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 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 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 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 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 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.