The world is fast becoming ever more reliant on China for vaccines, with India’s raging virus outbreak stifling its ability to deliver on supply deals, even as the US tries to position itself as a champion of wider access.
Over the past few weeks, leaders of some of the world’s most populous nations have sought more shots from China, despite concerns about their effectiveness. Demand is expected to rise even further if the WHO, as expected, authorizes vaccines from China’s Sinovac Biotech Ltd and Sinopharm Group Co Ltd, allowing developing countries in Asia, Africa and Latin America to access them through COVAX, the global vaccination effort.
“China has become not just the largest exporter,” said Huang Yanzhong (黃嚴忠), a China specialist and senior fellow for global health at the Council on Foreign Relations. “In many countries it has become the only option.”
China’s reliability as a vaccine supplier is increasing its geopolitical clout at a time when the US and EU have been slow at confronting the global pandemic and COVID-19 hot spots are raging out of control in India, Brazil and elsewhere.
Compounding the difficulties, India’s crisis has dried up vaccine supplies and prompted many countries to turn toward China. Amid this backdrop, the US, for months preoccupied with its domestic vaccination push, has come under intense criticism for hoarding shots at the expense of a global response.
US President Joe Biden last week made it clear that the US intends to start playing a more active role.
On Wednesday, the US threw its weight behind a movement to waive patents on COVID-19 vaccines to allow other countries to manufacture them.
Biden is vowing that the US is to become an “arsenal for fighting COVID-19” globally, as outbreaks elsewhere in the world risk spawning dangerous variants that could prolong the crisis.
The administration’s efforts so far include plans to give away 60 million doses of AstraZeneca PLC’s shot and to ramp up production of doses made by Moderna Inc, Pfizer Inc and Johnson & Johnson.
In the meantime, countries from Uruguay and Senegal to Indonesia have few places to turn, apart from Beijing — and China is making the most of it.
The country has already shipped about 240 million doses, more than all other nations combined, and has committed to providing another 500 million, science information and analytics company Airfinity Ltd says.
India, the world’s third-biggest supplier after China and the EU, had exported 67 million doses to nearly 100 countries until its devastating COVID-19 outbreak prompted it to halt most deliveries in the past few weeks.
The WHO is weighing data on Chinese vaccines before a decision on clearance, which is expected in days or weeks. Access to the shots would provide a boost to the WHO-backed COVAX effort, which relied heavily on the Serum Institute of India before the clampdown on exports.
COVAX has shipped more than 50 million doses to 121 countries and territories, well short of its goal and just one-fifth of what the US has administered domestically. A new pact with Moderna has expanded COVAX’s portfolio, but only a fraction of the 500 million doses it pledged are to be available this year.
WHO authorization of Chinese vaccines could make an immediate difference for governments waiting for that stamp of approval before giving them to citizens. Sri Lanka, for instance, has so far used less than 1 percent of its 600,000 Sinopharm shots on foreign Chinese workers.
However, some experts are worried about the potential public-health effect of widely deploying Chinese vaccines that have demonstrated lower efficacy rates than those made by Pfizer and Moderna, and Chinese shots have already been hampered by a lack of trial data and a preference for vaccines from the Western companies.
“The WHO approval of Chinese vaccines will, in the medium term, help to strengthen Chinese power and authority within the region,” said Nicholas Thomas, an associate professor at the City University of Hong Kong and editor of several books on global health and foreign policy. “However, the low efficacy rate of the Chinese vaccines means that this is an easily contestable position if the Western countries can ramp up their own supplies,” Thomas said.
That is all the more reason for China to seize the moment while it can.
Chinese Minister of Foreign Affairs Wang Yi (王毅) last week vowed that China would provide vaccines to countries that had been dependent on India during a call with counterparts from South Asian nations.
On the same day, Chinese Minister of National Defense Wei Fenghe (魏鳳和) secured an agreement to enhance military cooperation with Bangladesh. The country later approved emergency use of the Sinopharm shot after 15 million doses it paid for from the Serum Institute of India failed to arrive.
Last month, Chinese President Xi Jinping (習近平) vowed to oppose “vaccine nationalism” in a call with Indonesian President Joko Widodo, whose government green-lit Sinopharm for emergencies soon afterward.
Indonesia also secured as many as 15 million more shots of Sinovac.
“In plain view, India’s export ban has made Indonesia increasingly dependent on vaccine supplies from China,” said Pandu Riono, an epidemiologist at the University of Indonesia.
Other countries have had to play nice with China on geopolitical spats.
India’s export delays deprived the Philippines of its biggest vaccine order at a time it is sparring with China over a territorial dispute.
Philippine President Rodrigo Duterte last week rebuked his top diplomat for an expletive-laced post on Twitter denouncing Beijing over the spat while his government negotiates with Sinovac for a monthly delivery of as many as 4 million doses.
“China remains our benefactor,” Duterte said. “Just because we have a conflict with China doesn’t mean to say that we have to be rude and disrespectful.”
Some countries relying on Chinese vaccines, such as Chile, have moved relatively swiftly. However, worries persist about their potency: A Chilean government study last month found that Sinovac’s vaccine is 67 percent effective in preventing symptomatic COVID-19 infections and wards off 80 percent of fatalities.
In Israel, Pfizer’s messenger ribonucleic acid shot was found to be 92 percent effective in preventing symptomatic COVID-19 infections and 99 percent effective at preventing deaths — although it is harder to transport and must be stored at ultralow temperatures.
India is confident it can ramp up supplies again in a few months once this outbreak is contained, said an Indian Ministry of External Affairs official in New Delhi who asked not to be identified.
The government sees China as trying to exploit India’s crisis, but is confident that other countries understand its predicament, the official added.
“The shipments are being repurposed for domestic purposes given the demand,” ministry spokesman Arindam Bagchi said. “We have already stated that our external supplies would be done keeping in mind our domestic requirements.”
Meanwhile, from Pakistan to Brazil and Africa, many ordinary people have expressed a lack of confidence in Chinese vaccines. In some areas of Africa, which is using shots from China, India, Russia and the US, skepticism on vaccines mirrors that in parts of the developed world.
“We are being told that these vaccines are meant to get rid of Africans, so for now I will watch and observe those that have been inoculated,” said Passmore Mwanza, a 29-year-old worker in Zimbabwe. “I don’t want to be part of an experiment of an outcome I don’t know.”
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