Decades of scientific and technological development have shown that the international community can set aside political and strategic differences to collaborate for greater public good. As the Covid-19 pandemic continues to wreak havoc across the world, vaccine diplomacy is once again playing an increasingly important role in breaking the chain of disease transmission and reducing hospitalization and deaths.
According to a Bloomberg report, over 4.82 billion doses of the vaccine have been administered across 183 countries, with an average of 37.5 million doses being administered each day. This makes inoculation against Covid-19 the biggest vaccination campaign ever. But global immunization against is being stifled by technical bottlenecks, vaccine supply for self-interest and a narrow sense of vaccine nationalism.
Vaccine diplomacy lies at the intersection of national self-interest and global good. Being able to tap into the goodwill of advanced and wealthy nations is therefore a big challenge.
During the Cold War, the Soviet Union and the United States collaborated with medical researchers and scientists around the world to develop and distribute vaccines to countries where they were needed the most. But unlike the collaborative efforts seen during the Cold War, such as for smallpox and polio vaccinations, the fight against Covid-19 in a multi-polar world setting presents new challenges.
Medical research today is far advanced and widely available. Despite the fact that vaccine research involves global collaboration among scientists, politicians and hyper-nationalists are building a jingoistic narrative around its development, particularly in countries like Russia, China and India. Russia is seeking to regain the lost glory of the former Soviet Union and new powers like China and India are trying to exert their soft-power.
Thus vaccine diplomacy has become a tool for serving the self-interest of nations, to secure strategic goals and ensure one-upmanship. As the United States sought to stockpile vaccine doses for its own population, Russia and China carried out bilateral negotiations with countries to promote and distribute their own vaccines. Meanwhile, India’s experience with vaccine diplomacy showed that domestic pressure can quickly overturn global commitments. India was caught in a bind when it embarked upon competitive vaccine diplomacy and then was forced to suspend supply when it was hit by a deadly second wave.
Multilateral framework for vaccine diplomacy
Since the start of Covid-19, the World Health Organization (WHO) has been caught in a whirlwind of controversy. It was blamed for ignoring early signs of a pandemic, for failing to “exercise global health leadership” and for becoming “a tool of Chinese politics, power, and propaganda.” It has also faced the anger, particularly of Western governments, for not offering timely warnings, issuing misleading guidelines and making contradictory statements.
However, WHO’s initiatives have also helped create a global framework for scientific collaboration and equitable distribution of vaccines on a global scale. COVAX (or the Covid-19 Vaccines Global Access) is a worldwide humanitarian initiative to ensure equitable access to vaccines. The platform created by WHO along with Gavi, the Vaccine Alliance and CEPI (the Coalition for Epidemic Preparedness Innovations) supports research, development and manufacturing of a wide range of Covid-19 vaccine candidates and negotiates pricing. Committed to providing participating countries equal access to these vaccines, COVAX initially aimed to have 2 billion doses available by the end of 2021, enough to protect high risk and vulnerable people around the world.
However, COVAX has been hit by scepticism and obstacles. Several of the world’s wealthiest nations, including the US, directly negotiated deals with vaccine manufactures, securing ample doses for their population and not leaving much for others. Following President Trump’s decision to leave the WHO, the US said it did not intend to join the COVAX platform, although President Joe Biden reversed the decision. Initially, China and Russia also expressed their lack of interest and preferred bilateral negotiations for the supply of vaccines to other countries.
Europe took the lead in stepping up the global response to the pandemic. The European Union (EU) joined COVAX, contributing 400 million euros and helping to bring together 40 nations and raise 16 billion euros to finance research on tests, treatments and vaccines. However, several European countries, including France and Germany, although officially part of the global collaboration, entered into direct deals with vaccine companies to secure vaccines for their own citizens.
Having to contend with severe challenges including supply bottlenecks and vaccine nationalism, a recent report says that COVAX has been able to deliver 175 million vaccine doses to nearly 140 countries. But it has fallen way short of the 600 million doses initially forecast to be delivered by the end of July. These delays in vaccine supply under the COVAX platform drove even poorer nations to negotiate directly with vaccine manufacturing countries and pharmaceutical companies. Manufacturers in Russia, China and India have carried out bilateral negotiations with several of these countries seeking emergency use licenses, often side-stepping stringent regulatory mechanisms set in place by WHO. Most of these countries lack a robust framework for pharmaco-vigilance surveillance mechanism. Soon enough, allegations of corruption, and questions on quality and issues of efficacy were raised.
Russia and China
Faced with a severe shortage of vaccines and the failure of Western manufacturers to deliver doses on time, countries in Europe have also turned to Russia and China to augment their supplies. Following the failure of its own vaccine roll-out strategy, the European Council President remarked that member nations should not let themselves be misled by China and Russia as both regimes have “less desirable values” as “they organize highly limited but widely publicized operations to supply vaccines to others.”
The growing global acceptance of their vaccines and charitable supplies have enabled Russia and China to boost their soft-power and nudge international criticism for repressions and human rights violations back home. It has also enabled them to build a narrative about the superiority of their medical research and health infrastructure compared to the West.
Although European reliance on Russian and Chinese vaccines is due to the supply constrains they are facing at the hands of Western manufactures, it is not the same for several low-income and low-resource countries in Latin America, Africa and Asia. Their dependence on Russian and Chinese goodwill will have long-term geostrategic implications, enabling them to influence diplomatic relations and use soft power to serve their domestic interests.
Innovative yet lopsided
According to data collated by Bloomberg, enough doses have been administered to fully vaccinate 31.4 percent of the global population. However countries around the world have had unequal access to the vaccine. With a billion in Sub-Saharan Africans, 650 million in Latin America and several hundred million in poorer nations of Asia, estimates are that 4 to 5 billion doses of vaccines will be required to vaccinate a sizable population to block the continuing spread of Covid-19. Yet the reality is that there is not enough supply of vaccines available. Further, delivering billions of doses across the world is a gigantic logistical challenge.
With countries having the highest income vaccinating 20 times faster than those with the lowest, many of the poor nations might have to wait as long as 2023 or even 2024 for an adequate supply of vaccine dozes to meet their population demands, says a report from the Duke University Global Health Initiative.
Needed: a commitment to global public partnership
Global public health partnerships backed by governments, multilateral organizations along with private enterprise and NGOs have demonstrated time and again a commitment to develop a collaborative approach to eradicate deadly diseases.
On the one hand, the Covid-19 pandemic has demonstrated what technological progress and international action can achieve. On the other hand, it has exposed the fragility of global diplomacy and humanitarian cooperation. Countries are sharing their vaccines with other nations, spurred not by humanitarian motives but diplomatic goals.
The shortage of vaccines is not primarily a procurement problem, but a production one — not whether poor nations can afford to buy them, but whether they can be allowed to manufacture them.
There is a growing demand for a temporary waiver on intellectual property (IP) protection on coronavirus vaccines. Initiated by India and South Africa, the campaign is now backed by more than 100 countries, along with international organizations including the WHO and UNAIDS. The goal is to reduce barriers to enable countries to produce their own vaccines — particularly for the lowest-income nations. Earlier in May, the campaign got a boost when the US, Russia and China came out in support of waiver. However, pharmaceutical companies and most high-income nations, notably Japan, South Korea, the United Kingdom and European Union member-states are still opposed to the initiative.
Maintaining social distance and wearing a mask to protect ourselves from infections is something that we will worry about only if we have the luxury to do so. With more waves predicted, new mutations expected, and the growing risk of breakthrough infections, what this pandemic has taught us is that protecting others, is the best protection we have.