China's vaccine diplomacy and Turkey's choice

The most comprehensive protection against the coronavirus is vaccination. Major pharmaceutical companies around the world have developed vaccine formulae that are 90 percent effective. As news broke out of vaccines being developed, certain countries - especially rich ones - started buying those vaccines. Russia and China meanwhile, are attempting to combat the pandemic with their own, indigenous solutions.
Yet it seems like some countries are choosing which vaccines to adopt according to their investment ties, debt balances and prospective projects. This is most striking with those countries that are receiving their vaccines from China.

As vaccination efforts accelerated, the question arose as to how to distribute those vaccines across the world. The world’s wealthiest countries began vaccinating in December 2020 after ordering millions of doses of vaccines, well above the need for their populations. Meanwhile, billions of people have no access to vaccines whatsoever.

Some countries have not yet been able to purchase the vaccine and it doesn’t seem like they will anytime soon. For that reason, South Africa, which is known for its fight against AIDS, and India, which provides access to medicines at reasonable prices, especially for poor countries in the production of generic drugs, have requested that the World Trade Organization temporarily waive COVID-19 patent rights. The aim is to render COVID-19 vaccines easily accessible across the world and sold at affordable prices.

But WHO rejected this request, under pressure from the United States, Japan and EU member states. Those beyond the companies that have developed coronavirus vaccines will not be able to assure that other states have access to the vaccine. The statuses of vaccines, medicines and medical products are the same in the patent world.

While countries on the West engaged in nationalism with regards to their vaccines polices, proclaiming “Our citizens, first”, China has used its vaccination strategy as a diplomatic tool, first regionally, then globally.
The vaccine provides China with an opportunity in two regards. First, the vaccine is useful in refreshing its image. The fact that the virus originated from China and spread to the entire world, and the statements of some leaders like Trump that identified the virus with China has tarnished China's global image. China sent masks and hygiene supplies to several regions and countries, especially to Europe, to repair their image, which was damaged to such an extent that it could have lead to global exclusion. But that was insufficient.

After the vaccine development accelerated, Beijing began delivering its vaccines to many countries, from Brazil to the United Arab Emirates, including some vaccines that were still in their third phase of trials. Consequently, China agreed with all the countries that negotiated with them that they could deliver the necessary vaccine doses in time. In this context, China is both improving its image and following a more effective diplomacy than Western countries.

Second, China's vaccine diplomacy and the pandemic are serving as gains to China in the medium-run. In fact, the vaccine has been added to the “Belt and Road Project,” which covertly began in 2013. At the center of the Belt and Road Initiative is China's undertaking effective roles in infrastructure projects varying from roads to bridges. However, certain countries along the route do not have the economic means to finance these projects. At this point, Chinese banks and companies, including the Asian Infrastructure Investment Bank, assist countries in loans. Today, a similar strategy is employed for the vaccine. Beijing, for example, has extended low-interest loans for vaccines to certain countries, especially Latin American countries. Thus, to buy a vaccine from China, governments borrow from China, and then they buy vaccines with that loan.

China’s role in Africa is also noteworthy in that regard. According to 2019 data, there are 10,000 Chinese companies operating in Africa. Over the past 15 years, investments from China to Africa have exceeded $3 trillion. While much of the Chinese investment concentrates on roads and railroads, they also have experience delivering medicines and vaccines to Africa. For instance, when Ebola was a regional epidemic in 2014, it killed more than 12,000 people in Africa and infected tens of thousands of people. China sent health supplies, vaccines and financial aid to the African continent.

In the aftermath of the Ebola crisis, China started the Belt and Road Initiative, opening credits during the post-Ebola period and allocated $750 million for loans. Thus, one can say that China has experience turning the vaccine into a tool of diplomacy and using it effectively.
Aside from the African continent, two Middle Eastern countries receive vaccines from China, which are very rich compared to African countries: Bahrain and the United Arab Emirates (UAE). The UAE is also the first country in the world to approve a Chinese vaccine called Sinopharm. The trade volumes between China and those two Middle Eastern countries are significant. In 2018, Bahrain sold $360 million worth of products to China in 2018, while receiving $1.65 billion from China in return. The UAE exported $1.78 billion to China within the same year and became the largest importing state from China in the region.

There are three other countries receiving vaccines from China: Brazil, Indonesia and Turkey. Brazil, a member of BRICS and closely associated with China, has previously signed a $10 billion oil deal with China. Under the leadership of Jair Bolsonaro as well as joint initiatives within BRICS, the $2.4 billion joint funding between the two countries began to function effectively. This fund operates in six areas, including food and energy.

Indonesia’s dependence on China, meanwhile, has been criticized domestically and internationally. Currently, Indonesia owes China about $20 billion, which has increased by as much as 12 percent in the last three years. Indonesia's dependence on China is summarized as, “A 1 percent decline in Chinese economy means a 0.3 percent decline for Indonesia.”

At this point, the lack of alternatives for African countries and the bilateral investment relations of Middle Eastern countries with China, as well as Brazil's BRICS membership and hunger for investments, and Indonesia’s debt spiral help explain why those countries buy their vaccines from China.  

As for Turkey, it is rather odd that Ankara has bought 50 million doses of China’s Sinovac vaccine, which is anything but cheap and its trials are still ongoing. The issue is not the purchase of the vaccine but it is vital that the vaccines arrive in accordance with the measures taken.

Turkey experienced transparency problems throughout the pandemic. The same applies to the purchase of the vaccines. Which criteria were taken into account in the selection of vaccines? Why was China preferred? Or was the vaccine considered a prerequisite for future loans and investments? We have yet to receive answers to these questions.