From HIV-AIDS to COVID-19: International institutions and China’s approach to pandemic outbreaks

Over the past two decades, several factors have amplified the risk for epidemic diseases to spread beyond national and regional borders. With regards to pandemic outbreaks, specific concerns have been raised over Southeast Asia, interalia for its environmental and social/demographic specificities and the traditional averseness of its countries to accept global and formal instruments of international governance. Under this perspective, with its exceptional standing (size, population, economic growth) and a clear inclination for regional leadership, the People’s Republic of China is bound to critically effect the overall performance of the international health security regime at local, regional and, consequently, global levels. The present study precisely wants to explore China’s participation to the evolving health security regime. With this purpose, the study takes into consideration elements of embeddedness and compliance with the main institutions which compose the regime and looks for regime’s potential contribution to infectious diseases’ policy change in China (including through process tracing and comparative case studies of relevant health emergencies from HIV-AIDS onwards). A second objective is the one of screening those international political factors that may have informed China’s more cooperative attitude, building on International Relations theories and global health assessments. Beyond material power interests and functionalist accounts, a specific attention will be devoted to the socialization argument (Johnston, 2008) in order to investigate if socialization (for example with the WHO) did take place in the case under investigation and, if it did, which stage the process has reached (mimicking, social influence or persuasion). Finally, the study aims at understanding whether the Chinese renewed approach to health crisis, from secrecy and obstructionism (documented in the case of HIV and SARS) to international “constructive engagement” (registered in the case of Avian Influenza, 2013) endured throughout the recent COVID-19 response.