China Steps Into Covid-19 Vaccine Void in Asia’s Developing Nations

A million doses of Chinese vaccines touched down over the weekend in the Cambodian capital of Phnom Penh, where containers filled with the cargo were photographed and featured prominently on the prime minister’s Facebook page.

Similar shipments of Covid-19 shots have been landing in other capitals in Southeast and South Asia. Last week it was Manila and Bangkok. The week before, Kathmandu. And late last month, Jakarta.

Chinese vaccines, through a mix of small donations and larger sales contracts, have been a conspicuous part of rollouts in developing countries across Asia in the first half of 2021. Millions of doses have arrived as governments in the West focused on getting their own populations inoculated and Covax, a program backed by the World Health Organization to immunize the world, fell short of its goals.

Advanced economies—which bought up large quantities of vaccines—are now pledging to help resource-strapped nations. Leaders of the Group of Seven countries said on Sunday they would share at least 870 million doses directly over the next year. But in the last six months, deliveries of Chinese shots, even if they often arrived in small batches, helped several governments push their vaccination drives forward—and gave Beijing an opportunity to strengthen ties.

China Steps Into Covid-19 Vaccine Void in Asia’s Developing Nations
Photo: prakash mathema/Agence France-Presse/Getty Images

Indonesia is heavily reliant on shots made by Chinese company Sinovac Biotech Ltd., which account for 89% of the 95 million doses it has received so far. Cambodia has largely used two China-made vaccines to achieve one of the region’s highest inoculation levels, with 18% of its population at least partially vaccinated. After a slow start, the Philippines expects to increase vaccinations with about 10 million doses arriving this month, more than half of which will be Chinese.

“It has certainly left an impression that when things were tough, the Chinese stepped up,” said Evan Laksmana, a senior researcher at the Centre for Strategic and International Studies in Indonesia. The region’s residents will remember “how China locked down quickly, got its own issues under control and provided vaccines,” he said.

Chinese vaccines have also filled part of the void in South Asia, where countries were counting on AstraZeneca PLC shots manufactured in India. A severe Covid-19 surge in India disrupted those supplies.

‘It has certainly left an impression that when things were tough, the Chinese stepped up.’

— Evan Laksmana, Centre for Strategic and International Studies in Indonesia

Nepal is using 1.8 million doses of the vaccine developed by Chinese state-owned firm Sinopharm to vaccinate those older than 60. The donation is far short of what the country of 30 million people needs, but it fulfills a near-term gap by helping to inoculate at least one age group, said Dr. Krishna Paudel, the spokesman for Nepal’s health ministry. “Something is better than nothing, that’s how we are looking at it,” he said.

Sri Lanka has agreed to buy 14 million Sinopharm doses, and Bangladesh is in talks to buy 15 million from the firm.

Vaccine shipments have been accompanied by brisk diplomacy. Chinese Foreign Minister Wang Yi traveled to Southeast Asia in January, hosted four foreign ministers from the region for one-on-one talks in China in late-March and early April, and congregated with all the region’s foreign ministers in the Chinese city of Chongqing for talks last week, with vaccines high on the agenda. In late April, Mr. Wang held a videoconference with his counterparts from Nepal, Bangladesh, Sri Lanka, Afghanistan and Pakistan.

In a meeting this month with a senior Indonesian official, Mr. Wang remarked that a handful of developed countries had hoarded vaccines and said China would work to jointly produce vaccines with developing countries.

Chinese Covid-19 vaccines offer relatively low levels of protection compared with some of their foreign rivals. Here is why China is joining other countries in considering mixing and matching vaccines as a key to overcoming multiple vaccination challenges at once. Illustration: Ksenia Shaikhutdinova

“There has been a bit of momentum on the diplomatic side of things,” said Mr. Laksmana. “If China really is committing to long-term research and production cooperation with regional countries, it locks-in the region much longer into the relationship,” he said of Southeast Asia.

China in recent years has expanded its strategic and economic heft in the region, intensifying competition with the U.S. But it is also involved in disputes with its neighbors, including in the South China Sea. In a survey published in February by ISEAS-Yusof Ishak Institute in Singapore, more than three-quarters of the 1,032 policy makers and opinion-leaders who were canvassed across the region said they saw China as the region’s most influential economic power. Asked if Southeast Asian nations should align themselves with the U.S. or China if forced to choose, 61.5% picked the U.S.

Beijing has been vying for clout in South Asia too with regional rival India, through a mixture of aid, loans and infrastructure investment. Days before the first batch of vaccine donations arrived in Bangladesh in mid-May, the Chinese ambassador warned the country against cooperation with the Quadrilateral Security Dialogue, a grouping formed between the U.S., Australia, India and Japan, in part to counter China’s regional influence.

The warning triggered a rebuke from Dhaka. “We are an independent and sovereign state. We decide our foreign policy,” said Bangladeshi Foreign Minister A.K. Abdul Momen.

Asked whether China was using vaccines to gain political influence and encourage countries to make purchases, the Chinese foreign ministry said the country was trying to ensure a stable and diversified supply of vaccines in the developing world.

China Steps Into Covid-19 Vaccine Void in Asia’s Developing Nations
Photo: ted aljibe/Agence France-Presse/Getty Images

India, one of the world’s largest vaccine manufacturers, was expected to play a big role in countering China’s vaccine diplomacy. Its efforts were initially successful, with India sending more than 66 million doses abroad, before a Covid-19 surge brought deliveries to a halt. Exports are expected to resume by the end of the year.

Only a small number of vaccines produced by Western companies Pfizer Inc. and BioNTech SE and Moderna Inc. have arrived in South Asia and Southeast Asia, with the exception of wealthier places like Singapore. Doses of Western-developed vaccines are expected in higher numbers in the second half of the year.

The efficacy of Chinese vaccines has been the subject of debate in some countries. Clinical trial results for Sinovac’s shot vary widely and include a Brazil study that found the vaccine to be 50.38% effective against symptomatic infections—just enough to meet the WHO’s 50% standard. A clinical trial in Indonesia showed the vaccine to be 65.3% effective.

China Steps Into Covid-19 Vaccine Void in Asia’s Developing Nations
Photo: Sakchai Lalit/Associated Press

Sinopharm has said its vaccine is 79% effective in preventing symptomatic cases. The UAE started giving a third booster shot to some residents after doctors said Sinopharm’s vaccine wasn’t generating enough protective antibodies in some cases. Singapore hasn’t approved Chinese vaccines, and Vietnam, where suspicion of Beijing runs high, hasn’t administered China-made vaccines.

The WHO has approved both the Chinese vaccines for emergency use.

—Jon Emont in Singapore and Krishna Pokharel in Kathmandu contributed to this article.

Write to Niharika Mandhana at [email protected] and Sha Hua at [email protected]

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