How China is vaccinating the world

A superior response at home is paying dividends abroad

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Before sunrise on May 12, a Bangladeshi military transport plane touched down at an air base in Dhaka. Airmen driving forklifts then unloaded hundreds of thousands of Sinopharm vaccines -- the first major shipment of Chinese vaccines to one of the world’s poorest countries.

Days before, the World Health Organization approved Sinopharm’s vaccine, giving the green light for the People’s Republic of China to distribute it globally. More batches arrived in Turkey’s capital city, Ankara, which signed an agreement for 100 million doses -- enough to cover the country’s entire population. Pakistani planes returning from Beijing landed in Islamabad hauling more than 300,000 vaccines. In February, Hungary became the first European Union nation to receive Sinopharm with an air shipment of 550,000 of the jabs.

How has China surged past more developed economies to become the primary provider of COVID-19 vaccines to lower income countries? Through a unique combination of factors all stemming from China’s distinct political and economic model. 

The first is that China -- when facing its domestic outbreak -- bet on early and extensive contact tracing, large-scale testing, quarantine, and lockdowns which were among the most sweeping in the world. That suppressed domestic COVID in the main, although China still experiences localized cases of the disease which often appear to be imported. 

Initial success paradoxically makes Chinese less in a hurry to be vaccinated, because they can go to work or mingle in public with little risk of contracting the virus, even while Chinese report being the most willing to take a vaccine. That also puts China at risk from imported cases, hence concentrated quarantines lasting up to two weeks for travelers, followed by another week of home quarantine. State-owned companies have also required Chinese workers traveling overseas to be vaccinated before leaving -- lest they bring the disease back with them when returning.

But that means more vaccines for export, too. Chinese vaccines include:

  • BBIBP-CorV, developed by state-owned Sinopharm. Annual capacity: 3 billion

  • CoronaVac, developed by Sinovac Biotech. Annual capacity: 1 billion

  • A new vaccine developed by Shenzhen Kangtai Biological Products. Annual capacity: 500 million

  • Convidecia, developed by CanSino Biologics and the PLA Academy of Military Science. Annual capacity: 100 million

  • ZF2001, developed by Anhui Zhifei Longcom Biopharmaceutical and the Chinese Academy of Sciences. Annual capacity: 1 billion

But China is also the world’s most populous country, and the scale of the efforts required to vaccinate 1.4 billion people is immense. As a result, China’s domestic vaccination rate lagged behind that of Europe and the United States until recently, rising to 354 million vaccinations -- a quarter of the population -- last week compared to 38% of Americans.

China plans to vaccinate 40% of the population, or 560 million, by June. On Sunday, the number of jabs accelerated to 400 million in total, with 15 million vaccinations occurring every day. This is far and away the fastest inoculation rate in the world. Two new measures: mandating Communist Party members and employees of state-owned companies receive the jab.

“The whole country is being immunized in an orderly manner,” Shao Yiming of China Center for Disease Control and Prevention said. “People should feel urgency but no need for panic. Our supplies are sufficient and production capacity is increasing gradually.”

Globally, China is picking up slack as India -- the world’s largest vaccine maker -- halted exports last month in the midst of a deadly new wave of the disease. The resulting supply crunch imperils vaccination efforts in poor countries in particular, as India’s doses are cheaper than those made in rich countries. The United States and Europe have hoarded their own vaccines for domestic use.

China, on the other hand, has exported more than they have used on their own population: 700 million vaccines to 84 countries in an effort Beijing calls a “global public good.” By contrast, the United States has only exported 3 million jabs while producing 333 million to date.

Enter logistics. Most of China’s vaccines are more-traditional inactivated vaccines. In other words, they use dead viral particles to stimulate the body’s immune system. U.S.-based Moderna and Pfizer have developed mRNA vaccines, in which the virus’ hacked genetic code trains the body to build up antibodies. While highly effective, one downside is that the mRNA vaccines require very cold storage, while China’s inactivated vaccines can be kept safe in a standard refrigerator.

This simpler distribution is vital for delivering doses in poor countries. In Ethiopia’s capital, Addis Ababa, Chinese companies have set up a massive refrigerated storage and supply distribution system in an airport terminal. State-owned Ethiopian Airlines, which has seen its business flights tank, has now partnered with Chinese tech giant Alibaba’s logistics arm to fly vaccines to 52 of Africa’s 54 countries.

South of the airport: a sprawling, $80 million headquarters currently under construction for the African Union’s public health agency, financed by China and built by Chinese construction companies -- free of charge. The United States had previously expressed support for the project, but talks collapsed when former. Pres. Donald Trump cut $130 million of foreign aid to Ethiopia last year.

Western countries have pursued a different path: “vaccine nationalism.” Last month, U.S. Pres. Joseph Biden declared “our own vaccine supply -- as it grows to meet our needs, and we’re meeting them -- will become an arsenal of vaccines for other countries … But every American will have access before that occurs.”

Pharmaceutical companies have pushed this policy in their home countries, ferociously defending their vaccine patents. Pfizer and the other major vaccine makers have made billions this year alone, with more to come from booster shots later. Biden has endorsed a proposal by China, India and Africa to waive intellectual property restrictions on such vaccines, but this has met resistance from Germany, which co-produces the BioNTech/Pfizer jab. Biden’s move also comes months after poor countries first sought the waiver, too late for hundreds of thousands of Indian lives. 

The Biden administration has claimed the U.S. will export 80 million vaccines by the end of June, but American allies are already wondering why it hasn’t already. “This puts us in a very difficult situation,” Honduran official Carlos Alberto Madero told the Financial Times. “[The] Honduran people start to see that China is helping its allies and we start to ask ourselves why ours are not helping us.”

The answer to Madero’s question: maybe the United States isn’t such a good ally, and maybe China isn’t the villain U.S. politicians have painted it to be. 

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