Neeraj Singh Manhas
China has successfully and effectively controlled the spread of the COVID-19 pandemic since its inception. A country with 1.4 billion people, more than Europe and the United States combined, has reported some clusters of cases and has been able to prevent widespread community transmission. Although much of its success can be attributed to the SARS Epidemic in 2002, China’s disease control strategy included a well-balanced mix of prevention and protection.
Soon after COVID-19 was discovered in December 2019, Chinese scientists were able to identify the virus and share genome sequencing data with the rest of the world. Chinese doctors had already classified the clinical symptoms of COVID-19 patients, the risks of person-to-person transmission, genomic characteristics, and the epidemiology by the end of January 2020. This solid research foundation was backed up by top-level political commitment to use science to combat the outbreak decisively. For example, at the start of the outbreak, China’s National Health Commission dispatched three groups of national infectious disease experts to Wuhan to investigate the virus’s risks and transmissions, and their recommendations for a lockdown were immediately implemented. The government was also quick to respond to academic scholars’ advice, such as Cheng Wang, President of the Chinese Academy of Medical Sciences. His concept of Fangcang shelter hospitals, or temporary hospitals built by converting existing public facilities such as stadiums, became a critical strategy for quickly providing a large number of hospital beds and appropriate health care to disease patients. However, its prevention and control strategy would not have been possible without the unprecedented level of community engagement and solidarity seen during the COVID-19 outbreak. Control measures that could limit individual freedoms, such as mandatory mask wearing in public places and social distancing, were widely accepted by the public, in contrast to Western countries where anti-masking and anti-lockdown protests were common. Thus, after successfully limiting the virus’s spread, China’s next strategic goal was to successfully balance these immediate challenges with preventive measures, namely, providing safe and effective vaccines to protect the population from further infections.
While the United States and the majority of Western countries followed a market-driven model based on advanced purchase agreements, China adopted a state-driven model that incorporated both political mobilisation and the use of economic instruments. Responding to an outbreak of a new infectious disease solely through market mechanisms can be costly, as well as risky. Furthermore, market-based solutions may increase the likelihood of vaccine research being slowed due to high levels of uncertainty. For example, despite early access to the virus’s genome, several Western pharmaceutical companies continued to devote a greater share of resources to developing lucrative treatments for existing chronic diseases such as cancer rather than combating this infectious disease with global implications. The COVID-19 vaccine research by Janssen and Pfizer began only when a large-scale infection was imminent in Western countries in late February.
China’s Ministry of Science and Technology (MOST) had already launched emergency research projects to accelerate vaccine development by February, with vaccine research beginning as early as January 2020. It went on to support five technological roadmaps and 12 vaccine candidates, which included both private sector behemoths and fledgling start-ups. In order to quickly mobilise resources and coordinate policy goals across agencies, the government also established a COVID-19 Task Force comprised of senior officials from the National Medical Product Administration (NPMA), the MOST, and other relevant departments. The Task Force was part of the State Council’s Joint Prevention and Control Mechanism and reported directly to China’s Vice Premier. The vaccine research programme was directed and guided by the Task Force, and it included multiple players collaborating to maximise their joint performance. For example, because of the MOST’s long-standing relationship with domestic pharmaceutical companies, the Chinese government was able to quickly identify enterprises capable of developing COVID-19 vaccines during the public health emergency. These enterprises were then aided by the efficient allocation of vaccine development resources across the Chinese Academy of Sciences, universities, the army, and state-owned enterprises. Furthermore, the Task Force directed the NPMA to modify its procedure in accordance with China’s Vaccine Administration Law in order to streamline the vaccine inspection and review process and accelerate market approval.
Currently, four vaccines have been approved in China and at least one other country. The majority of China and its allies’ arsenal in the fight to defeat COVID-19 consists of Sinopharm’s BBIBP-CorV, Sinovac Biotech’s CoronaVac, CanSino BIO’s Convidecia, and ZhifeiLongcom’s ZF2001. In addition, the World Health Organization (WHO) granted emergency approval to the Sinopharm vaccine in May and the Sinovac Biotech vaccine in June 2021. Chinese manufacturers had already begun increasing production capacity when the vaccines were in the early stages of development, with the help of government resources and institutions such as the Chinese Academy of Sciences and the Academy of Military and Medical Sciences. Sinopharm had established production lines in Beijing and Wuhan as early as April 2020, with an annual capacity of 300 million doses and plans to eventually export 300 to 500 million doses to over twenty countries. Sinovac and CanSinoBIO, for example, increased their production capacities to 300 million and 200 million doses, respectively. This explains why Chinese firms are so bullish about reaching annual production capacities of more than a billion doses by 2021. For example, earlier this year, both Sinovac and Sinopharm announced that they could produce more than a billion doses per year. This increased capacity has enabled China to meet massive domestic demand as well as international orders. With Chinese vaccine developers conducting Phase III trials in Asia, Latin America, and Africa, China has emerged as one of the world’s leading suppliers of COVID-19 vaccines.
In exchange for preferential pricing, delivery time, and technology transfer, such vaccine developers would typically collaborate with local pharmaceutical companies or health departments, which assisted in recruiting volunteers, coordinating physical and institutional resources, and conducting trials. As a result, China has extended assistance to more than 80 developing countries. In order to ensure adequate supplies of COVID-19 vaccines, the government has actively encouraged companies to export independently to other countries. Some of the agreements signed by Chinese companies included an additional clause stating that if a local pharmaceutical company hosted the clinical trial, the country is designated as a partner in manufacturing and distributing vaccines for domestic and international use. This explains why China has supported vaccine production bases in countries such as Brazil, the United Arab Emirates, Egypt, Indonesia, and Turkey. Pakistan and Mexico. While the UAE would manufacture Sinopharm’s vaccine under the brand name Hayat Vax, Brazil, Indonesia, Turkey, and Egypt would manufacture Sinovac Biotech’s vaccines. Mexico and Pakistan have also begun producing CanSinoBIO’s vaccine in their respective countries via an exclusive production line.
China has reshaped its position as a supplier of affordable vaccines to several developing countries around the world as one of the market’s major producers of COVID-19 vaccines. By investing in research and production capabilities from the beginning of the pandemic, Chinese companies have not only taken significant steps to alleviate severe vaccine shortages in the developing world, but have also provided a viable alternative to expensive vaccines offered by pharmaceutical behemoths such as Pfizer and Moderna.
(The author is a Director, Indo-Pacific, at Raisina House, New Delhi.)
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