As US presence wanes, China works to increase its influence through foreign aid : NPR
When the United States withdrew its foreign aid last year, fears arose that China would rush to take America’s place. But China’s approach could mean a different role for it in global health.
LEILA FADEL, HOST:
The Trump administration has cut foreign aid by billions of dollars. NPR’s Fatma Tanis explains how China is trying to fill this void.
FATMA TANIS, BYLINE: The United States and China view foreign aid as a way to gain soft power influence. This means providing public services in low-income countries and engaging people-to-people relationships that can strengthen long-term cooperation. For a long time, China and the United States have operated on separate tracks with distinct goals when it comes to international aid. China considered itself a developing country and focused on sending Chinese teams to countries to build infrastructure that would also boost its own economy.
The United States was a world leader in health care and spent billions around the world to fight poverty and disease. But after the COVID-19 pandemic, China changed its strategy, says Carrie Dolan, who studies Chinese health policy at William & Mary.
CARRIE DOLAN: We’ve seen China’s approach really evolve into this soft power, this great power competition. We have found that the quantity and variety of aid has increased further during the coronavirus pandemic.
TANIS: China has stepped up what it calls small and beautiful projects to fight hunger and poverty. In recent years, it has renovated a maternity ward in Zimbabwe and sent medical equipment to Panama. Still, China couldn’t really compete with the United States for global health leadership, says Bryan Burgess, who tracks China’s aid spending at William & Mary.
BRYAN BURGESS: They’re taking short-term steps to win hearts and minds. But they are not investing in the kind of infrastructure and sustainability that major diseases need to be eradicated.
TANIS: Since the Trump administration’s overhaul of U.S. foreign aid, things look a little different, says Jennifer Bouey of Georgetown University.
JENNIFER BOUEY: China is now saying: OK, now the United States is withdrawing from the UN, withdrawing from the WHO. And this is the time for China to strengthen its global influence, dominate international organizations, and at the same time have a platform to expand its economic footprint.
TANIS: In February 2025, as the Trump administration was dismantling USAID, China’s humanitarian agency said it would carry out more small, beautiful projects. In April, when a major earthquake struck Myanmar, China pledged $137 million in aid, compared to about $9 million from the United States. In May, China announced a $500 million donation to the World Health Organization, in addition to its annual membership fee. Nadège Rolland works at the National Bureau of Asian Research. She says these measures have allowed China to present itself as the adult in the room.
NADEGE ROLLAND: You show the face of a power that is benevolent and responsible for humanity, basically, which fits very well with Xi Jinping’s vision of a world order that places China at the center.
TANIS: Although its strategy may be changing, overall China has still spent about the same amount on foreign aid as in previous years. Rolland says China won’t rush to fill void left by US
ROLLAND: I don’t think he’s quite ready to take on this role as a global health provider. And it’s probably because of the stones. It’s a Chinese expression that says we’re moving very carefully in this direction.
TANIS: One thing that is clear, Rolland says, is that China will try to increase its influence through foreign aid as the U.S. presence appears to be diminishing.
Fatma Tanis, NPR News.
(SOUNDBITE OF DEREK SHEARER’S “MY FAVORITE MEMORY OF YOU”)
Copyright © 2026 NPR. All rights reserved. Visit the terms of use and permissions pages on our website at www.npr.org for more information.
The accuracy and availability of NPR transcripts may vary. The text of the transcript may be edited to correct errors or match updates to the audio. Audio on npr.org may be edited after its original broadcast or publication. The authoritative record of NPR’s programming is the audio recording.
