On 13 January 2021, at Indonesia’s Presidential Palace in the capital city of Jakarta, the country’s President Joko Widodo received his first dose of the Chinese-made Sinovac vaccine against the SARS-CoV-2 virus. Media, including Chinese state news network CGTN, were invited to broadcast the event, which took place against the backdrop of a large red and white banner reading ‘safe and halal vaccine’ in Indonesian (CGTN, 2021c). Widodo was the first Indonesian to be vaccinated against the virus that causes COVID-19, closely followed by the country’s health and military chiefs, in an effort to demonstrate the safety of the vaccine to fellow citizens.

At the time of Widodo’s first dose, official data – which are widely understood to be a substantial underestimate – suggested that more than 24,000 Indonesians had already died of COVID-19 (Xinhua, 2021d). Over the following six months, Indonesia would become China’s largest customer for COVID-19 vaccines, purchasing over 50 million doses up to the end of June 2021.

Dur ing the initial months of the global rollout of COVID-19 vaccines, China emerged as the key supplier to countries of the Global South. Doses produced by Western manufacturers, on the other hand, were largely bought up by wealthy states in North America and Europe, which had seen severe health impacts from the pandemic, and made little effort to conceal their ‘vaccine nationalism’ despite warnings from the World Health Organization (WHO) of its pitfalls (Eaton, 2021).

China’s status as the principal supplier of vaccines to the Global South sparked concerns among media, commentators and some policymakers that China was ‘beating’ the United States and other Western players in ‘vaccine diplomacy’ (Smith, 2021). Relatedly, suspicion arose that – as one article in the British broadsheet The Times put it – China aimed to use its vaccines to ‘establish [a] new world order’ (Tang, 2021).

On the other hand, Chinese officials worked hard to frame the country’s vaccines as a ‘global public good’. At a virtual event to launch the 73rd World Health Assembly in May 2020, as the first wave of the pandemic was subsiding in China but raging around most of the rest of the world, President Xi Jinping (2020) proclaimed: ‘COVID-19 vaccine development and deployment in China, when available, will be made a global public good.

As the previous chapter described, the Chinese government’s international donations of COVID-19 vaccines have garnered substantial attention, both positive and negative. However, discussions of China’s role in the distribution of vaccines often fail to observe that the vast majority of Chinese vaccine doses shipped abroad are not donations but commercial sales. The author’s data indicate that of the Chinese-made doses delivered to the Global South during the first six months of 2021, around 90 per cent were commercial sales, and just 10 per cent donated. Unpacking the forces driving these sales is therefore crucial to understanding overall Chinese vaccine supplies. This chapter describes and explains patterns in commercial deliveries of Chinese vaccines overseas during the first six months of 2021, when Chinese exporters Sinovac, Sinopharm and CanSino were some of the few players (alongside AstraZeneca) shipping substantial numbers of doses to low-and middleincome states.

The first section provides an overview of the world COVID-19 vaccine marketplace during the initial rollout of vaccines, and situates China within it. The second section describes how Chinese firms were able to seize the opportunity of the pandemic to boost their position in global vaccine markets, in part thanks to their linkages with and support from the state. The third second section maps the distribution of vaccines sold by Chinese manufacturers during the first six months of 2021. The distribution of vaccines sales indicates that they were driven by two factors: first, market forces, and specifically by the classic ‘gravity’ model, in which trade is correlated with economic size and distance; and second, clinical trial partnerships between purchasing countries and Chinese vaccine companies, which turned to overseas partners to test the efficacy of their new products due to low case numbers in China.

The world COVID-19 vaccine marketplace

Customers from the Global North dominated the demand side of the market for COVID-19 vaccines during the initial global vaccine rollout. Up to mid-2021, of the total vaccine doses around the world agreed or in negotiation via commercial purchasing deals with manufacturers, two thirds involved high-income purchaser states, while around 16 per cent involved middle-income purchasers and just five per cent involved low-income purchasers.

This chapter describes and explains China’s official donations of COVID-19 vaccines to countries of the Global South during the first six months of 2021. The first section contrasts media narratives and China’s official framing of its vaccine donations, before arguing that these rhetorical debates are not very productive in understanding the actual distribution of Chinese vaccine donations. The second section maps these donations empirically and analyses the factors shaping the choices of the Chinese government about where to deliver vaccines during the initial overseas rollout, including ‘moving the anti-pandemic barrier forward’ by mitigating the risk of imported infections, promoting regional stability, and strengthening established ties with neighbours. This section also highlights some similarities between Chinese vaccine donations and its established aid practices. The third and final section illustrates these dynamics through the case studies of Myanmar and Pakistan.

Narratives on Chinese vaccine supplies

China’s economic engagement with the Global South has long been viewed with suspicion. In particular, the so-called ‘debt trap diplomacy’ narrative posits that China lures countries into debt in order to take control of their strategic assets (Chellaney, 2017). This narrative has been widely debunked by academic analyses (Brautigam, 2020; Singh, 2021), but remains influential among policymakers in North America and Europe.

China has similarly been accused of using vaccine donations as a tool of geopolitics. In February 2021, the New York Times described coronavirus vaccines as ‘a new currency for international diplomacy’ (Mashal and Yee, 2021), and the notion that a strategic programme of ‘vaccine diplomacy’ in competition with the West has driven Chinese vaccine distribution is pervasive. At its most extreme end this viewpoint situates vaccines at the centre of a competition for a ‘new world order’ between China on the one hand and the US and its allies on the other (Greenwald and Margolis, 2020; Tang, 2021). For example, in April 2021 an article in the prestigious Foreign Policy magazine argued that ‘vaccines will shape the new geopolitical order’, and contended that ‘Russia and China have begun supplying vaccines in exchange for favourable foreignpolicy concessions’ (Frankel Pratt and Levin, 2021).

This concluding chapter summarizes the key arguments of the book, draws broader lessons for students of IPE and China’s overseas engagement, and takes a forward facing tentative look at some of the challenges and opportunities facing China and its international partners in the area of COVID-19 vaccines. Challenges include efficacy questions posed by new variants, and increased competition, in particular from vaccines using mRNA technology. Opportunities include the potential for Chinese homegrown development of mRNA vaccines, and (perhaps most importantly of all) prospects for technology transfer and manufacturing partnerships that may reduce the dependence of the Global South on outside sources for this critical commodity.

Key arguments and implications

Chinese vaccine supplies to the Global South have attracted substantial global attention, and sparked a polarized debate. On the one hand, the Chinese government is accused by some, mostly in the West, of using COVID-19 vaccines as a tool of strategic geopolitical competition with the United States and its allies, or as a ‘trap’ with which to secure policy concessions from governments of smaller countries. On the other hand, China’s official discourse frames the country’s vaccines as a ‘global public good’, in other words freely and equally available to all.

This debate was particularly salient during the first half of 2021, when China was one of the few countries willing to deliver (as opposed to simply pledge or commit) vaccine doses overseas, and the media in North America and Europe became preoccupied with the notion that China was ‘beating’ the West in the race to vaccinate the world (Smith, 2021). However, it remains highly relevant today, given that a significant minority of the world’s population lacks access to vaccines (Mathieu et al, 2021), and new variants and booster programmes indicate that COVID-19 vaccination is likely to become a routine feature of life over the long term, rather than a one-off pandemicending event.

This book’s central contribution is to look beyond the polarized rhetorical debates to examine where doses of Chinese-made vaccines actually went during the ‘first wave’ of the global rollout vaccines for COVID-19, and to provide empirically grounded, objective, and nuanced explanations for those patterns.