Sri Lankan President Media Div​is/Redux

China’s Vaccine Stumble

by robert looney

robert looney teaches economics at the Naval Postgraduate School in California.

Published May 3, 2021.


Don’t look now, but China has discovered soft power. Beijing, better known for its brass-knuckles tactics in dealing with neighbors from Vietnam to South Korea to Japan, is attempting to position itself as the champion of developing countries by providing free vaccines to nations that might otherwise be relegated to the end of a very long line. But this is a hard road for a country that demands fealty in almost all foreign endeavors, economic and diplomatic. And the strains are already showing, as rival India was beating China at its own game before the latest surge of Covid-19 pounded the South Asian giant.

Head Start 

Beijing approved distribution of its Covid-19 vaccines in December 2020 — a rapid rollout aided in part by mass testing on the People’s Liberation Army. By February 2021, China was exporting both the Sinopharm and Sinovac vaccines to 22 of the 53 countries it hoped to supply in Asia, Eastern Europe and Latin America. 

China’s vaccine largesse came as the World Health Organization (WHO) was struggling to assist low-income countries through its COVAX initiative. Only about two billion of an intended six billion COVAX doses are slated for distribution in 2021. And with production delays and safety concerns dogging two of its vaccines, COVAX supplies may lag the target for delivery as more affluent Western countries elbow their place in line. This gave China an opportunity to burnish its new role on the global high ground, while smoothing over bruised feelings among less-than-satisfied partner countries.

In the Balkans, where China has long sought to increase its influence, the pandemic has threatened to overwhelm the region’s fragile health systems. Beginning in the early months of 2020, China shipped free masks, medical equipment and in some instances medical staff to operate them. By the fourth quarter of 2020 it was becoming clear that Covid-19 vaccines would not be arriving any time soon from the EU, so China followed up its “mask diplomacy” with offers of vaccine.

While most Balkan countries still pinned their hopes on vaccines and financial aid from the EU, their governments didn’t look a gift horse in the mouth. For China, it was an opportunity to make amends for the Belt and Road Initiative programs’ failure to deliver on their promise of high-profile infrastructure-led economic growth in the region.

Amends were plainly in order: the BRI has been light on results and heavy on debt for its Balkan partners. A Chinese-funded highway project to connect Montenegro’s Adriatic coast to Belgrade helped push public debt from 66 percent of GDP in 2017 to nearly 80 percent in 2019, even as project deadlines were repeatedly pushed back. By 2021, the situation had deteriorated to the point that Montenegro asked the EU for help servicing its Chinese road loan. In North Macedonia, a similar Chinese-backed highway project has overrun its original deadline, with no completion date in sight.

Actually, China’s unimpressive delivery of infrastructure has an echo in criticisms of the Chinese vaccines. The first complete vaccine trial data for a Chinese vaccine wasn’t released until mid-April 2021, after which China’s top health official admitted that the efficacy of the Chinese vaccines being exported to the world was “not high.” China is currently conducting further trials to see if mixing vaccines can close the gap.

In contrast, the EU has acknowledged that COVAX is not yielding satisfactorily rapid results and promised an improved effort that includes establishing a unique delivery mechanism for the western Balkans. Given that most western Balkan countries are EU hopefuls, it’s likely they will look to Europe for help, rather than settling for the problematic Chinese vaccines.

China is using its vaccine diplomacy to advance local acceptance of BRI infrastructure projects stalled by cost and/or environmental concerns, as well as to bully Southeast Asian countries into withdrawing their objections to Chinese incursions in multinational waters of the oil-rich South China Sea.

Not surprisingly, China has been more successful in exerting its leverage in countries where likely alternative vaccine suppliers don’t exist. In the PhilippinesIndonesia and Myanmar, China is using its vaccine diplomacy to advance local acceptance of BRI infrastructure projects stalled by cost and/or environmental concerns, as well as to bully Southeast Asian countries into withdrawing their objections to Chinese incursions in multinational waters of the oil-rich South China Sea. Philippine President Rodrigo Duterte quickly declared that his government would stop opposing China in the territorial dispute as he begged China for preferential vaccine access.

China is also using its vaccines to reduce international opposition to its claims to Taiwan, Tibet and Hong Kong, as well as to its violent repression of predominantly Muslim Uyghurs in Xinjiang province. For example, Guyana and Dominica received vaccines after backing China’s “One China Policy,” while Egypt and Kyrgyzstan received their vaccines only after expressing support for China’s position toward Xinjiang.

There’s another wrinkle to China’s vaccine diplomacy. Given production constraints, China must struggle to meet its ambitious export targets while delaying the completion of vaccinating a billion-plus Chinese adults. And further complicating matters, China has drawn India into the vaccine diplomacy game.

India’s Roll-Out

Before the pandemic, India manufactured roughly 60 percent of the world’s vaccines. India’s Covid-19 vaccine roll-out, which began in January 2021, currently involves two vaccine lines: Oxford/AstraZeneca, which is manufactured under license by the Pune-based Serum Institute of India and marketed as Covishield, and Covaxin, a home-grown product developed by the Hyderabad-based Bharat Biotech in conjunction with the Indian Council of Medical Research. By late February, India had given away 6.8 million vaccine doses worldwide, dwarfing China’s largesse.

India’s vaccine maitri (vaccine friendship) is rooted in Prime Minister Narendra Modi’s “Neighborhood First” foreign policy and has enabled other South Asian states to start vaccination drives without waiting for COVAX (or Chinese) supplies. The first recipient was tiny Bhutan, which has strong ties with India — and does not have diplomatic relations with China.

On the same day it sent vaccines to Bhutan, India gave doses of Covishield to the Maldives, reinforcing popular support for the Maldives government’s pro-India foreign policy at the expense of the country’s pro-China opposition party. India has also supplied Sunni Muslim Bangladesh with vaccine through commercial sales as well as gifts, which has helped to ease resentment over a bigoted Hindu nationalist-inspired law that gave non-Muslim immigrants from Afghanistan, Pakistan and Bangladesh a priority track to citizenship.

India’s vaccine diplomacy in South Asia has proved more successful than China’s. Nepal was quick to approve Covishield while delaying authorization of China’s Sinopharm. Sri Lanka delayed approval of Sinopharm, while it had no problems with CovishieldChina’s pledge to donate Sinopharm shots to Afghanistan came weeks after India gifted its Covishield vaccines to the country. In Southeast Asia, Myanmar and Cambodia requested and received Indian-produced vaccines, despite the fact that both countries have closer economic and diplomatic ties with China.

India was also garnering favorable reviews worldwide from its contributions to COVAX and other international immunization efforts. In February, Ghana became the first country to receive a COVAX shipment, which consisted of 600,000 doses of the Indian-made AstraZeneca vaccine. Then in March, the Quadrilateral Security Dialogue (Quad), an informal diplomatic group consisting of India, the United States, Japan and Australia, announced its own vaccine program. Its goal is to produce one billion doses in India and distribute them through Australia, with a focus on providing Southeast Asia with a more effective alternative to Chinese vaccines.

All that said, India’s ambitious plans to vaccinate much of the world has to be put on hold in mid-April by the spectacular surge in Covid-19 cases at home. There’s no reason to believe, though, that they won’t get back on track when India’s domestic woes subside.

• • •

At least at this stage, China appears to be losing the vaccine diplomacy contest. After observing India’s surprising success, a Wall Street Journal editorial noted, “There’s nothing wrong with India’s ambition to develop homegrown vaccines. But as the country’s own experience shows, India does best when it is open and collaborative — and takes a little help from its Western friends.” China might take note.

main topic: Geopolitics
related topics: Public Health