Over the years, thanks to the nurturing of generations of leaders, and people from all sectors of both countries, Pakistan-China friendship has flourished and witnessed sound and steady growth. No matter how the circumstances have been in the two countries, how the dynamics of the region and the world changed, Pakistan and China have always respected, understood and supported each other on issues concerning their respective core interests.
Pakistan acted positively as China’s backdoor channel during its years of diplomatic isolation. Pakistan became the bridge between Richard Nixon and Mao Zedong, and frontline in Beijing’s strategic struggles with the Soviet Union during the late stages of the Cold War. From China’s prism, it always sees a strong and capable Pakistan as an asset to China in its own right. In this context, in May 2026, Pakistan and China celebrated 75 years of successful diplomatic relations.
As China and Pakistan commemorate the 75th anniversary of diplomatic relations in 2026, the occasion also coincides with a decade of the Health Silk Road initiative, offering an opportunity to reflect on the evolving dimensions of bilateral cooperation. Hence, this op-ed series covers the evolving health sector transformation in Pakistan under Health Silk Road initiative which is an important component of China’s Belt & Road Initiative (BRI).
Notable healthcare projects include the Port Authority Hospital in Gwadar, the Medical Centre at the China-Pakistan Gwadar Fajr Colony Secondary School and Vocational Training Centre, refurbished Lady Reading Hospital in Peshawar, and the China-Pakistan Joint Laboratory for Infectious Disease Control and Prevention at the National Institute of Health in Islamabad
On June 22nd, 2016, President Xi Jinping formally introduced the HSR concept during a trip to Uzbekistan and later in January 2017, Beijing entered into a memorandum of understanding with the World Health Organization (WHO) in Geneva, pledging to back the HSR initiative and enhance health outcomes in BRI nations. Exactly after a decade in 2026, HSR, on its tenth anniversary, has emerged as a significant component of China’s efforts to strengthen global health governance and promote more equitable access to health resources, advance capacity building, and reduce disparities among participating countries, particularly those in the Global South and South Asian and East Asian Nations, where health system diversity and persistent gaps make these countries both key beneficiaries and important testing grounds for HSR cooperation.
HSR has evolved in three systemic phases these are (a) Institutional Inception and Policy Embedding Stage; (b) Mechanism Development & Project Implementation; and (c) Institutional Deepening and Regional Health Governance Expansion.
During first phase from 2016 to 2018, China assumed an increasingly significant role in global health, as cooperation between the World Health Organization (WHO) and the Chinese government was formalized in January 2017 after the proposition of ‘Health Silk Road’ concept in 2016.
Second phase from 2019 to 2021, of Mechanism Development and Project Implementation, marked a pivotal transition for the Health Silk Road initiative within CPEC framework. This phase was characterized by the institutional establishment of cooperative mechanisms and the concrete execution of health projects, signifying a turning point in Sino-Pak health cooperation from conceptual promotion to systematic implementation. Against the backdrop of the global COVID-19 pandemic, the pace of Sino-Pak health cooperation accelerated markedly.
Through the signing of multiple MoUs covering infectious disease prevention and control, laboratory capacity building, public health governance, and medical training, the two sides formalized and institutionalized their policy communication channels. Concurrently, the implementation focus shifted from macro-strategy to concrete actions. These encompass medical supplies assistance, vaccine collaboration, hospital construction, medical team deployments, and public health training programs, reflecting a tangible transition from policy advocacy to project execution. Overall, the period from 2019 to 2021 can be regarded as a dual-track advancement phase for the HSR within the China-Pakistan framework.
During third Phase (2022-2025) of Institutional Deepening and Regional Health Governance Expansion, the Chinese Centre for Disease Control and Prevention and the Pakistan Branch of the National Institutes of Health signed a memorandum of understanding) in February, 2021. This partnership primarily focuses on infectious disease prevention & control, laboratory quality & biosafety, and training in molecular diagnostic technologies. This collaboration helps reduce the risk of cross-border disease transmission, enhances regional capacity to respond to public health emergencies, and ultimately benefits China’s own health security.
On January 1, 2022, the Regional Comprehensive Economic Partnership Agreement formally came into effect, further advancing the new development paradigm where the domestic and international dual circulation mutually reinforce each other. Against this backdrop, healthcare has emerged as a significant area of cooperation, focusing on various aspects including the construction of hospitals and medical facilities, capacity-building initiatives. Notable healthcare projects include the Port Authority Hospital in Gwadar, the Medical Centre at the China-Pakistan Gwadar Fajr Colony Secondary School and Vocational Training Centre, refurbished Lady Reading Hospital in Peshawar, and the China-Pakistan Joint Laboratory for Infectious Disease Control and Prevention at the National Institute of Health in Islamabad (To be concluded).
The writer works at a public policy think tank and can be reached at [email protected].