Imagine a government medical facility in a remote area of Zimbabwe in the early months of 2021. A delegation who wanted their picture taken has arrived with a shipment of vaccines, which came from a Chinese state-owned manufacturer rather than the multilateral system established especially to stop this kind of inequality. The vaccines were delivered in boxes bearing the Sinopharm logo. The fact that there were doses at all relieved the nurses. Someone else was responsible for the politics surrounding the source of those doses. And that is the vaccine diplomacy story in miniature.
Even the phrase itself seems harmless. Negotiation, sincerity, and mutual gain are all suggested by diplomacy. However, the picture becomes much less comfortable when you focus on what vaccine diplomacy actually looked like during the COVID-19 pandemic. Fundamentally, it was a power struggle carried out on the backs of nations with limited options, no production capacity of their own, and no leverage at the WTO. There was a language of solidarity everywhere. In actuality, things were more transactional.
| Concept | Vaccine diplomacy — the use of vaccine donations, loans, and purchase agreements by powerful nations to project soft power, build alliances, and expand geopolitical influence |
|---|---|
| China’s Vaccine Reach (by March 2021) | Free doses provided to 69 countries; vaccines commercially exported to 28 additional countries — primarily in Asia, Africa, and Latin America, aligning with Belt and Road Initiative partnerships |
| China’s First Vaccine Diplomacy Move | July 2020 — first Chinese vaccine trial outside China began in Brazil; by November 2020, deals were signed with dozens of lower- and middle-income countries |
| Global Distribution Mechanism | COVAX — established in April 2020 by WHO, European Commission, and France; 190 countries participating, designed to ensure equitable access regardless of financial capacity |
| EU Financial Contribution to COVAX | One billion euros committed; China separately donated ten million doses to COVAX following a WHO request in April 2021 |
| Patent Dispute (WTO) | India and South Africa proposed temporary suspension of vaccine patent protections; endorsed by 100+ WTO members; US signaled agreement while EU remained divided and pharmaceutical companies opposed |
| Standard Antidepressant Parallel (STAR*D) | Like treatment-resistant patients, vaccine-access-resistant nations — without production capacity or political leverage — faced a system that offered aspiration but delivered inequitable outcomes |
| Key Nations in Vaccine Diplomacy Race | China (Sinopharm, Sinovac), Russia (Sputnik V), India (Covishield via Serum Institute), United States (Pfizer/Moderna distribution push), and increasingly the EU through bilateral agreements |
| Efficacy & Trust Concerns | International sentiment on Chinese vaccines was mixed — concerns around clinical data transparency, efficacy rates, and safety reporting tempered soft power gains despite wide distribution |
| Core Tension | Developed nations stockpiled doses while blocking patent waivers — creating a gap between public commitments to global solidarity and the private economic logic driving pharmaceutical policy |
China made the quickest and most deliberate moves. By March 2021, Beijing had given millions of free doses to 69 countries and exported vaccines commercially to 28 more. The destinations were mostly in Asia, Africa, and Latin America, which coincidentally coincided with China’s Belt and Road Initiative footprint. It wasn’t a coincidence. A 2021 study that looked at China’s vaccine diplomacy through the prism of nation branding characterized it as an endeavor to project influence, repair an image tarnished by early pandemic mismanagement, and expand what the researchers called “great power ambitions.” The vaccines were acting in multiple ways simultaneously. One of them was healing people.
India was moving doses through the Serum Institute and Russia was doing something similar with Sputnik V, but Delhi’s aspirations ran headlong into a second wave that forced the nation to completely halt exports in mid-2021. This serves as a reminder that domestic politics will almost always take precedence over international commitments when pressure mounts. Through a combination of bilateral agreements and COVAX funding, the United States, which had been slow to act on the global distribution front during the Trump administration, later made an effort to regain its leadership position. There’s a feeling that Washington realized, a little too late, that it had given up soft power territory from which it would be difficult to regain.
COVAX, which was introduced in April 2020 by the WHO, the European Commission, and France and eventually involved 190 nations, was the mechanism intended to keep all of this from turning into a geopolitical free-for-all. The goal was sincere: collectively buy vaccine doses, bargain for reasonable prices, and distribute them fairly to all nations, regardless of their financial capacity. In a June 2020 speech, Chancellor Angela Merkel stated that vaccines must be “affordable, available, and freely accessible around the world.” Excellent words. Subsequently, the affluent countries that had supported COVAX signed their own advance purchase contracts with Pfizer, Moderna, and AstraZeneca, thereby securing supply before COVAX could obtain it. Aspiration and reality were so far apart that they could be seen from space.
The patent dispute exacerbated the situation. In late 2020, South Africa and India proposed to the WTO that intellectual property rights on COVID vaccines be temporarily suspended, claiming that this was the only way to quickly increase production capacity in developing nations. It was approved by more than 100 WTO members. It was fiercely opposed by the pharmaceutical industry. The EU was split. When the Biden administration indicated support for the waiver, Germany, whose businesses had benefited greatly from the mRNA vaccine discovery, publicly denounced it. It’s difficult to ignore the fact that the nations that had previously obtained sufficient doses for their own populations were also the ones who were most reluctant to share the technology.
Beneath all the rhetoric of international solidarity at press conferences, vaccine diplomacy revealed a hierarchy that most members of international organizations would rather not identify. Developed countries have the authority to regulate intellectual property, manage distribution networks, and then give away excess doses as charitable deeds—on their schedule, with their branding, and with their geopolitical objectives. Developing countries get what they’re given, frequently with conditions attached, from whoever arrives first. China was aware of this dynamic and purposefully entered the area. It’s debatable whether or not the nations receiving Sinopharm doses were pleased with it; some weren’t, especially when worries about efficacy rates and data transparency emerged, but many had no other viable option.
As this develops, it’s hard to avoid the conclusion that the pandemic removed the polite illusions that typically conceal these disparities rather than creating them. Going forward, the question is not whether vaccine diplomacy will occur again, but rather that it will since the incentives remain the same. Whether the international architecture designed to combat it will ultimately have enough teeth to matter is the question.
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