China's COVID-19 aid in Africa: trends and implications for future pandemic preparedness.

Background: Chronic underfunding of pandemic preparedness remains a critical weakness in global health security. Without sustained, strategic investment, the world risks repeating the reactive approaches of past crises. This study examines the modes of COVID-19 aid delivered by the Chinese government across African countries and regions, offering a nuanced understanding of China's operational role in pandemic response. In doing so, it contributes to the global health assistance literature by providing a more comprehensive view of China's involvement in the prevention, treatment, and control of COVID-19.

Results: Analysis of 727 Chinese health-related project commitments to African countries indicates that the majority targeted the provision of personal protective equipment (43.33%), followed by diagnostic and medical equipment (26%), and vaccination initiatives (17.88%). Regionally, Southern Africa received the highest average number of projects per country, while Northern Africa received the lowest. At the national level, South Africa (5.09%), Zimbabwe (4.00%), and Cameroon (3.85%) accounted for the largest shares of total projects, whereas Eritrea (0.001%), Cabo Verde (0.004%), and Somalia (0.004%) received the smallest proportions.

Conclusions: This research reveals the growing significance of Chinese aid in the global health agenda through its active role in combating COVID-19 across the African continent. It also highlights emerging trends and suggests potential adjustments needed in pandemic financing strategies for more effective future efforts.