Did China Join COVAX to Counter or Promote Vaccine Nationalism?

On October 9, China’s Foreign Ministry spokeswoman Hua Chunying announced that China has formally joined COVAX. “We are taking this concrete step to ensure equitable distribution of vaccines, especially to developing countries, and hope more capable countries will also join and support COVAX,” she said. Hua made a point of adding that China is leading the world in developing several COVID-19 vaccines.

Seth Berkley, the CEO of Gavi – the public-private partnership that co-leads COVAX with the WHO – welcomed China’s participation in the initiative. “I am delighted to welcome China into the #COVAX facility. This announcement gives even more momentum to our mission to ensure future #COVID vaccines are distributed equitably because no one is safe until everyone is safe,” Berkley tweeted a day after the Chinese Foreign Ministry announcement.

Interestingly, though China has finally joined COVAX, it is yet to explain its earlier reluctance to stay out of the WHO-led collective vaccine distribution regime. In May this year, President Xi Jinping said in his video message to the WHO Health Assembly that “China would share with the world the COVID vaccines it is developing.” Despite the commitment, however, until early October China had been refusing to join COVAX.

There is some speculation that Beijing might have changed its mind after a recent poll conducted by the Pew Research Center revealed that “the negative views of the people in several countries towards China deepened during the pandemic.” The survey was conducted between June 10 to August 3 this year, and over 13,000 people from 13 countries, excluding China and the U.S., took part in it.

COVAX is the $18 billion WHO-supported effort to provide a coronavirus vaccine to developing countries. The initiative, backed by over 180 member countries, is being hailed as unique, especially given its focus on equitable access to a COVID-19 vaccine. As Christopher Brauchli recently observed, “The critical word in the [COVAX] description is ‘equitable.’ The WHO project is important for all the participants, but it is especially important for the small nations that are unable to develop or acquire a developed vaccine on their own.”

COVAX – a joint public-private partnership initiative by WHO, Gavi (the Vaccine Alliance), and the Coalition of Epidemic Preparedness Innovations (CEPI) – is designed to give governments an opportunity to hedge the risk of backing unsuccessful vaccine candidates and give less developed countries access to shots that would be otherwise unaffordable. It currently has nine vaccines under development – including two from China – and nine under evaluation in its portfolio.

As the September 18 deadline for joining COVAX was approaching, Beijing continued its ambivalent stance on whether to join the WHO vaccine program, which had already been snubbed by U.S. President Donald Trump. However, based on Xi’s earlier commitment to the WHO that China would “share” COVID-19 vaccines and Beijing’s statement just before the September deadline that it “supports” COVAX, many expected the Asian economic giant would end up joining the initiative.

Health experts and strategic affairs analysts in China, and globally, see Beijing’s decision to join the global vaccine distribution and manufacturing initiative as driven by three main factors:  “soft power” diplomacy, the ugly deterioration in relations between China and the U.S., and China’s attempt at an “image makeover” – both at home and in the world.

A Good PR Move

Notably, prior to committing itself to joining COVAX, China had been offering other assistance. Beijing has been promising loans under the Belt and Road Initiative (BRI) banner to countries lacking the resources to be able to secure millions of vaccine doses needed for their populations. Various countries, including Pakistan, Indonesia, Bangladesh, and Morocco, have signed formal agreements with Chinese vaccine manufacturers. This enabled the Chinese government to positively counteract the immense loss of face in the global arena due to factors such as negligence and suppression of information in Wuhan in the early phase of the epidemic; Xi Jinping’s more aggressive foreign policy; and threats to Taiwan and human rights abuse in Xinjiang and Hong Kong. “In many ways [joining COVAX] is a soft power win for China, coming amidst a slew of negative reports in other fields in recent weeks,” Nicholas Thomas, an associate professor in health security at the City University of Hong Kong, told Bloomberg.

U.S. Exits, China Enters

Second, ever since the BRI became China’s “national strategy,” Beijing has been consistent in moving in to fill gaps wherever the U.S. moves out of global leadership roles. By doing so, China hopes to both win friends abroad and strengthen its sphere of influence in relation to the existing U.S. dominance in different parts of the world. After the unexplained hesitation and considerable delay, China’s decision to finally back the WHO project is indicative of this strategy to quickly fill in any void left over by the United States. As the Chinese language news site Mingpao, based in North America, tries to explain: “China’s participation in COVAX fills up the gap left by U.S. President Trump’s neglect of the plan in the global health public leadership system.”

China will have to move fast to take advantage, as the gap may be temporary. Unsurprisingly, rival presidential candidate Joe Biden has promised to reverse Trump’s decision to quit the WHO. “Americans are safer when America is engaged in strengthening global health. On my first day as President, I will rejoin the WHO and restore our leadership on the world stage,” Biden tweeted on July 8, after Trump officially moved to withdraw the United States from the WHO.

Building Trust

Third, experts say Beijing may have revised its earlier decision to stay out of COVAX based on overriding concerns regarding a lack of trust in the distribution of Chinese-produced vaccines globally. Remember, China claims that the first round of COVID-19 vaccines could be available to the public as early as by the end of the year. China is ready to conduct the final phase III human trials in foreign countries for four of its nine vaccines under development. According to a recent Bloomberg report, almost 100 countries have established vaccine links with China so far. Key features of such vaccine agreements include Chinese loans for buying vaccines; official vaccine testing and manufacturing; and the priority supply of Chinese vaccine to these countries.

Interestingly, China does not have much experience in manufacturing and distributing a vaccine for global consumption. Yet COVAX as well as other international vaccine research institutions have welcomed China’s proactive approach to the equitable distribution of COVID-19 vaccines globally. “The potential role for Chinese vaccines manufacturers to play in the global rollout under COVAX will not only boost the domestic industry, but also help add much-needed credibility to Chinese-developed vaccines,” said Xiaoqing Lu Boynton, a consultant at Albright Stonebridge Group who focuses on health care and life sciences.

Furthermore, joining a popular initiative like COVAX would certainly help shift the perception that China is a bad actor. Calling the move to join COVAX a “shot in the arm” for Beijing, Malaysia’s popular news website The Star commented: “For China, joining COVAX gives it a chance to demonstrate the responsibilities of a superpower and promote health diplomacy and international exchanges.”

Finally, Beijing’s calculated move to join COVAX is being described as a boost to the global scheme to ensure fair access to COVID-19 vaccines for poorer countries. Both financially and politically, China joining COVAX is also seen by many as an effective counter to the “vaccine nationalism” of rich and developed nations, notably the United States.

Beate Kampmann, director of the London-based Vaccine Center, told China’s English language TV channel, CGTN that she welcomed China’s significant role in boosting COVAX to beat the U.S.-led trend “vaccine nationalism” in the race to first manufacture and make a vaccine available to the public.

Zha Daojing, a researcher at Peking University, told The Star that it was quite normal and a fact of life that governments may base their decisions about vaccine distribution on factors such as nationality or geopolitics. “It is kind of vaccine nationalism,” Zha quipped – and even China is not immune.