By Jeremy Youde*
In less than a year since the World Health Organization (WHO) declared COVID-19 to be a pandemic, there are already 10 different vaccines approved for use in various countries around the world. But vaccines are only effective if people can get vaccinated — and progress on that front is incredibly uneven. While many states in the Global North will likely achieve widespread vaccination by late 2021, middle and low-income countries may not receive significant vaccine access until 2024.
This lack of access persists throughout much of Asia. Most Asian states have not started vaccinating their populations, largely due to limited vaccine manufacturing capabilities, logistical challenges and regulatory delays. In contrast to the strong initial responses to COVID-19 by many Asian states, the slow rollout of vaccination programs threatens to undermine early successes.
There are efforts to improve COVID-19 vaccine access throughout Asia, two of which deserve particular attention. The first is COVAX, a joint partnership between the (WHO), the Coalition for Epidemic Preparedness Innovations (CEPI) and Gavi, The Vaccine Alliance (GAVI).
Its aim is to develop, purchase and supply COVID-19 vaccines to provide more equitable access, with the goal of vaccinating 1.8 billion people (or 20 per cent of the population in its target low-income states) by the end of 2021. Under this plan, Southeast Asian states should receive 695 million vaccine doses by year’s end, covering roughly half of the region’s population.
COVAX represents a global collaboration to fight against vaccine nationalism and widen vaccine availability. So long as significant portions of the world lack access to COVID-19 vaccines, the pandemic will continue to threaten the globe. Nearly every country in the world has signed on to COVAX’s plan, giving a strong boost to its legitimacy and reinforcing the interdependence inherent in fighting global pandemics.
Despite this optimism, COVAX faces three serious challenges that could limit its effectiveness for Asian states.
First, it lacks financial resources. While it has raised US$6 billion so far, COVAX’s leaders estimate that it will require at least another US$2 billion to achieve its goals. US President Joe Biden’s recent announcement of a US$4 billion contribution to COVAX should provide a significant boost.
Second, the initiative needs to overcome serious logistical hurdles — transporting the doses quickly, maintaining the cold-storage requirements, training enough medical workers to administer the vaccine and conducting public information campaigns.
Finally, some wealthier countries are negotiating their own deals with vaccine manufacturers, jumping the queue by offering to pay more. By doing so, they circumvent COVAX and increase the amount of time that other countries will have to wait for their doses.
The second effort is vaccine diplomacy, specifically efforts being undertaken by the Indian and Chinese governments. Vaccine diplomacy refers to governments providing other countries with access to vaccines as part of a strategy to build goodwill internationally.
India, which is home to 60 per cent of the world’s vaccine manufacturing capacity, and China, which has developed at least two COVID-19 vaccines, are both well-poised to make doses available to their Asian neighbours and have undertaken aggressive programs to do so. This comes in contrast to the United States and other wealthy states buying up existing vaccine stocks, and is part of a concerted effort by both countries to build alliances with regional partners.
India is giving free COVID-19 vaccines to Nepal, Bangladesh and Sri Lanka — all three of which have experienced tense relations with the Indian government in recent years. China is making its vaccines freely available in Sri Lanka, Indonesia and other Southeast Asian countries as part of its Health Silk Road Initiative.
The obvious advantage to Asian states from these vaccine diplomacy efforts is that they allow more people — primarily people who would have had to wait years — to gain access to the vaccine. This will sustain the successful efforts that many of these states have already undertaken to limit COVID-19’s spread.
But one main challenge is how recipient states navigate the geopolitical tensions that helped give rise to Indian and Chinese vaccine diplomacy. Both countries have sought to use the vaccines to curry favour with regional partners, rebuild frayed diplomatic ties and counteract diplomatic moves by the other.
This could have far-reaching foreign policy effects for the receiving states, particularly if China and India ‘overpromise and underdeliver’. There are also questions about China’s unwillingness to share accurate and complete data about the efficacy of its vaccines, raising suspicions about its motivations.
The other challenge is rooted in Indian and Chinese domestic politics. Both countries are making vaccines available to other countries at times when their own internal vaccination campaigns are in a nascent state, a situation that could lead to questions about why Beijing and New Delhi are not prioritising their own citizens.
Because Asian states have largely done a good job containing COVID-19, they may not face the same immediate pressures to unleash widespread vaccination campaigns. But that reality should not hide the glaring inequalities around access to COVID-19 vaccines and the need to overcome them.
*About the author: Jeremy Youde is Dean of the College of Liberal Arts at the University of Minnesota Duluth.