Suzuki, Mao & Yang, Shiming (2023), ‘Political Economy of vaccine diplomacy: Explaining varying strategies of China, India, and Russia’s COVID-19 vaccine diplomacy’, Review of International Political Economy, 30:3, 865-890. DOI: 10.1080/09692290.2022.2074514
Traditionally, Western powers have been the major donors of health aid while non-western nations have been the recipients. Aid of this kind has been a part of a country’s diplomatic toolkit, to be deployed judiciously in pursuit of geopolitical goals. During the Cold War, for instance, the two big powers, the U.S. and the Soviet Union, both developed and delivered vaccines against small pox and polio, in what came to be known as ‘vaccine diplomacy’.
In this paper, the authors, Mao Suzuki and Shiming Yang, argue that during the COVID-19 pandemic, for the first time in history, three non-Western powers — Russia, China and India — dominated international vaccine diplomacy. These countries, which had long been recipients of health aid, finally made their debut on the world stage as vaccine inventors. Not only were they more proactive than Western powers in distributing vaccines to emerging markets, they did so at a time that was remarkable for two reasons — one, many countries were in desperate need of vaccines; and two, Western nations were hoarding vaccines. This provided an opening for non-Western powers to step in. The paper details how, for each of the three powers, their geopolitical aims and political, economic and technological constraints determined the nature and scope of vaccine diplomacy.
The authors profile the three powers on their relative strengths along three axes: vaccine R&D, manufacturing, and delivery. They argue that “countries with an advantage in vaccine R&D would be more open to technology transfer; countries with greater manufacturing capability would be more likely to keep vaccine production within their borders than outsourcing it overseas; and countries with expansive distribution networks would prefer bilateral to multilateral distribution.” The authors demonstrate that Russia, India and China fit these three different profiles respectively.
Russia’s technology transfer
Russia, which is strong in vaccine R&D and weak in production and distribution, has relied on outsourcing vaccine production with technology transfer. This has two advantages. First, a country with home-grown vaccines “can use technology transfer to either promote sales when its vaccines have low global credibility or encourage offshore production when the country has limited domestic production capacity.” Second, “because technology transfer is welcomed by many developing countries striving to secure vaccine supply and to develop their pharmaceutical industry, it can also be used to enhance soft power of the giving country.”
Unlike emerging non-Western powers, Western nations don’t need to use technology transfer as a bait to attract foreign customers because “their reputation in pharmaceutical R&D is already established”. So, this was the approach Russia took with its Sputnik-V vaccine. Riding the rich experience of the Soviet era, it was the first to develop a vaccine for COVID-19. But with severely limited production capacity, Russia contracted out Sputnik-V production to pharmaceutical manufacturers in Asia, Latin America and Eastern Europe. This included a 300 million-dose contract with the Serum Institute of India (SII). The authors also note that the geographical coverage of Russia’s vaccine diplomacy overlaps with its sphere of influence, with the Commonwealth of Independent States (CIS) and the Balkan nations buying Sputnik-V for mass inoculation. Central Asia was its primary target for vaccines sales as well as production outsourcing. Given its limited production capacity, Russia’s contribution to COVAX, the worldwide platform for equitable vaccine access, was miniscule, with the bulk of Sputnik-V doses channelled into bilateral deals. Russia’s vaccine got approved in 70 countries, but it chose to sell rather than donate, aiming to “increase its presence in the global scene of COVID-19 vaccination, but with no intention to give away vaccines for free”.
India’s massive donations
As for India, the paper notes that the country was producing 60% of the world’s vaccines even before the pandemic. So India’s vaccine diplomacy was “characterised by mass-production of Western-invented vaccines, prompt bilateral donations, and large-scale sales to bilateral buyers and multilateral COVAX initiative.” The “Western-invented” Covishield was the major currency of India’s vaccine diplomacy, as it leveraged the massive capacity of SII, the world’s largest vaccine producer. As the SII had already signed a deal to produce AstraZeneca-Oxford vaccines back in April 2020, when it was still under clinical trials, it “had hundreds of millions of doses ready to ship when governments around the world began granting EUAS for the vaccine in December 2020.”
India quickly rolled out large scale bilateral programs called ‘Vacciner Maitri’ (Vaccine Friendship). With more than 90 countries swiftly approaching India, neighbouring countries got priority access to India’s donations, the paper states. One of India’s largest donations was to Nepal (1.1 million doses), “where India and China are competing over influence.” Myanmar, which also shares a border with both India and China, was another big beneficiary of India’s vaccine diplomacy. The paper notes two broad patterns in India’s vaccine diplomacy: a ‘neighbourhood first’ policy, and a preference for a range of Caribbean and African states with sizeable populations of Indian diaspora.
But geopolitical interest was not India’s only consideration. Also important was the need to cover the cost of manufacturing. So, the sales versus donation conundrum was resolved thus: “India concentrated donations on countries with which it has strong geopolitical and economic ties, but it sold a much larger sum to relatively wealthy countries beyond its geopolitical reach.” Thus, even though India bilaterally exported more than 46 million doses to 65 countries between January and April 2021, nearly 80% of these doses were sent on a commercial basis. “Only Bangladesh (3.3 million), Myanmar (1.1 million), and Nepal (1.1 million) received a donation of more than a 1 million doses”. At the same time, India sold much larger volumes to countries like Saudi Arabia (4.5 million) and Morocco (7 million). India balanced “geopolitical interests and financial reality by carefully deciding how many vaccines it donates and/or sells and to which countries.”
India’s vaccine diplomacy, however, was interrupted by the second wave of COVID-19, which hit India in early April 2021. Facing skyrocketing domestic demand amid spiralling infection rates, India banned all vaccine exports starting mid-April. This provided an opportunity for Chinese manufacturers to step up and fill the gap, the paper notes, concluding, “India’s bitter experience highlights how a surge of domestic demand can hamper a country’s ability to conduct vaccine diplomacy.”
In this context, the paper details how governmental support for industry could be a game-changer — both in enhancing vaccine R&D capability and increasing production capacity. Both Russian and Chinese governments poured vast resources into vaccine R&D, but the Indian government did not. Similarly, though China’s vaccine manufacturing capacity was initially moderate, “the government poured in resources to help vaccine developers expand production and backed their marketing strategies abroad”. In contrast, “In India, SII and Bharat Biotech had to finance their own production without support from the Indian government.” It was only in April 2021, amid the Delta wave, that the Indian government agreed to provide $600 million to these two companies to expand production. The paper concludes: “the slow and limited governmental support made it unavoidable for India to delay its promised vaccine delivery to COVAX and bilateral buyers by half a year. This has affected India’s reputation as a reliable vaccine supplier.”
China’s costly investments
Coming to China, the paper points out that “China’s vaccine diplomacy is the costliest, with tremendous investments in vaccine development, production, and distribution”. Though it arranged its clinical trials, sales and donations across the developing world, it provided preferential access only to African and ASEAN countries — regions that are focus areas of the Belt and Road Initiative (BRI). While its vaccine aid has been mostly bilateral, the geopolitical rivalry between China and India in South Asia meant that Pakistan became “the first and largest beneficiary of China’s vaccine aid”.
The paper also notes how the three non-Western powers deployed vaccine diplomacy for image-building objectives as well. Russia, which neither gave away vaccines for free nor considered the developing world as its only market, sought to project itself as a scientific superpower. China’s ambition was to be recognised as an “all-round vaccine supplier in the global market”. India, with less advanced R&D, sought to sustain the image of a “humanitarian actor who supplies advanced Western pharmaceuticals at affordable prices — a self-portrait that may have contributed to India’s active engagement with COVAX.”
Case study of Brazil
The paper concludes with an interesting observation about how the BRICS countries “are intertwined in the complex structure of vaccine enterprise”. For instance, when Russia received a large order from Brazil, it outsourced production to China and India. China, on its part, had conducted clinical trials in Brazil, and Russia, while it also supplied API (active pharmaceutical ingredients) to Brazil, it had done the same for India for Covishield production. And India has exported Covishield to Brazil and South Africa. Such interdependence, the authors write, “can, at least in the short-term, mitigate outright conflicts between the rising powers.”
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