Unable to get U.S. vaccines, world turns to Russia and China

As Western countries pursue “America First” and “Europe First” Covid vaccination plans, other leading nations are looking outward in search of commercial and political gain.

India has a 49-country vaccine “friendship program,” while China is shipping 1 million doses a week across Africa and has vaccinated 7 million Turks. Argentina was just one of 50 countries that turned to Russia for help when it was unable to secure contracts with Western producers.

But the lead enjoyed by India, China and Russia in so-called vaccine diplomacy is set to evaporate in coming weeks.

Several Western vaccines preordered by dozens of governments are now close to authorization, including from Johnson & Johnson, Novavax and GSK-Curevac — tilting future global distribution of vaccines toward Western options.

The COVAX vaccine facility — which pools financial resources and spreads its bets across vaccine candidates — has handed over the first of 337 million doses it has allocated to around 130 countries for the first half of the year. COVAX receives around 90 percent of its funds from G-7 countries and the EU, but none from China, India or Russia.

Though the Biden administration has shot to the top of the COVAX donor list with a $2 billion commitment, the project is still $800 million short of what it needs to reach its goal of vaccinating 2 billion people in 2021. That financial reality, coupled with China, Russia and India winning the lion's share of early vaccinate donation headlines, means it could take months for U.S. stock to rise in the developing world.

In the meantime, the race to outpace new variants of the virus continues. Over the coming weeks, COVAX must deliver vaccines to all participating economies to ensure that those most at risk are protected, wherever they live,” said Seth Berkley, the CEO of Gavi, an alliance that works to vaccinate the world’s children, and a key backer of COVAX.

European countries and the U.S. are stuck managing both a health crisis and a political one: namely, the legitimate demand by their citizens that they be vaccinated first.

Free from democratic pressures, Beijing is able to extend greater charity and ramp up its vaccine diplomacy. Russia, on the other hand, has freedom to do global deals for a different reason: The Kremlin is struggling to convince Russians to use its homegrown vaccine.

But today’s leading donors — while reaping the early public relations win — are unlikely to be able to match COVAX’s growth through 2021.

China and Russia face domestic challenges

For China, the barriers are the effectiveness of its vaccines (just 50 percent in some trials), and Beijing’s need to eventually vaccinate its own population of 1.4 billion — 97 percent of whom haven’t received a jab.

While Russia’s Sputnik vaccine has 95 percent effectiveness, it is already running into production problems among 15 sites around the world.

The Indian government — echoing the EU — is worried that it miscalculated with early generosity, and has blocked its main manufacturer, the Serum Institute from sticking to a plan to send 50 percent of its production overseas, according to Serum Institute CEO Adar Poonawalla.

Colombia’s vaccine deals and timeline illustrate how the balance of global vaccine distribution is likely to change.

The country has started vaccinating its population with China’s Sinovac and expects to receive 2.5 million doses by the end of March. But from late March, COVAX will start to become the dominant supplier of vaccines to Colombia, a government spokesperson said. Bilateral deals with four Western vaccine makers — Pfizer/BioNTech, AstraZeneca, Moderna and Johnson & Johnson — will deliver the other 39 million doses Colombia has ordered.

For now, Chinese and Russian vaccines are attractive to many governments simply because they’re available.

Hungarian prime minister Viktor Orbán has bought both Chinese and Russian vaccines — to the annoyance of other EU leaders. He said in a Feb. 22 interview with Focus magazine that his obligation is to obtain “as many vaccines as possible, as quickly as possible.”

“There’s no such thing as an Eastern vaccine or a Western vaccine: There are only good vaccines and bad vaccines,” said Orbán, who came to prominence and power as an anti-Communist firebrand, adding “under communism we were vaccinated with Soviet vaccines as children; and, as you can see, we’re fine.”

Balkan Trojan horse

Other countries, including neighboring Serbia, are making political statements with their access to Chinese and Russia vaccines.

China and Russia have long sought to exert influence in the Western Balkans, via energy, finance and infrastructure loans and investments. Jilted by the EU — which has stalled membership discussions with Serbia — the country has shifted from being a recipient of China’s “mask diplomacy” in 2020, to a Trump-style deal making. "I wrote to Xi Jinping in October, and the price was drastically lowered," Serbian President Aleksandar Vučić told local media, proud to have bypassed the typical conditions attached to EU funding and aid.

Today, Serbia’s 15 percent vaccination rate outstrips every EU country, thanks mostly to Chinese and Russian vaccines. The Serbian government said in a statement that it's trying to "act responsibly" and has donated Pfizer and Sputnik vaccines to neighboring countries "thus far unable to procure the vaccines on the world market."

The tiny nation of Seychelles (population 98,000) has suffered just a single death from Covid-19 but is already the recipient of 150,000 free vaccine doses — donations from India and the United Arab Emirates. Officials have vaccinated two-thirds of the population: more than any country except Israel.

The strings may come later: India is reportedly looking to establish a military presence there, to keep tabs on China’s Indian Ocean activities. The Seychelles parliament already rejected India’s overtures once; the question is whether locals will feel differently after their free Indian vaccines.

From hoarders to donors

Western countries stand accused of vaccine hoarding: In some cases, like Canada’s, government have bought around seven doses for every person. Those contracts are insurance policies — a national version of the COVAX system, where a government spreads its vaccines bets and hopes enough are approved for use that they won’t fall short. If the government bets well, it will have millions of excess doses to share back with other countries. COVAX members are encouraged to “gift” unused excess doses back to other members, rather than sell them.

Israel will be the first country with that choice: 90 percent of Israelis have received inoculations and the government is slowly shifting into donor mode. Prime Minister Benjamin Netanyahu, via a spokesperson, stressed that his country’s donations will remain at a “symbolic quantity” until every Israeli who wants to be vaccinated is vaccinated. Israel’s donations so far include just 5,000 doses to the Palestinian National Authority, on Israel’s doorstep. But Israel has more to offer: After serving as the Israeli government’s vaccine distribution partner, Teva Pharmaceutical is now in talks with vaccine makers about licensing their vaccines to increase overall global production.

In the U.S., President Joe Biden confirmed on Feb. 18 that the U.S. has enough doses to vaccinate every American resident by July. With the U.K following a similar timeline, a glut of excess doses will likely be available for poorer countries towards the end of summer.

In the end, the real race may not be between vaccine donors for soft power but between all vaccines and variants of the virus. The dominant variant in South Africa wrecked the government’s plan to distribute the AstraZeneca vaccine earlier this month, rendering the vaccine effective in only 10 percent of cases.

The threat of new and more transmissible variants is a reminder that the political and financial costs of vaccine diplomacy are dwarfed by the costs of further lockdowns and additional economic rescue packages.

A recent paper estimated that if vaccination doesn’t reach the developing world quickly in 2021 and 2022, further disruptions could cost the global economy $9 trillion dollars, dwarfing the extra $800 million COVAX is requesting from national governments.

Mirroring statements from EU diplomats, State Department spokesperson Ned Price tweeted Wednesday that the Biden administration is proud to be the biggest COVAX donor, urging “other partners to do their part.”

The political question looms: Is it better for the U.S. to pay more than its fair share now to avoid writing billion-dollar checks later? Or will domestic concerns require splitting the bill equally, even if that means higher costs in the long run?