How the Oxford vaccine can help the West beat China at its own healthcare-diplomacy game
The UK has a decisive new tool to expand its international influence, if it chooses to use it
UPDATE. An article based on this blog post is now in CapX.
Here’s a question for you: is it unethical for a country to use overseas aid in the form of healthcare to further its own interests?
China certainly doesn’t think so, as it showed with its so-called “PPE-diplomacy” during the early stages of the Covid pandemic.
Now, with the announcement of the highly effective Oxford vaccine, the UK has the potential to take a leaf out of China’s book, as does the US with the Pfizer/BioNTech and Moderna vaccines. Should they do so?
China hasn’t been shy on using Covid to further its own international aims. Early on in the pandemic the country made much of its ability to send millions of pieces of personal protective equipment (PPE) like masks out to the world. Many in the West claimed that this was China deflecting attention away from the virus’ origin, and also the country’s early mishandling of the response.
Nonetheless, Beijing’s mask-diplomacy was well received by many. When Italy and a number of Balkan countries appealed to the EU for help dealing with the pandemic, they were turned down. It was China that came to the rescue, shipping out PPE by the plane load, along with medical staff to help their beleaguered hospitals. When the first shipments of China’s contribution arrived in Belgrade, Serbian President Alexander Vucic publicly kissed the Chinese flag in gratitude.
It wasn’t just masks that China wanted to export. In May this year President Xi Jinping announced to a virtual gathering of the World Health Assembly that his country was working on a Covid vaccine, which, when ready, would be dispatched abroad as a global public good. A dozen countries signed up for this, including Indonesia and Brazil.
Why would China do all this?
There are several reasons. The first is to show that it is able to rise to the challenge of global leadership, something that was made considerably easier by the cack-handed response of the Trump Administration. Not only did Washington force suppliers to divert PPE supplies away from other countries, including allies like France and Germany, the President announced that he was pulling the plug on WHO funding in retribution for what he called undue Chinese influence.
There are no prizes for what happened next. No sooner had this withdrawal of funding been announced when China told the world it was injecting an emergency $30m into the WHO’s coffers. China’s influence increased, and yet again the nation was able to proclaim itself the good global citizen – with America its antithesis.
This brings us to the second advantage that China gains from this health diplomacy: being able to manipulate the WHO to its own ends.
I’ll write more on how China is co-opting international institutions soon (for example, it now controls a third of the UN’s agencies, far more than the West). But if we just look at the WHO for now, it’s plain to see that Beijing is using its influence there to increasingly isolate Taiwan, what it considers to be a renegade province. China has also encouraged the WHO to dampen criticism of its early handling of the crisis to ensure that it comes out of this with a good reputation. Indeed, the WHO’s head, Tedros Adhanom, has said that Beijing has set “a new standard for outbreak control”.
(It’s useful to note that China helped to have Dr Adhanom elected as Director General of the WHO.)
The third advantage China gains from all this is the establishment of long-term patronage networks and dependency relations. These, it hopes, will be converted at some point into distinct commercial advantage. By using aid to tap into the health ministries and medical communities of countries like Italy and Brazil, Chinese officials aim to pave the way for their state-owned and private sector companies to sell them more medical products. This is very similar to the way that the Chinese company ZTE has built out the African Union’s digital health infrastructure, ostensibly as an aid project but in reality a nifty piece of commercial land-grabbing.
Yet for all this effort by China it looks like the health-aid tide is beginning to turn. Xi’s talk of a Chinese vaccine saving the world has come to nothing so far, and instead it has been Western countries, in particular the US and UK, who have led the scientific fightback against the virus.
First, it was UK researchers who discovered the effectiveness of the drug dexamethasone in treating hospitalised Covid patients. An American drug, Remdesivir, is also being used to alleviate symptoms.
Then it was vaccines from Pfizer/BioNTech (US-German) and Moderna (US) which were the first to the market. These were followed yesterday with the announcement by Oxford University and its partner AstraZeneca that its long-hailed vaccine offers up to 90% protection. The even better news is that, unlike the Pfizer/BioNTech and Moderna vaccines, it is far cheaper and simpler to store, thus making it easier to ship it to all corners of the Earth.
These advantages are going to be put to the test by the welcome announcement that the Oxford vaccine is going to be sold to low- and middle-income countries in the developing world on a non-profit basis “in perpetuity”.
British scientists, led by researchers at one of the world’s leading universities (disclaimer: where I went as an undergrad), have potentially reopened the door to kickstarting the world economy. When it is remembered that tourism, which is far more important for developing economies than most developed nations, has all but stopped because of the pandemic, this medical breakthrough will very much help the poorer parts of the planet.
It will be interesting to see how much political capital the UK seeks to make out of the vaccine. If it doesn’t rush to claim the title of the world’s vaccination saviour then it will leave the door open for China to do so as and when it creates its own. Chinese pharma giant Sinopharm will quickly have billions of doses ready to export for the (national) good.
Vaccines though aren’t the only means that the UK has to counter Chinese health-diplomacy. Whilst its $30m of extra WHO finding made the headlines, China’s contribution is dwarfed by the UK’s annual funding of $464m. If you add some of the UK’s closes allies to the mix – Australia, Canada, Japan, and New Zealand – then the combined budget contribution is 19% of the total, about the same as the US used to give (and may well do again under Biden).
China’s domination of the WHO exceeds by far its economic worth to the organisation. It might even be called a bluff, as PPE-diplomacy was.
China’s claim to have been a munificent saviour with its PPE distribution was in fact a steadfast example of smoke and mirrors, according to a Bloomberg report. Whilst it was busily sending out PPE by the plane load, Chinese citizens, organised by a Communist Party-run agency called the United Front, were buying up protective equipment in many of the same recipient countries and sending it back to China. According to the report this amounted to 2.5 billion pieces of PPE taken from Europe, Asia, South America, and elsewhere and handed over to the People’s Republic, even as PPE aid was headed the other way.
China has tried to use Covid-inspired health diplomacy to further its political and commercial ambitions during the pandemic; by doing so it is creating commercial advantage for itself and thus hoping to enrich the country and the Chinese people.
Yet it is the UK and the US who have done the most to find a way back to “normality” – ironically, given how badly they have been impacted by the virus at home. They now have the opportunity to take a leaf out of China’s book and further their own global ambitions.
There will be many in the West who feel uneasy about this: when the British government announced it was merging its aid agency (DFID) into its foreign ministry, to create the Foreign, Commonwealth, and Development Office, it met stiff opposition.
Yet arguments against the use of aid for the national interest, and that by doing so it “puts politics above the needs of the poorest people”, miss the wider point. China has deeply politicised aid and is using it to drag countries into its sphere of influence. The only way the West will be able to maintain its aid-related standing in the world is to do the same, otherwise voters will increasingly question why China is benefiting from aid when no one else is.
The Oxford vaccine is an historical milestone in global health. It should also be the catalyst for change in the way that the UK and the West use health-diplomacy to beat China at its own game - to the benefit of the whole world.
POSTSCRIPT. This article has been updated to reflect that it was a Pfizer/BioNTech vaccine, not just Pfizer. This makes any use of this particular drug as part of a diplomatic push much more tricky, as I am reliably informed that the German government is refusing to indulge in such diplomacy. The choice for the UK, however, remains very much alive.