.For example, not long after it was built, a Chinesebuilt hospital in Angola experienced structural problems such as wall fissures.This incident casts doubt on the caliber of infrastructure built as part of initiatives supported by China, including the HSR.To guarantee the extended-term influence of HSR public health projects, it is essential to provide good building standards, appropriate maintenance, and sufficient training for healthcare staff.

Security Issues and Geopolitical Repercussions
The HSR has come under fire for its lack of openness in the financing, implementation, and choice of projects.This ambiguity can lead to mismanagement, corruption, and detrimental effects on the environment and society.To optimize the possible advantages and reduce the possible dangers of HSR initiatives, it is imperative to maintain excellent governance and transparency.Trust may be established within China and its ally nations, in addition to among other parties involved in participating in the field of global health efforts, by enhancing openness and accountability in the HSR.For instance, China sent Zimbabwe a sizable donation of Sinopharm COVID-19 vaccinations at the beginning of 2021.Although the gifts were viewed as a good first step in the fight against the epidemic, questions were expressed regarding the purchase terms, price, and selection procedure.Critics contend that rather than focusing on the most pressing public health issues, China's vaccine diplomacy lacks openness and can be motivated through governmental considerations.Some claim China deliberately targets nations with political or economic interests, such as those with natural resource wealth or those participating in the Belt and Road Initiative.Vaccine contributions have helped combat the epidemic, but their actual objectives remain unclear due to the opaqueness of the governmental and possible political reasons driving China's diplomacy on vaccines.This takes us to the most significant part of the HSR (Yetiv, S. A., & Lu, C. 2007)

Motives for China's Health Silk Road
The Health Silk Road (HSR) is a significant initiative by China that aims to boost its pharmaceutical, medical equipment, and medical industry sectors to promote the country's economy.China plans to invest in the medical field services furthermore infrastructure is taking part nations in order to increase its export markets and establish itself as a significant provider of medical supplies and services.HSR initiatives may also lead to contracts for Chinese building firms and job openings abroad for Chinese laborers (Chaziza, M. 2020).
China uses the HSR as a tool to improve bilateral and diplomatic relations with participating countries, building goodwill and long-term ties with these nations by offering medical aid, technical help, and infrastructure development for healthcare.These improved ties may lead to more political backing for China in international affairs and make cooperation on other key projects easier.As a consequence of its efforts to provide medical assistance and support during the COVID-19 pandemic, including donations of masks, ventilators, and testing kits, China has further enhanced its diplomatic ties with a number of countries.
China's timely aid to Italy during the COVID-19 issue is indicative of its dedication to world health and long-term growth.China responds to criticism about its labor and environmental policies while demonstrating its creativity and experience in healthcare technology by offering assistance and support.China's engagement in tackling worldwide issues, including the 2014 Ebola outbreak in West Africa, enhances its standing as a responsible power and enhances its reputation internationally.China finances its neighbor's infrastructure and healthcare in an effort to promote security and stability in the area.A healthier population not only encourages social and economic progress but also reduces the likelihood of migration, disagreement, and other problems that might endanger stability in the region.(Lewis, B. 2002).
The HSR, which aims to promote disease surveillance, prevention, and control in member states, is designed to strengthen China's health security.The Health Silk Road (HSR) plays a crucial role in lowering the risk of cross-border disease transmission and strengthening regional and international response capabilities to public health emergencies, particularly given the growing threat of infectious diseases and the interconnectedness of global health.Cooperation in disease surveillance, control, and prevention has been facilitated by the HSR.As an illustration, China and the Association of Southeast Asian Nations (ASEAN) are collaborating to establish a regional framework for the coordination of public health emergencies (Van der Putten, F. P. 2016).
China's HSR policies are greatly influenced by international organizations like the UNSC, or United Nations Security Council and the Group of Twenty (G20).Because of their impact on international norms and global governance, these institutions have the ability to directly or indirectly affect the strategy and execution of the Human Security Review.China frequently uses the G20 as a platform to promote its health-related reforms (HSR) and other global health initiatives, hoping to win support and cooperation from other participating nations.However, if other members express concerns about matters like debt sustainability, openness, or other international concerns pertaining to the HSR, the Group of 20 (G20) may also provide China with policy obstacles.
The UNSC has the potential to influence China's HSR policies as well, because China frequently uses this forum to win over other countries to its causes, such as the HSR.However, the UNSC may also bring up potential security implications of the HSR, such as the geopolitical fallout from China's growing influence on global health or potential security risks associated with health infrastructure projects in high-risk areas.China therefore needs to exercise caution while navigating diplomatic and policy obstacles when carrying out the HSR, even though the G20 and UNSC may present China with an opportunity to advance the plan (Bertelsen, R. G. 2014).

Finding and Discussion
A number of noteworthy challenges are present in China's continuous expansion of the (HSR), which may compromise the initiative's efficacy and long-term viability.To assess the possible course and overall impact of the HSR, it is important to understand these obstacles.The distribution and administration of resources provide a significant challenge, with money being a primary issue.Given the economic downturn brought on by the COVID-19 epidemic, China's financial resources may be put under stress by the significant investment needed for the HSR.(Sun, Y., & Yu, B. 2023).Furthermore, it can be difficult and complex to manage these assets in a way that guarantees their transparent and effective use.It is true that (HSR)-specific initiatives require a substantial financial commitment, even though comprehensive cost data is not easily available.Effectively overseeing such vast resources is extremely difficult, especially when it comes to ensuring that money is allocated to the most impactful programmes and that it is protected against corruption or inefficiency.Another challenge facing the (HSR) projects is a lack of openness, which was previously noted as having unfavorable implications (Bliss, K. E. 2013).
The absence of transparency in the selection, financing, and execution of projects has led to criticism of the initiative.The initiative's legitimacy and efficacy may be weakened as a result of participating nations' and foreign observers' uncertainties and fears raised by this lack of openness.Concerns exist over the process of choosing and approving health initiatives in connection with the (HSR).For example, it has been stated that certain projects were selected not just on the basis of health requirements but also on their ability to further China's strategic goals.
One of the biggest challenges is overcoming the countries' political and economic instability.The majority of the countries along the (HSR) route are still in the process of developing, with weak economies and unpredictable political environments.These elements may provide serious hazards to HSR projects' long-term sustainability and effective execution.For instance, the violence that broke out in Sudan on a regular basis severely affected projects that China supported, forcing the Chinese government to provide security for hundreds of its residents.Similarly, Pakistan's continued political unrest and economic difficulties, a major HSR partner, may negatively impact the execution and viability of health initiatives there.(Anwar, M. A., Madni, G. R., & Yasin, I. 2021).

Conclusion
Within the framework of the Health Silk Road (HSR) and the Belt and Road Initiative (BRI) of China, there is a critical intersection of geopolitical influence, economic strategy, and health diplomacy.The launch of this effort by President Xi Jinping in 2016 and the establishment of cooperative relationships with the World Health Organization (WHO) highlighted China's desire to become a major participant in the global healthcare arena.China's Health Silk Road, an integral component of the Initiative for the Belt and Road, represents a strategic shift in global influence through Middle Eastern medical diplomacy.This initiative demonstrates China's geopolitical objectives in the region by aiming to enhance collaboration and the infrastructure of healthcare.China hopes to expand its influence, affect international relations, and maybe change the geopolitical dynamics of the Middle East by combining healthcare support with diplomatic objectives.In addition to enhancing healthcare, the Health Silk Road is a flexible tool that represents China's broader goals of using soft power and forging closer ties with Middle Eastern countries.This study emphasizes the HSR's many facets and complexity, as well as how it has the potential to revolutionize global health governance and international relations.The study provides a thorough analysis of the collaboration between Pakistan and China inside the China-Pakistan Economic Corridor (CPEC), highlighting both the benefits to healthcare infrastructure and the issues of sustainability of debt, transparency, and geopolitical effects.China hopes to expand its influence, affect international relations, and maybe change the geopolitical dynamics of the Middle East by combining healthcare support with diplomatic objectives.In addition to enhancing healthcare, the Health Silk Road is a flexible tool that represents China's broader goals of using soft power and forging closer ties with Middle Eastern countries.This study emphasizes the HSR's many facets and complexity, as well as how it has the potential to revolutionize global health governance and international relations.The study provides a thorough analysis of the partnership between China and Pakistan in the China-Pakistan Economic Corridor (CPEC), highlighting both the benefits to healthcare infrastructure and the issues of regional influence, sustainability of debt, and transparency.