The 'Cold War' diplomacy behind Covid-19 vaccines

The main goal of countries procuring vaccines is to save lives. But in a realpolitik world, relationships with source or donor countries also sustain alliances—which can be leveraged for other diplomatic priorities. This is the theory behind "vaccine diplomacy."

However, diplomatic leverage is only part of the story. Vaccine diplomacy is also about validating the underlying principles of those vaccine programs.

In other words, Russia and China aren't just selling vaccines—they're peddling a value set that undermines international norms. It is this ideological clash that makes the Cold War metaphor more apt than pundits realise.

The first principle endangered by the Russian and Chinese vaccination programs is transparency. In the case of Covid-19, this means openly sharing data within the medical community.

In contrast, Chinese state-run vaccine producers have failed to publish late-stage clinical trial data, and not a single one has allowed a scientific peer review of its vaccine.

Western leaders like Emmanuel Macron have criticised this lack of transparency, as have experts within China.

Leading Chinese drug researcher Ding Shen recently called for Chinese pharmaceutical companies to release original clinical trial data to allow experts to accurately assess the drugs' efficiency—and safety.

Transparency concerns are only one reason why worries remain about the safety of these vaccines.

China and Russia widely deployed homegrown vaccines before completing clinical trials, as researchers ran roughshod over established scientific protocols and ignored a WHO recommendation that all vaccines undergo full testing before distribution.

Russia registered the Sputnik V vaccine for public use after it was tested on just 76 individuals. At the time, some 40 scientists signed an open letter noting irregularities in even this small data set.

Gamble

Sputnik V has since been confirmed safe and 91.6 effective, according to a peer-reviewed paper published in British medical journal The Lancet in February.

However, about a dozen countries gambled with their citizens' lives by approving Sputnik V well before that paper's publication, including Serbia and Hungary.

Safety concerns also raise questions about the role (and credibility) of regulators.

Drug safety agencies like the European Medicines Agency are designed as bastions of public health. When member states bypass the EMA approval process, as Hungary did when it became the first EU country to approve both the Sputnik V and China's Sinopharm vaccines for emergency use, they undermine the existing health system.

And if they get it wrong, it can have devastating consequences on public health and trust, including fuelling the already potent anti-vaxxer movement.

While criticism that the EU's collective approach to vaccine procurement has been slow is justified, there can be no analogous critique of the EMA dragging its feet to approve non-Western vaccines.

No Chinese or Russian developer has yet sought EMA sign-off (though the EMA is beginning to review data on Sputnik V should an application be filed).

Nor should drug regulators in Western countries outsource the approval process to vaccine-producing countries.

This is precisely the case in Hungary, where a government decree permits emergency approval of any vaccine administered to at least one million people worldwide - without review by the EMA or even the domestic regulator.

However, millions of doses of both the Sinopharm and Sinovac shots were administered in China before the jabs received Chinese regulatory approval.

The credibility of China's regulator is further undermined by incidents like manufacturer Sinovac's bribing of Chinese authorities for vaccine approvals, and a 2018 scandal in which defective vaccines for childhood ailments were administered to hundreds of thousands of babies.

To the individual observer, debates about vaccine diplomacy may seem out of touch. Communities decimated by Covid-19 rationally prioritise the swiftest possible delivery of lifesaving jabs.

Czech president Miloš Zeman said "vaccines have no ideology." This is simply not true.

Selecting a vaccine equates to endorsing – and therefore perpetuating – the underlying values of vaccine programs. As such, choosing a Chinese or Russian vaccine directly undermines the international system constructed to protect global health.

Our current system relies on transparency, collaboration, and credible institutions. A rewrite of these global health norms to match the Chinese and Russian governance models would have long-term consequences for Europe and the world.

Delays based on production capacity or unfulfilled contracts must be righted.

The EU should deliver on its commitments to help vaccinate the citizens of the Western Balkans and to the COVAX scheme. But at the same time, a timeline that allows for the transparent, complete testing of vaccines for effectiveness and safety and full approval by regulators ought to be embraced.