The World Mind

American University's Undergraduate Foreign Policy Magazine

China’s COVID Vaccine Diplomacy

Anna Janson

Ever since January 2020 when the first cases of COVID were discovered in Hubei Province, China has had a significant role to play in the development and distribution of COVID vaccine doses. The public-private partnerships which joined the resources of the Chinese government with the manufacturing capabilities of the country’s pharmaceutical companies have allowed them to make speedy progress, and that has opened opportunities for providing global assistance during the pandemic. Indeed, China has made offers to a number of countries in a move that could be seen as a public service, a strategic play, or a combination of the two. The Chinese government has pushed one narrative, of course, but there is no denying that China has extensive room for growth in terms of soft power. China’s capabilities have increased its competitiveness with the West and opened doors to its expansion on the national market. Though, much of China’s COVID vaccine operations remain ambiguous. Firstly, there is uncertainty about the safety and efficacy of the country’s three vaccines. There is also confusion and a lack of transparency surrounding the vaccine research. There is skepticism about China’s follow through and what they may ask for in return. There are also the Chinese people who need to be cared for. China is acting on the center stage during this COVID pandemic, and there is no unified expectation from its spectators.

Global Assistance from China

Last May, Chinese President Xi Jinping allocated large sums of money to about 17 vaccine projects and gathered 22 firms and research institutes to get to work. With this devotion to overcoming the pandemic that killed so many and initially tarnished China’s reputation, China has committed to delivering about half a billion doses of vaccine to over 45 countries. These countries are low and middle income, and they are struggling to meet their demand due to the costs and requirements of Pfizer, Moderna, and the like. One difference between these Western vaccines and China’s, for example, is that the latter do not require ultracold storage; standard refrigerators are sufficient. This alleviates the problem of transporting mass amounts of vaccines to areas without substantive infrastructure. Many low and middle income countries see China’s offer as more cost-effective and distributable than the other vaccines. 

Although the Chinese government rejects the phrase due to its negative connotations, this global assistance has been called “vaccine diplomacy.” Many suspect that China’s actions are less of a public service than they are a political move, and the Associated Press relayed “concerns about what China might want in return for deliveries.” It is not yet clear what China expects from the countries they have pledged to help, but no matter the intention, China has a lot to gain from this circumstance. 

China’s Competition with the West

China’s primary gains from assisting low and middle income countries are in regard to competing with the West. Assisting Serbia and Hungary, for example, is a “geopolitical victory in Central Europe and the Balkans.” This will give China greater economic influence in the region. This diplomacy is also about showing China’s advancements and proving that they can keep up with the United States. Foreign Affairs quoted a Chinese virologist who said that China is “not lagging behind the United States as far as the technology is concerned,” and the research is being conducted in public-private partnerships. President Emmanuel Macron of France said that China’s vaccine diplomacy was “a little bit humiliating” for the West, and to top it all off, the Chinese government is pushing rhetoric and theories about how COVID did not originate in the country and American vaccines are unsafe. China is attempting to establish itself as the world leader in COVID response.

Additionally, China’s involvement in COVAX (COVID-19 Vaccines Global Access) compels the World Health Organization (WHO)to approve vaccines that were developed in China. This is because China has committed to buying a certain amount of vaccines, and they have the option to choose Chinese brands. If the WHO permits the use of China’s COVID vaccines, COVAX may order these vaccines for developing countries, therefore expanding China’s market share. Some estimates predict that COVID vaccines may bring more than 10 billion dollars in sales. COVID vaccine diplomacy is a way for China’s pharmaceutical companies to broaden their scope. 

Joining COVAX is also a way that China is leading in comparison to the United States because former President Donald Trump chose to give up the opportunity for soft power that China has been pursuing. He refused to join COVAX, and he refused to offer vaccine aid to any country — including allies of the U.S. Foreign Affairs viewed the United States’s action — or inaction — as a nationalist path, yet they also pointed out that this play only bolstered China’s benefits from vaccine diplomacy. While the Biden administration has since joined COVAX, China has already been able to make major strides in distribution pledges and gain influence. If former President Trump had just joined COVAX from the beginning, it is possible that the low and middle income countries that China has been collaborating with would have had a more difficult decision. Instead, the concerns about the safety and efficacy of China’s COVID vaccines have been overlooked by these countries due to their major lack of options.

The Safety and Efficacy of China’s COVID Vaccines

China has developed several vaccines, but there are concerns about how safe and effective they are. One of the vaccines, Sinopharm, is reportedly 79 percent effective. CanSino is reportedly 65 percent effective. There is a significant amount of variation in research about the Sinovac vaccine, and it could be anywhere from 50 percent to 91 percent effective. Although the Sinopharm, CanSino, and Sinovac vaccines seem to have their benefits, this should be put in perspective. Although the three vaccines developed by the Chinese seem to have their benefits, these efficacy rates are significantly lower than the Pfizer and Moderna vaccines that are 95 percent and 94.1 percent effective, respectively. To be fair, while Dr. Anthony Fauci said that he would like a vaccine to be at minimum 75 percent effective, the minimum requirement for a vaccine to be approved by the Federal Drug Administration is only 50 percent. The main issue here is about whether or not these percentages are even on the nose. 

This issue has arisen because information about the Chinese vaccine studies is difficult to come by. None of the three Chinese companies have released their late-stage clinical trial data to the public, and multiple requests to interview have been declined by the vaccine companies. If China cannot deliver, Beijing will not gain much from the pledges it has made. As stated by the Associated Press: “China’s vaccine diplomacy will be only as good as the vaccines it is offering, and it still faces hurdles.” 

Honoring Promises and China’s Own Population

Western vaccine makers are not alone in their struggle to meet production goals; there is widespread concern that China may not be able to follow through with the commitments they have made in a timely manner. As aforementioned, Chinese vaccine makers have not been the most transparent, and the public only knows a bit about how production levels are thus far — but what is known does not paint a good outlook. For example, Sinovac production levels reached only half of its intended manufacturing capacity in January.

It is unclear if China will be able to deliver on its promises, and shipments have already been delayed and fallen short repeatedly. In Southeast Asia, the region which has been promised the most vaccine doses, it is predicted that mass immunization will take until at least 2024. Revealingly, China has promised many countries in Southeast Asia priority access to the Chinese vaccines. Moreover, there is uncertainty about how the Chinese government will proceed with juggling their vaccine diplomacy on top of taking care of their own people. There are 1.4 billion people in China, and its COVID vaccine makers have been consistently coming up short. China has a goal to vaccinate only 40 percent of its population by the end of July, and at the beginning of March, “China had committed more than ten times as many doses overseas as it had administered in China,” according to Foreign Affairs

China has been a prevalent actor in the development and distribution of COVID vaccine doses. Although the Chinese government has denied that they are participating in “vaccine diplomacy,” they have made moves to help them restore their reputation, pull ahead of Western competition, and expand China’s share in the international vaccine market. However, while the public-private partnerships in the creation and manufacturing of Chinese vaccines jump-started the country’s scientific and diplomatic successes, their gains have been threatened by their shortfalls on pledges made to low and middle income countries in need of vaccine doses, and there remains uncertainty about the safety and efficacy of each Chinese vaccine. On top of that, China has not yet delivered much for its own citizens. There is significant uncertainty surrounding China’s vaccine diplomacy that will unfold in the coming months.