In May and June 2021, the World Health Organization’s (WHO) Strategic Advisory Group of Experts (SAGE) listed two Chinese COVID-19 vaccines – Sinopharm’s ‘BBIBP-CorV-2’ and Sinovac’s ‘CoronaVac’ – for emergency use and issued interim policy recommendations.
The two vaccines, which were among the first to be developed globally, met the requirement of 50% efficacy needed for WHO approval. Though further data is expected, the existing preliminary data shows that Sinovac’s vaccine has an efficacy of 51% against symptomatic COVID-19 infection and 100% against severe infection, while Sinopharm’s has an efficacy of 79% against symptomatic cases and hospitalization.
The Chinese vaccines have contributed to addressing the shortfall in supplies and helped sustain immunization campaigns in low and middle income countries in the midst of a global vaccine inequity crisis. Many countries, including UAE, Bahrain, Egypt, Turkey, Hungary, Brazil, Malaysia and Indonesia, had approved one or both vaccines for emergency use even before the WHO process concluded. Currently, Sinopharm is approved in 53 countries and Sinovac in 32 countries. China has practically been filling in for the failure and delays of the Covax project in supplying vaccines.
China has committed to providing around 350 million doses of COVID-19 vaccines, of which quite a bit has already been supplied. The country has committed to provide them either in the form of aid or through commercial agreements. Incidentally, the first has seen China being criticized for engaging in vaccine diplomacy while the cost of the vaccine has been raised as an issue in countries like Sri Lanka and Bangladesh.
Public support key for technology development
China’s modern biotechnology success is the result of government-led initiatives to drive indigenous innovation. Launched in 1986, the ‘National High Technology Program or 863 program’ was intended to stimulate the development of advanced technology. In addition to contributing to the foundation of research and development, it is to be noted that Sinopharm is a public sector undertaking. The research and manufacture is funded by the state, and the vaccines produced are free of cost for Chinese citizens. Though Sinovac is a private entity, it has been supported by the Chinese government through grants and aid to encourage research and development, and manufacturing.
On June 20, China announced that it had administered over one billion doses as part of its vaccine efforts. The Chinese government aims to fully vaccinate 40% of the country’s population by July and the entire population by the end of this year. The reason for the success has been the ability to develop and manufacture vaccines at a large scale and under the strategic direction of the state.
Support for local production in low and middle income countries
An interesting feature of Chinese cooperation with various countries on vaccines is that both companies are involved in strengthening local production through the transfer of technology. For example, Sinopharm is helping local manufacturing in UAE, Egypt, Belarus, Serbia and Bangladesh. Sinovac has similar initiatives in Brazil, Egypt and Hungary. This stands in contrast to the model followed by US and UK-based companies who have been against technology transfer, despite their vaccines having largely been developed in public institutes and funded by public subsidies.
In Egypt, the state-owned Vacsera has entered into a comprehensive partnership with Sinovac for manufacturing the vaccine wherein Sinovac would assist with transfer of technology and technical assistance for manufacturing. This includes supporting Vacsera in developing technological capabilities for manufacturing, and testing of the final product.
Science and known technology
After the two vaccines got approval by the WHO, some sections were quick to cast doubts on their effectiveness. Certain sections of the global media argued that countries which inoculated their populations with Sinovac and Sinopharm had seen a surge in cases, thereby implying that the vaccines had failed. On a closer examination, one finds that the reports do not go into the details of severe disease and hospitalization or factors such as the role of variants, ease of restrictions and weather change in the southern hemisphere to winter.
Both Sinopharm and Sinovac vaccines are inactivated vaccines which contain the virus whose genetic material has been destroyed. The technology has been used in the past for many vaccines such as those for Hepatitis B and Tetanus. It is known to have a well-documented safety profile, and similar technology is being used in the development of other COVID-19 vaccines. In addition, countries which have not used the Chinese vaccines have also shown a surge, for instance India and the UK.
This raises the question of whether the recent media response relies on science or is politically motivated. On the issue, Professor Satyajit Rath, an immunologist, says “When one says that these two Chinese vaccines do not work, they are actually casting a doubt on the entire technology of inactivated vaccines. For example, even the Indian COVID-19 vaccine uses the same technology of inactivating the virus. We need not make it a mRNA vs inactivated vaccine story. The issue here is the capitalist model that made this into a global competition between vaccines while it should actually have been a global collaboration, where we could build on each other’s work and mix and match the vaccines as they work best.” Recent studies confirm that mixing vaccines does elicit a good immune response.
Western countries and market forces have miserably failed at ensuring vaccine equity. The negative reporting on the Chinese vaccine is a veiled attempt to discredit what represents an opportunity for countries from the south to reduce their dependence on western-controlled production.