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February 13, 2013

Chinese donations: Tale of frustration that lies behind health aid to Africa

In the best-equipped laboratory in Amana hospital, one of the largest in Tanzania, Focus Mbawala still diagnoses malaria with a simple microscope, despite the cutting-edge equipment that surrounds him.

A donated computer, freezer and a PCR (polymerase chain reaction) machine for amplifying DNA all remain untouched since the Chinese-funded malaria centre opened in November 2010.

“We were given very little instruction on how to operate them,” says Mr Mbawala, who runs the malaria centre in the hospital in the Ilala district of Dar es Salaam. In 2009, he was given a five-day crash course led by doctors from China, but it was hardly useful as their English was very limited.

Picking up a pack of disposable medical gloves, he says: “I cannot read the Chinese written on the package, I even feel a bit afraid of them.”

Nearby, 10,000 treatments of donated Arco Chinese malaria medicines have been sitting in a corner and collecting dust for almost two years. Still sealed, they are within a few months of their expiry date.

Meshack Shimela, the hospital’s chief medical officer, says: “Arco was introduced to Tanzania quite recently. It is effective, but no tests have been made to prove it is safe to use on young children.” The centre only treats patients aged under five.

Since 2007, China has set up 30 malaria centres across Africa, with facilities and medicines donated by Chinese companies through a government scheme, each estimated to have cost about $500,000.

Yanzhong Huang, director of the Centre for Global Health Studies at Seton Hall University in the US, says China’s health aid focuses on rebranding the Chinese healthcare service and promoting the export of Chinese medical products.

“In the words of a ministry of health official, China’s health aid should ‘not only serve China’s foreign policy, but also act as a broker for economic development in China and recipient countries’,” he says.

Chinese drug companies that participated in state schemes are also frustrated. “Supplying to the government donation scheme is never commercially incentivised,” says Zhou Yong, general manager at Holley Tanzania.

Holley-Cotec, its parent company, contributes a third of China’s overseas malaria drug donations.

Mr Zhou says purchases by the government are all but compulsory, and the orders are usually placed at a price that only just covers costs. “We normally make the donation to gain better brand recognition overseas.”

While donated Chinese drugs are left untouched in Tanzania, doctors instead prescribe Coartem, sold by Novartis.

“Coartem was discovered by Chinese scientists,” says Claude Faruant, a consultant to Holley-Cotec who says promotion abroad has become a political project of the state. “They lacked the ability to exploit its commercial value overseas, so sold it to Novartis in 1994.”

He adds: “The Chinese are now eager to demonstrate their research and innovation capacity in the pharmaceutical sector and the field of malaria drugs is where they are most likely to achieve a breakthrough.”

Africa is the single biggest market for world’s malaria drug makers. But, having arrived late in Africa, Chinese malaria drug businesses have so far struggled to catch up.

Hamisi Malebo, research scientist at the National Institute of Medical Research in Tanzania, says: “Western companies have invested a lot in clinical trials in Africa, and we lack the data from the Chinese companies to compare their products.”

The greatest barrier for two of the biggest Chinese producers, Holley-Cotec and Kunming, which produces Arcom, is that they cannot supply to the public sector in Africa. International donors strictly limit procurement to products that have passed international standards, including pre-qualification by the World Health Organisation.

Beibei Yin participated in the 2011 Wits China-Africa Reporting Project

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