A Blog by Jonathan Low


Mar 21, 2021

The Age of (Very) Competitive Covid Vaccine Diplomacy Has Begun

There is acute global consciousness about who has bought and hoarded vaccines and who has shared. 

Until this week the US had fallen far behind China, Russia and India in terms of perceptions about which countries were making vaccines available to the less fortunate. This was initially by design. But the greed is good era of US geopolitics has ended, at least for the next four years. The challenge is that changing those perceptions while attempting to vaccinate one's own population is complicated, especially as other countries tout their own generosity, even if it is mostly illusory. JL

Mary Beth Griggs reports in The Verge:

Millions of doses of COVID-19 vaccines sitting in US warehouses are now destined for Mexico and Canada. The donation marks the US’ first step into the contentious world of pandemic vaccine diplomacy. But the US is late to the party when it comes to vaccine donation. China, India, and Russia have all been pushing this version of soft power for a while. The US is losing the messaging war. “Six months from now, it may well be that the U.S. donated more doses than any other country. But right now the storyline is we’re buying more and hoarding more of the supply.” When this is all over, the nations of the world will be left with how they treated other human beings

Millions of doses of COVID-19 vaccines currently sitting in United States warehouses are now destined for vaccination sites in Mexico and Canada, according to the White House. The donation marks one of the US’ first steps into the dawning — and deeply contentious — world of late-stage pandemic vaccine diplomacy.

The neighborly gesture is reportedly a loan — the US expects that they will return the favor and hand over some vaccine doses in the future. The US can certainly afford to be generous with these doses. The AstraZeneca vaccine that it’s donating hasn’t been authorized in the US. The country reserved doses just in case it is eventually given the green light by the FDA, but the vaccine is still being tested in the US. Results from that trial are expected soon, but functionally, the US has a whole bunch of doses sitting around that it can’t do anything with.

But other countries can. Many places have given AstraZeneca the all-clear, including Canada and Mexico. And the US has lined up enough authorized vaccines to innoculate the entire US populations. That’s left many people pushing the Biden administration to let the doses go to countries that need them. Now, it seems, they are finally going to do just that.

(Quick aside: Complicating everything, there’s a whole mess with the AstraZeneca vaccine rollout in Europe — some weird blood clotting showed up in a few patients, causing several countries to halt vaccinations. Vaccinations resumed this week, with several regulators — and AstraZeneca — insisting that the vaccine is safe.)

The few million doses being handed to Mexico and Canada are a start. But on the global stage, the US is a bit late to the party when it comes to vaccine donation. China, India, and Russia, among others, have all been pushing this particular version of soft power for a while now. India, which has a massive pharmaceutical manufacturing industry, is in a prime position to donate vaccines to other countries. The UAE is jockeying to become a major vaccine hub in the Middle East, both buying and distributing vaccines. China and Russia have both developed their own vaccines and are using them to bolster alliances around the world. So now you’ve got multiple countries pushing their own vaccine supplies (and their own national agendas) to countries who can’t afford to negotiate their own deals with a limited number of manufacturers.

Then there’s COVAX. COVAX is a vaccine distribution effort put together by international organizations including the World Health Organization. Its goal is to make sure that poorer countries also have access to COVID-19 vaccines. So far, it’s shipped about 30 million vaccines around the world. That’s not nothing, but a small fraction of the more than 420 million vaccine doses administered worldwide. And it’s well short of COVAX’s goal of administering more than one billion doses to poorer countries by the end of this year.

This has left COVAX very annoyed at all the bilateral wheeling-dealing happening between countries, and between countries and drug companies.

“We have made great progress,” WHO Director-General Tedros Adhanom Ghebreyesus said in February. “But that progress is fragile. We need to accelerate the supply and distribution of COVID-19 vaccines, and we cannot do that if some countries continue to approach manufacturers who are producing vaccines that COVAX is counting on. These actions undermine COVAX and deprive health workers and vulnerable people around the world of life-saving vaccines.”

Biden has pledged $4 billion to COVAX, but international pressure is increasingly building for wealthy countries like the US to put their doses where their wallets are.

“From a U.S. perspective, we’re losing a bit of the messaging war out there,” Krishna Udayakumar, director of Duke University’s Global Health Innovation Center told Axios last month. “If we look six months from now, it may well be the fact that the U.S. has donated more doses than any other country in the world. But right now the storyline is how we’re buying more and hoarding more of the supply.”

The US appears to be trying to change that storyline — but it’s still taking its own diplomatic path to get there. In March, President Biden met with leaders of Australia, Japan, and India on a plan to boost production of vaccines, and flood countries in Asia and the Pacific with vaccines this year. At the same time, there’s internal pressure for the US government to quickly roll out the vaccines they have to their own population, which, due to the Trump administration’s own bungling of the pandemic has suffered the highest official death toll of any country in the world.

As the rollout continues, this is all going to keep happening. Countries will try to vaccinate the people in their borders, and they’ll simultaneously try to make the most of any donations to the rest of the world. For now, it’s a messy political problem that’s getting tied into other international negotiations. But when this is all over and the vaccine vials are empty, the nations of the world will be left with how they treated other human beings — whether they held on to a security blanket of extra doses, or whether they handed over some of their bounty to a neighbor in need.


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