Photo taken on Feb. 25, 2021 shows a consignment of the Sinopharm COVID-19 vaccine donated by China at an airport in Freetown, Sierra Leone. Sierra Leone on Thursday received a consignment of 200,000 doses of China's Sinopharm COVID-19 vaccine donated by China to support the country's vaccination campaign. (Photo by Abu/Xinhua)

One of China’s most valued contributions to the global fair accessibility to COVID-19 vaccines is to enable more developing countries to hone their ability to produce vaccines by themselves, Zha Daojiong, professor of International Political Economy from Peking University, who closely studies the global vaccine equitable allocation framework, told the Global Times in a recent exclusive interview. Sharing his insights on widely discussed “vaccine nationalism,” “wavering vaccine intellectual property,” and “COVAX operation challenges,” Zha believes that China is advocating negotiations among countries on equitable global distribution of vaccines from a humanitarian, and global perspective.

China has vowed to make efforts to provide the world with 2 billion doses of COVID-19 vaccines this year and donate $100 million to COVAX to promote global vaccine provision. This commitment comes amid the rampaging Delta variant, which is bringing more challenges for developing countries to access vaccines and combat the pandemic while the West continues to drag its heels in fulfilling its promises.

The promise was made at the first meeting of a forum on international cooperation on COVID-19 vaccines held on August 5. Zha suggested that the forum, alongside the Initiative for Belt and Road Partnership on COVID-19 Vaccine Cooperation, reflect China’s efforts to support long-term cooperation in the vaccine industry globally.
 
However, some Western media have labeled China and Russia as the pioneers of the global "vaccine diplomacy" campaign. The choice of vaccines by countries has become the epitome of global geopolitics. 


Foreign comments on China using "vaccine diplomacy" in a narrow geopolitical sense reflect the real competition among COVID-19 vaccine providers, Zha told the Global Times. Due to China’s mature vaccine technologies, longer shelf life and lower requirement for storage and transportation, Chinese made vaccines are a more preferable choice for many developing countries with relatively weak vaccination infrastructure . This has been reflected in the approval of Chinese vaccines in more than 100 countries. 

But the phenomenon of “vaccine nationalism” was never absent in the decision by governments to choose vaccines, Zha suggested. “For example, some countries and regions would include geopolitical factors in choosing vaccines. These countries would reject certain vaccines. Moreover, some media outlets refuse to accept the fact that the professional assessment of vaccine efficacy is also a scientific process. Instead, they made comments on potential vaccines based on their geopolitical interests. This is also a kind of “vaccine nationalism”.

Voices blaming “vaccine nationalism” have long been present in developed countries. For instance, Zha recalled how, during the H1N1 pandemic of 2009 which affected more than 200 countries and regions for more than a year, certain developed countries bought out entire stocks of vaccines against H1N1 once they were developed. Though some of those countries had promised to donate vaccines to others after they met their vaccination needs, the virus had long disappeared before their donations were made. Therefore, many in other nations lost the opportunity of a timely vaccination.

Providing assistance from one country to another in the field of infectious or non-infectious diseases is often referred to as "health diplomacy." Some international public health research literature support "health diplomacy" because cooperation in this field is conducive to the improvement of political, economic and diplomatic relations, Zha said.

China has taken important steps to close the global vaccine gap, including the acceleration of large-scale production, boosting fair distribution, and licensing local production in more countries.

Photo of Zha Daojiong Photo: Courtesy of Zha

 

Zha suggested that the “keystone” to allow faster local vaccination is that Chinese companies obtain approval for local production of vaccines in other countries. It saves time and costs for cross-border transportation and could shorten the time for placing products in countries lacking vaccines, he added.

China should now focus on cross-border handover of vaccines and monitor clinical data and possible side effects during the vaccination phase, he noted.

By now, both the US and China have expressed their support to waive intellectual property rights (IPR) for COVID-19 vaccines.

Zha explained that the producer of a vaccine could apply for registration of a wide range of IPR, including products, methods, and uses. Original drugs enjoy the longest protection term on IPR, which is 20 years. It would be a time-consuming and laborious process to follow the regular IPR transfer process.

Therefore, if the COVID-19 vaccine IPR is exempted, it will largely boost local processing capabilities in many countries and quickly transfer technology in a global scale, according to Zha.

The announcement from the Biden administration supporting the exemption of IPR of COVID-19 vaccines should be welcomed. However, the US government can only directly exempt the part of the IPRs where they have invested in. It cannot decide if the IPRs that are developed under companies’ sole investment can also be exempted, Zha highlighted.

“Moreover, negotiations on the exemption of COVID-19 vaccine IPRs should be conducted under the framework of the World Trade Organization (WTO). Their  decision-making mechanism is one country, one vote, and one veto. This is the challenge in international cooperation,” Zha noted.

Getting the approval from the WHO is a prerequisite for Chinese-made vaccines to enter the global market, Zha indicated. In the 2000s, four vaccine products developed by Chinese pharmaceutical companies passed the WHO’s vaccine certification which allowed them to be included in the international procurement list. Since then, they have been sold to more than a dozen countries and regions. This record of expertise provides a platform for China's COVID-19 vaccine to gain wider international recognition.

However, Chinese developers of COVID-19 vaccines also cooperated with various global partners, mostly developing countries, in clinical trials. The uneven levels of R&D, and the different medical systems and basic infrastructure are factors that combined have made it difficult to collect and analyze data from medical trials and publish it in professional journals. All of these have increased the economic and time costs for the approval of China's COVID-19 vaccines by the WHO.

Timely and appropriate information sharing on the monitoring and management of adverse reactions surrounding the current overseas use of COVID-19 vaccines is critical to enhance public confidence in Chinese vaccines, Zha warned.

So far, at least two vaccines developed by Chinese producers Sinopharm and Sinovac have been approved for emergency use by the WHO. Moreover, China has supplied more than 750 million doses of vaccines overseas and will provide another 110 million shots to COVAX in the following four months. China will also donate 3 billion dollars to the international community in the next three years. 

However, managing COVAX has never been an easy process. 

In terms of the price, it can be negotiated to a favorable price if a COVID-19 vaccine is sold in developed countries as, low- and middle-income countries under COVAX are subject to anti-Trust regulations in different countries of registration. 

The price difference depends on each country's ability to bid, whether the promised aid is in place with the strings it is attached to. These factors prevent COVAX from working efficiently, said Zha. 

Zha believes that cross-border trade of vaccines involves many steps and each of them must be overseen with clear accountability.