Beijing’s diplomacy more effective than its vaccines

China may be behind on the science battle, but it’s still winning the narrative war.,

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China may not have fully mastered the science of vaccine development — but it’s turned out to be an expert at the expectations game.

Growing evidence that the Sinopharm and Sinovac immunizations don’t work as well as most Western counterparts show few signs of denting Beijing’s vaccine diplomacy efforts.

With Hungary, Turkey and Serbia leaning heavily on Chinese jabs, political backlash has been minimal, even as a top Chinese official acknowledged that they don’t measure up.

By selling shots to willing takers — before regulatory approval and without prioritizing its own population — China cemented its position as the go-to country for urgent supplies, experts say. China won the race by being first; no one really expected it to be the best.

“The geopolitical dimension is to some extent decoupled from the efficiency of the vaccine,” said Moritz Rudolf, who has been tracking China’s health diplomacy for the German Institute for International and Security Affairs.

Neither Sinopharm nor Sinovac has been approved by top regulators; the World Health Organization plans to decide whether to grant them emergency use listing in the coming weeks. Based on available data, they both appear to meet or exceed the WHO’s efficacy threshold of 50 percent. (The European Medicines Agency has not yet begun reviewing the Chinese jabs.)

Yet a rare acknowledgment of the vaccines’ disappointing performance came earlier this month, when the head of the Chinese Centers for Disease Control said the country should consider tweaks to “solve the problem that the efficacy of the existing vaccines is not high.” He quickly backtracked, but his comments stood in stark contrast to the Chinese social media campaign to deride Western vaccines.

Brazil and Chile are essentially testing Sinovac in the real world — and studies emerging from those countries and others in recent weeks show a range of 51 to 82 percent efficacy.

Beijing Biological Products Institute hasn’t released trial data for the Sinopharm vaccine — a major component of Hungary’s campaign. Yet the developers claim it’s 79.3 percent effective, even as the United Arab Emirates has started offering a “very small number” of people third doses due to low immune response.

In Hungary, the public relations for Prime Minister Viktor Orban — who said on Facebook he received the Sinopharm jab — couldn’t be better. While much of the political provocation around Europe has centered on Russia’s Sputnik V, it’s the Sinopharm jab that’s helped Budapest race to the top of the EU rankings on vaccinations, with some 30 percent having received a first dose.

And you don’t have to take Orban’s word for it: On April 21, WHO European Regional Director Hans Kluge stood next to Hungarian Foreign Minister Peter Szijjarto as he praised Budapest and declared at the end of his visit: “Vaccination rates are testament to planning, collaboration and resourcefulness.” Hungary used a loophole in EU rules to green-light the Chinese and Russian jabs at national level.

Meanwhile, while long-stalled EU donations of the BioNTech/Pfizer vaccine to the Western Balkans are only scheduled to start flowing in May, Albania and Bosnia were able to substantially expand their vaccination campaigns in late March thanks to Sinovac orders, with some doses acquired from Turkey.

Prompt delivery of more than 1 million Sinopharm jabs helped Serbia become a global leader on vaccinations. President Aleksandar Vucic received the Chinese jab on live TV in early April, just as concerns that a third shot would be necessary started cropping up.

Dueling narratives

“It’s mostly just a fight about the narrative,” said Rudolf.

Given Beijing’s lack of transparency, the underwhelming efficacy results are “not that surprising,” Rudolf said. It’s a missed opportunity for China to assert some R&D prowess; however, the Western narrative that Beijing can’t deliver on its promises isn’t likely to resonate in places where there are no alternatives.

The playbook looks similar to China’s face-mask diplomacy efforts earlier in the pandemic. Desperate countries were grateful to have supplies quickly, even if some PPE ultimately malfunctioned.

Beijing has also mastered on-the-ground optics. It’s mostly selling these vaccines, not donating them, noted Agatha Kratz, who leads research on EU-China relations at the Rhodium Group. Yet those sales are bilateral, rather than through some international effort like COVAX. “Every single country that they deal with will issue a statement … saying, ‘We received Chinese vaccines,'” she said.

It’s similar to the situation with development assistance, said Kratz. The EU gives more of it, but because the Belt and Road Initiative is done on a bilateral basis with extensive press coverage, it looks like China is “doing much more.”

While subpar efficacy may be shrugged off by many, Kratz said, the emergence of severe side effects — like the blood clots under investigation in the Oxford/AstraZeneca and Johnson & Johnson vaccines — could be a bigger problem.

So China’s advantage may be a combination of luck and timing: They supplied the shots well ahead of major regulatory scrutiny, and so far, there don’t seem to be major side effects.

China’s vaccine customers seem more concerned about quantity than quality. Turkish President Recep Tayyip Erdogan publicly scolded China’s foreign minister last month over delays fulfilling a 100 million-dose Sinovac order. Ankara “may be more cautious” in the future “if China overpromises,” a Turkish official told the Washington Post.

Political science

As with the Russian vaccine, backlash against China’s vaccines has been more about politics, both foreign and domestic.

Uyghurs in Turkey have accused Ankara of staying mum on persecution of the Muslim minority in China in exchange for Sinovac shipments. Paraguay is reportedly reconsidering its relationship with Taiwan in hopes of buying Chinese shots. And in North Macedonia, negotiations with Sinopharm fell apart amid allegations that Health Minister Venko Filipce was using a dodgy shell company to buy them.

Orban also faces questions about purchasing Sinopharm through a murky middleman. In a radio interview earlier this month, he excoriated opposition parties in parliament for pushing a ban on the Chinese jab, saying Hungary’s vaccination rate would be halved without the Russian and Chinese shots.

He also addressed an expected shortfall of 580,000 Johnson & Johnson vaccines, paused amid safety reviews. Those doses will likely be replaced, Orban said, “with others from elsewhere, mainly from China.”

Lili Bayer contributed reporting.

This article is part of POLITICO‘s premium policy service: Pro Health Care. From drug pricing, EMA, vaccines, pharma and more, our specialized journalists keep you on top of the topics driving the health care policy agenda. Email [email protected] for a complimentary trial.

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