Currently, ESG is facing significant global divergence—while the EU and Asia-Pacific regions continue to push forward, the United States has slammed on the brakes and is now shifting into reverse.
ESG translates the abstract concept of sustainable development into concrete action, urging companies to measure their value not just by financial performance but also through environmental, social, and governance (ESG) lenses. Over the past 20 years, ESG has become central to global sustainability agendas. Many countries have actively integrated ESG into finance, investment, and industry, with the U.S. and Europe previously racing ahead together as leaders in ESG investment.
Since 2021, however, amid shifts in global political and economic dynamics, a strong anti-ESG sentiment has gained traction in the U.S., fueled by arguments that ESG hampers economic growth. This sentiment has escalated into political action, with more than a dozen states passing anti-ESG legislation and others considering similar measures. Under political pressure, major U.S. financial institutions like JPMorgan Chase, Goldman Sachs, and Citigroup announced their withdrawal from international ESG coalitions in 2024. Simultaneously, U.S.-based ESG investment funds have seen continuous outflows, leading to a 77% year-over-year drop in net global ESG fund inflows in the first three quarters of 2024.
Sustainable development is unquestionably the world’s most pressing challenge in addressing resource, environmental, and social issues. But with the world’s largest economy turning away from ESG, can its future still be considered promising?
China is currently in a catch-up phase in the ESG space. Within the healthcare industry, some forward-looking companies are actively integrating ESG into their operations and have already seen early results. However, with shifting global sentiment, will their commitment to ESG change?
To explore these questions, ‘Health Insight’ recently spoke with experts from investment institutions, listed companies, and leading industry organizations. They agree that sustainable development is an inevitable trend, but for businesses, ESG is not merely a report or rating—it is a journey from concept to execution, culminating in value creation and the evolution of business civilization. To complete this ESG journey, companies must pass through three critical gateways.
The Gateway of Belief
Looking beyond the noise: truly valuing ESG
Dr Jianzhong LU, a board member of the Global Reporting Initiative (GRI), believes that the evolution of business toward higher forms of civilization is a historical inevitability—unstoppable by any single force. The recent ESG retreat in previously leading markets presents a rare opportunity for China to take the lead.
Crystal Zang, Executive Vice President and CFO of Ping An Good Doctor, shares a similar view. In 2024, Ping An Good Doctor earned an AA ESG rating from MSCI and ranked first for overall ESG performance among health care providers and services. Crystal Zang believes healthcare companies are inherently aligned with social responsibility, making them naturally suited to ESG principles. In times of global uncertainty and fragmentation in ESG, she sees opportunities instead of obstacles: “We need to reflect deeply—from the industry to each company—on how ESG can be meaningfully practiced.”
Despite the backlash in the U.S., the global ESG foundation remains resilient.
On the policy front, according to a Ping An Securities report, while the EU continues to lead in ESG disclosure and rating regulations in 2024, more economies—including China, Australia, Singapore, and Malaysia—have developed localized disclosure frameworks. All three major Chinese stock exchanges have issued ESG reporting guidelines, signaling that mandatory ESG disclosure for listed companies is on the horizon.
As of the end of September 2024, 5,348 institutions had signed onto the UN Principles for Responsible Investment (UN PRI), managing over USD 120 trillion—surpassing the world’s total nominal GDP for the year. Despite net outflows in the U.S., global ESG funds have reached USD 3.3 trillion and continue to attract net inflows. China's domestic capital market has also made strong progress, with the number and scale of ESG funds rising significantly under the guidance of sustainability goals and the national dual-carbon targets.
Junxian Wang, ESG Associate Director at C-Bridge Capital’s healthcare infrastructure platform, shared that many investors, particularly large mutual and sovereign funds, are increasingly concerned with whether their investments qualify as “responsible.” “Recently, European investors have shown the strongest interest in ESG, followed by those in the Middle East. Although U.S. private equity investors are less enthusiastic—due to economic pressures and geopolitical tensions—there hasn’t been strong opposition either. Many are just waiting to see if the trend reverses.”
From a management perspective, Crystal Zang emphasizes that internal motivation also drives ESG efforts. For instance, Ping An Good Doctor’s mission—to create happy workplaces for companies, provide family doctors for every household, and enable longevity for every user—naturally aligns with the social responsibility dimension of ESG. Moreover, the unique nature of the healthcare sector demands attention to issues such as equitable access to medical resources and data security. ESG evaluation frameworks, through quantitative indicators, can also enhance operational efficiency when closely integrated with business functions.
Dr. Jianzhong Lu believes that integrating social and commercial value creation actually expands the room for companies to survive and thrive. He also stresses the need for ESG awareness to become an industry-wide consensus. Right now, ESG performance among Chinese companies is highly polarized, with a significant gap between leaders and laggards. “The weaker players pose serious risks to the entire industry. We must help them catch up and build a solid middle tier—only then can the industry be truly healthy.”
The Gateway of Practice
Beyond superficial gestures: deeply integrating ESG with corporate management
Crystal Zang is particularly cautious about one common pitfall—when ESG becomes a surface-level exercise disconnected from a company’s actual business performance system. “You can’t have great ratings and flashy publicity on one hand, while your ESG work is totally detached from how your business performs.”
She argues that if ESG ratings don’t reflect real substance, and ESG metrics lack a logical connection to business operations, companies will struggle to gain credibility with investors.
“In my view, Ping An Good Doctor has developed a thorough understanding of how ESG can truly empower business operations—and, more importantly, it has acted on that understanding.”
Crystal Zang recalls the company’s ESG journey: starting in 2020, Ping An Good Doctor began actively focusing on ESG, followed by launching a comprehensive ESG framework, establishing a Sustainability Committee, and formulating the “CARE” strategy centered on sustainable ecosystems, tech empowerment, data security, and inclusive healthcare. At the heart of these actions lies one principle—embedding ESG into corporate governance and operational practices.
Ping An Good Doctor's CARE Sustainable Development Strategy
Structurally, Ping An Good Doctor’s board of directors, Sustainability Committee, and dedicated execution teams each take on responsibilities for strategic planning, goal management, and task implementation in ESG. With this framework, the company has internalized ESG as part of its core development strategy—integrating over 20 sustainability topics into its business processes, management practices, and service innovation.
This transformation isn’t easy. For companies, ESG represents a profound shift in governance. “Traditional management focuses on profit and maximizing shareholder value,” Dr. Jianzhong LU explains. “ESG, on the other hand, involves developing a sustainable business model centered around stakeholders—investors, customers, suppliers, communities, government bodies, and NGOs—and finding the greatest common ground among their interests.”
With so many ESG indicators out there, how should companies prioritize them? Junxian Wang believes it depends on the type of healthcare business—each company has different ESG focal points. “You don’t need to be perfect across the board. Excelling in one key area can become your ESG signature.”
Crystal Zang explains that Ping An Good Doctor focuses on two core ESG priorities. The first is inclusive healthcare and social responsibility: “For example, we address the needs of underserved populations by training village doctors and upgrading rural facilities to bring healthcare to remote areas—creating synergy between business value and social impact.” The second is technological empowerment to improve quality and efficiency: “Our self-developed AI model ‘Ping An Medical Master ®’ supports diagnosis for over 2,000 diseases, achieving a triage accuracy of over 99%. At the same time, our use of technology strengthens privacy protection and data security.”
In addition to strengthening internal ESG capabilities, building a sustainable supply and ecosystem is also critical. Dr. Jianzhong LU shared with ‘Health Insight’: “Many companies report that clients are now asking for carbon footprint reports, ESG ratings, or certifications for green products and supply chains. If they can't provide these documents, they risk being dropped from supplier lists or losing contracts—posing a real threat to survival.”
“In our external investments, we also evaluate the ESG characteristics of the target company to ensure alignment with our corporate and ESG strategies,” Crystal Zang adds. “Given the heavy regulation in healthcare, we must be vigilant against black swan and gray rhino risks. This requires us to invest not just in our operations but also in the broader industry ecosystem.”
The Gateway of Value
How does social responsibility translate into measurable value?
“Economic sustainability is a core part of sustainable development,” notes Junxian Wang. While investors tend to favor companies with strong ESG performance, he emphasizes that ESG is not the only lens investors use. “Some scholars even replace ESG with the three Ps: People, Planet, and Profit. Among them, profit remains the most crucial—without profit, a company’s vision cannot be sustained.”
In 2024, Ping An Good Doctor not only secured an AA rating from MSCI but also achieved its first annual profit—reaping both social impact and financial success. Crystal Zang shared that many investors have taken note of the company’s strong ESG credentials, and she remains confident about attracting even broader investor support going forward.
However, ESG doesn’t directly generate profits. Unlocking its value is perhaps the most critical—and most challenging—step for companies committed to long-term ESG strategies.
For ESG value to be monetized, two conditions must be met: market recognition and quantifiable metrics that support valuation. Among the ESG pillars, the Environmental (E) component currently has the clearest path. In China’s capital markets, ESG investments are most popular in areas like new energy, green buildings, and sustainable manufacturing. These sectors align closely with China’s carbon neutrality and peak emission goals, and enjoy a range of incentives—subsidies, tax breaks, and access to green finance. As China continues to build out its ESG regulatory framework, rating systems, and investment infrastructure, a policy-driven approach remains the safest ESG investment route. Moreover, “dual-carbon” goals are highly quantifiable, and carbon trading markets are already well-regulated.
In contrast, quantifying and monetizing the Social (S) and Governance (G) dimensions—and incorporating them into valuation models and ESG investment strategies—remains an open challenge. Governments, investors, rating agencies, and industry bodies all need to collaborate in overcoming this hurdle. For healthcare companies focused on S and G, this represents a critical area for future breakthroughs.
That said, ESG performance in healthcare companies still offers meaningful reference value for investors.
“You need financial strength before you can build a good reputation,” Junxian Wang admits. “A company with strong ESG performance is usually financially sound. The capital market is pragmatic—if a business is underperforming, no amount of ESG posturing will help; in fact, it might even come across as greenwashing.” In healthcare investment, he says, ESG metrics can at least serve as a useful screening tool for avoiding risk.
This underscores the importance of an appropriate ESG evaluation system. Studies show that while international ESG frameworks are authoritative, they don’t always align with China’s specific context. A standardized, locally-adapted ESG rating system is still needed.
Crystal Zang believes that a localized ESG framework must, first and foremost, reflect China’s economic and social realities. It should also be grounded in industry practices and focus on how ESG indicators—especially those under S and G—can form closed loops within business operations.
In other words, ESG must not only be embedded into corporate activities—it must also be evaluated and regulated through a system that respects business logic. Only when companies and stakeholders align on value orientation, and when governments, investors, and industry bodies work in tandem, can ESG deliver its full potential.
