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Workers transport the Sinopharm Covid-19 vaccine at the Phnom Penh International Airport in Cambodia. Photo: Xinhua

Can China stay ahead in the global vaccine diplomacy race as the US offers 80 million doses to the world?

  • Washington and its fellow members of the Quad earlier this year raised expectations they would play a key role in vaccine distribution - but India’s second wave put paid to that
  • China has taken the lead through its shipments of more than 265 million doses, as its tussle for influence with the US runs alongside the world’s urgent need for more inoculations
When Gayle Smith, the US State Department’s global coordinator for Covid-19, spoke to reporters on Wednesday about Washington’s vaccine distribution plans, one question kept coming up: would any of the 80 million doses US President Joe Biden pledged to share with the world go to Asian economies in need of them – such as India, Taiwan and Vietnam – or would supplies be fully distributed by the Covax vaccine-sharing programme?
Smith said she could not confirm the process at this point, but stressed that the United States was assessing “what the most effective allocation of these doses will be” based on countries’ needs.

Quizzed about whether Washington would be going against the principles of ensuring equity and of not practising vaccine diplomacy should it distribute supplies outside of the World Health Organization’s Covax Facility, Smith said: “We do not intend to use [vaccines] as means for influence or pressure, and our decisions will be made on the basis of need, public health data, and again, collaboration with key partners, absolutely including Covax.”

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The exchange has cast the spotlight on the increasing pressure faced by the US to share its excess supply of vaccines, as domestic Covid-19 cases fall and close to 60 per cent of American adults over the age of 18 have received at least one shot. Earlier this week, WHO head Tedros Adhanom Ghebreyesus said the world was in a state of “vaccine apartheid”, with poorer countries that made up half the world’s population having received just 17 per cent of doses.
In Asia, the US and its fellow members of the Quad alliance – Australia, India and Japan – had in March raised expectations that they would play a key role in vaccine distribution.

The Quad’s leaders, in seeking to demonstrate unity against China’s growing influence, announced after a virtual meeting that they would, among other things, expand vaccine production. The plan was for the US, Japan and Australia to provide funding for India, the No 1 producer of vaccines globally, to manufacture up to 1 million doses for distribution to Asia – mainly Southeast Asia – by the end of next year.

03:26

India’s mass-vaccination drive falters as country hits 20 million coronavirus cases

India’s mass-vaccination drive falters as country hits 20 million coronavirus cases
But a surge of Covid-19 cases in India soon after saw Prime Minister Narendra Modi’s government freeze vaccine exports. The Serum Institute of India, the world’s largest vaccine manufacturer, has not been able to fulfil production commitments of the Oxford-AstraZeneca vaccine for Covax, and recently said it could probably only restart exports to the facility and other countries later this year. Covax has only shipped out 68 million doses to developing nations so far, falling behind its target of 2 billion doses this year.

In comparison, China has shipped about 265 million Covid vaccine doses, more than all other nations combined, with commitments to provide 440 million more, according to science information and analytics company Airfinity.

Speaking at a Global Health Summit late on Friday, Chinese President Xi Jinping said that on top of providing additional vaccines, China will provide an additional US$3 billion in international aid over the next three years to support pandemic response and economic and social recovery in developing countries. Xi said Beijing will also support Chinese vaccine companies in transferring technologies to and carrying out joint production with developing countries.

Russia, meanwhile, has signed agreements for the production of 700 million doses of its Sputnik V vaccine abroad, but had produced just 33 million vaccines as of May 12 and exported fewer than 15 million, according to a Reuters tally that counted each vaccine as consisting of two doses. Moscow is reportedly in talks with Indian pharmaceutical companies and 20 other manufacturers in 10 countries including China, South Korea and Kazakhstan to produce the vaccine.

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Analysts say it remains to be seen whether the promised donation from the US can help the Quad play catch-up. Hannah Elyse Sworn, a senior analyst with the S. Rajaratnam School of International Studies (RSIS) at Singapore’s Nanyang Technological University, said the problem was that the Quad countries were not centrally in control of producing and supplying vaccines.

Beijing had a head start through its regional production hub for the Sinovac vaccine in Indonesia, she said, adding that even if the Quad countries were able to deliver on their vaccine promises in the next two years, people in the region might have already turned to Chinese vaccines.

“Given the potential risks associated with mixing different types of vaccines, these additional vaccines might be too late,” Sworn said.

CHINA: 1, QUAD: 0?

Yury Yarmolinsky, an analyst with the Belarusian Institute for Strategic Research, said in the vaccine diplomacy race, “the winner will be the one who moves faster from declarations and rhetoric to concrete steps”.

“Chinese vaccine manufacturers are seeking to ensure technology transfers to accelerate their development and supply, primarily to developing countries along the Belt and Road routes,” Yarmolinsky said, adding that the tally for China versus the Quad was “1:0 in favour of the Celestial Empire”.

Bakshi Hardeep Vaid, a professor at the Nanjing University of Information Science and Technology, said India – which has recorded more than 26 million infections and is facing a severe vaccine shortage, with only about 13 per cent of its 1.4 billion people inoculated – would not be able to help with vaccine supplies for the world at this point.

In fact, The Hindu newspaper reported that external affairs minister S. Jaishankar was expected to head for the US next week to try to procure more vaccines from American drug makers.

“Delhi has even allowed Indian states to import vaccines from international manufacturers,” Vaid said, adding that Japan and Australia were unable to pick up the slack as both were still focused on inoculating their local populations. Canberra has also offered limited doses to the Pacific island nations, where there is competition between Beijing and the West for influence.

Li Xing, a professor of development and international relations at Denmark’s Aalborg University, said the other three Quad members’ “slow reaction or symbolic help” to India’s Covid-19 crisis suggested their ties were based on a “marriage of convenience … not a real security community”.

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Jeremy Youde, dean of the College of Liberal Arts at the University of Minnesota Duluth in the US, said there were other ways for Quad countries to stay true to their pledge of ramping up vaccine manufacturing in the region – such as being advocates from within the World Trade Organization (WTO) to allow for patent waivers of Covid-19 vaccines.
“It is one thing for governments to say that they won’t oppose a waiver or that they support it, it’s another thing entirely for them to use their diplomatic capital to promote this outcome,” Youde said, referring to the US joining India, South Africa and several developing countries earlier this month in calling for a temporary waiver of patents for Covid-19 vaccines, in the hope of boosting production and allowing a fairer distribution across the world.

But the leaders of the G20, a grouping of the world’s largest economies, have watered down the US plan and instead suggested leaving it to drug makers to voluntarily share licences of vaccine patents.

The European Union and other vaccine-producing countries argued that there were other ways of ramping up global production, such as the removal of US export restrictions on vaccine raw materials, the transfer of know-how and voluntary cooperation among vaccine makers. On Friday, European Commission president Ursula von der Leyen said Europe aimed to donate “ at least 100 million doses to low- and middle-income countries by the end 2021”.

Sworn of the RSIS said the waiver would only be effective if there were supplemental aid or loan packages for countries to invest in manufacturing capabilities and technology. And, she said, this would require the US to pressure pharmaceutical companies to engage in technology transfers to potential manufacturers in other countries if the firms were unwilling to do so.

02:01

China considers mixing Covid-19 vaccine types to boost effectiveness

China considers mixing Covid-19 vaccine types to boost effectiveness

A ‘COVID-19 QUAD’ LED BY CHINA?

Beijing’s upper hand in being the provider of vaccines to the developing world will likely get a further boost from the WHO’s recent authorisation of the vaccine made by China’s Sinopharm Group, paving the way for Chinese shots to be distributed through Covax. The WHO is expected to approve the Sinovac inoculation soon.

But concerns over the efficacy of the Chinese shots, which show lower protection rates compared with other vaccines, could compromise Beijing’s lead. In some communities, there is also resistance to China-made shots – such as in Vietnam, where Hanoi will face challenges in convincing its population to be inoculated if it accepts vaccine help from China.

Another issue is the perception that Beijing is using the vaccines to pressure countries diplomatically.

Taiwan last week accused China of seeking to use the shots for political gain after its diplomatic ally Honduras said it was considering opening an office in China in a bid to acquire the much-needed vaccines. Last month, Beijing was similarly accused of offering Chinese-made vaccines to pressure Paraguay to sever ties with Taiwan, which only has 14 diplomatic partners worldwide.

Youde of the University of Minnesota Duluth said the distribution of Chinese vaccines through Covax might help negate these perceptions, which came about because “bilateral efforts mean that the choices about which countries receive the vaccine are almost inevitably tied with the donor state’s geopolitical concerns”.

“This then leads to allegations that the efforts are more about establishing a market for pharmaceuticals rather than a genuine interest in helping,” he said, pointing out that India had also used vaccines as a diplomatic tool to counter China’s influence. India had exported almost 69 million doses to nearly 100 countries before it stopped due to the surge in domestic infections.

“While I wouldn’t say that the motivation is solely about competition or that altruism plays no role, it’s hard to deny the competitive part of the equation,” Youde said.

A health worker administers a dose of the AstraZeneca vaccine at the Bach Mai Hospital in Hanoi. Photo: AFP

Analysts said Beijing could extend its current advantage if it showed partner countries it was focused on helping them beyond stopping the immediate spread of the coronavirus.

“If the Chinese government’s outreach to other countries puts this holistic sense of recovery front and centre, that could prove incredibly attractive and beneficial to the countries at the negotiating table,” Youde said.

Chinese Foreign Minister Wang Yi’s video conference with his counterparts from Afghanistan, Pakistan, Nepal, Sri Lanka and Bangladesh last month sparked talk of this “Covid Quad”, as India was noticeably absent from the discussion on how to combat Covid-19 and ensure post-pandemic economic recovery in the region.

Apart from providing medical supplies and technical assistance to participating countries, China also announced the setting up of an emergency supplies reserve, a poverty reduction and development cooperation centre, and a forum on rural e-commerce poverty reduction cooperation.

However, Sworn from RSIS said she believed Beijing was most comfortable with bilateral set-ups so it could maximise the soft power benefits that came from being the sole or major benefactor of vaccines and economic recovery assistance.

“As a growing power, China doesn’t feel the need to form a similar grouping where it would have to compromise its interests by establishing and adhering to shared principles with diverse partners,” she said.

As Washington decides how to allocate the 80 million vaccines from its stockpile, Youde said sending the supplies through Covax would still send a “powerful message” to the world.

“It would be further proof of the US’ willingness to re-engage with the global health system after the Trump presidency,” he said.

Additional reporting by Reuters and Bloomberg

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