China’s first batch of emergency humanitarian aid to Myanmar is loaded onto an airplane in Beijing in March, 2025. In response to a request from the Myanmar government, China gave emergency humanitarian aid to support earthquake relief efforts.
Chen Yehua/Xinhua via Getty Images
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Chen Yehua/Xinhua via Getty Images
Foreign aid has long been a way for the United States and China to gain soft power and influence—providing public services in low-income countries that help them tackle poverty and disease, and engaging with people to build cooperation over the long run.
For decades, the two countries had adopted separate international aid strategies. But the Trump administration has dismantled much of the United States’ traditional foreign aid systems and is charting a new path, while China has also been adjusting its approach—stepping up visible contributions to global institutions while scaling back some of the large infrastructure projects that once defined its strategy.
The result is a moment of convergence and competition: the U.S. is moving toward a more transactional model long associated with Beijing, and China is positioning itself to become a bigger presence in global health and development.
The three phases of Chinese aid
China’s post-World War II foreign aid strategy goes back to the 1950s when it supported the emerging communist states North Korea and Vietnam. In those days, China itself was receiving aid from the Soviet Union, says Carrie Dolan, an expert on Chinese health aid at the College of William and Mary.
“Phase one was this anti-imperialism solidarity,” Dolan says. Then, in the 1990s, China shifted.
“Phase two, we saw aid supporting Chinese development,” says Dolan. China framed its foreign aid as mutually beneficial with countries in the global south, promoting economic cooperation and increasing trade.
In the 2010s, with Xi Jinping’s rise to power, China sought global leadership and competition with the U.S., says Dolan.
“And then phase three, we’re really seeing them transition to this soft power, great power competition.”
The way China has given out aid in this third phase has largely been through bilateral agreements like the Belt and Road Initiative, according to Yanzhong Huang, a global health expert with the Council on Foreign Relations. That means government-to-government deals, often with large loans from China.
“[The initiative] was more focused on large scale infrastructure like ports, railways, power plants, financed primarily through the bilateral loans to build physical connectivity and secure economic returns for China,” Huang says.
Until recently, China’s methods stood in contrast with the U.S. on various levels, according to Samuel Brazys, professor of international development at University College Dublin.
China preferred working directly with governments, while the U.S. had traditionally worked through international organizations and NGOs. The U.S. emphasized democracy, governance, and human rights, while China focused on infrastructure projects and economic development.
The U.S. has invested billions of dollars in funding aid groups and international organizations like the United Nations to address issues such as poverty and disease. This approach focused on long-term solutions and came with conditions for recipient governments to improve human rights, democracy, and reduce corruption. In contrast, China’s foreign aid was criticized for not always considering local needs or maintaining the longevity of its projects. China is now shifting towards smaller projects in low-income countries and increasing involvement with the United Nations, following a similar model to the U.S. In response to China’s increasing influence, the U.S. has implemented a new America First Global Health Strategy that focuses on bilateral agreements with low-income countries. The administration’s goal is to increase access to resources such as minerals in Africa and provide opportunities for American businesses. Huang suggests that the U.S. is following China’s previous model, while China is moving away from it. Huang and Dolan warn that commercializing aid could lead to similar issues that China faced. Dolan emphasizes the importance of focusing on actual health outcomes rather than over-commercializing, as prioritizing commerce may compromise health outcomes.
