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www.jogh.org • doi: 10.7189/jogh.09.010312 1 June 2019 • Vol. 9 No. 1 • 010312 China, the emerging economic giant in the world, is now playing an active role in the arena of global health. It is active in bilateral collaboration, South-South collaboration and the Belt Road Initiative, and has dispatched medical teams, built infrastructure and provided assistance with health technology overseas. Despite its bilateral health initiatives, China has invested little in established multilateralism mechanisms. Although several university global health institutes have been established, China’s participation on the global health stage, such as at the World Health Assembly, has been limited. Global health leaders require capabilities beyond financial resources, and human resources inevitably play a critical role. Limited global health professional capacity in China is a challenge. Alongside global health strengthening, in-country health systems development is also essential. China, a country of 1.4 billion people, has invested in universal coverage and health security with some challenges still remaining; however, success would be a valuable lesson to the world of global health. Gigantic China with successful universal health coverage could shift the existing global paradigm. While challenges need to be overcome, with collective effort and strong political commitment China is positioned if it wishes to become the next leader in global health. China’s impact will hugely benefit not only the Chinese people but all peoples around the world.