Commentary by Manuel Silvério*
Between health, youth, international cooperation and sport, the Macao SAR can turn the current context into a new cycle of opportunity and strategic relevance.
Signs of stability
A changing regional context and a strategy of continuity
While many analysts see China gaining a structural advantage globally and regionally – irrespective of the challenges posed by the Taiwan issue – recent developments demand closer scrutiny.
What we are seeing is not a linear reality, but a complex picture in which different levels of analysis coexist and do not always move in the same direction.
If an initial reading of recent events highlighted a sequence of signals of stability and external projection on China’s part, a second reading reveals something more structured: the construction of concrete instruments of influence, capable of operating progressively across the economic, social and institutional spheres.
The 10 measures announced by Beijing at the end of the visit by Cheng Li-wun, chairwoman of the Kuomintang (KMT), should be understood in that framework. They include stronger political dialogue, the promotion of youth exchanges, the resumption of direct flights, the gradual reopening of tourism, deeper infrastructure links with Jinmen (Kinmen and Mazu (Matsu), logistical facilitation, support for agricultural and fisheries trade, the opening of cultural content, broader economic cooperation and, as a political foundation, the reaffirmation of the “1992 Consensus” and opposition to independence.
More than a set of isolated measures, this is an architecture of gradual rapprochement. Its logic is clear: to act where political decisions are formed, through mobility, economics, human contact and the building of trust. It is a long-term strategy, not aimed at immediate results, but at gradually shaping the space in which decisions are made.
Macao ’s place
Between national strategy and regional application
It is in this context that Macao can, and should, reposition itself.
The Macao SAR does not take part directly in the political equation of the Taiwan Strait. Yet it is increasingly involved in the broader model of opening-up and external linkage that China is developing. It is precisely in that intermediate space, between strategy and implementation, that Macao can gain relevance.
Recent diplomatic movement also deserves closer attention here. The succession of visits by European leaders to Beijing, sometimes extending to Macao, together with Chief Executive Sam Hou Fai’s current visit to Europe, confirms that this movement is already under way. It is within this framework that one should read the visit by Portuguese Prime Minister Luís Montenegro to Beijing and Macao, the visit by the President of the Portuguese Parliament to China, including Macao, the visit by Spanish Prime Minister Pedro Sánchez to Beijing, and Sam’s visit to Portugal and Spain, with further stops in Geneva and Brussels. Taken together, these contacts suggest an expansion in the scale of relations between China and Europe, including Macao, reinforcing the idea that the MSAR can play a more active role as a platform for linkage, contact and articulation.
This dynamic was further reinforced in Macao by recently hosting the 43rd General Assembly of the Union of Portuguese-Speaking Capital Cities (UCCLA), accompanied by high-level institutional meetings and by the election of the Macao SAR to the presidency of the Executive Committee for the 2026-2028 term. More than a protocol event, this confirms the continuing relevance of a vocation that Macao has cultivated with consistency: that of a platform for contact, cooperation and articulation between China and the Portuguese-speaking world. The fact that the assembly also included visits to the Commercial and Trade Co-operation Service Platform between China and Portuguese-speaking Countries as well as to the Guangdong-Macao In-Depth Cooperation Zone in Hengqin reinforces that reading still further.
In this context, Macao is not merely a place one passes through. It can become a point of articulation.
That singularity also has a practical expression which should not be underestimated. In the sporting world, China; Hong Kong, China; Macao, China; and Chinese Taipei take part in a range of international events and structures, and all four are full members of the Olympic Council of Asia (OCA). Yet the importance of this goes beyond sport itself. It shows that there are concrete spaces of contact, representation and cooperation in which different institutional models can coexist in functional terms. It is precisely this accumulated experience of differentiated participation that can be better used in areas such as health, science, training, youth, and technical cooperation.
This reading becomes even more significant when viewed from a long-term perspective. The point is not to question the current phase of “One Country, Two Systems”, but to recognise that Hong Kong and Macao are moving towards important milestones within that framework, which requires vision, continuity and capacity for adaptation. That preparation, however, should not be seen merely in terms of the calendar. It should be understood, above all, as part of a strategy aimed at raising the quality of life, strengthening public well-being, valuing local professionals, creating new skilled jobs, and developing essential areas such as health, training, and sport.
Health, sport and opportunity
Two areas in which ambition can take concrete shape
Health is a prime example of this opportunity. Previously, external cooperation was framed narrowly—often limited to the occasional recruitment of doctors. Such an approach is no longer sufficient given the possibilities now available.
Taiwan has a highly developed public and private healthcare system with strong international recognition, particularly in medical technology, hospital management and clinical research. The Chinese mainland, for its part, offers scale, resources, integrative capacity and an institutional and infrastructural base that cannot be ignored. Portugal offers a medical and academic tradition with which Macao retains deep affinities. The articulation of these three spaces – the Chinese mainland, China’s Taiwan region and Portugal – could give rise to a new structured axis of cooperation, with Macao in a position to connect and to lead.
Within this framework, Macao’s Islands Healthcare Complex, The Islands Healthcare Complex – Macao Medical Centre of Peking Union Medical College Hospital, also known as Macao Hospital Macao, can play a central role. Its management by Peking Union Medical College Hospital gives it a solid institutional base, and its full operational development, in coordination with the University of Macau (UM) and with research and training networks, could turn the MSAR into a regional hub for medical science, clinical innovation, and academic cooperation.
It is also in this context that the Asian Beach Games in Sanya should be understood. After successive postponements, their return was used by China and the Olympic Council of Asia (OCA) as a showcase of stability, openness and organisational capacity. More than replicating that model, the lesson for Macao may lie in the way different sectors can themselves be used as instruments of projection, qualification and public usefulness.
Sport, too, should be thought about beyond competition and visibility. In articulation with health, training and research, it can create new opportunities for young people, improve residents’ well-being and make better use of existing infrastructure. In that sense, the proximity between the new Sports Medicine Centre of the Sports Bureau (ID) and the Islands Healthcare Complex suggests a concrete possibility: to develop in Macao an integrated space for preparation, rehabilitation, sports medicine, technical training, and university cooperation.
Given Macao’s scale and the inevitably small number of athletes, the Sports Medicine Centre should not be viewed in isolation. Its real usefulness will depend on its connection with the Islands Healthcare Complex, making it possible to link sports medicine, rehabilitation, research, training and public health. Only at that more integrated level will the centre fully justify its value - not merely as a support for local sport, but as an asset of broader utility for the MSAR.
That vision would gain even more weight if it were accompanied by stronger exchanges among the Chinese mainland, Hong Kong, Macao and Taiwan in areas such as sports medicine, performance science, technical training, rehabilitation and prevention. The synergy between these spaces could open new possibilities for learning, the exchange of knowledge, and better resource management – giving the centre a broader purpose better suited to the region’s future needs
More importantly still, this direction could have direct effects on residents’ lives. An integrated vision linking public health, training, science and sport would help raise service quality, create new opportunities for young people, enhance the value of qualified professionals, improve quality of life and strengthen Macao’s integration into networks of knowledge and innovation. The point is not simply to project the image of the MSAR abroad, but to build, on the basis of these sectors, a model of development that is more useful, more modern and more centred on people.
Youth, talent and regional circulation
Opening opportunities and creating more attractive models for health and sport
This potential becomes even more relevant when another, often underestimated, factor is taken into account. There are already highly qualified professionals from Macao and Portugal working in Taiwan, the Chinese mainland and elsewhere in Asia, particularly in health, science, technology and also sport. Many highly skilled Portuguese professionals currently work in hospitals, universities, training centres and technical structures int the Chinese mainland, showing that this exchange of expertise is not an abstract possibility, but an existing reality.
Creating mechanisms to attract, reconnect, and engage these professionals – through research projects, cooperation programmes, or flexible mobility models – would allow the MSAR to build a regional knowledge network.
More than simply attracting resources, the aim would be to position Macao as an active node in a network of talent, innovation, and qualified experience.
This effort could also pave the way for a complementary model – one that is more flexible, better suited to current demands, and capable of attracting skilled talent in health and sport.
The aim is not to bypass rules, but to create mechanisms better adapted to regional realities –ones that are more competitive in attracting expertise and more appealing to professionals who might otherwise avoid Macao if faced with rigid or uninviting structures.
This debate also has a generational dimension that cannot be ignored. For too long, the vision for Macao’s future has been narrowed to a handful of sectors—primarily business and public administration. Yet Macao’s youth are more diverse than that, and so are their aspirations.
For many young people in Macao –particularly those in health, science, sport, and research – the future cannot be reduced to waiting for recruitment notices from the Conde de São Januário Hospital Centre, or being forced to switch professions for lack of opportunity. Building a more ambitious axis of regional and international cooperation would open new paths for that generation, allowing them to remain connected to Macao without being constrained by the narrowness of the local market.
To achieve this, what is required is not merely adjustment, but a change of scale. It means moving from a reactive logic to one of anticipation, and from sectoral policy to an integrated strategy.
External articulation and a future vision
Macao as a point of contact, cooperation and ambition
Seen in this light, health and sport cease to be merely specialised sectors or venues for symbolic representation. They also become instruments of knowledge, qualification, prevention, well-being and external projection. This is particularly relevant at a time when the country is combining strategic stability with concrete instruments of influence. The question, therefore, is no longer only what Beijing is doing, but how places such as Macao interpret that movement and position themselves within it.
For the MSAR, the challenge is no longer one of framework, but of ambition. Situated between integration and functional autonomy, heritage and innovation, and connection and projection, Macao today possesses unique conditions to assert a role of its own. But that role will not emerge by inertia; it depends on vision, coordination, and the capacity to execute.
If the earlier phase was marked by the reading of signals, the phase now opening will be defined by the ability to turn them into strategy. It is at this intersection—where politics, economics, knowledge, and quality of life meet—that Macao’s place in the next regional and international cycle will, to a significant extent, be decided.
*The author is an independent sports analyst and regional development consultant. A former public official with extensive international experience, they have a long-standing commitment to public policy and sports development.
