China and Russia versus the West: What will be the true cost of vaccine nationalism for Africa?

A nurse prepares to administer the Sinopharm Covid-19 vaccine jab at Wilkins Hospital, Harare, Zimbabwe, 27 February 2021. (Photo: EPA-EFE / Aaron Ufumeli)

By Tatenda Mazarura and Mark Heywood

29 Mar 2021

Sidelined by rich Western nations, Africa has been left with no option but to rely on the willingness and benevolence of Russia and China, because the fight against the coronavirus is witnessing the worst of vaccine nationalism. For many in Africa, the two countries are seen as the only wealthy nations that have shown an interest in aiding Africa in the fight against Covid-19. But there’s a sting in the tail.

In January 2021 the World Health Organization (WHO) warned that only a quarter of African countries have adequate plans for funding Covid-19 inoculation programmes. Nonetheless, the WHO hopes that 3% of Africans will be vaccinated by March 2021 and 20% by the end of next year.

Based on data on the numbers of vaccinations so far, even this modest target seems unlikely. According to the Economist Intelligence Unit, vaccines will not be available in most African countries until April 2022 at the earliest.

According to the New York Times’ vaccinations tracker, as well as UCT’s Vaccines for Africa Initiative, the top 10 African countries by percentage of the population vaccinated are:

Rwanda: 2.8%

Senegal: 1.5%

Ghana: 1.4%

Malawi: 0.6%

Togo: 0.5%

South Africa: 0.4%

Mauritius: 0.3%

Angola: 0.3%

Gambia: 0.2%

Guinea: 0.2%

Altogether, fewer than two million people have been vaccinated across Africa – compared with 33 million in the UK alone.

An elderly man receives a shot of Covid-19 vaccine at a health centre in Qatameya, Egypt, on 4 March 2021. (Photo: EPA-EFE / Mohamed Hossam)

This is the grim reality of a continent that clearly cannot manage the pandemic without all the outside help it can get. Indeed, once again it seems Africa will be the worst hit of all continents, given its weak economies and public health facilities and unavailability of social safety nets for its vulnerable citizens.

In 2021, much of the continent is already reeling from the second wave of Covid-19, driven by new variants. Now it faces a real possibility of a third wave. In South Africa, according to Shabir Madhi, executive director of the Wits Vaccines and Infectious Diseases Analytics Research Unit:

“It is highly probable that it will start in May and June when we head into the cooler months, as people are more likely to gather indoors. But if people start gathering during that Easter period, then we might expect it to occur earlier.”

Other countries such as Kenya had already confirmed a third wave in early March.

“We are about to start another difficult period, but we can also overcome this period. It has taken a toll on us over the past year, and it is at this time that we can’t let our guard down,” the country’s health minister, Muthai Kagwe, stressed.

In Zimbabwe, the acting chief executive of Bulawayo’s Mpilo Central Hospital, Solwayo Ngwenya, warned of an imminent third wave coupled with deadly variants, which would result in an unprecedented spike in fatalities.

Across Africa, the third wave is linked to a slow vaccine rollout, fragile economies and a disregard for physical distancing and mask-wearing as citizens desperately eke out a living.

Unfortunately, though, Africa’s problems are being made worse by what has been termed “vaccine apartheid”.

Despite warnings, Western countries and regional blocs like the EU are adopting an increasingly inward-looking approach. Even the new US president is talking the language of America first. “We’re now on track to have enough vaccine supply for every adult in America by the end of May,” Joe Biden said on 3 March.

The US’s “problem” now is that it has a glut of vaccines – according to the New York Times, an estimated 70 million more doses than are needed by its own population. Yet there is not the slightest suggestion of assisting Africa before the whole of the US is inoculated.

The People’s Vaccine Alliance, a network of non-government organisations, reports that rich nations, representing only 14% of the world’s population, have bought more than half of the most promising vaccines. Africa is at the back of the queue.

Enter China and Russia: Vaccine nationalism solidifies stranglehold on Africa

As was once the case with antiretroviral medicines for HIV, Africa is once more abandoned, vulnerable and desperate.

The continent is being left behind because it lacks the finances to pre-order the vaccines now authorised for emergency use, notably the Pfizer, AstraZeneca, Moderna and Johnson & Johnson vaccines. Making matters worse, there is evidence that it is not being spared from excessive pricing by Western pharmaceutical companies.

“We now have an entire continent that is stretched from a financial point of view,” said Duarte Pedreira, head of emerging and frontier markets at UK-based Crown Agents Bank.

In this context, China and Russia are exploiting the gap to good effect by providing vaccines at favourable pricing, or as donations. According to Robert Besseling, CEO at Pangea-Risk, a specialist intelligence company focusing on Africa:

“They are seeing a real opportunity to extend their commercial, diplomatic, political and geopolitical security relations with the African continent.”

Thus Moscow has offered 300 million doses with financing to the African Union’s (AU) purchasing scheme, while Beijing has pledged nearly a quarter of all its vaccine donations to Africa, according to data compiled by Bridge Consulting, a Beijing-based health sector advisory.

So far, China has sold and donated vaccines to 13 African countries.

Morocco, Mauritania, Algeria, Ethiopia, Zimbabwe, Egypt, Sierra Leone, Senegal and Equatorial Guinea have already received supplies of the Sinopharm vaccine; Algeria, Guinea, Gabon and the Congo are using Russia’s Sputnik V; and, in addition, the AU has said it is planning to acquire 300 million doses of Sputnik V.

Sidelined by rich Western nations, Africa has been left with no option but to rely on the willingness and benevolence of Russia and China because the fight against the coronavirus is witnessing the worst of vaccine nationalism. (Photo: iccwbo.org / Wikipedia)

In South Africa, sources say there have been meetings with both the Chinese and Russian embassies over procurement of their vaccine, amid complaints that Western vaccines are being favoured.

Sputnik has reportedly submitted a dossier to the SA Health Products Regulatory Authority (SAHPRA), although an anticipated problem is that it does not have data on the 501V.2 variant. Sinovac has told the media that it has committed five million doses of its CoronaVac vaccine to SA.

Even if African countries were to harness the resources to procure the Western-manufactured vaccines, several of them will be difficult to administer as the vaccines were not manufactured with consideration of the realities of Africa’s broken health systems.

By contrast, according to media reports, both Chinese and Russian vaccines can be stored in ordinary refrigerators, unlike the Pfizer vaccine which needs extreme cold temperatures.

“These vaccines were not made for developing countries. They have to be frozen,” Eric Olander, founder of the information platform China-Africa-Project, observed.

Economic influence at the core of vaccine politics

The Covid-19 rescue mission in Africa by China and Russia should not be viewed in isolation. China has already shown its interest by launching a game-changing entry into Africa from the turn of the millennium.

China has been ramping up its relationship with Africa in a massive “second coming” that has been punctuated by large-scale industrialisation, low-cost manufacturing, technology transfer and an infrastructural revolution under its Maritime Silk Road Initiative (MSRI), a strategy for global infrastructure development.

Even though the immediate concern is the Covid crisis, it is clear that for China, an economic imperative of vaccine diplomacy has been carefully crafted and been in the works for some time.

According to the Wall Street Journal, for months, China’s government, state enterprises and private companies have laid the groundwork for a vaccination push from Africa to the Middle East and Latin America. They have assembled a supply chain that would maintain temperature controls from the point of manufacturing through every step of distribution – and further the “Health Silk Road”, as Beijing has called it.

The images of Chinese ambassadors receiving consignments of the Sinopharm vaccines at African airports, or African leaders on front pages reportedly getting the jab as a way of endorsing the vaccine in the face of sceptical citizens, is a powerful soft coup for China.

Russia and China’s efforts to cement their influence in Africa has been termed vaccine diplomacy by the New York Times. China’s vaccine diplomacy follows its mask diplomacy, in which it shipped personal protective equipment and other medical supplies to countries in Africa and other parts of the world.

It cannot be ignored that China does not have the best of reputations among many ordinary people in African countries, who view it as a predatory force bent on a “second colonisation”, often in cahoots with African elites.

The hope is that Covid-19 may dilute some of these strong negative feelings.

“For people receiving Chinese vaccines, it will change their impressions of China,” said Peng Nian, a researcher at the National Institute for South China Sea Studies, a government-backed think tank in China. “That’s hard to achieve through big-scale construction projects or government agreements.”

But can China and Russia’s vaccine diplomacy deliver?

Despite China and Russia’s readiness to come to Africa’s rescue, they face some notable problems in the short to long term.

So far, vaccine donations from Beijing and Moscow have been small – the commercial deals they offer are costly and some African governments are wary about the lack of published research data on safety and efficacy, says Reuters.

Speaking to CNN, W. Gyude Moore, a senior policy fellow at the Center for Global Development in Washington DC and a former Liberian minister of public works, expressed concern that China’s “promises concerning vaccines in Africa have been really vague. There has been no timetable.”

The number of vaccine doses that China has donated is relatively low – the most doses given freely to an African country are 300,000 to Egypt, says Eric Olander.

At the moment, one of the two Chinese vaccines, Sinovac, is not in major use in Africa. This is due to a number of factors, including scepticism around the efficacy of the Chinese and Russian vaccines overall within the African population in general, and a lack of clinical trial data.

A nurse prepares to administer the Sinopharm Covid-19 vaccine jab at Wilkins Hospital, Harare, Zimbabwe, 27 February 2021. (Photo: EPA-EFE / Aaron Ufumeli)

In Zimbabwe, which is the only country currently using Sinovac, the provincial medical director for Mashonaland West, Gift Masocha, said health personnel, including doctors, nurses, pharmacists and other support staff, were reluctant to be vaccinated due to negative publicity surrounding the safety and efficacy of the doses.

“There is a lot of negative publicity, especially on social media, about the vaccine. People are asking whether it is safe.”

Some critics also warn that “China’s vaccine diplomacy” can be seen as an extension of the Chinese “debt-trap diplomacy”, a theory that became a cornerstone of the Trump administration’s Africa policy – despite being disproved – to deter African states from cooperating with China.

The term “China’s vaccine diplomacy” implicitly raises questions about the efficacy of China’s vaccines by encouraging the notion that the rollout is simply a strategy to boost China’s global influence.

Finally, the murky arrangements surrounding the provision of vaccines to Africa raise questions as to what exactly African governments are offering China in return?

Given recent history, there is more than enough reason to assume the worst, especially in countries like Zimbabwe which appear too eager to do China’s bidding at every turn.

However, sidelined by rich Western nations, Africa may yet be left with no option but to rely on the professed benevolence of Russia and China. The two countries are seen as the only rich nations that have shown an interest in assisting Africa in the pandemic fight.

However, in the bigger scheme of things, this has raised several questions, especially how Africa could risk being further disempowered as a result of its lack of choices and desperation.

China and Russia’s motives are clearly grander than the face value health assistance, and the true extent of Africa’s benefit from this gesture remains uncertain. DM/MC

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