COVID-19 and the Global Vaccine Race
If 2020 was the year of “mask diplomacy”, as countries raced to tackle the spread of the SARS-CoV-2 virus and acquire the necessary protective gear and equipment, 2021 is likely to be remembered as the year of “vaccine diplomacy”. Growing competition between states to secure the necessary quantities of vaccines to inoculate their population has already become an established feature of the post-COVID international system and such trends are only likely to increase in the near future.
It normally takes up to a decade to transition from the development and testing of a vaccine in a laboratory to its large-scale global distribution. Despite current challenges, the speed of COVID-19 vaccination campaigns is unprecedented. To put an end to the current pandemic – which in one year has led to the loss of 2.6 million lives and triggered the worst economic recession since the Second World War – the goal is to ensure the widest immunisation of the world population in a timeframe of 12 to 18 months.
In this context, COVID vaccines emerge as instruments of soft power, as they symbolise, on the one hand, scientific and technological supremacy and, on the other, means to support existing and emerging foreign policy partnerships and alliances with relevant geopolitical implications. From their experimentation in laboratories, to their purchase and distribution, the vaccine has emerged as a significant tool for competition between powers, often associated with the promotion of competing developmental and governance models across third countries.
Indeed, the name given to Russia’s vaccine, the “Sputnik V”, is purposely meant to evoke the Soviet Union’s early achievements in the Cold War space race against the United States in the late 1950s, and offers evidence of Moscow’s efforts to employ the vaccine as an instrument of external influence. China, meanwhile, quickly sought to develop a global vaccine distribution strategy from the onset of the crisis, involving key partners in the framework of the Belt and Road Initiative and beyond.
Against this backdrop, and with growing competition over the vaccine also now present in Europe and between the EU and the UK, it is clear that three segments of geopolitical competition are emerging in the current global vaccine race.
The race to develop
In the “race to develop”, countries try to establish themselves as world powers with their capacity to develop a locally produced vaccine, a sign of scientific and technological superiority and of strategic autonomy. The current vaccine development race has been facilitated by massive government financing schemes and incentives through market mechanisms.
There are 79 vaccines in clinical trials, 22 in the final trial or approval stage, while 13 have been approved for use in at least one country. Among those in distribution, four were developed in Europe and the United States (Pfizer/BioNTech, Moderna, Oxford/AstraZeneca, Johnson & Johnson), two in Russia (Sputnik V and FBRI), five in China (SinoVac, CanSino, two by Sinopharm and ZF2001) and two in India (Covishield, the locally produced Oxford/AstraZeneca vaccine, and Covaxin).
The United States, currently the main country for the production of COVID vaccines in the world, has benefited from “Operation Warp Speed”, a public-private initiative launched in May 2020 by the Trump administration, which provided over 12 billion dollars funding for research and development of a vaccine. Meanwhile in China, the state-owned conglomerate Sinopharm has been one of the major actors behind the Chinese vaccine development race. In the Russian Federation, the sovereign Russian Direct Investment Fund supported the development in record time of a vaccine produced by the Gamaleya Institute, later named “Sputnik V”.
Other important tools to mobilise resources for vaccine development have been Advance Purchase Agreements, which are at the core of the European Vaccine Strategy and cover part of the upfront costs faced by producers in exchange for the right to buy a given amount of doses within an agreed timeframe.
By leveraging the phenomenon of global outsourcing, the “race to develop” also includes the ability of nations to establish themselves as regional or international production hubs. This is the case of India, which aims to become “the pharmacy of the world”, both through the development of indigenous vaccines and licensing agreements with major pharmaceutical companies.
Joint vaccine development activities are also emerging through south-south cooperation. In addition to the relationships put in place between major G20 members from the emerging world (China, Russia and India), there are also partnerships involving non-traditional actors. For instance, the Iranian Pasteur Institute and the Finlay Vaccine Institute of Cuba are together experimenting the “Soberana 2” vaccine.
The race to buy
When it comes to the acquisition of the vaccine, or the “race to buy”, countries and regional players attempt to guarantee the greatest possible supply of vaccines for their own population, in some cases at the detriment of equitable distribution mechanisms put in place multilaterally.
Given the limited amount of vaccines currently available in the global market – and also considering the delays in deliveries by some pharmaceutical companies in the West – international competition arises for the purchase of as many doses as possible. The “race to buy” is aimed, on the one hand, at containing the health emergency by achieving so-called “herd immunity”, and on the other, at accelerating the re-launch of national economies, providing a competitive advantage in the short term to countries with the highest numbers of vaccinations per capita. However, the purchase of large quantities of vaccines does not always correspond to their rapid deployment on a large scale due to national regulatory barriers.
When it comes to COVID vaccination campaigns, a dilemma emerges between the national and the global dimension, between short and medium to long-term objectives. Although the pursuit of a rapid national vaccination campaign may lead to an economic revival in the short term, on a global scale, the pandemic can be contained and the spread of new variants curbed only through an equitable access to immunisation campaigns, which have been defined by the UN General Assembly as a “global public good”.
The COVAX Facility, led by GAVI, CEPI, the World Health Organisation and with UNICEF as a distribution partner, is one of the cornerstones of the multilateral response to the pandemic and 186 countries are part of the initiative. However, the minimum coverage goal set by COVAX (20 per cent of the population) is currently insufficient to achieve global herd immunity, which instead would require a vaccination coverage estimated at between 60 and 80 per cent of the population. On the top of this, out of the almost 14.9 billion doses reserved internationally (6.3 million of which are still under negotiation), COVAX has only managed to purchase 1.1 billion doses, compared to the 4.6 billion secured by high-income nations.
Several countries have therefore resorted to alternative vaccine procurement mechanisms, also at a regional level. Among these, the EU purchasing mechanism stands out as the most advanced form of regional cooperation for vaccine procurement. In addition, the African Union, under the South African Chairmanship, has set up a task force for the acquisition of vaccines across the continent, securing the supply of 670 million doses to be shared among member states on an equitable basis.
The race to distribute
In light of the current supply and demand mismatch of COVID vaccines, especially in low and lower middle-income countries with no autonomous development capacity and limited purchasing power, the international distribution of the vaccine has become a tool of soft power in support of emerging and traditional foreign policy partnerships.
In the “race to distribute” towards third countries, the COVID vaccine becomes an instrument of projection of influence, generating geopolitical competition between global and regional actors in traditional and emerging areas of interest.
With relatively less ambitious internal vaccination objectives than in the West, China, Russia and India are the great protagonists of this first stage of “vaccine diplomacy”, leveraging on their own production capabilities, with an early strategy centred on a strong role of the state and the creation of international testing and production alliances.
As far as the West is concerned, the COVAX Facility is at the heart of every initiative for the joint distribution of vaccines to third countries. At the G7 Summit held on 19 February 2021, the leaders of the bloc decided to accelerate efforts to promote an equitable access to vaccines on a global scale, pledging 7.5 billion dollars to support vaccination campaigns across countries in need. With the change of leadership in Washington, the US joined COVAX and announced a contribution of 4 billion dollars to the Facility. The EU has also doubled its support for COVAX, announcing a contribution of an additional billion euro.
Furthermore, in line with the “Team Europe” approach, the Commission announced the forthcoming establishment of a common mechanism for the external sharing of some excess doses, paying particular attention to the Western Balkans, its southern and eastern neighbourhood as well as Sub-Saharan Africa. However, due to delays in deliveries and vaccine administration campaigns in the West, a longer time horizon may be required for such initiatives to unfold.
What role for Italy and the EU in vaccine diplomacy?
It is becoming progressively evident that in order to put an end to the current global pandemic it is not only necessary to develop and produce the highest possible number of vaccines, but also to ensure the widest immunisation of the global population. With the spread of variants of COVID-19, that in some cases may threaten the effectiveness of vaccines developed so far, the vaccine race also becomes a race against time, which requires a global response.
Considering the vaccine as a global common good is both an ethical and health related issue, with important economic and geopolitical implications. In line with their values, Italy and the EU should be driven by the objective to ensure the immunisation of countries in need, regardless of political affiliations or short-term interests.
If the priority in the short term remains the achievement of adequate vaccination coverage at the national level, Italy and the EU can adopt a medium to long-term strategy with regards to the international distribution of the vaccine through a multi-level and integrated approach.
First of all, taking advantage of the opportunities offered by Italy’s current G20 Presidency and the “Global Health Summit” to be hosted in May, multilateral initiatives aimed at containing the pandemic should continue to be encouraged. In particular, an equitable and rapid access to the vaccine around the world can be ensured by continuing to strengthen the COVAX Facility, in support of vaccination campaigns across low and lower middle-income countries.
At the EU level, by leveraging the “Team Europe” approach and the European Vaccine Strategy, the Commission’s proposal to establish an external sharing mechanism for a European vaccine should continue to be supported, allowing part of the surplus doses acquired to be shared with other struggling states, also in the framework of strategic bi-regional partnerships in Africa, Asia and Latin America. Moreover, the Atlantic Alliance could favour the distribution and administration of vaccines in countries in need where NATO operates. More in general, personnel of multilateral and regional peacekeeping missions deployed abroad could actively contribute to vaccine distribution campaigns.
Beyond donations and financing mechanisms to facilitate access to vaccines, Italian and EU soft power could also be deployed to strengthen international cooperation programmes in the healthcare sector aimed at supporting countries left behind in vaccination campaigns, including through capacity-building initiatives. Such programmes should also proactively involve civil society actors. The private sector could also play an important role in supporting vaccination campaigns, by offering solutions to strengthen vaccine storage and distribution chains.
In the current vaccine race, the accelerated global competition between the United States and Europe on one side and China and Russia on the other, becomes increasingly evident. Moreover, India progressively emerges as a major geopolitical actor to counter Chinese influence in its neighbourhood but also to establish itself as a global leader in the ongoing vaccine development and distribution race. With regard to the European continent, and in light of Brexit, the United Kingdom has demonstrated autonomous capacity to rapidly develop a vaccine and deploy effective internal immunisation campaigns, while, for the EU, the vaccine race is increasingly becoming an important arena to demonstrate its growing emphasis on strategic autonomy.
While some examples of positive collaboration among developing countries emerge, North-South divides are above all affecting low-income countries with no local production capacity and limited purchasing power. Yet, the pandemic can only be defeated through inclusive international cooperation, ensuring that no country is left behind in vaccination campaigns.
This implies a difficult choice or balancing between strategic autonomy, and thus the requirement to prioritise national immunisations across Europe before beginning to share COVID vaccines internationally, and the growing realisation that national inoculations will be insufficient in the long-term should the rest of the world be left behind in the vaccination process. EU support for the COVAX initiative represents one element of this balancing, but this requires a further scaling up of international efforts in the medium to long term, given the limited coverage capacity of the Facility at present.
With these thoughts in mind, further multilateral efforts would need to be promoted by the EU and Italy, while also seeking to complement these through other regional and bilateral initiatives in an effort to inoculate the most amount of people in the least amount of time. This, ultimately, is the only avenue out of the crisis. Italy and the EU now have a chance to actively contribute to this objective by deploying their soft power and support for multilateral solutions to this global emergency.
Lorenza Errighi works at the Policy Planning Unit, Secretariat-General, of the Italian Ministry of Foreign Affairs and International Cooperation. Any view or opinion expressed in this paper belong solely to the author and do not necessarily reflect the position of the Italian Ministry of Foreign Affairs and International Cooperation.
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