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Background  China launched the Belt and Road Initiative (BRI) aiming to develop a mutually-beneficial, sustainable trade model with partner countries. The processes of international health exchanges are key parts of how this model can be sustained into the future. This paper aims to contribute to broader understanding by exploring various intentions, needs, advantages and barriers of BRI countries and then define ways China can achieve better health cooperation.    Methods  In this study, a survey questionnaire was developed to investigate the perspectives of 60 international experts from 29 BRI countries. The survey was distributed and collected during the “Belt and Road High-level Meeting for Health Cooperation”, held in Beijing in August 2017. The data were entered into EpiData 3.0 by two team members respectively and analyzed with SPSS22.0.    Results  Altogether 58 valid questionnaires were obtained. More than 93% of participants showed their willingness to be part of BRI health cooperation. Frist, three key areas were identified, which are broadly defined as BRI country “needs”: (1) “Develop health industries”; (2) “Prevent and control infectious diseases”; and (3) “Provide health services”. Second, three “advantages” of participating in BRI Health Cooperation were found: (1) “The establishment of a long-term partnership”; (2) “Quality investment and financing system”; and (3) “The convenience of cooperation”. Third, two main cross-cultural “barriers” for cooperation were encountered: (1) “Cultural differences”; and (2) “Lack of communication platforms”.    Conclusion  In this study, we have identified priority fields that China can collaborate with BRI countries and show its leadership. It is suggested that successful health cooperation between China and other BRI countries should focus on maximizing present health-industry partnerships, investment and financing, as well as overcoming cultural and communication barriers.

The intentions, needs, advantages and barriers: a survey of twenty-nine countries participating in the “Belt and Road Initiative” health cooperation