Are COVID-19 vaccines the key to world power?

HEALTH AFFAIRS: In the competition between China, Russia and the West to wield influence, there’s a formidable new weapon.

WORKERS UNLOAD containers transporting the first batch of Russia’s Sputnik V COVID-19 vaccine at an airport on the outskirts of La Paz, Bolivia, in January. (photo credit: DAVID MERCADO/REUTERS)
WORKERS UNLOAD containers transporting the first batch of Russia’s Sputnik V COVID-19 vaccine at an airport on the outskirts of La Paz, Bolivia, in January.
 Prime Minister Benjamin Netanyahu’s decisions to exchange COVID-19 vaccines for an Israeli woman jailed in Syria and to offer doses to allies as a sign of gratitude are part of a shifting dynamic in which a medical serum will join energy and arms as an effective tool in wielding world power.
While economics and diplomacy have forever been intertwined, the commodities of 2021 have shifted. Today, COVID-19 vaccines are the most precious resource on the market. And some of the countries that have them are using them to strengthen and accelerate their global influence.
“The newest entry to the pandemic lexicon might be ‘vaccine diplomacy,’ with some countries using their jabs to strengthen regional ties and enhance their own power and global status,” Dr. Michael Jennings of the SOAS University of London told The Jerusalem Post.
While it is unlikely that vaccine diplomacy will shift world power on its own, according to Eckart Woertz, a professor of contemporary history and politics of the Middle East at the University of Hamburg, it has undeniably become another “aspect of a growing power competition” between China, Russia and the West.
Take what happened with Bolivia. As the country struggled to purchase COVID-19 vaccines, its incoming president, Luis Acre, turned to Russia for help.
“It was a really marathon task,” said Bolivian trade minister Benjamin Blanco of the procurement quest in an interview with a Japanese newspaper, The Japan Times, “but Russia’s political will made it possible.”
He said that Western vaccines makers had told the country that it would have to wait until June to receive any doses. As such, Bolivia secured enough shots from Russia to start inoculating its population in mid-January.
On January 19, Acre spoke with Russian President Vladimir Putin.
“The two leaders discussed reviving Russian investments in Bolivia to develop gas reserves, rekindling a nuclear plant project and cooperating on lithium mining,” said Blanco, according to the Japanese daily.
A similar dialogue played out in Egypt, where Russia is already invested in developing a nuclear power plant.
While the United States, Europe and, of course, Israel have spent the last two months vaccinating their own citizens first, China and Russia are sending millions of coronavirus vaccine doses to countries around the world and lagging in their efforts at home.
Russia is home to around 145 million people. It launched its vaccination campaign in December, and, so far, according to a February update released by the country, around two million citizens have been vaccinated.
Nearly two-thirds of Russians are not willing to receive Russia’s Sputnik V vaccine, a poll conducted by the Levada Center revealed this week.
China has 1.4 billion citizens. A February report showed that only around 1.6% of China’s population received their first shot by the end of January, and that pace has not really picked up.
A senior health adviser told Reuters earlier this week that the country aims to vaccinate 40% of its population by the end of July, a figure that most analysts have indicated is untenable.
An argument can be made for focusing inward during a time of crisis. But there are growing indications that the West will resurface from the pandemic in a year or two having ceded a critical soft power advantage to its non-democratic rivals.
“Out of humanitarian considerations but also because of their own interests, the US under the new Biden administration and the Europeans should and probably will push their own versions of vaccine diplomacy,” Woertz said.
“Russia and China are using the rollout of their own coronavirus shots to advance their interests,” explained Agathe Demarais, global forecasting director and trustee for the Economist Charitable Trust, an independent charity that is meant to leverage the journalistic expertise of The Economist newspaper.
She said that Russia and China are using their vaccines as part of a long-term strategy to reassert their global footprints, making it harder for the countries they help to say no to their demands in the future.
A report by the Economist Intelligence Unit, for which Demarais works, explained that “in early 2021 three vaccines, from Pfizer (US)-BioNTech (Germany), Moderna (US) and AstraZeneca-Oxford University (UK), will be rolled out on a massive scale in developed countries. Meanwhile, Chinese and Russian vaccines are being rolled out both domestically and to emerging countries such as Egypt, via diplomatic bilateral deals. This will foster so-called vaccine diplomacy – with Russia and China trying to bolster their global status via the delivery of vaccines – this year and beyond.
“Both countries will also seek to adopt a transactional approach to the delivery of vaccines, using coronavirus shots as a bargaining chip to advance their national interests,” the report said.
Developing countries are vulnerable and therefore susceptible to this type of diplomacy. The Economist report showed that of the around 12.5 billion doses that the main vaccine producers have so far pledged to produce this year, more than half have already been preorders, mostly by wealthy countries. Unlike for Israel, which reportedly paid more than other countries to secure its doses, this is not an option for poorer countries.
The COVAX international effort to supply vaccine doses to developing countries, which is backed by the World Health Organization, is unlikely to be able to vaccinate many developing countries until the end of 2023, The Economist predicted, making alternatives more attractive.
COVAX committed to secure six billion vaccine doses for poorer countries, including two billion that would be given already this year, mainly to healthcare workers. But the supplies have been slow to arrive and be delivered. Moreover, many developing nations do not have the staff or infrastructure to administer the vaccines when they get them.
Some COVID-19 vaccine doses were administered for the first time earlier this week in Africa, for example. So far, the program has allocated doses to India, Ghana, Cote d’Ivoire and the Republic of Korea, among other places.
“Vaccine diplomacy could play a big role in determining which developing countries get access to a vaccine in the coming months,” Demarais said.
In the case of China, it is using its homegrown vaccines – now there are four – as a central component of its Belt and Road Initiative to physically connect Asia with Africa and Europe via land and maritime networks, thereby increasing trade and stimulating economic growth.
The country has agreements to send doses to somewhere between 40 and 60 countries, mostly across South American and Africa, according to various reports and statements.
“In early February, half a million doses of the Chinese Sinopharm COVID-19 vaccine arrived in Pakistan, before soon also reaching 13 other countries, including Cambodia, Nepal, Sierra Leone and Zimbabwe,” Jennings wrote in an article on the subject. “The Chinese ambassador to Pakistan declared it a ‘manifestation of our brotherhood,’ a sentiment echoed by the Pakistani government.”
Chinese companies and the government have been working in Ethiopia to create cold-chain infrastructure to help transport and distribute vaccines.
Quality and transparent data on Chinese vaccines has been scant, leading some to question the efficacy of their shots. In the clinical trials data that have been published, the Chinese vaccines appear to be less effective than their Western or Russian counterparts. But they do have some advantages for developing countries, such as that they do not require storage in ultracold environments. The newest one requires only one shot.
In any case, for poorer countries that might otherwise not be able to get their people jabbed, a Chinese vaccine would be better than nothing.
This week, the Russian Direct Investment Fund announced the approval of its Sputnik V vaccine by regulatory authorities in the Republic of Angola, the Republic of the Congo and the Republic of Djibouti – making it approved for use in 42 countries with a total of 1.1 billion people, RDIF said.
Sputnik V, like the Chinese vaccines, at first raised skepticism among scientists that the vaccine had not been properly vetted for safety and efficacy. But a February report published by The Lancet on its most recent trials showed that the vaccine has a 91.6% efficacy rate – on par with its Western competitors – and no severe side effects.
AS NOTED, in the US and Europe, governments have been focusing on getting coronavirus vaccines to as many citizens as possible, especially the most vulnerable. With an eye toward the contrary efforts being made by Russia and China, some in the West have “sought to cast doubt on the credibility of Chinese and Russian efforts, presenting them as cynical ploys for diplomatic advantage,” Jennings said. “You may be getting vaccines, they have been telling the world, but at what cost in your obligations to Russia and China.”
Several thought leaders are inclined to agree.
While no doubt vaccinating as many people in as many places as possible will help bring an end to the global pandemic and, on the one hand, China and Russia are cooperating in their diplomatic efforts, on the other hand, they are “directly competing for the same vaccine markets – and the national prestige that comes with it,” Prof. Elizabeth Wishnick of Montclair State University told the Post.
“Chinese officials want their country to be remembered for Silk Road health diplomacy and successful vaccine development, not China’s role in the pandemic’s origin and spread,” she wrote in a recent post.
Russia also hopes to use the vaccines to improve its public image.
Russia named its vaccine Sputnik V after the Soviet-era satellite that triggered the space race, a nod to the project’s geopolitical importance for Putin.
The satellite launch “changed global perceptions of Soviet military and space power,” Wishnick said. “Kremlin officials see Sputnik V enhancing its soft power overseas and raising the profile of Russian science.”
Jennings said that Russia’s reputation for more than a decade has taken a considerable beating, from being accused of using chemicals and other forms of poisoning to harm opposition figures, human rights violations, and attacks on democracy. Being able to deliver a vaccine that shows scientific strength and knowledge, and then to donate it to help others, could help convert the country’s image from rogue regime to trusted international actor.
“Poor countries will remember who came to their assistance, and when,” The Economist wrote in its report. “Moscow and Beijing saw an opportunity early on, sending masks and protective gear to hard-hit countries last spring. Now, with low- and middle-income countries clamoring for vaccines, countries from Serbia and Algeria to Brazil and Egypt are getting doses from China and Russia.”
Russia and China are presenting themselves as “saviors” of populations in emerging countries, Demarais said, while Western nations are being presented as rich and greedy countries whose vaccines are expensive, leading to a high level of resentment against them.
“Russia and China want to show, ‘we are not like them,’” Demarais said, referring to Western countries. “They say, ‘We have cheap, almost free vaccines, and we have come to save you.’”
But vaccines are not free.
Because it is likely that coronavirus is going to be in the world for many more years, and that even those who are vaccinated will likely need to get booster shots at minimum yearly, it can be assumed that the vaccine ties being formed today will last at least as long.
Russia does not have the manufacturing capacity to produce all the doses it has committed. As such, it deepened ties with Brazil, India, China, Iran, and South Korea – countries that are now producing Sputnik V vaccines on the Kremlin’s behalf.
In mid-February, RDIF told the Financial Times that it had signed contracts with 15 manufacturers in 10 countries to produce 1.4 billion jabs, enough to vaccinate 700 million people.
“These are not short-term vaccine deals,” Demarais stressed. “This is not just shipping” the vaccines. She said Russia and China are coming with their factories, training local workers, and exerting their influence.
Eventually, she said, it is likely that a country like Russia would create a training program on its own soil and bring locals from these countries to Russia to study and be trained – establishing further goodwill and connectedness.
As the vaccine plants grow, they will become a source of employment and further able to have influence in these countries.
To sign a deal with a country – as opposed to a pharmaceutical company – entails “a completely different mindset,” Demarais said. “When you have a deal between a country and a country, you are talking about politics and diplomacy. These vaccine deals are political.”
Of course, China and Russia are not the only countries that have gotten in on the game.
India, too, has also started developing its own vaccines and shipping them abroad – in part, according to Wishnick, to counter China.
The United Arab Emirates, which is one of the leaders in vaccinating its own people, has also begun donating Chinese vaccines to countries where it has strategic or commercial interests.
“The prospect of global health becoming a new arena for global power competition and rivalry should worry us all,” Jennings wrote. “Whatever benefits may have emerged from such rivalries in the past, they did so through cooperative rivalry.”
He said the global response to coronavirus has thus far been mostly “uncooperative and divisive” and that it is essential that all countries put their support behind COVAX.
“Protecting only your country is not sufficient,” Jennings told the Post. “It increases the opportunity for new strains to emerge that may become resistant to the vaccines.”
“Any working vaccine is helpful from wherever it comes from,” added Woertz.
He said that the large amount of Chinese and Russian vaccines being provided to other countries shows the high priority they attribute to vaccine diplomacy.
“However, over time I would expect the multilateral COVAX vaccination program that was launched by the WHO, the European Commission and the government of France to gain increased importance and possibly overshadow the Chinese and Russian efforts at vaccine diplomacy,” he said. “The multinational nature of the COVAX initiative is preferable to the national approaches of Russia and China.”
Demarais said she expects the US and EU to eventually want to get in on these efforts and, aside from the money they have committed to the COVAX program, also provide vaccines. But she does not envision such a move until perhaps next year, and by then, she said, it may be “too little, too late.”