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This book unpacks the political economy of China’s COVID-19 vaccine supplies to the Global South. Examining the political and economic forces at play, the book demonstrates how China’s vaccine provisions have been determined by a complex set of commercial interests, domestic politics, and geopolitical relationships.
The book sheds light on how domestic interests shape China’s role in global governance and its international economic engagement. Its analysis contributes to broader academic debates on the politics and economics of crises, as well as offering new insights on how pre-existing political and market forces shape aid and trade in the context of crisis.
This concluding chapter summarizes the book’s core arguments and findings, namely that China’s overseas vaccine supplies are driven principally by commercial imperatives, as well as by the party-state’s need to maintain its performance-based legitimacy domestically. It then discusses some broader implications of this analysis. With respect to China’s foreign relations, the findings of this book point to the importance of domestic factors and state-corporate linkages in shaping China’s external interactions. With respect to international political economy, they offer insights into how crises are shaped by existing institutions and patterns, but also provide new opportunities for actors able and willing to seize them. The chapter finishes by looking ahead to the future of Chinese vaccine supplies overseas as production and exchange of COVID-19 vaccines becomes a routine transaction. It outlines both the challenges of increasing competition from other players (in particular, those further ahead in the use of mRNA technologies) and successive variants of the virus, as well as promising opportunities for further development, in particular in vaccine manufacturing collaborations in the Global South.
This chapter lays out the pre-pandemic initial conditions that shaped China’s overseas COVID-19 vaccine supplies by contextualizing China’s position in global health in recent history. First, it describes China’s domestic health governance and its increasing importance to the party-state’s performance-based legitimacy, in particular following the outbreak of the COVID-19 pandemic. Next, it charts China’s role in health sector foreign aid and international health governance institutions, highlighting Beijing’s longstanding preference for bilateral cooperation over multilateral engagement through institutions such as the WHO. Finally, it describes China’s position in the global pharmaceutical industry and vaccine markets, which has expanded rapidly in recent years – facilitated in part by state support for technological innovation – but nonetheless pre-pandemic was relatively weak compared to other major industrialized economies.
This chapter sets the scene for the analysis in the remainder of the book. It describes the developmental and health impacts of the COVID-19 pandemic in the Global South, as well as the inequities in global vaccine supplies, in particular during the first wave of the vaccine rollout in which vaccine nationalism in the West created a space for China to step in to. It then situates the book in context by reviewing existing understandings of China’s relationship with the Global South, and of the political economy of crises. Next, the chapter summarizes the analytical framework and main argument: that the distribution of Chinese COVID-19 vaccines was shaped by the ‘opportunity management’ of state and corporate actors, with the former seeking to consolidate their performance-based legitimacy and the latter to expand internationally into new products and markets. Finally, the chapter describes the data sources and provides a roadmap of the book.
This chapter examines commercial vaccine exports from Chinese manufacturers, which were the majority of Chinese vaccine doses administered abroad during the first half of 2021. It first reviews the histories of the companies involved, including Sinopharm (officially known as China National Pharmaceutical Group Corporation), which is an established central state owned enterprise under the State Owned Assets Supervision and Administration Commission (SASAC), and Sinovac and CanSino, which are both relatively young private firms started by entrepreneurial scientists, and were little known before the pandemic. It then describes how these companies each leveraged state support to quickly develop and bring to market their vaccine candidates. Finally, it maps patterns in Chinese vaccine sales during the initial mass vaccination rollout, which were driven both by standard market forces of supply and demand, and by clinical trial partnerships between manufacturers and host states.
This chapter examines China’s official donations of COVID-19 vaccines. It first briefly reviews competing narratives on Chinese vaccine supplies outside China (grand strategy of ‘vaccine diplomacy’) and inside the country (‘global public good’), and explains why neither is particularly helpful in explaining patterns in the actual distribution of China’s vaccine donations during the first half of 2021. It then empirically charts those patterns, showing that – in line with the state’s performance-based legitimacy goals – Asian neighbours were prioritized over traditional aid recipients in Africa. The evidence suggests Beijing’s vaccine donations were motivated mainly by a pandemic-induced desire of Chinese officials to avoid ‘imported infections’ at home (and their potentially significant consequences for domestic legitimacy) and maintain regional stability, and relatedly by pre-existing strategic partnerships with the country’s neighbours.
This worldwide crisis initiated frantic comparison (and competition) between nations to search for a response to the coronavirus. Sweden has been more than ever in the spotlight, under media and popular scrutiny. The daily briefings of Anders Tegnell and his sidekicks were followed by journalists and experts around the world. Initially there were more favourable opinions about a strategy that avoided lockdown and mitigated the effects on the economy, but it became increasingly controversial as the mortality rate rose. This chapter reflects on the comparison of policies, statistics, infection rates, death counts and the moral and normative dimensions that surrounded the justification of each nation’s ‘strategy’, along with forms of ‘health care nationalism’ that emerged in many countries, and markedly in Sweden. Indeed, the high and stable legitimacy of the Public Health Agency, []FHM, and its main experts has been striking and in sharp contrast with the situation in other European countries w[h]ere experts and politicians alike have faced sharp criticism. I show that this is coherent with traditional forms of trust in science, expertise and public institutions in this society but that it also hides a tendency to avoid divisions and conflicts
This chapter reviews the initial phases of the Swedish response to the epidemic emergency. The ‘slow’ and ‘delayed’ response Sweden was criticized for is accounted for in all its complexity. It is important to try to explain why Sweden deviated so much from the rest of Europe, in comparison with its direct neighbours, but also by contrast to its own history of handling epidemic crises. This response met with a lot of astonishment, especially in light of the fact that Sweden has one of the lowest hospital bed capacity in the OECD and could have been expected to react very differently. While the role of FHM, the Public Health Agency, and of its chief epidemiologist, Anders Tegnell, corresponded to a traditional form of administrative independence and heeding of expertise, it went much further than what is generally expected, and other factors must be taken into account to make sense of their unprecedented influence. The lack of certain legal instruments is also important in this regard. The most controversial debate around ‘herd immunity’ and whether Sweden strived to achieve and even more or less openly promoted are some of the issues discussed in this chapter.
