The COVID-19 vaccines produced by Chinese companies have gained increased global recognition, with more than 40 countries placing orders from China. Given the surging demand for vaccines across the globe, what is the current state of the global vaccine supply market? How do developing countries choose which COVID-19 vaccines to buy? What kind of challenges will Chinese vaccines face when they are used overseas?
In a recent interview with the Belt and Road Portal (BRP), Zha Daojiong (Zha), a professor with the School of International Studies and Institute of South-South Cooperation and Development at Peking University, said that China is making its own contribution to the building of a human health community by promptly providing its domestically produced vaccines to countries that recognize them.
“When supplying vaccines to foreign markets, Chinese companies are expected to not only make the products available and affordable, but also fulfil their legal obligations in the entire such as international transportation, delivery and administration.”
BRP: What is the current situation like in terms of basic global vaccine supply?
Prof ZHA: For a long time, the world’s vaccine market has four features.
The first feature is that those Western countries that are capable of independently researching and developing (R&D) vaccines make the products for themselves and usually do not export them.
In the second feature, some Western vaccine producers develop and produce vaccines jointly with countries that lack independent R&D capability or do not have a complete vaccine industry chain.
The third feature is that the United Nations International Children's Emergency Fund (UNICEF), together with some international charities, buys vaccines from Western producers and offers subsidized sale of the products to mid- and low-income countries. Along the way, multilateral aid and development institutions can help low-income countries certify and ensure the quality of imported vaccine products.
The fourth feature is more frequently seen in the Caribbean, Latin America, central and South America region: participating member countries of the Pan American Health Organization (PAHO)’s revolving fund use a cooperation mechanism for the joint procurement of vaccines, syringes and related supplies.
BRP: What is China’s position in the global vaccine supply market?
Prof ZHA: China is a new participant in the global vaccine supply market. The World Health Organization (WHO) pre-qualified a Chinese-made vaccine for the first time in 2013. The WHO-endorsed vaccine is effective for preventing a strain of encephalitis, the leading viral cause of disability in Asia and primarily affecting children.
In 2015, China-made vaccines entered the world market. Thus far, with only four Chinese-made vaccines pre-qualified by the WHO, China accounts for less than 1 percent in the global vaccine market for human use.
Historically, developed countries that have vaccine R&D capability have led the world in implementing national immunization programs. Countries with relatively weak vaccine R&D capability mostly procure vaccines through support from other countries or international organizations. Therefore, a kind of inertia has gradually formed in the global supply of vaccines. That is, most countries around the world recognize vaccine products from developed countries.
In 1974, the WHO established the Expanded Program on Immunization (EPI), and recommended and helped developing countries to join. China started implementing planned immunization in 1978 and participated in EPI activities in 1981.
In 2020, the Developing Countries Vaccine Manufacturers Network was established. It has attracted many Chinese R&D and production companies to participate.
BRP: Given the current situation in global vaccine supply, what kind of rules do Chinese producers have to comply with when they are ready to provide COVID-19 vaccines to world markets?
Zha: Although Chinese vaccines have a relatively short history in the world market and its share of the global vaccine market is small, it does not mean that China's COVID-19 vaccines are blocked from the global supply.
Along with meeting domestic demand for COVID-19 vaccines, Chinese producers are expected to increase vaccine supply around the world to ensure countries that need them can have access to Chinese-made COVID-19 vaccines, too. In addition, efforts are being made to accelerate production and overseas deployment. A key and necessary premise is quality control.
BRP: What factors will developing countries take into account in choosing a COVID-19 vaccine?
Prof ZHA: Developing countries that are not capable of developing vaccines, understandably, go through three scenarios when choosing COVID-19 vaccines. The first is whether or not they have the ability to independently test the safety and effectiveness of a vaccine. If a country cannot carry out independent testing, it can choose to outsource part of the testing work to a country with that ability and accept the reported results . Based on the “inertia” trend in global vaccine supply and demand, it is more likely that these countries will choose a COVID-19 vaccine produced by a country that they historically trust.
Under a second scenario, more and more developing countries follow the method adopted by Japan. If a country plans to mass import a COVID-19 vaccine produced by a foreign company, it requires joint R&D and production in the country. More specifically, the phase II and phase III clinical trials should be jointly conducted in the country.
Under a third scenario, if a developing country does not have the capacity to participate in the R&D of a COVID-19 vaccine, or it does not have the funds or channels to seek outsourcing cooperation in product quality testing, it references the pre-qualification issued by the WHO in making decisions on procurement.
BRP: Some foreign media accuse China of “vaccine diplomacy”. What’s your view on that?
Prof ZHA: Historically speaking, it is not a new phenomenon. For instance, during the Cold War, when several effective vaccines produced by the Soviet Union were used in Central and Eastern Europe, the Western media characterized it as “vaccine diplomacy”. Nowadays, some foreign media label China’s vaccine support for developing countries as political diplomacy. This is a continuation of geopolitical competition.
Given such noises, what can we do? Firstly, China should seek comprehensive cooperation with the WHO in the COVID-19 vaccine pre-qualification process. Chinese vaccine firms and pharmaceutical regulatory authorities should work with WHO departments such as the Strategic Advisory Group of Experts to obtain certification and only export vaccines approved by the WHO.
Secondly, when exporting vaccines, Chinese companies should invest in upgrading a recipient country’s capacities. They should not only off the products but also involve themselves in the entire procedure, including l transportation, inoculation and observation after vaccination. Chinese vaccine companies are required to earnestly fulfil their legal obligations, not only in compliance with Chinese laws and regulations, but also in compliance with local laws and regulations of the participating foreign countries.
BRP: What kind of challenges will China-made COVID-19 vaccine products face when exported to Belt and Road Initiative (BRI) markets?
Prof ZHA: In the history of global vaccine supply, Chinese vaccines are new arrivals and many countries have not experienced using Chinese-made vaccines before. Therefore, these countries may not readily recognize China’s COVID-19 vaccine products.
In the past few decades, China’s vaccine industry experts have conducted international exchanges and cooperation more with colleagues in developed countries than with peers in developing countries.. As a result, the Chinese vaccine industry has some way to go in establishing close networks of experts and companies in the sector with developing countries.
Despite these challenges, Chinese vaccine companies have made their contribution to the world supply of vaccines commensurate with their capabilities.