Category: Commercial development

Advancing Frontiers: The Rise of Minimally Invasive Surgical Techniques

Advancing Frontiers: The Rise of Minimally Invasive Surgical Techniques

In the realm of medical science, the evolution from open surgical procedures to minimally invasive surgical techniques marks a significant stride towards better patient care and enhanced operational efficiency. This shift not only epitomizes the advancement of medical technology but also mirrors the relentless pursuit of reducing surgical invasiveness and the associated risks. The focus of this article is to unravel the various minimally invasive surgical techniques currently in use, the ongoing research aimed at honing these methods, and the global implications of such medical innovations.

Unveiling Modern Techniques

The scope of minimally invasive surgical techniques is continuously expanding, thanks to relentless innovations in medical technology. Here’s a glance at some of these modern techniques.

Laparoscopy

Known as keyhole surgery, laparoscopy is widely used in gastrointestinal, gynecological, and urological surgeries. Recent advancements include the integration of artificial intelligence (AI) and robotic assistance, enhancing surgical precision, but also Single-Incision Laparoscopic Surgery (SILS), Natural Orifice Transluminal Endoscopic Surgery (NOTES), and telementoring, which have shown promise in bettering surgical outcomes and patient recovery times. The global market for laparoscopy devices is projected to grow at a CAGR of 6.5% from 2020 to 2030, reflecting the escalating adoption of this technique.

Endoscopy

Utilizing an endoscope, this technique allows visualization of internal body cavities. Surgical polarimetric endoscopy, a recent advancement, has been employed for the detection of laryngeal cancer. The year 2023 saw the launch of Olympus’s EVIS X1™ endoscopy system, marking a substantial stride in endoscopic technology​. The convergence of artificial intelligence and robotics with endoscopy is a trend to watch, as these technologies are driving further advancements in this domain.

Robotic Surgery

Robotic surgery, once a futuristic idea, has become a reality with its application spanning across various surgical domains, including cardiothoracic, colorectal, urological (in particular with EDAP TMS’s FocalOne® robotic HIFU solution), general, gynecology, and head-and-neck surgery, driven by ongoing technological advances. The surgical robotics market, now exceeding $3 billion, is poised for significant growth, with an increased demand for Robotic-Assisted Surgery (RAS) across the globe.

Laser Surgery

Laser surgery employs beams of light to cut, remove, or cauterize tissue, and is hailed for its precision and minimal damage to surrounding tissues. Recent advancements in refractive surgery, such as the rise of Small Incision Lenticule Extraction (SMILE) and the introduction of technically competitive laser systems, mark a paradigm shift in surgical precision, efficacy, and patient outcomes​. Improvements in aesthetic laser devices, including longer dye lives and increased wavelength capacities, contribute to the enhanced precision and accuracy of laser treatment​.

These techniques, each with its unique advancements, contribute to better patient care, faster recovery times, and reduced healthcare costs, showcasing significant strides in the surgical domain.

The Spectrum of Benefits

Minimally invasive surgical techniques hold a plethora of benefits that significantly enhance both patient care and operational efficiency. Here are the key advantages underscored by recent data:

Reduced Recovery Time

Smaller incisions expedite healing, enabling patients to resume normal activities sooner, substantiated by reduced postoperative complications and shorter hospital stays.

Lesser Pain and Scarring

Patients experience less post-operative pain and minimal scarring, contributing to better cosmetic results and an improved recovery experience​.

Lower Risk of Infection

The minimized exposure of internal body structures to potential contaminants lowers the risk of post-surgical infections, aligning with improved postoperative pain control and shortened postoperative hospitalization​.

Cost-Efficiency

Quicker recovery times, lower infection risks, and shorter hospital stays contribute to lower healthcare costs, aligning with the medico-economic benefits associated with MIS​.

Trailblazing Research and Emerging Techniques

The voyage of minimally invasive surgical techniques into new horizons is steered by groundbreaking research. Here’s a glimpse into the contemporary research and emerging techniques that are pushing the boundaries.

Robotic Assistance

The symbiosis of robotics with minimally invasive surgery is escalating surgical precision and control to unprecedented levels. The advent of sophisticated robotic systems is enabling surgeons to perform complex procedures with enhanced accuracy and minimal invasiveness. Recent innovations like the reconfigured robotic arm design, faster docking to reduce operative time, and fluorescence-detection to identify structures and lesions are notable advancements in this domain. Moreover, robotic-assisted surgery has become a popular trend offering prospective benefits to patients like shorter hospital stays, earlier recovery, and less pain, along with operational benefits to surgeons.

Artificial Intelligence (AI)

AI is the torchbearer of predictive analytics and real-time decision support during surgical procedures. It is fostering a paradigm of data-driven surgery, where AI algorithms aid in enhancing surgical precision and optimizing patient outcomes. While not aimed at replacing surgeons but rather at making most use of their experience and knowledge, AI has the potential to revolutionize surgery, particularly in technical skill assessment and integration into surgical robots, which paves the way for improved preoperative planning and intraoperative guidance.

3D Visualization and Augmented Reality (AR)

3D visualization and AR are revolutionizing the way surgeons interact with medical imaging data. Technologies like the XR90 augmented reality-based surgical visualization and navigation platform combine CT imaging with live ultrasound to perform minimally invasive procedures with enhanced precision. AR technology superimposes artificial targets onto a live view of patient anatomy, offering a more intuitive understanding of anatomical structures and enhancing surgical planning and execution.

Telemedicine and Remote Surgery

The combination of telemedicine with minimally invasive surgical techniques is greatly enhancing the application range for remote surgery and consultations. Telementoring, a form of remote teaching in surgery that includes more and more 3D/AR visualization modes, enriches the training options for surgical trainees, while telemedicine addresses some barriers to surgical care, especially in low- and middle-income countries, by providing remote healthcare services.

Advanced Imaging Technologies

Cutting-edge imaging technologies are the linchpin of successful minimally invasive procedures, offering clearer and more detailed visualizations crucial for surgical success. The evolution of medical imaging systems has been rapid, with the integration of artificial intelligence, cloud-based solutions, and mobile technology revolutionizing medical imaging.

Bridging Surgical Frontiers

The significance of minimally invasive surgical techniques extends beyond the operating rooms of developed nations to developing countries where healthcare resources are often limited. Moreover, the global reverberations of advancements in minimally invasive surgery are palpable, with countries like China embracing and investing in these techniques to foster a robust healthcare ecosystem.

VVR medical, a conduit for European innovators in medical technology and diagnostics, facilitates a smooth entry and establishment in the Chinese market, accelerating China market entry through strategic diagnosis, qualification, and efficient commercialization of products and services. This symbiosis of surgical advancements and market access strategies elucidates a promising trajectory towards a global surgical landscape that is not only efficient and effective but also inclusive and progressive, steering the global healthcare community towards a horizon where surgical care is more accessible, less invasive, and profoundly impactful.

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How do you pay for your purchases when travelling in China? The guide, by VVR International

China leads the way in the use of electronic payments in Asia and worldwide

In China, the preferred method of payment has shifted from cash to mobile payment, to the detriment of credit cards. Indeed, China is now the world leader in the use of payment via mobile phone applications. Alipay and WeChat Pay are the main payment methods used by almost the entire Chinese population, whether urban or rural, and can be used to pay for fruit from a street vendor or to buy a plane ticket to Europe.

Electronic payment: essential for accessing certain applications and services

Cash payments are still accepted in theory, with the exception of orders and services linked to applications such as DIDI, a very widespread car-for-hire service in China, equivalent to Uber, or home catering services. These applications can only be paid for by electronic payment. You will therefore not be able to order a DIDI driver without first setting up an electronic payment solution. Note that DIDI can be used directly via Alipay and has an English interface, which is not the case for all applications. In fact, some applications such as Meituan and Ele.me, which sell takeaway food, are still only available in Chinese.

The decline in cash payments in all sectors of the Chinese economy

It should be noted, however, that the majority of vendors (taxi drivers, grocers, etc.) and businesses (restaurants and others, etc.) strongly prefer to be paid by Alipay and WeChat Pay rather than in cash.

In theory, international bankcards are accepted in shops, restaurants and hotels in major cities such as Shanghai, Beijing, Shenzhen and Guangzhou, but as terminals accepting international cards have been used very little or not at all over the last 3 years, this is no longer possible.

Electronic payment is now available to foreigners.

Historically, these 2 methods of payment were only available to holders of a bank card issued by a Chinese bank, which made travelling in China increasingly complex for non-resident foreigners.

To make your journey easier and ensure that you can make payments in all circumstances, it’s advisable to opt for one of the electronic payment options: WeChat Pay and Alipay.

Since August 2023, these methods have finally been accessible to foreigners who do not have a Chinese bank account! It is now possible to register for Alipay or WeChat Pay with :

  • a non-Chinese telephone number
  • foreign passport details
  • an international bank card

… Finally, create an Alipay and/or WeChat Pay account. Once you’ve done that, you can use these 2 applications for your everyday purchases.

The exchange rate applied to your transactions is set by the bank issuing your bank card. However, some functions, such as money transfers or red envelopes (an option for sending gifts to contacts, echoing the tradition of red envelopes given to children for the Chinese New Year), may not be accessible with a foreign bank card.

Before signing up for WeChat Pay and Alipay

  • Before registering for one of these applications, make sure that you are able to receive the verification codes by SMS that will be sent to you when you create your account (if not, you will need to obtain a Chinese SIM card).
  • It is possible to register from abroad, but identity verification must be carried out in China, as the face scan function is not available in some countries.

Practical installation guide : ALIPAY

  1. Download the application and sign up for the international version
  2. Add your bank account by pressing “add now”, then let the application guide you through the registration process.
  3. Scan the retailers’ QR codes or present your personal QR code to pay.

Practical installation guide : WECHATPAY

  1. Install WeChat on your phone (or make sure you have the latest version, update if necessary) then register with your phone number or log in.
  2. Activate Weixin Pay: to do this, click on “Me” – “Service” then “Wallet” in the application. You can also activate Weixin Pay by clicking on Me – settings – general – tools – weixin pay at the bottom of the screen.
  3. Enter your details and add a card by going to the Wallet tab and then pressing “add a card” to add your card. You will need to accept the terms of use and follow the steps to complete the identity details (if you are using a passport for this step, you will receive a notification prompting you to upload a copy of your ID to the app). Finally, press “Next” and follow the instructions in the application to add your card.
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PEO in China: the beginning of a development strategy

PEO involves using a company based in China to provide physical and legal housing for a foreign or Chinese employee. It allows companies that do not have an office in China to recruit and work with an employee locally. PEO solution is an important and sometimes decisive step to ensure a safe and successful development in China: the company can start its development while limiting risks and investments

It’s a transitional option between setting up and establishing a structure in China. The “portage” company offers support throughout the process of creation and acquisition of full autonomy.

In this way, PEO service offers companies wishing to enter the Chinese market the opportunity to gain an insight into the market without the need for a physical presence or a legal entity in China. This solution offers great flexibility and efficiency in deployment and customization. The employee is almost immediately ready to operate locally.

Thanks to its support and in-depth knowledge of the Chinese labor market and its legislation, the PEO services company enables the foreign company to start its business in China without the need for specific experience or multicultural management skills.

The company delegates the management of the employee’s payroll and related administrative formalities to all local authorities. In effect, the third-party company becomes the local employer of the employee, who benefits from a local contract. As such, the umbrella company will take the necessary steps to obtain work visas and residence permits for foreign employees coming to work in China. The company will act as an intermediary for the payment of salaries and the various taxes and charges associated with the employee (insurance, contributions).

Our HR Team in China is responsible for managing and monitoring the employee’s expenses and is the local contact person for maintaining solid contact with the employee in China. Finally, if necessary, the company can rent office space or any other premises required for the company’s activities in China.

PEO IN CHINA: SPECIFICS AND LEGAL FRAMEWORK

PEO is strictly regulated in China. Few companies can legally offer this service. In fact, VVR International is the only European company to benefit from licenses recognized by the Chinese authorities, such as the Labor Dispatch License. It should be noted that the portage of a Chinese employee and that of a foreign employee are not regulated in the same way by law.

In China, PEO requires the PEO company to pay all taxes and social security contributions in the employee’s place of residence. Thanks to its multiple locations, including four strategic regions of the country – Shanghai, Beijing, Guangzhou and Shijiazhuang – VVR International offers a wide choice of zones in which to develop the company’s activities according to its field and strategy.

VVR INTERNATIONAL: EXPERTISE IN HUMAN RESOURCES AND MANAGEMENT OF FRANCO-CHINESE TEAMS

Differences in culture and work practices can be an obstacle, leading to misunderstandings that negatively affect a company’s operations in China. VVR International, with its strong presence in France and China and its experts in human resources and in the management of Chinese teams, ensures that the collaboration is set up in the best possible conditions and helps to manage difficult and unforeseen situations (accidents, resignations, epidemics, etc.).

VVR INTERNATIONAL: CUSTOMIZED RECRUITMENT, YOUR OUTSOURCING SOLUTION IN CHINA

The choice of employees is crucial to the success of the first stages of development in China. That’s why, in addition to our PEO services, VVR International’s teams can take care of the recruitment of a new Chinese or foreign employee.

Thanks to the expertise of its dedicated VVR RH department, VVR International will search, interview, sort through a unique process and finally select the best talents to offer you the ideal candidate for recruitment. To do this, our teams will carry out a diagnosis of the company and its needs in order to define the profile best suited to the position.

Download our fact sheet on PEO in China.

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Interview with Camille Verchery, in the newletter of the Club Chine de l’EM Lyon

Camille Verchery, Director and Founder of VVR International, discusses the strengths and dynamics of the Chinese market and highlights the opportunities for French companies in an interview with the Club Chine de l’EM Lyon.

ENERGY: AT THE HEART OF CHINA’S DEVELOPMENT STRATEGY

First and foremost, Energy has become a strategic sector for China in just a few years. Lacking fossil fuels, the country has invested heavily in research and development of alternatives to increase its independence from the rest of the world. As a result, China is now a leader in wind and photovoltaic energy, as well as nuclear power. It is also a major player in the battery industry and hydrogen technologies.

The challenge for French companies at the forefront of these fields will be to position themselves on the Chinese market, which is hungry for innovative technologies.

THE BOOMING CHINESE HEALTHCARE MARKET AND MEDICAL DEVICES

The Chinese healthcare market is extremely dynamic. Growth is driven by an aging population and increasing demand for healthcare services. China is keen to benefit from the excellence of foreign companies in this sector and is pursuing an attractive policy.

Finally, the introduction of social security as part of the government’s drive to improve the overall health of the population offers numerous development opportunities for innovative French healthcare and medical device companies.

START-UPS AND INNOVATION: CHINA AT THE FOREFRONT OF THE INTERNATIONAL SCENE

China has become one of the world’s leading incubators for start-ups. This success is driven by government funding and incentive policies that recognize the critical and strategic role of innovation in the international political and economic game.

In this context, the challenge is to identify the sectors in which France is a leader and to analyze Chinese advances in order to develop strategies that will enable French companies to benefit from them.

REGIONAL EXPERTISE FOR GLOBAL SUCCESS

Given the current market dynamics and challenges, the international development of companies is often destined to go beyond China. That’s why VVR International co-founded Globallians. Today, this network of partners brings together 16 international development support companies, each specializing in a particular region of the world.

By working together through the Globallians network, these companies are able to help companies expand internationally while providing the expertise needed to address the unique characteristics of each target region.

Read the full interview online on EM Lyon’s LinkedIn page, or click here to download the PDF.

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CHINA’S URBAN MAP

First, second, third and fourth-tier cities

A May 2018 report by Morgan Stanley asserts that the future of China’s growth (by 2030) will lie within lower-tier cities (namely the third and fourth-tier). It is more and more common to see economic analyses regarding China make use of this urban classification. While being a useful analytical tool to understand China’s society, the definition of tiers is actually not so obvious and requires that we stop for a while and think about it.  This article thus gives you the keys to better understand this aspect of China, and the resultant opportunities for your businesses.

A ranking of cities

To begin with, there is no official definition of what is a first, a second, a third and a fourth-tier city in China. To give you a general idea, Beijing, Shanghai, Shenzhen and Canton are unanimously classified as first-tier cities, while second-tier cities are generally provinces’ capitals. Yet, some rankings would label Suzhou and Wuxi as second-tier cities because of their economic growth and despite the fact that they are not capitals. Similarly, Hefei, the capital of Anhui province, is sometimes categorized as a third-tier city because of its weak domestic growth. Three-tier cities generally include non-capital cities with a dynamic economy (high economic growth rate). Lastly, fourth-tier cities are important cities in terms of their population size, but which economy is not so flourishing.

Each year, Yicai Media Group’s Rising Lab issues a ranking of the Chinese cities in terms of tier and make part of their methodology open to the public, allowing us to take a look at their criteria (Yicai Media Group is one of the first economic media in China). They use five criteria: the density of commercial resources, the degree of transportation’s connectivity (is the city a hub?), urban residents’ habits (to what extent do they use e-commerce?), the diversity of activities available in the city and the degree of visibility into the city’s future (the real estate market, the fluidity of the road traffic, the pollution, the talents’ attractiveness, the entrepreneurial index…) Be aware, classifying a city in a first, second, third of fourth-tier is likely to have a tangible impact on the city’s real estate price…

Thus, each organization speaking about tier cities is likely to have their own and different criteria. Most criteria revolve around the local GDP, the population size, and the administrative status of the city (whether it is a province’s capital or not). While the type of criteria does not vary so much from a report to another, the way it is measured does, inducing porous frontiers between different tiers: some cities can be classified in different tiers. Furthermore, the denomination “lower-tier cities” technically encompasses second, third and fourth-tier cities. This can be misleading since second-tier cities are generally wealthier than the average Chinese city.

Another limit in this definition is that very different realities are described with the same word. Indeed, second-tier cities include industrial cities (Tianjin, Wuhan, Changsha…) coastal cities whose consumption market is more developed (Nanjing, Hangzhou, Wuxi, Suzhou…) as well as inland cities, often industrial but that are also becoming hubs with the One-Belt-One-Road initiative (Chengdu, Chongqing…)

A map of consumers

Despite these limits, knowing the tier of a city still is useful as a reading grid to understand to some extent the geographical diversity of China. Morgan Stanley’s report is an illustration of it, identifying a 6,9 trillion USD potential for growth within third and fourth-tier cities by 2030. They identify more specifically five city-clusters with high growth potential: the Jing-Jin-Ji region, the Yangtze River delta, the Canton bay, the Mid-Yangtze region, and the Chengdu-Chongqing area.

They support this assertion by several arguments, the first one being political support for growth in these very cities. Indeed, the central government and regional governments have been recently issuing many development plans, respectively inter-regional and intra-regional, allocating wide investments in connectivity infrastructures. As a result, there has been a multiplication of high-speed trains connections which divides the travel time by two and helps dis-enclave cities.

Besides, the cities offer financial allocations to help young talents buy real estate properties, a must do after graduation in China (this refers mainly to second-tier cities which have the financial resources for it). Besides, contrary to first-tier cities (except from Shenzhen) who implement stricter hukou* policies in order to hamper their population’s growth, second-tier cities make the promotion of their hukou policies, easy to obtain for young talents. As a result, Morgan Stanley’s report forecasts a 2.5% annual urban growth in lower-tier cities between 2017 and 2030. Lower-tier cities also have a higher fertility rate which accounts for this higher growth, as life costs (and the costs of having a child) are lower than in Beijing or Shanghai.

For European companies, as well as for Chinese ones, this demographic evolution means that lower-tier cities, especially second-tier cities, will gather an increasingly qualified manpower as well as better infrastructures in the near future. Implementation costs are to decrease, while labor costs are increasing on the coast. Chinese and foreign companies already started to move in these inland cities (cf VVR’s September article).

Another consequence of interest for European businesses lies in distribution. Indeed, more and more retailers are attracted to these new and untapped markets opening in these smaller cities, as they become more accessible and people’s incomes are increasing. Firstly, residents from these cities devote a larger part of their budget to discretionary spending as their fixed costs are lower (rents). Besides, although there is in these cities a smaller part of the population earning enough to afford European products (often more expensive and assimilated to rather high-end products), the quantities bought per consumer are comparatively larger than in first-tier cities. In other words, less people buy European goods, but the ones who do buy more of them.

Turning more specifically to these consumers’ habits, a survey by AlphaWise on more than 3000 households notes that the income gap between first-tier and lower-tier cities is reducing, but also that consumption habits changed significantly. Third and fourth-tier cities’ consumers now pay more attention to the value of the goods they buy: they upgrade their consumption and are increasingly sensitive to brands (mostly local brands for now). They also care about the fastness, quality and entertainment’s aspect of the service. In terms of industries, the sectors of daily consumption goods shall mostly benefit from these changes: house appliance, food & beverage (especially dairy products), beauty products and make-up… Most of this growth is also expected to happen within the e-commerce because of accessibility reasons. The entertainment industry (cinema, tourism) and the education industry are also likely to see some positive trends in their consumers’ pool.

There are yet some limits to this overall positive picture of the economic potential within lower-tier cities.   Firstly, today, the costs and risks of implementation in third and four-tier cities are still rather high: quality retail spaces are still few, and the size of the consumers’ pool remains to be verified. Thus, it is recommended to use e-commerce to test these markets (although this retail channel also bears its own limitations, cf VVR’s July article).

Furthermore, third and fourth-tier cities’ consumers might have a similar spending power as in the first and second-tier cities, this does not mean that they have similar consumption habits: it is crucial to analyze accurately the local consumption habits and to not launch a product merely because “it worked well in Shanghai”. Each expansion strategy must be thought locally and a dose of education on international products (on geographical indications for instance) might very well be necessary.

Lastly, the consumption’s growth in the lower-tier cities is conditional upon regulatory changes, especially regarding the real estate market. Indeed, these cities’ attractiveness relies on their low real estate prices, enabling young households to buy property. Besides, these young households’ budget is also less taken up by rent and more is available for consumption. On that point, there is no study that is today forecasting such a change in the near future.

In short, China has diverse markets, and it is important to understand their local specificity. Tiers are one way to approach diversity and allows for the above analyses. It is then one way, but it is not the only one and it can not account for the entire diversity of China. For instance, it is also important for retailers and employers to understand the different generations in China…

* The hukou is a resident permit that each Chinese citizen gets, binding them to a province (Shanghai’s hukou, Beijing’s hukou, Jiangsu’s hukou). It is rather similar to a province-scale “nationality” and serves to obtain a right to some public services in the location of the hukou.

By Manon Bellon

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SPOTLIGHT ON THE “TAOBAO VILLAGES”

Taobao : It is Alibaba’s e-commerce platform, launched back in 2003. This C2C platform gathers today over 500 millions of active users. Besides, they also developed a B2C platform in 2008 called T-Mall. These two platforms saw the transaction of some 3 trillion yuans over the year 2017.

It is very likely that a large part of the Halloween costumes worn this year in the coastal cities all come from the same place: a small village in a rural province of China, which specialized in the confection of costumes that they then sell online. This is what we call a “Taobao village”, another aspect of the retail revolution taking place in China. In this month’s article, we provide you with a reading of this phenomenon, which we hope can also be a source of inspiration for your approach of the Chinese e-commerce. What are exactly these “Taobao villages”? How rural entrepreneurs with few resources at hand managed to appropriate these tools and how do they use it? Knowing about “Taobao villages” and these micro-enterprises can be of interest, especially for European retail companies who also need to appropriate themselves the Chinese e-commerce.

A rural community geared towards e-commerce

The official definition of a “Taobao village” is a rural community in which at least 10% of the families use Taobao for retail, or where 100 online shops were open; and where the trading volume reach at least 10 millions of yuans. This definition is given by Aliresearch, the research department from Alibaba, whose mission is to collect and make use of the enormous amount of data Alibaba have at hands. The “Taobao villages” developed themselves firstly with Alibaba (hence their names, from Alibaba’s famous e-commerce platform). The Chinese authorities were then prompt to support these initiatives as they contribute to reach primordial goals set in the 13th Five-Year Plan: eliminating poverty, developing the Western provinces and slowing down the rural exodus. As a matter of fact, 45% of the Chinese population still lives in villages (often much bigger than our European villages). The dose of personal entrepreneurship at the roots of “Taobao villages” is seen very positively by the authorities: seen as one of the key of the development success of coastal cities in China, entrepreneurship now moves to the countryside. Today, JD.com are promoting their own platform to rural communities.

Increasing by 25% in 2015, the number of “Taobao villages” reached 2 118 in 2017, with a total of 120billion of yuans in sales (Aliresearch). Overall, 1.3% of the Chinese population is involved in some e-commerce activity in 2017 (approximately 10 millions). Alibaba’s support is concretized in a 2017-2019 investment plan amounting to 1.6 billions of dollars. Their objective is to open 100 000 Taobao centers in rural places. The Chinese government also makes substantial investments (for the reasons mentioned above). It claims 300 millions of dollars allocated to 200 rural counties to build warehouses, train skilled manpower… The government overtly encourages young Chinese to come back to their native villages to open businesses. It seems so far to be working as 52% of these online entrepreneurs are less than 30.

An experimenting field for micro-enterprises

These statistics seem to point at the success of a rather new business model, with a unique management style: these micro-enterprises are often run by people will low qualification level, who seize the opportunity of low entry barriers to experiment, test their products with the market and adapt them, thanks to the statistics provided by Taobao and the customers feedbacks available. Most of these micro-enterprises produce in the villages and then sell in the cities, but some are the other way around. For those who sell in the cities, e-commerce brought them a significant improvement as it abolishes distances and they could get access to markets where consumers have more purchasing power. Regarding what is sold, there are different strategies. Some villages get specialized in the local food products (Ningxia’s Goji berries, Suichang’s bamboos shoots, tea and sweet potatoes…) while some others get specialized in a product that is not related at all to their localization (outdoor equipment, costumes…) An interesting pattern then stands out: most of the time, the online shops of a village all get involved in the same activity, bringing the specialization to the level of the village (and constructing thereby a sense of identity within the products). The very denomination “Taobao villages” implies an organization to the level of the village. Lastly, it seems that local food products are more successful as consumers await local products that are cheaper and potentially healthier (organic agriculture).

Regional specialization?

Not only do “Taobao villages” bring new products to the coastal cities’ consumers, but it also impacts on the very structure of these villages, creating new associations. In order to guarantee a certain quality for instance, some villages put in place “Taobao associations”, in a way similar to the industry chambers. Moreover, “Taobao villages” require a development of the tertiary sector (sales, delivery, storage), which in some cases amounts to 50% of the local gross product. At last, other activities develop, such as the eco-tourism. This last aspect is all the more interesting as it is also readily observable in Europe. Not mentioning the thematic travels around Europe (such as “Grands Crus tours” in Fance), every year more numerous, one can think of this small Bulgarian village, Momchilovtsi, which local yogurt became extremely popular in China recently, albeit because of a company and not because of e-commerce. As a result, this village now sees buses of Chinese tourists coming to visit. This example is telling as it shows the strength of local identity in nowadays branding in China.

How to fight competition on these platforms

“Taobao villages” actually do not alwqys run so smoothly, and they do encounter some difficulties. First of all, access to digital technologies is still limited in rural China with 1% of the families having a broadband connection in most of the villages (the official goal announced in “Internet+” is a 98% coverage by 2020). Another limit which is more closely linked to the e-commerce characteristics: branding remains limited and many businesses suffer fakes issues. Thus, in Qingyangliu, a “Taobao village”, only 20% to 30% of the businesses are making profit. The identified cause is the fact that the market is saturated and dominated by large companies.

Seeing either as an opportunity, or as a concept with a debatable long-term profit, “Taobao villages” nonetheless are a characteristic trait of the revolution of retail in China. They picture the dynamic entrepreneurial mindset of Chinese businessmen. They also confirm the analysis that e-commerce in China do open many opportunities because of the low entry barriers and larger access, but that many challenges remain when it comes to build a brand image on this already saturated market.

By Manon Bellon

Image credits: Greg Jenkins

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CHINA’S BEER MARKET

Last week, temperatures went up to 35° in Shanghai and Guangzhou, and reached 40° in Beijing… Summer and its dog days are back in China! For more and more Chinese, it is time to enjoy a cool beer, beer that comes as a huge opportunity for European breweries: imported beers are increasingly popular among Chinese consumers, and 75% of these beers are European. This month, we will then explore the characteristics of this expanding market where European companies enjoy such a reputation’s advantage.

The first worldwide market for beers

Twice the size of the American market, five times that of Germany (the biggest consumers of beers in Europe), the Chinese beer market reached 45,7 billion liters in 2017. Beer is the first alcoholic beverage consumed by Chinese (in terms of volume), making up 75% of the whole consumption (below figure). This market has been growing fast over the last years and is now in maturation: volumes decrease but the value remains at the same level. In other words, there is a premiumization of the beer market in China. This trend is all the more advantageous for European breweries as their products are premium on the Chinese market (high quality beers).

Source: SME Center

The millenials seeking for premium products

The reason for this phenomenon lies within the profile of the Chinese consumers, and the market segmentation induced. Like many consumer goods, the millennials are the driving consuming force today in China: young, urban, with increasing incomes and a sharp eye for the quality and services offered by brands (cf VVR’s June article). In the beer market, which can be divided in three sub-sections: mass consumed beers, leisure beers and craft beers (EU SME Centre classification), these young consumers are increasingly turning to leisure beers and craft beers, which happen to be both mostly imported beers.

Mass consumption beers: manufactured locally

The largest subsector, mass consumed beers are today declining in sales (a 3% decrease over the last three years).  Most of these beers are domestically produced. They have a low alcohol rate (3%) and are very cheap (1euro per liter). They are consumed by all type of consumers, mainly to go with Chinese-style dinner.

The European beers are leisure beers. They are mainly consumed in first and second-tier cities

European beers are mostly part of the second subsector: the leisure beers. These leisure beers are mostly sold in bottles (330ml, 500ml, using original packaging, rarely available on kegs). Almost all of them are from foreign brands, produced either abroad or in China. In all cases, their price is much higher than the mass consumed beers’ one: 13 euros per liter in bars. Thus, they are consumed by urban high-income Chinese, in bars or at home, alone or with snacks. While this type of beer is mostly found in first and second tiers cities, the fast adoption of e-commerce by Chinese consumers rends sales available in the rest of China possible as well. No specific type of beer, nor specific brands are dominating this market. In fact, it is rather characterized by a strong diversity in the offer, in terms of tastes and brands. Chinese consumers seem to be liken this diversity and show interest for… innovation.

13 European countries among the Top 20 countries exporting beers to China

This market is expanding fast (38% growth rate in 2017) and is therefore a huge opportunity for European breweries whose products correspond to the demand. Thus, more and more of them are entering China now, and the volume of importations has had a double-digit growth for the last 5 years. All in all, in ten years, importations were multiplied by 22. Particularly successful countries are Germany, United States, Belgium, the Netherlands and Portugal, the 5 largest exporters of beers to China in 2017. No less than 13 European countries are also among the 20 largest exporters.

Draft beers: a closed market

The last category is craft beer. Either locally produced or imported (in the latter case, they shall be counted as part of the importations figures mentioned above), these beers are very expensive (13,4euros the liter in bars). Craft beers are commonly consumed alone or to go with Western-style meals, by young, urban consumers with high-income. It was almost impossible to find any craft beers 10 years ago. Because of their relative newness, we mostly find them in first tier cities, and they develop fast in second tier cities. Like for the leisure beers, there is no preference for a type of beer neither even if blondes do get the upper hand. Meanwhile, the number of actors on this market is by contrast very restrained, with only a few foreign breweries. This is explained by the Chinese regulation which only allows for breweries with big production capacity. Thus, microbreweries can only either outsource part of their production, or sell their beer to an actor already present on the market, such as AB InBev who is largely dominating the market.

Regulation

When it comes to leisure beers, regulations do not seem to be a major obstacle for importation. Like any food and beverage, one need to satisfy the customs (CIQ), the food safety regulations, as well as the regulations on labelling of pre-packaged food (2011) and pre-packaged alcoholic drinks (2005).

In short

Because there is no need for changing one’s packaging, the cost of entry for leisure beers stands relatively low compared to the high potential profit this market can yield today. European business should enjoy this golden opportunity given on them by the reputation of European beers among the Chinese millennials. Yet, one should bear in mind the high level of competition that is characteristic of the Chinese market for any consumer good: to stand out of the crowd, it is thus important to have a quality product, and a solid marketing strategy. The Anufood China, an exhibition on Food and Beverages is happening next November in Beijing. It might be an interesting first step, in order to investigate one’s potential competitors as well as potential partners, two must-do when one prepares their entry on the Chinese market.

By Manon Bellon

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HOW CAN A COMPANY ADAPT TO THE NEW CONSUMPTION HABITS IN CHINA?

Two stories about tea and dairy products

The conclusions of the governmental report that was released in May at the E-commerce Convention in Beijing came as no surprise: e-commerce transactions grew by 11,7% in 2017.

Several facts were as well underlined in this report: the outstanding development of the cross-border e-commerce (+120% in cross-border imports), the fact that online platforms and offline industries are increasingly integrated through the use of big data technologies, and the dramatic changes in consumption habits such as the use of mobile payment which increased by 44%. In other words, e-commerce is today one of the main distribution channels for consumption goods, when it is not the most important one.

This article thus explores how companies, especially in traditional sector (tea and dairy products), adapt to this new (online) normal. Their stories are not only inspiring for tea and dairy products’ companies, they are also characteristic of an essential asset companies must display on the Chinese market: the faculty to adapt.

Tea for the millenials

Tea is to China what wine is to France or beer to Germany, a part of their culture. Now is the time when the “Grands crus” arrive on the market, and some of them can reach several thousands of euros for a kilo of tea leaves (the price is determined by the region where the tea leaves are grown). Yet, tea is less and less affectionate by young Chinese. Besides, it is a challenge for the consumers to recognize a good tea from the taste, and even a bigger challenge to recognize it from the packaging, when buying one’s tea in supermarkets. Contrary to wine, price is not a reliable indicator of quality.

Recently, several tech companies saw an opportunity and came up with innovative business models in order to tackle these challenges: Xiaomi introduced Xiao Guan Tea, NetEase came up with Yanxuan, and Penguin Guide also launched their own tea brand. These undertakings seem at first daring as none of them had previous experience in the tea business where it does matter. Yet, Xiaoguan’s 700 millions yuan sales in 2017 indicates otherwise.

Indeed, these tech companies used their technology and innovative sales methods and adapted them in the tea market. They thus managed to improve and modernize the consumer’s experience, a decisive feature in a brand’s success say all the recent consumers studies in China. For instance, selling on e-commerce platforms gave them a reach to the post-90s consumers, and it simplified the purchasing act for the consumers.  Reaching the post-90s is primordial in nowadays market as they become the driving force of the consumption market (McKinsey survey 2017). These consumers are now looking for high quality unique and traceable products, as well as to a lesser extent, other generations of consumers.

XiaoGuan also used the authority of height “tea masters” for marketing, which provided the brand with an image of know-how, guaranteed quality and uniqueness. The fact that the founder of the brand is himself originating from a traditional growing area surely helped: it brought a feeling of tradition, and a deal of personal history to XiaoGuan’s products.

The opening of offline shops completed this innovative strategy. Decorated by the Apple stores’ designers, these shops are the offline side (consumer’s unique experience) of the online sales (easy purchasing process).

All in all, in adapting their products to the new consumption loci and in developing a branding strategy, these tech companies could enter a traditionally rather close market with success.

Improve your knowledge of your consumers, personalize the consumers’ experience

Certain actors, already since long on their market, are also starting to use big data, such as Mengniu, one of the leaders in dairy products for around one century in China.  For Mengniu’s CEO, Jeffrey, Minfang LU, artificial intelligence is a tool for companies to use to improve their organization and their service to consumers (McKinsey interview, 2017). It is all the more necessary that digitalization of the commerce in China also creates several challenges for big traditional companies. Indeed, in the dairy products’ case, Chinese increasingly buy online and opt for home delivery. Consequently, they buy more often and in smaller quantities. They are thus more often choosing a product in a market that is also having a wider offer, and dairy products’ companies need to convince them more often, and through a different media for what it matters.

A national company such as Mengniu counts more than 20millions of “active” consumers, meaning that these consumers share voluntarily information about their preferences and their consumption habits on e-commerce platforms and social networks. For Jeffrey LU, these data are a goldmine to know how to improve their products and marketing. Yet, the company’s current resources are insufficient to treat all these data. One solution that was found is to cooperate with e-commerce platforms who already collect and analyze these data. For instance, Mengniu has a project with Alibaba to analyze their supply chain and determine where to produce, and how to improve their transportation network to gain in efficiency. Mengniu’s teams also analyze consumers’ data in order to design more personalized products, which the consumers are now looking for.

Lastly, market digitalization is not only an opportunity for companies to gather more data about their consumers, it also opens a new communication channel where they can rather directly reach these consumers. Chinese consumers want healthier products with a better traceability, information that a firm like Mengniu can easily provide as it disposes of data on all their farms and even on their cows. Thanks to nowadays data technologies, Mengniu has the capacity of taking up an informative role towards their consumers, not only providing them with information on the products, but also on the nutritional values of dairy products. Jeffrey LU also sees an opportunity to build a story around their milk: “We are not just a milk manufacturer telling you what we can do; we want to be part of your life.” as he says.

Hence, these two stories illustrate the trends of the markets, and the changing expectations from consumers, whatever the sector, and how companies can deal with that. The tea companies showed innovative capacity and put in place a new business model that seems successful in a market in needs of modernity. Regarding the dairy products industry, Mengniu managed to take advantage of their great pool of data to answer requirements from the consumers in terms of better information, personalized products and service. Exploiting these data is also useful in order to improve the supply chain of the company. In many instances in China today, it is all about building a story with the consumer.

By Manon Bellon

Credits : Photography by 魏徐亮 Wei Xuliang

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2018 CHINESE PHARMACEUTIC SECTOR AT A GLANCE

China’s 1.4 billion-large population is getting richer and older, creating one of the potentially most profitable market for pharmaceuticals, an industry where Western companies’ R&D has still no Chinese equivalent. In 2016, China becomes the second largest market worldwide for medicines, with a market worth 110 billion USD. Yet, this market is still not mature in many aspects, which causes foreign brands to face many entry barriers and other issues.

In 2020, 18% of the Chinese population will be over 65 years

Life expectancy in China is 78 for women and 75 for men, with around 15% of the Chinese population being over 65 (against 10% in France) and 1.8% over 80 (2017). Forecasts for 2020 are that 18% of the Chinese population will be over 65, and 6.5% over 80. In 2035, Chinese median age should also be higher than the French median age.

Urbanization, sedentarization and enrichment of the middle class

Besides these favorable demographic data, changes in Chinese society also seem to pave the way for pharmaceutical sales. The rising middle class not only has a stronger purchasing power, but they are also living in cities, changing their eating habits and lifestyle. Consequently, today Chinese main health issues, just like the developed countries’ ones, lie in chronic diseases. In 2016, 26% of deaths were due to cancer, 22.1% to cardio-vascular diseases, 20.4% to cerebral-vascular diseases, and 12% to respiratory diseases. Likewise, diabetes prevalence increased to one Chinese in ten, and is still increasing. China also faces infectious diseases like AIDS, tuberculosis, hepatitis, mainly in its Western, poorer regions and the Chinese government is offering substantial funds to help tackle them. Regarding its Eastern part, internationally connected hubs are increasingly concerned with new epidemics risks. Finally, China is chronically short of medicines for rare diseases, pediatrics and infant diseases, market niches for European pharmaceutical laboratories.

79% of medicines are delivered under prescription

Two third of medicines sold in China are chemical, and 13% of them are using biotechnology, mostly bio-similar ones. 79% of Chinese medicines are prescription drugs, thus making doctors the priority target of laboratories’ promotional activities. Most of the prescribed drugs are generics, a sector where local competition is particularly high and low-cost.

Imported medicines are consequently mainly patented drugs.

In the last few years, the Chinese governments and local laboratories have been encouraging the setting of partnerships with Western well-known laboratories in order to develop new drugs.

Major players on the pharmaceutical market are large companies as well as SMEs, foreign companies (for patented drugs) and domestic ones (for generics). The three largest domestic players are Sinopharm, Shanghai Pharma, and Jointown Pharmaceutical Group. Only this latter is a private company and they all benefit from close relationship with hospitals, the main sales point for medicines.

Chinese legal environment in pharmaceuticals is ambiguous and often changing.

A health reform has been under way since 2009. It aims among others at expanding reimbursement of health expenses, thus opening lower-tier cities markets to Western, more costly medicines. Yet, the procedure to added on the list of reimbursed drugs is obscure and favorize de facto domestically produced drugs since it exerts a downward pressure on prices.

China also opened its market to foreign investments in certain health sectors. Besides, similarly to what is seen in the food sector, the government stepped up their inspection procedures to control for the authenticity, quality of drugs, as well as to fight against corruption in hospitals (cf GSK scandal).

Thus, the pharmaceutical sector comes with many opportunities for European companies, provided they find the right way to enter the Chinese market and the right local partners to stay on this market. Indeed, accessing this market is not an easy task as customs duties are high and distribution channels are extremely fragmented, varying across Chinese provinces. One might need up to 6 intermediaries to sell their medicine in certain regions. Consequently, imported drugs loose in competition, as they are substantially more expensive than local drugs.

Registering a new drug in China, and understanding the legislation frame for promotional and sales activities are other serious challenges one can hardly undertake alone. Indeed, these legislations meld in old legislations, temporary measures and new laws together. Besides, if there is a trend towards reinforcing the legislator framework, there is also a trend towards favoring domestic manufactured products, as the government wishes to establish “national champions”, in the bio-similar technology domain for instance. Thus, foreign companies sometimes face differentiated or discriminatory treatment from local authorities.

Another challenge is the downward pressure caused by the increase in the number of reimbursed drugs.

Lastly, intellectual property rights protection is still weak or inadequate. As a matter of fact, 17 000 applications for the registration of foreign drugs were left untreated in 2016, which renders complex the planning for the safe launch of a new drug on the Chinese market. Despites the government’s increased efforts, counterfeit drugs remain a lingering issue on the Chinese market.

Demand is growing, and the local offer can not satisfy it

Nonetheless, international companies are looking into the Chinese market and they have good reasons for that. Not only consumers are numerous, but they also ask for better quality healthcare: it appears from a 2014 survey that they are the nationality who care the most for their health, when compared with Brazilians, Russians, Indians, Americans, Europeans and Japanese. Thus, vitamins and food complements’ sales are said to double by 2020 (compared to 2014 sales). This is all the more interesting for European companies since Western drugs are enjoying a good reputation in Chinese consumers’ views, representing security and quality. Moreover, despite the economic slowdown, Chinese are increasingly solvable thanks to the universal medical insurance and the development of private insurances.

Although Chinese workers’ qualifications level improved and large investments are put into research, Chinese laboratories are still lacking R&D capacity. This explains the recent pushes, some of them successful, for partnerships with Western laboratories.

Pharmaceutical companies’ network

In order to overcome the many obstacles seen above, institutional support is precious. Thus, Business France and Biomérieux founded the “French Health Alliance” (Club Santé Chine) which gathers large groups, SMEs, hospitals and the French Embassy, in order to gain visibility on the Chinese market but also to share information. This alliance has four working groups on: hospital design and management, ageing and aged-link dependency, chronic diseases and infectious diseases. Recently, Shanghai received a delegation from Les Pays de la Loire and composed of many pharmaceutical companies, several of them specialized in biotechnology.

Innovation is another strength for the health sector in China

Health applications of Artificial Intelligence is yet another land of opportunities for European businesses. Part of the National Strategy for Development of AI, it is also the targets of recent investments made by Baidu, Tencent and Alibaba, and is the topic of many articles in the Chinese media, sign that it is a priority of the country.

Other distribution channels to satisfy the demand

Lastly, e-commerce constitutes a specific area of potential development for OTC drugs (except from injections) as consumers increasingly use this sales channel for buying drugs too. A 2017 survey found that Internet is a primary source of information when patients look for medical explanation. Thus, not only can SMEs increase their visibility by using this sale channel, but it is also a necessary platform of advertising for any pharmaceutical company, provided publications are bear an informative value.

By Manon Bellon

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CHINA AND SMART ENERGY

Smart energy solutions must be discussed when one tries to understand the current Chinese economic environment. In three of our publications already, we described Chinese engagements in electric cars, green buildings and renewable energies, and we showed the challenges that the Chinese authorities faced to fulfill these commitments.

In this April article, we offer you a critical synthesis of different reports by the National Reform and Development Council of China (NRDC), the World Bank, the US Trade Ministry and other global players. Indeed, we noticed that all these reports coincide in three points: China needs to develop an efficient management system for its energy distribution and consumption, AI technologies can be of some help (see VVR’s article from last month), and whatever happens in China will most probably be of global importance in the domain of energy.

China, a global leader in reducing carbon emissions?

With the Paris Agreement, China definitely took a leading role in the fight against carbon emissions. This strategic choice in terms of international relations, was also dictated by its internal situation, namely the alarming atmospheric pollution rate. China is thus becoming a laboratory of the energetic transition for developing countries: indeed, in 2016, coal was still amounting for 62.6% of China’s energy mix (US Trade Ministry). Besides, Chinese energetic challenges are typical of developing countries: a fast-speed urbanization rate and the development of rural zones, both increasing the country’s needs in energy. These latter increased by 6.6% in 2017, compared to 5% the year before (Global Energy Statistical Yearbook). Overall, China’s energy consumption could increase by 40% on the next 15 years (World Resources Institute).

An unefficient electric grid

Large Chinese investments have been announced in renewable energies, but worldwide analysts agree on the assessment that nowadays Chinese production in renewable energies is overly wasted because it is not connected to the country’s grid. This grid is a monopoly of two State-Owned enterprises, so it is hardly accessible to foreign businesses. Nonetheless, it is interesting to know that the State Grid Corporation, responsible for 80% of the national distribution system, has published large investments targets in smart meters (they plan to install 280 million of them by 2022) as well as automatization and distribution systems (investments worth USD 7billion by 2020).

Source : International Finance Corporation (World Bank)

Building, work in progress

Thus, green building is a priority of the 13th Five-Year Plan; in theory, half of the new constructions should be “certified” green. However, higher costs and delay in getting the certifications often deter private promoters for engaging in green building. As such, the clients looking for smart grid technologies are often the local authorities: the China Daily reported that 290 cities already launched a smart city project, amounting to 95% of the provincial capitals. These projects are likely to have a global impact: Kuala Lumpur already showed some interests in the Hangzhou’s City Brain (a project launched together with Alibaba and Foxconn). Some nuance needs to be done here: most of the projects we read about are located on the East coast, and especially in Shanghai, Zhejiang, and Jiangsu, as these provinces dispose of the suitable development and urbanization state for such projects as well as financial resources.

70% of the energy in China is going to the buildings today, 60% of which (around USD 100 billion) is wasted because of outdated or broken equipment (China Economic Review). And it just happens that 70% of carbon emissions come from cities, one third of them from the electricity consumed by buildings (NRDC).

The International Finance Corporation (World Bank) identified green buildings as the sector that will receive the most investment by 2030 in China: an amount estimated at USD 12.9 trillion.

All in all, to solve the gap between electricity offer and demand in China, the central government, local authorities, and State-Owned enterprises all turn to smart grid and other smart energy solutions. Both public and private actors in China seek to attract innovative start-ups around events such as Arup’s forum on green building (Shanghai, April 2 and 3) and the Smart Energy China Fair (focusing on IoT) and the Energy Storage China Fair (both in Tianjin, on September 19, 20 and 21). The first one claim to be the locus of discussion on public policies in Shanghai while the other two invite government officials to speak at conferences.

Which place for European companies?

Able to produce equipment at low costs, China is now looking for smart energy and smart grid technologies, which often come from the West. Some American start-ups are thus already present on the market.

Some challenges to the entry of foreign businesses in this sector should be pointed out. Firstly, there is an overall preference for local actors. One reason for that might be the fact that energy is strategic for any country’s government. Secondly, also due to national security concerns, Chinese authorities increasingly require that the data processed in big data technologies should not leave the Chinese territories, obliging foreign businesses to develop facilities in China. Solutions exist to these challenges, one of them is to find a Chinese partner. Lastly, another obstacle might be the lack of unification in urban policy, making this environment complex for a foreign actor not acquainted with the Chinese system to understand. Besides, policies are not always implemented. For instance, the objective to reduce carbon emissions as a part of China’s GDP by 40 to 45% between 2005 and 2020 had to be lowered. In China, terms such as “green” or “environmental” are mostly political or used for communication purpose, and they rarely fit with the European definitions.

Owning innovative technologies, European and French are fit for the Chinese smart energy market. During the Smart Mobility Forum which happened in Marseilles last February, French businesses showed their dynamism and innovative spirit in the domain of smart energy (although the focus of the forum was mostly transportation). Besides, France already stepped in the Chinese market: in 2016, EDF launched a smart energy project with Changfeng Energy for the city of Sanya, to reduce the carbon emissions of this town.

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