China’s Vaccine Diplomacy in the Middle East

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China’s Vaccine Diplomacy in the Middle East

Gulf states like Bahrain and the UAE are using a Chinese-made COVID-19 vaccine, highlighting a new type of cooperation with China.

China’s Vaccine Diplomacy in the Middle East

In this April 2, 2020, file photo taken through a tinted car window, a technician takes a nasal swab for a coronavirus detection test at a drive-thru testing facility in Abu Dhabi, United Arab Emirates.

Credit: AP Photo/Jon Gambrell, File

As one of the biggest consumers of oil in the world, China has had little trouble finding eager trading partners in the Persian Gulf. The ongoing pandemic, however, has created opportunities for new types of cooperation between Asia’s most powerful country and the wealthy monarchies of the Arabian Peninsula. While China, the United States, and other world powers race to produce the leading vaccine, Bahrain and the United Arab Emirates have already selected a Chinese candidate as one of their primary weapons in the fight against the coronavirus.

On December 9, the UAE became the first country in the world to approve a Chinese vaccine when Emirati officials authorized a product developed by China National Pharmaceutical Group Corporation, better known as Sinopharm. The UAE stated that early data from phase three clinical trials placed the vaccine’s effectiveness at 86 percent. Bahrain approved the vaccine on December 13, citing the same information as authorities in the UAE.

Bahrain and the UAE began inoculating their populations as of mid-December, with Bahraini King Hamad bin Isa Al Khalifa receiving his dose on December 16. The two countries’ campaigns to vaccinate their citizens mark a significant vote of confidence in Sinopharm and an evolution of the relationship between China and its well-resourced allies in the Gulf.

Prior to the pandemic, international trade guided ties between China and the energy superpowers of the Middle East. In addition to exporting $17.4 billion of goods to China in 2018, the UAE imported more products that year from China than from any other country. Bahrain, which sold China $359 million in goods in 2018, received $1.65 billion in Chinese products the same year. Kuwait, Oman, and Saudi Arabia, the largest country on the western side of the Gulf and a regional power, also sent the biggest share of their exports to China in 2018.

From the perspective of Gulf countries, the coronavirus transformed China from just a business partner to a scientific benefactor and collaborator. Before moving to administer the Sinopharm vaccine on a wide scale, Bahrain and the UAE participated in the vaccine’s phase three clinical trials alongside Egypt and Jordan. The Emirati test run even saw Sinopharm working with Group 42, an Abu Dhabi company specializing in artificial intelligence and cloud computing.

Bahraini and Emirati officials are placing a lot of trust in Sinopharm. Authorities in the United States analyzed reams of data from clinical trials before approving vaccines from the American companies Moderna and Pfizer; the scientific community’s understanding of the Sinopharm vaccine, on the other hand, has come from press releases about the success of Sinopharm’s clinical trials, not the data from the clinical trials themselves. The vaccine’s initial claimed effectiveness of 86 percent also means that it underperforms Moderna and Prifzer’s doses.

Despite some doctors’ reservations about the Sinopharm vaccine, Bahrain and the UAE have shown little hesitation in deploying it. Prior to approving the vaccine for the public, the UAE issued an emergency use authorization for the Sinopharm vaccine back in September. Bahrain took the same step in November. In an intriguing move, the full-scale Bahraini and Emirati approvals came weeks before China gave its own authorization to Sinopharm on December 31.

At the time of the Chinese approval, Sinopharm assessed the effectiveness of its vaccine at 79 percent, below the number cited by Bahraini and Emirati officials earlier in the month. The Sinopharm vaccine also falls short of the standard set by its Moderna and Pfizer competitors, both of which have an effectiveness of over 90 percent. Nonetheless, most countries would only need a vaccine for the coronavirus to have an effectiveness of 50 percent to authorize it, a standard that Sinopharm has more than met according to regulators in Bahrain, the UAE, and now China.

As a new variant of the coronavirus ravages the United Kingdom and spreads across the globe, more countries seem likely to follow Bahrain and the UAE’s example. Western world powers are stockpiling many of the millions of doses produced by Moderna and Pfizer for their own citizens. China, however, is manufacturing its vaccines with the goal of distributing them throughout the Global South and amassing influence in developing countries neglected by its Western rivals.

Brazil and Turkey have reported divergent findings on another Chinese vaccine, pioneered by Sinovac Biotech. Turkey described the Sinovac vaccine as 91 percent effective based on limited, interim results from clinical trials, but Brazil, home to its own Sinovac clinical trial, has given a much lower estimate of about 50 percent. Precise data from Sinopharm and Sinovac clinical trials remain scarce, feeding the public’s skepticism of Chinese vaccines and concerns about the lack of transparency that has characterized China’s battle with the coronavirus.

Whatever the Chinese vaccines’ exact effectiveness, they meet the threshold of 50 percent that most countries will need to authorize their use. The Sinopharm and Sinovac vaccines also present fewer challenges to store and transport than Moderna and Pfizer’s doses, ideal qualities for distribution in the overtaxed health systems and rural areas of the Global South.

Regardless of these advantages, China will face plenty of competition in Bahrain, the UAE, and the rest of the Gulf. The UAE is hosting a phase three clinical trial of a controversial vaccine from Russia, a world power with a history of scientific breakthroughs, and the Emirati megacity of Dubai will inoculate its residents with the UAE’s first batch of the Pfizer vaccine for free. Bahrain, Kuwait, Oman, Qatar, and Saudi Arabia are also deploying the Pfizer vaccine.

Countries that decide to purchase the Chinese vaccines must look past the healthcare industry’s history of scandals in China, which have come to include Sinopharm and Sinovac. A Sinopharm subsidiary once manufactured defective vaccines for diphtheria, tetanus, and whooping cough, and Chinese investigators implicated Sinovac’s chief executive, Yin Weidong, in bribery. The recent resignations of two top Sinopharm officials, including the company’s chief executive, may further increase scrutiny on the firm as it distributes its vaccine.

Sinopharm and Sinovac’s missteps notwithstanding, many countries may opt to follow in the footsteps of Bahrain and the UAE, which have their own understandings with China.

China has long pursued a foreign policy of noninterference in other countries’ internal affairs, refraining from criticizing Bahrain’s persecution of dissidents and the UAE’s support for accused war criminals in Libya and Yemen. Bahrain and the UAE, in turn, overlooked China’s detention of Uyghurs and crackdown on Hong Kong protesters in the name of their economic partnership. The same logic will likely underpin China’s scientific cooperation with its Gulf allies.

If the UAE and Bahrain help China test its vaccines and forgive its shortcomings, officials in Abu Dhabi and Manama will continue to reap the benefits of their Chinese counterparts’ successes.