How joining vaccine initiative Covax could be shot in the arm for China
- Adding its weight to the WHO-led alliance is also a way of safeguarding China’s own access to vaccines
- Engaging with global bodies and standards could aid acceptance of vaccines produced in China after past scandals
Joining the initiative, after having initially opted out, will give China access to vaccines not previously available in its domestic market and could help its scandal-plagued vaccine industry gain the international recognition it has lacked, experts said.
Nonetheless, the Chinese government has agreed to buy vaccines for 15 million people through Covax, and has boosted the initiative’s resources by pledging to deliver at least 2 billion doses of China-made vaccines, if approved, by the end of next year to be available to its 172 member countries.
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These doses may yet be needed to meet China’s own domestic demand as well, Tang Bei, assistant professor in the international relations and public affairs faculty at Shanghai International Studies University, said.
“Chinese vaccines look very promising, but joining Covax is like a double insurance to have access to all the vaccine candidates procured by Covax,” Tang said. Some vaccine candidates, including one developed by Germany biological company BioNTech and another by the University of Oxford and biopharma company AstraZeneca, could be available in China through Chinese partners, but others such as one being developed by US biotech start-up Moderna could not.
“China might not need those vaccines, but in the event of its production capacity not meeting demand, it can use its rights from joining Covax and purchase the vaccines,” Tang said.
Joining Covax is also an opportunity for Chinese domestic vaccine developers to increase their competitiveness and global presence, she said.
Shop window for China
“For China, joining Covax gives it a chance to demonstrate the responsibilities of a superpower and promote health diplomacy and international exchanges,” said a public health expert with experience of international vaccine procurement, whose name was withheld because he was not authorised to discuss the matter.
“It also lays the foundation for Chinese vaccines to go abroad and will undoubtedly increase their competitiveness in the international market.”
Nicole Hassoun, a professor of philosophy at Binghamton University who has been studying equitable access to Covax, said: “It seems most likely that China will have an opportunity to sign a multimillion-dollar agreement with Covax that will let Covax secure billions of vaccine doses if the Chinese vaccines prove to be safe and effective.”
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Fast track to approval?
Covax will consider procuring vaccines that complement its portfolio from any producers in the world that are approved by a high-standard regulatory authority or are classed as “pre-qualified” by the WHO, according to a Gavi spokesperson.
The WHO’s prequalification programme assesses the quality, safety and efficacy of drugs for United Nations agencies such as Unicef. The four non-Covid-19 Chinese vaccines that have previously been pre-qualified under the programme spent several years in preparation, but the programme has scope to fast-track vaccines for emergencies such as containing a pandemic.
That, though, “mainly depends on the quality control capabilities of the national regulatory agency and the vaccine manufacturers”, according to the public health expert with experience of procurement.
China’s regulatory body, the National Medical Products Administration, passed the WHO’s assessment in 2011 and 2014 and will receive its third evaluation in March.
But if they satisfy Covax, vaccine candidates would still need to pass the confidence test for countries to use them, with several recent Chinese vaccine scandals yet to fade from memories.
In 2016, vaccines worth 570 million yuan (US$85 million) were confiscated in the eastern province of Shandong because they had been improperly stored and transported.
The public health expert said such scandals had harmed the industry and the country’s image, but the fact that the problems had been uncovered by the drug regulator indicated the regulator was functioning and capable.
“In the aftermath of these incidents, China adopted a stringent law on vaccines, which promotes quality control,” he said.
Zha Daojiong, a foreign relations expert at Peking University, said joint development projects with foreign partners were conductive to quality evaluation and brand recognition.
Calling it “a form of vaccine nationalism”, Zha said it was “conceivable” that governments may base their decisions about vaccine imports on factors besides quality, such as nationality or geopolitics.
“Foreign scepticism about a made-in-China product is a fact of life,”he said.