Similar to the Belt and Road Initiative (BRI), the Health Silk Road (HSR) is not precisely defined and is covering a wide scope of activities. COVID-19 highlights the need for public health infrastructure for many countries, especially developing countries. The HSR provides the policy frame for China to strengthen and reform its foreign medical aid system, increase its influence in regional and global health governance, direct BRI investment to basic public health investment, enlarge China’s role in the supplies of medical products and services and to improve its image. Southeast Asia will be an important region where China promotes the HSR.