China-EU-Africa trilateral cooperation for health governance: Mapping out of the mechanisms and challenges

In the current period in which the world lives, facing geopolitical tensions and a global economic recession as a result of the direct and indirect consequences of the COVID-19 pandemic, the value of international cooperation-namely in health sphere-proves to be indispensable. However, even if this need is identified by various actors on the international scene, there are several variables to be taken into account when implementing this cooperation effectively-particularly political ones. In fact, the "war of narratives" (Verma in Asia Europe Journal 18:205-209, 2020) that exacerbates potential systemic rivalries between the EU and China is a current reality, the weight of political decisions resulting from the management of the pandemic, the effects of the Belt and Road Initiative in the world and particularly in African continent, are just some of the constraints on the potential trilateral cooperative framework (Stahl in An EU trilateral cooperation agenda with africa and china for a post-COVID-19 world, Hertie School, Jacques Delors Centre, 2021). This chapter aims to contribute to a better understanding of China-EU-Africa relations with regard to the health sector, in order to achieve a cooperative model of sustainable development, in which everyone benefits, toward a "future of shared destiny for mankind". The qualitative analysis methodology will be grounded on a mapping of mechanisms adopted by the (i) China-EU, (ii) China-Africa and (iii) EU-Africa binomials in terms of health cooperation in a period of analysis from 2000 to current days, complemented by a review of the main white papers that define the strategic health policy guidelines of the three regions, namely: the Health Silk Road (China), Team Europe (EU) and Agenda 2063 (Africa). The aim is to answer the following questions: (i) Is it possible to establish a trilateral agenda with win-win benefits, without colliding with the internal strategic objectives of each of the parties involved? (ii) What mechanisms are used and what challenges need to be overcome in order to achieve quality health systems as well as a harmonious and sustainable development on a global scale? Despite academic literature on bilateral agreements being abundant, there are still scarce and spared studies focusing on trilateral arrangements; therefore we aim to shed light on this topic going further in mapping and analyzing such trilateral cooperation mechanisms in the case of health-related issues.