China has pledged millions of coronavirus vaccines to countries around the...

Vaccines can also be used by Beijing as “a foreign policy instrument to promote soft power and project international influence,” said Yanzhong Huang, senior researcher for global health at the Washington-based Council on Foreign Relations.
Earlier in the pandemic, China’s efforts to curry favor by donating masks and other supplies to countries hard hit by the virus were tarnished by reports of shoddy supplies and accusations according to which Beijing was launching a disinformation campaign to change the narrative of the coronavirus.

Beijing Vaccine Diplomacy, Huang said, could give it another chance.

“Vaccine diplomacy”

China currently has five coronavirus candidates from four companies that have reached Phase 3 clinical trials, the last and most important step in testing before regulatory approval is sought.

After largely eliminating the coronavirus within its borders, Chinese drugmakers have had to look overseas for places to test the effectiveness of their vaccines. Together, they have deployed Phase 3 trials in at least 16 countries.

In return, many host countries were promised rapid access to effective vaccines – and, in some cases, the technological know-how to manufacture them locally.

Sinovac Biotech, a Beijing-based Nasdaq-listed drugmaker, has signed agreements to deliver 46 million doses of its Covid-19 vaccine to Brazil and 50 million doses to Turkey. It will also deliver 40 million doses of the vaccine in bulk – the vaccine concentrate before it is split into small vials. – in Indonesia for local production.

CanSino Biologics, which has developed a vaccine against the coronavirus with a Chinese military research unit, will deliver 35 million doses of its vaccine to Mexico, one of the five host countries for its trials.

Sinopharm chairman Liu Jingzhen said last month that dozens of countries have asked to buy the company’s vaccines. He did not name the countries or specify how many doses they were offering, but said the CNBG was capable of producing more than a billion doses in 2021.

“China not only has the political will (for its vaccine diplomacy), but it also has the strong capacity to achieve it,” Huang said.

Because China has largely contained the virus, there is no urgent need to vaccinate each of its 1.4 billion people. “It gives him that leverage… to make deals with countries that need vaccines,” he said.

“Silk Road of Health”

China’s global vaccination campaign is in stark contrast to the Trump administration’s “America First” approach, which focuses on vaccinating its own citizens before those elsewhere.

“So far, we haven’t heard the United States say or suggest that they are going to allocate a percentage of their vaccine to support poor countries. So that puts China in an even better position to use the vaccine to serve its foreign policy objective, ”Huang told me.

In October, China joined a global initiative supported by the World Health Organization to ensure the rapid and equitable distribution of Covid-19 vaccines to rich and poor countries alike.

The project, known as COVAX, is designed to discourage governments from stockpiling coronavirus vaccines and instead focus on vaccinating high-risk groups in each country. But it was avoided by the United States, in part because President Donald Trump did not want to work with the WHO, leaving China with a void of global leadership in public health.

From the start, Chinese leaders have repeatedly emphasized that Chinese vaccines are to be shared, especially with developing countries.

In May, Chinese President Xi Jinping told the WHO annual meeting that China would make its coronavirus vaccine a “global public good”, calling it “the country’s contribution to ensuring accessibility and ‘affordability of the vaccine in developing countries’.

During a video summit with African leaders in June, Xi vowed that “once the development and deployment of a Covid-19 vaccine is completed in China, African countries will be among the first to benefit. “.

In August, Chinese Premier Li Keqiang said Beijing would also give priority access to Cambodia, Myanmar, Laos, Thailand and Vietnam. Afghanistan and Malaysia are other countries to which priority access has been promised by the Chinese authorities.

Many of these countries are also participating in the Beijing Belt and Road Initiative, a multibillion-dollar infrastructure and trade program that has lost some of its momentum during the pandemic. Recently, the Chinese authorities have intensified discussions on a “Silk Road for Health”. At the WHO meeting in May, Xi pledged to donate $ 2 billion over two years to help countries cope with the pandemic. Beijing has also offered a billion dollar loan to Latin America and the Caribbean to access its coronavirus vaccines.

But there are signs that China’s vaccine diplomacy will not always run smoothly. In Brazil, Sinovac’s vaccine, CoronaVac, has been embroiled in a political feud between President Jair Bolsonaro – known for his anti-China staunch stance – and Sao Paulo governor Joao Doria, who is expected to run against Bolsonaro in the the country’s next presidential elections in 2022. In Bangladesh, Sinovac’s trial is blocked due to a funding dispute.

International public health experts have also questioned China’s emergency use program, which inoculated nearly a million Chinese people with experimental vaccines before their safety was fully proven in trials. clinics.

Then there is the question of efficiency. Last month, Pfizer and Moderna announced that initial results showed their vaccines to be over 90% effective, while another candidate jointly produced by the University of Oxford and AstraZeneca had an average effectiveness of 70%. So far, none of the Chinese vaccine candidates have announced preliminary efficacy results, although company executives have repeatedly stressed their safety, insisting that there are no serious side effects. has been observed in vaccinated volunteers.

Cold room

Compared to Pfizer and Moderna, Chinese vaccines have a crucial advantage – most of them do not require freezing temperatures for storage, which facilitates transportation and distribution, especially in developing countries that do not. do not have cold storage capacities.

Kate O’Brien, director of the WHO’s Immunization and Vaccines Department, likens vaccine development to building a base camp in Everest. “But the climb to the top is really about delivering the vaccines,” she told a press conference this month.

The Pfizer and Moderna vaccines use pieces of genetic material called messenger RNA (mRNA) to trick the body to make synthetic pieces of the coronavirus and stimulate an immune response – a new technology that has not been used in existing vaccines.

But mRNA is vulnerable to degradation at room temperature. Moderna vaccine should be stored at -20 degrees Celsius (-4 degrees Fahrenheit) or refrigerator temperature for up to 30 days, while Pfizer vaccine should be stored at an ultra-cold temperature of -75 ° C (- 103 ˚F), and used within five days of refrigeration at higher temperatures.

Sinopharm and Sinovac, on the other hand, use an outdated approach that has long been proven successful in other vaccines, such as polio and flu shots. Their coronavirus vaccines use whole inactivated virus to induce the body to develop immunity, and should only be stored at standard refrigerator temperatures of 2˚C to 8˚C (36˚F to 46˚F). CanSino’s vaccine, which uses a cold virus called adenovirus 5 to transport genetic fragments of the coronavirus around the body, can also be stored between 2 ° C and 8 ° C.

Nevertheless, the required temperatures must be maintained throughout transport, from the exit of the production facility to storage at the airport and finally to global distribution.

Cainiao, the logistics arm of Chinese e-commerce giant Alibaba, will help distribute Chinese vaccines as soon as they get the green light. It says its end-to-end air-conditioned infrastructure is in place and ready.

The company has partnered with Shenzhen Baoan International Airport, which recently received certification for pharmaceutical logistics from the International Air Transport Association. A cold chain warehouse was built in 2019 for frozen products and products. Earlier this year, it was converted to store coronavirus test kits – and now vaccines. The airport has said on its website that it wants to make Shenzhen a “global Covid-19 vaccine distribution base.”

Cainiao is also in partnership with Ethiopian Airlines, which will send the Chinese vaccines to the Middle East and then to Africa. Since the pandemic, the airline has transported more than 3,000 tons of medical supplies from Shenzhen to Europe, Africa, the Middle East and South America.

But Cainiao is also looking to add more routes for greater global reach, according to its CEO Wan Lin.

“Of course, we’re not quite sure just the exact demand on this just yet, but we’re definitely building our ability to prepare for this,” Wan said.