Effective global or regional health governance lies in creatively integrating global knowledge with local experience. Photo: TUCHONG

Western developed countries, leveraging their advantages in scientific research, have long dominated agenda-setting in global health and the formulation of health governance norms, often giving insufficient weight to the concrete needs and local experience of developing countries. Western scholarship has similarly paid limited attention to the agency of countries in the Global South and to non-Western practices. Against this backdrop, China and Southeast Asian countries have developed regionally specific pathways of health governance through distinctive forms of local knowledge production and indigenous knowledge systems, contributing to a reconfiguration of the knowledge structure of global health governance.

Knowledge dilemmas, paradigmatic breakthroughs in Southeast Asian health governance

Within the global health governance knowledge structure, knowledge production and dissemination have long been shaped by Western developed countries, while research institutions in the Global South have often been confined to the roles of “data providers” and “knowledge consumers.” This unequal structure has produced a dilemma of “exogenous knowledge production” in Southeast Asian health governance research. Although Southeast Asia faces frequent health security risks, including infectious diseases, and has accumulated extensive experience in disease prevention and control, such experience has proven difficult to translate into forms of “scientific knowledge” recognized by the international community, constraining the autonomous development of local research capacities.

Public health governance in Southeast Asia exhibits pronounced local characteristics. Governance capacity varies widely across countries and between urban and rural areas, while cross-border labor mobility and refugee flows further intensify infectious disease risks. The Lancang–Mekong River Basin is among the world’s most challenging regions in this regard. Health cooperation between China and Southeast Asia began here, initially as humanitarian assistance, then expanded into bilateral cross-border disease control, and eventually evolved into a regional, multi-country system of joint prevention and control. This has promoted the institutionalization of regional health cooperation while offering new perspectives for global health governance reform.

First, knowledge production within China–Southeast Asia health cooperation is oriented toward local practice, with knowledge generated through problem-solving and experience consolidation. Since the 1990s, humanitarian assistance teams led primarily by Chinese medical professionals have operated in Myanmar. Over time, this initially informal cooperation evolved into regularized malaria control programs along the China–Myanmar border, achieving comprehensive coverage. The resulting “point-to-point” cross-border malaria control model laid the groundwork for subsequent joint mechanisms for infectious disease prevention and control.

Second, China–Southeast Asia health cooperation emphasizes adapting to local conditions and systematizing indigenous experience. By foregrounding local knowledge and social relations, China and Southeast Asian countries have been able to coordinate and lead cooperation in areas that the global health governance system has struggled to reach. One example is the “1–3–7” malaria control strategy developed by Chinese health experts through informal border cooperation, later recognized by the World Health Organization. Training networks established in northern Myanmar have also helped alleviate shortages of medical personnel in remote areas.

Third, China–Southeast Asia health cooperation has generated a spiral model of local knowledge production characterized by the interaction of “practice–knowledge–institutions,” moving beyond the linear “theory–practice” model. Through the shift from bilateral to multilateral cross-border disease control, local knowledge has been continuously produced and shared, forming a multi-layered knowledge sharing system encompassing policy, academic, practical, and hybrid knowledge.

Within this system, policy knowledge provides strategic guidance; academic knowledge facilitates explicit knowledge transmission through training and exchanges; practical knowledge drives the circulation of tacit knowledge; and hybrid knowledge enables iterative development through ongoing interaction among practice, knowledge, and institutions. Over time, China and Southeast Asia have gradually formed a multi-level regional health cooperation governance system centered on the China–ASEAN cooperation framework, the Lancang–Mekong cooperation, and the Greater Mekong Subregion Economic Cooperation mechanism, involving health governance departments at different levels and diverse governance actors.

Toward knowledge symbiosis

China–Southeast Asia health cooperation demonstrates that there is no single, universally applicable model for global or regional health governance. Effective governance does not lie in mechanically replicating global standards, but in creatively integrating global knowledge with local experience. This requires reexamining unequal structures of knowledge production and recognizing the value of plural knowledge systems.

Contemporary global health knowledge production must remain attentive to local specificity and contextual conditions, rather than defaulting to uncritical replication of Western theories. At the same time, indigenous knowledge construction cannot proceed in isolation, but must seek points of convergence with international concerns and explore the broader relevance of particular practices. Deepening dialogue and exchange is therefore essential to enhancing the legitimacy of diverse knowledge systems within global health governance, reversing unequal divisions of labor in knowledge production, and moving toward a future of knowledge symbiosis.

Zhang Lei is an associate professor from the Institute of International Relations at Yunnan University.