Vaccine Diplomacy: An Interplay of Global Powers

Sam Thomas and Gazi Hassan

The year 2020 will go down in history as the year where an invisible virus brought the world to its knees. It started off with Wuhan gaining international attention for spreading the COVID-19 pandemic, to banning international flights, lockdowns of cities and religious institutions and finally ending with the visuals of the American President and President-elect being vaccinated for the virus on live television. The discussions over the development of vaccine took precedence in the latter half of 2020 and so did the nuanced notion of vaccine diplomacy.

The conferences on Health and Sanitation were already underway since the time Cholera and Yellow fever were first known to mankind. The Oslo Ministerial Declaration in 2007 was the year when global health became a part of foreign policy of various countries. Global health diplomacy has since then been categorised as core diplomacy, where negotiations between nations lead to treaties; a multi-stakeholder diplomacy, when international organisations have a seat at the negotiation table among nations; and finally, an informal diplomacy; bringing peer-to-peer scientific partnerships to the forefront. Depending on the situation, vaccine diplomacy loosely falls in all three categories.

The term Vaccine Diplomacy was first introduced in 2001. It is an aspect of global health diplomacy that involves the use and/or delivery of vaccines. Vaccine diplomacy was popularised by International organisations like WHO and UNICEF as a tool for humanitarian intervention. Historically, vaccine diplomacy is blind to political ideologies and is focussed on global health; the most popular example would be when the US and the USSR joined hands in developing an oral polio vaccine for children in the mid-1950s.  

Years of research and multiple rounds of testing and trials go into developing a vaccine. With the coronavirus, labs around the world have access to advanced technology and years of pre-existing research on viruses that fall within the same family. That being said, a new vaccine has to jump through the same hoops as any other vaccine would need to. Vaccines are given their seal of approval in a long and cumbersome process. There are three broad steps: 1) Laboratory Testing with animal subjects 2) Clinical Studies with human subjects 3) Approval and licensure. 

A vaccine gets approvals with government oversight and standardised procedure in regulations. Regulations will increase as the vaccine makes its way through the process. Interestingly, the standard regulation is that a vaccine needs to show 50 per cent efficiency in human trials for any form of approval. With regards to the coronavirus vaccine, the regulation was amended to add ‘efficiency not below 30 per cent’ to speed things up.

Countries are in a race to develop a vaccine that is ready for mass distribution. Starting off with China, there are a few vaccines in Phase 3 of clinical trials: BBIBP-CorV has been approved for limited use within China, Bahrain and the UAE and its Phase 3 trials are underway in Peru, Morocco and the UAE; Convidecia (Ad5-nCoV) developed by the Chinese military was approved for distribution despite its ongoing trials in Russia, Mexico, Pakistan and Saudi Arabia. The United States of America too has a handful of vaccines in Phase 3 trials: NVX-CoV2373 of Novavax is being tested in the UK as well as in the US, and has partnership with the Serum Institute in India to manufacture it for distribution; mRNA-1273 from Moderna has moved forward with the approval for mass distribution in Canada and the US. The United Kingdom’s University of Oxford along with AstraZeneca worked on AZD1222 and have completed their Phase 3 trials and moved forward for the UK approval with their published results. The Russia vaccine Sputnik V is moving ahead with its phase 3 trials, and has also been approved for limited use within Russia. The German-American initiative by Pfizer and BioNTech has already been approved for inoculation in many countries including the USA, Canada, the UK, Switzerland, etc. Indian laboratory Bharat Biotech’s vaccine Covaxin is in Phase 3 of its trials. So far Pfizer-BioNTech and Moderna are the pharmaceuticals that have got international approval for vaccine production.

The United Kingdom has already begun its mass rollout to inoculate millions of its citizens within months despite the news of a new variant of the virus (70 times more infectious and contagious) being detected in the country. The United States follows the UK with two different vaccines ready for distribution. Other countries like China, Russia, Germany and India are also nearing the finish line with the logistics of vaccine distribution still a question that needs clear-cut answers.

Quite a few countries have witnessed a sense of vaccine nationalism. Many of the rich countries like the USA, Germany, the UK, Japan, etc had funded the development of vaccines and now have pre-ordered millions of doses. This will soon create an affordability and accessibility issue for the poorer countries of the world. China and Russia have witnessed a state-led approach in their vaccine development. They have now extended the olive branch of vaccine diplomacy in an attempt to strengthen their ties and leverage a better global position.

China was the recipient of allegations that went along the lines that the virus was synthetically created in a lab at Wuhan. In the meantime, China is looking to restore its ‘image’ and even increase its global influence. A good number of different vaccines are being developed in China and their trail runs are happening outside its borders in Pakistan, Indonesia, the UAE, etc. China is seen to be expanding its geostrategic and economic interests by promising vaccines for Brazil, the Philippines and other countries in the South China Sea as well. One thing that is certain is that the Chinese vaccine diplomacy is not unconditional, its economic clout and coercion go hand in hand. Russia has similar intentions; it wants the position it once had as a global power. Venezuela and many other countries are in talks with Russia vis-a-vis the vaccine (Sputnik V).

India has put its money on both tables. Reports suggest that India has purchased the largest number of the COVID-19 vaccine, a whopping 1.6 billion doses. India, unlike the other high-income countries, used its large manufacturing infrastructure to push itself higher on the list for pre-orders. Almost 60 per cent of the global vaccine supply comes from India, making it the world’s dispensary. Earlier in August, India too extended its hand in vaccine diplomacy, promising Bangladesh a priority recipient country.  Promises have been made to Nepal, Myanmar, Bhutan and Maldives as well as other SAARC countries. India is keen on ensuring its ontological security by pursuing ‘Neighbourhood First Policy’. The New Year will actually be a testament to who actually won the diplomatic game. One thing is certain, humanity needs to be victorious no matter who makes the political gain.

Sam Thomas, Research Intern and Gazi Hassan, Senior Research Associate at CPPR. Views expressed by the authors are personal and need not reflect or represent the views of Centre for Public Policy Research.

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