As Russia and China seek to boost their global influence, analysts warn vaccine diplomacy is here to stay

• Russia and China had made distributing face masks and protective equipment to hard-hit countries a central tenet of diplomatic relations last year.
• Now, both countries are seen adopting a transactional approach to the delivery of vaccines.
• The World Health Organization's top official has warned of a "catastrophic moral failure" because of unequal Covid vaccine policies.

LONDON — International diplomacy is likely to determine who gets access to coronavirus vaccines over the coming months, analysts have told CNBC, with countries such as Russia and China seen using one of the world's most in-demand commodities to advance their own interests abroad.

It is hoped the rollout of Covid-19 vaccines could help to bring an end to the pandemic. While many countries have not yet started vaccination programs, even high-income nations are facing a shortfall in supplies as manufacturers struggle to ramp up production.

Russia and China had made distributing face masks and protective equipment to hard-hit countries a central tenet of diplomatic relations last year. Now, both countries are seen adopting a transactional approach to the delivery of vaccines.

Agathe Demarais, global forecasting director at the Economist Intelligence Unit, told CNBC via telephone that Russia, China and to a lesser extent India, are betting on providing Covid vaccines to emerging or low-income countries to advance their interests.

"Russia and China have been doing this for a long, long time … especially in emerging countries because they feel traditional Western powers have been withdrawing from these countries," Demarais said.

"In the past, although it is actually still the case, we saw that China launched the Belt and Road Initiative, we saw that Russia did a number of things especially in the Middle Eastern countries with nuclear power plants, and vaccine diplomacy is a new brick in the whole edifice of their attempt to bolster their global standing."

Vaccine timeline

This strategy is likely to see Russia and China cement a long-term presence in countries around the world, Demarais said, noting that the fundamental importance of vaccines to populations will make it "super, super tricky" for countries to resist diplomatic pressure in future.

The problem for Moscow and Beijing, however, is that "there is a big, big chance" they are both going to overpromise and underdeliver, she added.

Russia's Sputnik V vaccine and China's Sinopharm and Sinovac vaccines have already begun global rollouts. In total, 26 countries including Argentina, Hungary, Tunisia and Turkmenistan, have authorized Russia's Covid vaccine. China's queue of clients includes Brazil, Indonesia, Thailand and the United Arab Emirates, among others.

Analysts say both Russia and China have typically signed supply deals that reinforce pre-existing political alliances, but production problems for vaccines manufactured in the West may be enough of an incentive for some non-traditional allies to look to Moscow and Beijing.

Russia and China are currently unable to meet the vaccine supply demands of their respective domestic markets and still export to countries around the world. Production represents the main hurdle to this challenge, while many high-income countries have pre-ordered more doses than they need.

A report published by the Economist Intelligence Unit last month projected that the bulk of the adult population of advanced economies would be vaccinated by the middle of next year. In contrast, this timeline extends to early 2023 for many middle-income countries and even as far out as 2024 for some low-income countries.

It underscores the global mismatch between supply and demand and the stark divide between high-income and low-income countries when it comes to vaccine access.

Last month, the World Health Organization's top official warned that the world was on the brink of a "catastrophic moral failure" because of unequal Covid vaccine policies.

Dr. Tedros Adhanom Ghebreyesus said on Jan. 18 it was clear that even as they speak the language of equitable vaccine access, "some countries and companies continue to prioritize bilateral deals, going around COVAX, driving up prices and attempting to jump to the front of the queue."

"This is wrong," he added.

Tedros condemned what he described as a "me-first approach" from high-income countries, saying it is self-defeating and leaves the world's poorest and most vulnerable people at risk. Almost all high-income countries have prioritized vaccine distribution to their own populations.

When asked whether there was any prospect of countries changing their so-called me-first approach after WHO's warning about vaccine diplomacy, Demarais replied: "No. It's not going to happen. I follow it very closely and it is all very depressing."

'The big challenge'

COVAX is one of the three pillars of the so-called Access to COVID-19 Tools Accelerator, introduced by the WHO, European Commission and France last April. It focuses on the equitable access of Covid diagnostics, treatments and vaccines to help less wealthy countries.

Analysts have long been skeptical about how efficiently COVAX can deliver supplies of Covid vaccines to middle- and low-income countries around the world, despite calls from several heads of state for global solidarity at the beginning of the pandemic.

International aid group Medecins Sans Frontieres has described what we see today in terms of global vaccine access as a "far cry from a picture of equity."

"The big challenge, once you zoom out to the global level, is every time any country secures a bilateral agreement it makes it that much harder to put vaccines into the multilateral pot through COVAX," Suerie Moon, co-director of the Global Health Centre at the Graduate Institute Geneva, told CNBC via telephone.

In addition to this concern, Moon said: "We have no system right now at the international level, for example, to make sure that you can match vaccine efficacy with where there is a variant circulating."

She cited South Africa as a striking example. Earlier this month, South Africa put its rollout of the Oxford-AstraZeneca vaccine on hold after a study raised questions about its efficacy against a highly infectious variant first discovered in the country.

"In a rational and ethical world, South Africa suddenly would have access to vaccines that are effective against their variant and the AstraZeneca vaccines could be sent to another part of the world where that variant is not in circulation. That would be the rational way to do it, but we just don't have arrangements in place for that kind of transaction," Moon said.

"Ideally, that's the kind of thing that happens if you have strong international cooperation, but I think in reality it is going to be a mess," she continued.

"We are going to have vaccines expiring in some countries when they could be used elsewhere, we are going to have vaccines effective in one place but they are not in the right place (and) we are going to have excess vaccines sitting as a security measure while in another country people have nothing."

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