Chinese COVID-19 vaccines herald new era of country’s participation in global health sector: expert

Editor’s Note:

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?

Zha Daojiong, professor with the School of International Studies at Peking University

In a recent interview with the Belt and Road Portal (BRP), Zha Daojiong (Zha), a professor with the School of International Studies at Peking University, said that China has made its own contribution to the building of a human health community by promptly providing its domestically produced vaccines to countries that recognize and demand them.

“When supplying vaccines to foreign markets, Chinese companies are expected to not only invest in the products, but also fulfil their legal obligations in other procedures such as purchasing, transportation and vaccination.”

BRP: What is the current situation like in terms of basic global vaccine supply?

Zha: For a long time, it was common to see the world vaccine supply situation fall into four categories.

First, Western countries that are capable of researching and developing (R&D) vaccines make the products for themselves and do not export them.

Second, some Western vaccine producers that do not seek profit maximization take the initiative to develop and produce vaccines jointly with countries that lack independent R&D capability or countries that do not have a complete vaccine industry chain.

The third situation is that the United Nations Children's Fund tries to work with some Western charities, buys vaccines from Western producers and offers subsidies on the products, which are then sold to low-income countries at a relatively cheap price. In this way, international multilateral institutions can help low-income countries certify and check the quality of vaccine products.

The fourth situation is frequently seen in the Caribbean, Latin America, central and South America — vaccines are mainly provided by regional health organizations or these organizations arrange for their distribution or use.

BRP: What is China’s position in the global vaccine supply market?

Zha: China is a new participant in the global vaccine supply market. The World Health Organization (WHO) pre-qualified a China-made vaccine for the first time in 2013.

In 2015, China-made vaccines entered the world market. Due to the short entry period and only having four pre-qualified vaccines, Chinese vaccines account for less than 1 percent of the global vaccine market.

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 most likely acquire vaccines through support from other countries or procurement. 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), which 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, in which many Chinese R&D and production companies participated.

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 not big, it does not mean that China's COVID-19 vaccines are blocked from the global supply.

After 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 COVID-19 vaccines. In addition, more efforts are expected to be made to accelerate production and application based on the premise of stable quality control.

BRP: What factors will developing countries take into account in choosing a COVID-19 vaccine?

Zha: Developing countries that are not capable of developing vaccines often encounter three situations when choosing COVID-19 vaccines. The first consideration is whether they have the ability to independently test the safety and effectiveness of the vaccine. If a country can not carry out independent testing, it can choose to outsource part of the testing work to a country with that ability and accept the result report. 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 has been trusted historically.

Secondly, more and more developing countries tend to follow the method adopted by Japan. If a country plans to mass import a kind of COVID-19 vaccine or inoculate citizens with a vaccine produced by a foreign company, joint R&D and production with the foreign producer is required in the country. More specifically, the phase II and phase III clinical trials should be jointly conducted in the country.

Thirdly, if some developing countries do not have the ability to participate in the R&D of the COVID-19 vaccine, or the funds or channels to seek outsourcing cooperation in product quality testing, they will refer to the pre-qualification issued by the WHO for procurement.

BRP: Some foreign media accuse China of “vaccine diplomacy”. What’s your view on that?

Zha: Historically speaking, it is not a new phenomenon. For instance, during the Cold War, several effective vaccines produced by the Soviet Union were described as "vaccine diplomacy" when used in Central and Eastern Europe. Nowadays, some foreign media label China’s vaccine support for foreign countries as political diplomacy, which is also part of international geopolitical competition.

Given such noises, what can we do? Firstly, China is expected to 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 are expected to invest more — not only in the product itself, but also in other procedures like selection, transportation, vaccination and follow-up after the 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 foreign countries.

BRP: What kind of challenges will China-made COVID-19 vaccine products face when exported to Belt and Road Initiative (BRI) markets?

Zha: In the history of global vaccine supply, Chinese vaccines are new arrivals and many countries have not encountered China-produced vaccines before. Therefore, these countries may not recognize China’s COVID-19 vaccine products.

In the past few decades, China’s vaccine industry expert teams have mainly conducted international exchanges and cooperation with developed countries but few exchanges with developing countries in vaccine R&D, production, testing and follow-up research. As a result, the Chinese vaccine industry has not formed a close network 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 according to their capabilities.