Beijing Uses Global Lead on Vaccinations for Diplomatic Leverage

China’s domestic COVID vaccination drive started slowly, perhaps hampered by lackluster early trial results and public distrust of a pharmaceutical industry wracked by corruption allegations. Now, China leads the world in vaccinations, inoculating nearly 14 million people per day. From Bloomberg News, an examination of how small COVID flareups and a concerted effort to boost vaccine numbers have turned China into a world leader:

The ramp up in shots is being helped by a flareup of cases in the eastern province of Anhui and northeastern region of Liaoning. Videos on social media showed citizens rushing to get their vaccines, with long queues at inoculation sites despite heavy rain. Hefei, Anhui’s capital city, administered 360,000 doses on Friday, the most in a single day for the hub of 10 million people, Xinhua News agency reported.

[…] The escalation of shots in China — figures from the National Health Commission show 13.7 million vaccines were administered on Friday — means the country is now closer to its target of vaccinating 40% of its population, or at least delivering 560 million doses, by the end of June. As of Sunday, some 393 million doses had been given, with 210 million of those occurring over the past month, a sign of the accelerating roll out, official data show. According to the World Health Organization, China can now administer 20 million doses a day.

[…] It’s estimated China will have 900 million to 1 billion people vaccinated by next year, when herd immunity is expected to be reached, the head of the Chinese Center for Disease Control and Prevention, George Fu Gao, said in a recent interview. [Source]

A nationwide push to get 560 million people vaccinated by June led some municipalities to adopt coercive methods to spur vaccination, while others offered a host of incentives including vegetable oil, eggs, toilet paper, rice, milk, and laundry detergent. The recent increase in vaccinations, however, is primarily driven by fear of two small outbreaks in Anhui and Liaoning, where low vaccination rates (less than 20 doses per 100 people) left the population vulnerable. At The South China Morning Post, Guo Rui reported on how minor outbreaks spurred the public at large to abandon vaccine hesitancy:

Hefei mother Fan Feng said she had been reluctant to get inoculated because there had been no cases in the city, but the new infections had changed that.

“It’s [suddenly] hard to get vaccinated … We will probably have to wait several days. The queue was already long at 7.30 in the morning on Saturday and remained long despite the heavy rain during the day,” Fan said.

[…] “Many people have not been willing to get vaccinated, which is a problem, but we should learn a lesson from this round of cases that the virus is not far from us. If so, maybe a bad thing will turn out to be a good thing,” Zhao with the Southern Medical University said. [Source]

China’s vaccines have received a further boost from their success in real world trials. After finding that the Sinopharm vaccine’s estimated efficacy rate is 79%, the World Health Organization earlier this month approved it for emergency use worldwide. Data from Indonesia showed that Sinovac’s shot prevented 96% of hospitalizations among health care workers. A one-shot vaccine created by CanSino is now being deployed across China after phase three trial results showed it to have a 65.28% efficacy rate. China also leads the world in vaccine production capacity:

Of the one billion COVID vaccines that have been administered worldwide, only 0.2% of doses have been administered in low-income countries. China is filling the void. More than half of the 144 million vaccines delivered to Latin America have come from China. In total, China has already exported 252 million doses while the United States has exported a comparatively paltry three million.

China’s global vaccine dominance has allowed it to pursue its diplomatic goals more aggressively. At the Financial Times, Michael Stott, Kathrin Hille, and Demetri Sevastopulo reported on China’s efforts to pressure Honduras and Paraguay to end diplomatic recognition of Taiwan in return for access to vaccines:

Carlos Alberto Madero, Honduras’s chief cabinet co-ordinator, who is akin to a prime minister, said that while the country wanted to avoid breaking longstanding ties with Taipei, access to vaccines was “much more urgent than anything else”.

[…] Washington has intensified its diplomatic engagement with Paraguay after China offered to provide the nation with vaccines in exchange for dropping its diplomatic recognition of Taiwan.

[…] El Salvador’s access to Chinese vaccines has helped it inoculate 16 per cent of its population. Honduras, meanwhile, has failed to secure a supply contract with Chinese vaccines. [Source]

At Bloomberg News, Iain Marlow and James Paton examined how China is using its production capacity to vaccinate the world and exercise political power:

About China, at least, he’s not wrong. So far the country has shipped about 265 million Covid vaccine doses, more than all other nations combined, with commitments to provide an impressive 440 million more, according to Airfinity Ltd., a science information and analytics company. Other leading powers haven’t kept up. President Joe Biden has vowed the U.S. will become an “arsenal for fighting Covid-19.” His administration promises to boost production of U.S. vaccines and donate 80 million doses overseas by the end of June, including 20 million authorized for U.S. use—the first time he’s shared doses he could have given to Americans. Europe has done better, exporting about 118 million domestically produced doses so far, according to Airfinity, even amid criticism for a slow start to its vaccination drive at home. India, meanwhile, had exported almost 69 million doses to nearly 100 countries until it suffered the world’s worst outbreak and halted further deliveries.

[…] The WHO authorization, a de facto approval for regulators in poorer countries, could help unleash hundreds of millions of doses of Chinese shots. The impact of the country’s contributions will also be magnified by the absence of India, making this “the best time for China to practice vaccine diplomacy and to make more use of its first-mover advantage,” says Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations.

[…] “Bangladesh, which was reliant on Indian doses, is now being subjected to pressure from China over its strategic foreign partnerships in the midst of bilateral negotiations for a large sale of urgently needed vaccines,” says Nicholas Thomas, an associate professor at the City University of Hong Kong and editor of several books on global health and foreign policy. “It would be foolish to conclude that the aid and supply of vaccines that China is now giving to Asia and the world will not translate into a long-term diplomatic advantage.” [Source]

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