In early March, US President Joe Biden and the leaders of India, Japan and Australia the so-called Quad group — chose to put Covid-19 vaccines at the centre of their strategy to limit China’s growing influence in Asia.

Their plan to use one billion largely Indian-manufactured vaccines as a geopolitical tool was swiftly overtaken by events though US officials have said it is still on track. Having started the year by describing itself as a “vac superpower” and “pharmacy of the world”, India has now halted exports and is seeking vaccines from elsewhere as the Covid-19 pandemic overwhelms its hospitals.

At the start of 2021, almost every big nation producing a Covid-19 vaccine hoped to use the vaccine race to boost its global influence. Few have seen things turn out as they planned. From China struggling to gain acceptance for its test data to doubts about the performance of Russia’s Sputnik V vaccine causing a political crisis in Slovakia, almost all have suffered significant setbacks.

Last week, the United States took the once unthinkable move of throwing its weight behind calls from emerging countries led by India and South Africa to temporarily lift patent protection for Covid-19 vaccines.

Having started the year by describing itself as a “vac superpower” and “pharmacy of the world”, India has now halted exports and is seeking vaccines from elsewhere as the pandemic overwhelms its hospitals

That move together with the United States beginning its own significant vaccine exports could prove a game-changer for developing nations though analysts say it in effect amounts to the “expropriation” of the intellectual property of drug firms such as AstraZeneca, Pfizer and Moderna. Western states had previously rejected that approach, saying it could jeopardise future investment in vaccine development.

Beijing remains the largest exporter of Covid-19 vaccines, having shipped more than 200 million doses overseas. The United States is far behind but the situation looks set to change dramatically. Washington has already earmarked 60m unused AstraZeneca doses for export, with Pfizer shipments also looking set to be agreed upon.

Exactly where such supplies might go remains unclear. The scale of India’s outbreak makes that country an obvious early priority, but a host of other nations including South Africa and Mexico are eager for Western vaccines.

Supply squeeze

Russia and China have targeted multiple emerging countries for vaccine sales or donations of sometimes as little as a few thousand shots, helping them build influence. Most people in those nations, however, will also need to rely on the international Covax programme potentially able to deliver vast quantities of vaccines from any nation whose product passes regulatory testing.

The main constraint remains supply. Western drugmakers such as AstraZeneca and Pfizer have been striking deals with foreign producers including Russia, China and India since last year, and Russia has now also reached a deal with Chinese firms to produce its Sputnik V vaccine there. India is also looking for its own overseas manufacturers.

The vast majority of vaccines so far administered have been in rich Western nations. Even though the European Union made a slow start, it is now vaccinating significant proportions of its population.

The EU is suing AstraZeneca over what it says was a failure to supply promised doses. As recently as March this seemed likely to open the door to multiple European nations accepting Russian and Chinese vaccines but it now seems less certain.

Serbia, which wants to join the EU, embraced Russian and Chinese vaccines early on and pulled ahead of other European nations in its vaccination rate, but Serbs are now welcoming the arrival of Western vaccines.

Data worries

Last week, Reuters quoted the World Health Organisation (WHO) experts as saying the WHO had “very low confidence” in some of the data provided by Chinese vaccine firm Sinopharm although it was not clear if this would affect the chances of the vaccine receiving WHO registration. The European Medicines Agency is also reviewing the vaccine.

While Russia’s Sputnik V was recorded as performing well in Phase 3 trials published by the British medical journal The Lancet, it has also faced questions over quality and data. Brazil has denied emergency usage to Russias Sputnik, citing concerns over data and performance, prompting a furious response from Moscow.

In April, Russia demanded the return of 200,000 doses after Slovakia questioned their quality, saying they were found not to be the same as an earlier batch that had been approved.

That fuelled a row in Slovakia that took down its government and Prime Minister Igor Matovic, who had welcomed the Russian vaccines but faced an angry public backlash.

Russia has also seen hopes of getting Sputnik V into the Czech Republic falter in the face of rows over alleged Russian involvement in a fatal arms dump explosion in 2014.

Such disputes are not entirely new. China’s efforts to sell vaccines to Brazil were caught in what local media termed a “vaccines war” in November, as rival politicians backed different vaccine policies.

Those to come could prove even more contentious but ironically, it may be the race for global influence that gets the world vaccinated faster.

Published in Dawn, The Business and Finance Weekly, May 10th, 2021

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