Vaccine Wars, the ASEAN and the Quad

The recent Quad declaration of the US, India, Japan and Australia has not foregrounded the military axis of their meeting but stressed more on the vaccine thrust against the Covid-19 pandemic. With the threat of a second or a third wave in various countries, vaccines are emerging as the centrepiece of not only global recovery but also of global diplomacy. That is why ASEAN—or South East Asia—with its 700 million people and huge market, is at play in vaccine competition between the US, its Quad allies and China. Lost in this diplomatic game is the dire need of fighting together as humanity against essentially a civilisational challenge of the Covid-19 pandemic.

The US belief in its exceptionalism isolates it from the rest of the world on the issue of vaccines. Its self-declared goal is to reserve its vaccine supply solely for itself till it has vaccinated its population, only then provide for others. This is its famous—or infamous—oxygen mask in aircraft analogy: help yourself before you help others. So, for the next six months, exports from the US to other countries of mRNA vaccines from Moderna and Pfizer are unlikely, except for some amounts going to its close European allies and Israel. Secondly, the ultra-cold chain and the high cost of the vaccine precludes these mRNA vaccines from being used for most of Asia, Africa and even Latin America. Thirdly, the US and other rich countries refuse to allow any consideration of the pandemic being allowed to dilute the profits that companies obtain through their intellectual property rights over the vaccines. Even if vaccine production is idling in many countries, they cannot produce the successful vaccines, as proprietary knowledge to produce these vaccines will not be shared by the companies.

Vaccine production is not just about patents but also other forms of intellectual property such as trade secrets. Reverse engineering the whole vaccine technology during a raging epidemic is not a worthwhile option. That is why South Africa and India, supported by a large number of countries and civil society groups, has asked for a temporary waiver of certain TRIPS obligations on copyrights and related rights, industrial designs, patents, during the Covid-19 pandemic. Predictably, it has been opposed by the rich countries: the US, the UK, European Union, Japan, Australia. Profits for big pharma trumps human lives even during a global epidemic.

The western world expected that while the high-cost mRNA vaccines requiring stringent ultra-cold chain would be used in the rich countries, the rest would make do with AstraZeneca-Oxford and other vaccines in the western companies’ pipeline. Generic vaccine manufacturers in other countries would then produce these vaccines under license from Big Pharma. Serum Institute of India, the world’s largest vaccine manufacturer, has tied up with AstraZeneca for producing Covishield.

For the US, its vaccine battle is to keep out Russia and China from entering various regions. Since vaccine cases continue to rise in many countries, keeping Russian and Chinese vaccines out means being able to provide them with other vaccines. Serum Institute’s alliance with AstraZeneca is the cornerstone in the US battle of denying Russia and China vaccines markets in Latin America, Europe, Asia and Africa.

The dismal performance of the European Union on vaccine rollout has unfortunately been compounded by the temporary stoppage by many European countries of AstraZeneca’s vaccine. This is due to the risk of formation of blood clots post-vaccination. Though the European regulator has now given it a green signal holding the risk to be low against the benefits of vaccination, it is likely to increase the vaccine hesitancy that already exists in Europe. AstraZeneca’s vaccine had earlier been backed by WHO, the UK and the Indian regulator, holding its gains far outweigh the risks. The US regulator has yet to clear the AstraZeneca vaccine, even though it is holding a large stock of its vaccine.

With many EU countries seeing a spurt in numbers recently, China and Russia have stepped into this vaccine breach. Hungary and Serbia are using Russian and Chinese vaccines, with Serbia emerging as one of the countries with the highest proportion of its people vaccinated. The European Union regulator, after initially stonewalling Russia’s Sputnik V vaccine, is currently reviewing it. But many European countries are not waiting for the EU regulator, striking their independent deals with Russia and China. Italy is even proposing to start manufacture of Sputnik V domestically.

The US used its clout to try and keep the Russians and Chinese out of Latin America. However, even countries favourable to the US found Pfizer’s demands on availing its vaccine equivalent to holding countries to ransom during a pandemic. Argentinian officials said that Pfizer demanded that governments not only indemnity it against civil claims filed by citizens who suffer serious adverse events but also cover damages as a result of Pfizer’s own acts of negligence, fraud, or malice. To add insult to injury, Pfizer asked Argentina to pledge its sovereign assets—federal bank reserves, embassy buildings, or military bases—as collateral. Negotiations with Brazil also broke down on similar demands.

Both Argentina and Brazil have now turned to Russia and China for vaccines. Argentina has placed orders for 25 million doses of the Sputnik V vaccine. Argentina has opened the door to Latin America for Russia, with Sputnik V orders from Mexico, Bolivia, Venezuela, Nicaragua, Honduras, Guatemala following Argentina’s orders. Mexico has bet big on Chinese vaccines as has Chile. Chile is now accepted as one of the country’s emerging as a champion on quick vaccination of its people outpacing even the UK and the US in numbers of people vaccinated per hundred, the bulk of it from the 10 million does it has received from China’s Sinovac.

Brazil under Bolsonaro has been a disaster with death rates spiralling and its hospitals again near breaking down. Earlier, Bolsonaro derided the Chinese vaccines. The US Department of Health and Human Services (HHS) has proudly described how it persuaded Brazil to reject the Russian COVID-19 vaccine (Page 48, HHS Annual Report 2020). With the current variant reinfecting many people who had been infected earlier, Brazilians have realised the idiocy of a Bolsonaro. A chastised Brazilian government is now procuring vaccines from Sinopharm and Sinovac, and also entering into production arrangements for these vaccines.

Africa is looking at the WHO Covax platform, China and India for its vaccines. Contrary to what the US has been claiming, the WHO’s Covax platform is not under Chinese influence but the control of the vaccine alliance CEPI and GAVI, with the Bill and Melinda Gates Foundation playing an outsized role there. They have been reluctant to accept either Chinese or Russian vaccines and bet heavily on AstraZeneca’s vaccine licensed to Serum Institute. With AstraZeneca running into difficulties, only 237 million doses (two doses, so for 117.5 million people) of its Covishield will be delivered up to May 2021 to 142 countries that have signed up for the WHO’s Covax platform. Pfizer is making available a paltry 1.2 million doses subject to countries providing them with immunity for any damages due to the vaccine. At this pace, the poorer countries will have to wait till 2025-26 before their entire population is vaccinated.

This brings us back to the recent Quad statement on vaccines. The US’s play here is to have Japan pay for the vaccines, and India manufactures them and keeps Russia and China out of the ASEAN countries. Unfortunately for the US, major ASEAN countries—e.g., Indonesia, Malaysia, Thailand—are already using Russian or Chinese vaccines. Indonesia has ordered 50 million doses of China’s Sinovac and 60 million doses of Sinopharm vaccine. Malaysia has ordered 6.4 million vaccine doses of Sputnik V from Gamaleya and another 12 million Sinovac vaccines. These countries are unlikely to stop their procurement from China and Russia for future uncertain deliveries of AstraZeneca, given that AstraZeneca is currently not able to fulfil its European and WHO commitments.

Unlike the US, EU and the UK, countries such as India, Russia and China are all offering vaccines to others while also vaccinating their people. As we have written in these columns earlier, the rich countries are hoarding vaccines, while denying vaccines to other countries. So far, all of Moderna’s doses and 96% of Pfizer/BioNTech’s have been acquired by rich countries. Remember Bayer CEO Marijn Dekkers’ quote in 2013 regarding a cancer drug? He said, “We did not develop this medicine for Indians. We developed it for Western patients who can afford it.”

As the current rising numbers from Brazil, Europe and India indicate, herd immunity will come only when the bulk of the population is vaccinated. Countries understand that and are willing to take vaccines from whoever is prepared to offer them, and at reasonable prices. It is only the stupidity of the US and its allies that vilifying Russian and Chinese vaccines with a return to cold war rhetoric is enough for people to wait indefinitely for “superior” western vaccines, that too at prohibitive prices. India is better off with its foreign policy of strategic autonomy than tying itself to the US containment of China’s vision of the Indo-Pacific. Fighting the pandemic demands all nations cooperate rather than play a zero-sum game with each other.