Why China’s vaccine internationalism matters

As rich nations stockpile COVID-19 vaccines, China is providing a lifeline to Global South nations spurned by Western pharmaceuticals and excluded by the West’s neocolonial vaccine nationalism. So why is China being smeared for its efforts?

United Nations Secretary-General António Guterres called it “the biggest moral test” facing the world today. World Health Organization Director General Tedros Adhanom warned of a “catastrophic moral failure” whose price would be paid with the lives of those in the world’s poorest countries.

Such cautionings of inequitable global vaccine distribution have been shunted to the margins; instead, optimistic chatter of “returning to normal” is circulating once again as Global North citizens line up for their long-awaited COVID-19 vaccine. But normal, as ever, is relative: public health advocates warn that some countries may not be able to even begin their vaccination campaigns until 2024.

Vaccine apartheid is here, and it is revealing once more the ways our world continues to be structured by the geopolitical binaries of colonialism, capitalism, and racism. The People’s Vaccine Alliance reports that rich countries have bought enough doses to vaccinate their populations three times over. Canada alone has ordered enough vaccines to cover each Canadian five times over. Until March, the United States was hoarding tens of millions of AstraZeneca vaccines—not yet approved for domestic use—and refusing to share them with other countries (only under immense pressure did the Biden administration announce it would send doses to Mexico and Canada). Israeli officials, lauded for delivering a first dose to more than half of its citizens, have likened their responsibility to vaccinate Palestinians living under apartheid to Palestinians’ obligation to “take care of dolphins in the Mediterranean.” The European Union has extended controversial “ban options” which allow member states to block vaccine exports to non-EU nations. Meanwhile, countries like South Africa and Uganda are paying two to three times more for vaccines than the EU.

As of March 2021, China had shared 48% of domestically-manufactured vaccines with other countries through donations and exports. By contrast, the United States and United Kingdom had shared zero.

While the Global North hoards global vaccine stockpiles, China—alongside other much-maligned states such as Russia and Cuba—is modeling a very different practice of vaccine internationalism. As of April 5th, the Foreign Ministry reported that China had donated vaccines to more than 80 countries and exported vaccines to more than 40 countries. Science analytics firm Airfinity reported that as of March 2021, China had shared 48% of domestically-manufactured vaccines with other countries through donations and exports. By contrast, the United States and United Kingdom had shared zero. China has also partnered with more than 10 countries on vaccine research, development, and production, including a joint vaccine in collaboration with Cuba.

Crucially, China’s vaccine sharing has provided a lifeline to low-income Global South nations who have been out-bidded by rich nations racing to stockpile Western-made vaccines. Donations to African nations including Zimbabwe and Republic of Guinea, which both received 200,000 Sinopharm doses in February, have allowed those countries to begin vaccine rollouts for medical workers and the elderly rather than wait months or even years for access to vaccines through other channels. Just a week after Joe Biden ruled out sharing vaccines with Mexico in the short term, the country finalized an order for 22 million doses of China’s Sinovac vaccine to fill critical shortages.

Even more, Chinese vaccine aid has reached countries isolated from global markets by sanctions and embargoes enforced by the United States and its allies. In March, China donated 100,000 vaccines to Palestine, a move praised by the Palestinian health ministry for enabling the inoculation of 50,000 health workers and eldery in Gaza and the West Bank who have been cut off from accessing Israeli vaccine rollouts. Venezuela, with many of its overseas assets frozen by U.S. sanctions, received 500,000 vaccines donated by China in a gesture praised by Nicolás Maduro as a sign of the Chinese people’s “spirit of cooperation and solidarity.” China’s international vaccine policy follows the broad pattern of China’s early pandemic aid, which similarly equipped low-income and sanctions-starved nations with the tools to combat the pandemic at home.

From Venezuela to Palestine, Chinese vaccine aid has reached countries isolated from global markets by sanctions and embargoes enforced by the United States and its allies.

In the face of a global pandemic that the U.S. alliance has used as a political cudgel against China, China’s vaccine internationalism has been a natural outgrowth of its philosophy of mutual cooperation and solidarity. From rapidly sequencing the viral genome and making it immediately publicly accessible to world researchers, to sending medical delegations to dozens of nations around the world, China’s pandemic response has been guided by a simple axiom of global solidarity. Xi Jinping made China the first nation to commit to making a COVID-19 vaccine a global public good in May 2020, meaning any Chinese vaccine would be produced and distributed on a non-rivalrous, non-excludable basis. In a telling contrast, that commitment came just as President Donald Trump threatened to permanently freeze U.S. funding to the World Health Organization in an attempt to punish the organization for daring to work cooperatively with Chinese health officials. Chinese Foreign Minister Wang Yi has similarly emphasized vaccine solidarity, urging his colleagues at the United Nations Human Rights Council in February that “solidarity and cooperation is our only option.” Wang chastised countries that he noted are “obsessed with politicizing the virus and stigmatizing other nations” and implored that global vaccine distribution be made “accessible and affordable to developing countries.” China’s record to date shows it is working to follow through on the lofty rhetoric its officials have used to implore global solidarity to defeat the pandemic.

Because China’s vaccine internationalism models a form of multilateral cooperation beyond the scope of U.S. hegemony, it has been met with relentless media propaganda designed to cast China’s vaccination efforts as shady, manipulative, and unsafe. In November 2020, the Wall Street Journal gleefully announced that Brazil had suspended trials of the Sinovac vaccine following an “severe adverse event.” Jair Bolsonaro, the right-wing Brazilian president and Trump ally, declared it a “victory.” Casual observers would reasonably assume that there were serious safety issues with the Chinese vaccine; only closer reading would fill in the crucial context, that the cause of death of the participant was in fact suicide. A similar ruse was exploited in January, as headlines blasted that a Peruvian volunteer had died in the midst of a Sinopharm vaccine trial. Again, behind the salacious headlines was a crucial detail: the volunteer, who died of COVID-19 complications, had received the placebo rather than the vaccine.

Because China’s vaccine internationalism models a form of multilateral cooperation beyond the scope of U.S. hegemony, it has been met with relentless media propaganda designed to cast China’s vaccination efforts as shady, manipulative, and unsafe.

As study after study shows the efficacy of Chinese and Russian vaccines, the media has turned to painting vaccine aid and exports as a dangerous form of “vaccine diplomacy.” Human Rights Watch nonsensically described China’s vaccine aid as a “dangerous game,” citing conspiracies about the research development of Chinese-made vaccines. The New York Times wondered if China had “done too well” against COVID-19, claiming that the government was “over-exporting vaccines made in China in a bid to expand its influence internationally.” Headline after headline bemoaned that China was “winning” at vaccine diplomacy, making clear that Western pundits view the lives of Global South peoples as pawns in a zero-sum game valued only insofar as they further the interests of Western hegemony.

Some advocates say the bias against Chinese vaccines is based both on geopolitics and racist notions of scientific expertise. Achal Prabhala, coordinator of the AccessIBSA project, which coordinates medical access in India, Brazil and South Africa, said “the entire world—not just the West—is incredulous at the idea that you could have useful science in this pandemic come out of places not in the West.” Yet he emphasized the importance of Chinese and Indian vaccines as a “lifeline” to low and middle-income countries, both in addressing vaccine gaps in the developing world and as a “useful cudgel” for negotiations with Western pharmaceuticals.

Despite mainstream media tropes of Chinese “vaccine diplomacy,” it is the United States—not China—whose pharmaceutical companies are employing exploitative tactics to profit from vaccine sales. Pfizer, for instance, has been accused of “intimidating” Latin American governments in their vaccine sale negotiations, asking countries to put up embassy buildings and military bases as collateral to reimburse any future litigation costs—leading countries like Argentina and Brazil to reject the vaccine outright. One can only imagine the media hysteria which would ensue were Sinopharm to be caught demanding overseas military bases as collateral for its vaccine exports. But because it is a U.S. company, Pfizer’s medical neocolonialism has been absolved and flown under the radar.

Despite allegations of Chinese vaccine opportunism, it is the United States which has politicized its recent foray into vaccine exports. During his first meeting with leaders of the “Quad,” an anti-China alliance likened to NATO and consisting of the United States, Australia, India, and Japan, Joe Biden announced his intention to use the alliance to produce one billion vaccines for distribution in Asia in an explicit bid to “counter” China. It is telling that while China stresses global cooperation through channels such as COVAX (to which it has donated 10 million doses) the WHO, and the UN peacekeeper’s vaccination program, the United States is pursuing vaccine diplomacy through a highly-politicized military alliance designed to contain China. Likewise, despite the Biden administration’s lofty rhetoric about its leadership over a global “rules-based order,” it is the United States which has violated a UN Security Council resolution demanding a global military ceasefire to facilitate pandemic cooperation with recent airstrikes in Syria.

Perhaps most egregiously, the United States and other rich nations have blocked a proposed World Trade Organization waiver on intellectual property restrictions which would enable Global South countries to manufacture generic versions of COVID-19 vaccines. Proposed by South Africa and India with the backing of China, Russia, and the majority of Global South nations, Global North obstruction of vaccine IP waivers in the WTO makes clear that the status quo of vaccine apartheid is not an accident, but a product of deliberate policy by Western nations to put the profits of their pharmaceutical companies above the lives of the world’s poor.

Obstruction of vaccine IP waivers in the WTO makes clear that the status quo of vaccine apartheid is not an accident, but a product of deliberate policy by Western nations to put the profits of their pharmaceutical companies above the lives of the world’s poor.

With Global North nations stockpiling vaccines and experts warning that new rounds of vaccinations may be necessary to combat COVID-19 variants, critical vaccine shortages are here to stay. China’s manufacturing power and macroeconomic policy puts it in a position to continue to be the world leader in vaccine production. As of April, China’s Sinovac announced it had reached the capacity to produce a whopping 2 billion doses of CoronaVac per year, thanks in part to Beijing district government efforts to secure the company additional land for vaccine production. China’s vaccine production builds on the successful model of state intervention and coordination through which state-owned enterprises and private companies rallied to construct hospitals, manufacture PPE, and coordinate food supplies during China’s February 2020 outbreak.

The vaccine policies forwarded by China versus the U.S. and its allies serves as a microcosm for two very different worldviews: where China has insisted on global solidarity to defeat the pandemic, the Western world has refused to ease the pressures of its neocolonial regime. While China supports bids for vaccine equity in the WTO and UN, the Global North is bolstering vaccine apartheid for the sake of corporate profits. These differences alone ought to be enough to put to rest vacuous assertions that render U.S.-China conflict as a matter of “competing imperialisms.”

Xi Jinping stressed at the beginning of the COVID-19 pandemic a commitment to “protect people’s lives and health at all costs.” Not when it is profitable, not when it is geopolitically expedient—at all costs. Western obstruction of efforts towards vaccine equity forwarded by China, Cuba, South Africa, and other Global South nations only reveals the very different calculus which governs the West’s continuing neocolonial regime.