Background: Access to long-lasting insecticidal nets (LLINs) remains a critical challenge in malaria-endemic regions of Africa. China, home to a growing number of WHO-prequalified LLIN manufacturers, has become a key supplier within international procurement systems, while also promoting South-South cooperation (SSC) in health. This study investigates China’s dual role in LLIN provision: (I) its function as a global manufacturing hub; and (II) how World Health Organization (WHO)-prequalified Chinese LLIN manufacturers contribute to equitable access to LLINs in Africa through SSC.
Methods: The study draws on semi-structured interviews with respondents from international procurement and financing organizations, China’s LLIN manufacturing sector, African national malaria control programmes, and implementing and development partner organizations. Interview data were thematically analyzed using a qualitative research approach and triangulated with secondary sources.
Results: The findings indicate that China supplies a substantial share of global LLINs through vertically integrated and cost-efficient production systems, supported by a large skilled labor force, strong upstream material integration, and stable supply chains. Beyond large-scale manufacturing, Chinese manufacturers also support local LLIN production in East Africa through technical assistance and capacity-building, thereby strengthening the regional resilience of LLIN supply chains.
Conclusions: This study contributes to the literature on the global supply of medical goods and SSC by illustrating how an emerging economy—China—has evolved from a manufacturing base into a development partner in global health. These practices expand access to preventive technologies and help clarify the operational dimensions of SSC in practice. The findings suggest that emerging economies can shape more equitable global health systems not only as suppliers, but also as contributors to South-South learning and knowledge exchange, advancing universal access to LLINs and broader progress toward universal health coverage (UHC).
