China and US Vaccine Diplomacy in the Middle East and North Africa

Since the outbreak of COVID-19, health cooperation and solidarity in fighting the pandemic has been essential in mitigating the crisis. In turn, cooperation on health issues has strengthened overall diplomatic support between nations. After the breakout of COVID-19 in Wuhan, China faced a crucial crisis at home and also pressure abroad, in the form of accusations that it mishandled the pandemic’s early stages. Some politicians in the United States even raised a conspiracy theory over the origins of the virus. Then-U.S. President Donald Trump repeatedly accused China of being responsible for spreading the virus; he even used the expression “Chinese Virus” in public addresses, which created the impression of China as a threat to the world. This confrontational approach led to a significant deterioration in diplomatic relations between the U.S. and China. By contrast, Beijing sought to use vaccine diplomacy to highlight its role as a responsible actor on global health issues. China has practiced health and vaccine diplomacy around the world, including in the Middle East and North Africa.

In 2020, China sent doctors, nurses and researchers to hold conferences with doctors in Abu Dhabi. In August of that year, China established a laboratory in Baghdad, Iraq, with support of Chinese experts to help the country to confirm cases during the start of COVID-19 outbreak. In addition, China provided test kits, medical masks, personal protection suits, and other anti-COVID-19 supplies to Yemen. It also provided test kits and ventilators to both Palestine and Algeria. Moreover, China also localized vaccine production with Egypt, Algeria, the UAE, Bahrain, and Turkey, while Iran and Palestine both relied exclusively on Chinese vaccines in fighting the pandemic.

In Asia and Africa, most of the countries who received the vaccine were already participants in the Belt and Road Initiative (BRI). Through its vaccine diplomacy, China thus highlighted and reinforced the importance of the BRI in countries strategically important to Beijing. For instance, in Egypt, where the Suez Canal is an important strategic crossroad to Europe, in addition to vaccine donations, China also built a factory to manufacture Chinese vaccines in Egypt. This will allow Egyptian partners to gain influence and increase their exports to other African nations.ADVERTISEMENT However, the effectiveness and safety of Chinese vaccines has remained a crucial concern across the MENA region. There is a perception in many countries that Chinese products are of low quality; this has affected public trust levels toward the efficacy of the vaccines from Sinopharm and Sinovac. In Egypt, the populace has been skeptical of Chinese vaccines, while showing great trust in Western vaccines such as AstraZeneca. In part this is due to the apparent transparency of scientific research in the West in contrast to more opaque methods in China. In 2021, Saudi Arabia announced specific requirements for visitors to take at least one dose of the Pfizer, AstraZeneca, Moderna, or Johnson and Johnson vaccines in order to enter the country – or at least two booster shots of Sinovac and Sinopharm. Despite the wide use of Chinese vaccines across the region by many countries, positive opinions of the Chinese vaccines declined once alternative options were available from Western countries.

Despite the fact that the U.S. entered the vaccine diplomacy race later, Chinese vaccine diplomacy has faced a big challenge due to the spread of the highly transmissible Omicron subvariants BA.4 and BA.5. Chinese vaccines were less effective against the new subvariant, even if they were used for a booster shot. Subsequently, Sinopharm and Sinovac exported a total of 6.78 million doses in April, down 97 percent from the peak in September 2021. Western vaccines such as Pfizer and Moderna are based on newer mRNA technology, which is not yet available in China, and both are more effective against the virus than the Chinese vaccine in single doses.

The U.S.-led world order has witnessed a big shift in terms of the role of China as a rising power. Indeed, the COVID-19 situation accelerated the competition between two powers. The future world order will no longer be defined by a single power; therefore one single country will find it difficult to lead this order. China has emerged from the COVID-19 pandemic as an influential actor; vaccine diplomacy has been effective in upgrading China’s relations with many poorer countries. This situation puts China in a favorable position to pursue global leadership, but the degree of its involvement will matter in the long term. At least theoretically, there should be no natural conflict between the United States and China in the Middle East. Both share an interest in stability, and both are deeply invested in the status quo. The Chinese approach in the MENA region is more focused on economic and development integration, rather than challenging the interest of other nations. China is a leading regional power in terms of infrastructure and technologies. The vast growth in the Chinese presence in many areas, such as infrastructure, technology, clean energy, and finance, has contributed to boosting its foreign direct investment and provided employment opportunities in developing countries, which the U.S. and Western powers have failed to achieve.

China enjoys a strong friendship with most of most of the countries in the MENA region. China’s position in the region of course serves its interests – to maintain a stable domestic environment by focusing on economic cooperation – but overall China’s engagement with the region has been successful due to the declining U.S. role in the region, which has happened gradually over time. While the two powers’ competition includes the race to distribute vaccines, Chinese diplomacy will maintain its focus on prioritizing its interests without becoming involving in regional issues that might lead to a conflict with the United States. Ultimately, neither the U.S. nor China has been able to be very successful in ending the COVID-19 pandemic. Their policies at home and globally prioritize their different values and  political systems. Subsequently, the pandemic has brought their competition to a sharper point.


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