Who Actually Won The Vaccine Diplomacy in Bangladesh?

Apon Zahir | 18 September 2022
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The year was 2021, and the term “Vaccine Diplomacy” suddenly became commonplace in the headlines; in the backdrop, the COVID-19 pandemic was well on its way to killing more than 6 million people worldwide. A brief look at google search trends illuminates the rise and eventual fall of the topic in public discourse. Even now, the term carries with it a hint of cynicism. A subtle reminder of the immense power of giant pharmaceutical companies, of the prioritization of patents over patients, and of rich nations boldly advocating for global cooperation while buying out all the vaccines without any consideration for the underdeveloped and impoverished.

In the most cynical definition, diplomacy is merely a means of leveraging soft power over other nations to gain in matters of national interest. International online magazine The Diplomat stated in an article titled Vaccine Diplomacy in Asia that “so-called ‘vaccine diplomacy’ has emerged as a new channel through which major powers seek to curry favor and shape the international environment to their benefit, doling out vaccines to favored countries according to perceived national interest.”  When all the world needed life-saving vaccines, and the COVID-19 Vaccines Global Access initiative (COVAX) failed to keep its promise of equitable vaccine distribution, it was prime time for developed nations to leverage their pharmaceutical industries in order to gain soft power over their neighbors. All developing and underdeveloped nations were fair game, and Bangladesh was no exception. However, if we try to find out who gained the most amount of soft power over Bangladesh through bilateral vaccine delivery, we will be hard-pressed to find a simple answer.

According to the vaccine tracker program from McGill university, Canada, there are currently nine COVID-19 vaccines approved for use in Bangladesh. These include AstraZeneca, Pfizer, Sinopharm, Moderna, Sinovac, Johnson & Johnson, and a few others.

If we look at the nations supplying these approved vaccines, it boils down to China, India, Russia, the UK, and the USA.

Looking at the actual number of vaccine doses being administered currently in Bangladesh, we see a very skewed picture. By June of 2022, approximately 87.7% of all vaccines administered are ones from China (Sinopharm and Sinovac); 6.8% of all vaccines administered are from USA origins (Moderna, Pfizer, J&J); and 5.4% are from India (SII). The overwhelming vast majority of the people of Bangladesh have been administered vaccines from China.

An analysis of the timeline of vaccine distribution from the official COVID-19 vaccination dashboard for Bangladesh shows that the first type of vaccine in distribution was the AstraZeneca products, which came to Bangladesh around January 21, 2021. However, vaccine administration slowed down to a trickle from April to early July and then ramped up again from August. From then on to the rest of 2021, the lion’s share of vaccines administered was from Sinopharm. Early 2022 saw the administration briefly rise for Pfizer products, but by the end of February, it was dominated mainly by Sinovac products. Moderna was very briefly in vogue during August 2021 but has been generally out distributed by the other vaccines mentioned above. There are no official records for the J&J and Sputnik products being administered in Bangladesh.

At the onset of the pandemic in 2020, Bangladesh ordered a large quantity of the AstraZeneca vaccine from India. The Serum Institute of India was the closest COVID-19 vaccine production lab at the time. However, due to the pandemic hitting India quite hard at the time, the government of India cut down vaccine export in order to focus on supporting its own population. According to the Indian Ministry of External Affairs, two large shipments of vaccines were made to Bangladesh in January and February 2021, but the rest of the order was delayed to October 2021. This failure to deliver orders by India had a rippling effect worldwide, serving as a critical blow to the COVAX program’s reputation and straining bilateral relations between Bangladesh and India. India finished delivering the commercial order by the end of 2021 and even supplied additional doses to Bangladesh through COVAX. However, it would be quite a stretch to assume that India gained any kind of soft power over Bangladesh through the whole ordeal.

The failings of the overall COVAX system worldwide are now well documented. Doctors Without Borders/Médecins Sans Frontières' (MSF) made a statement with the headline COVAX: A broken promise for vaccine equity, where a senior vaccines policy advisor for MSF stated that “efforts to equitably distribute those same lifesaving vaccines have been an epic failure, and today we still face unacceptable inequalities in vaccine access around the world.” We see how entire batches of vaccines delivered to Africa had to be destroyed because they arrived at the hospital too close to the expiry date, leaving no time to distribute them. A Washington Post article, titled Why Covax, the best hope for vaccinating the world, was doomed to fall short, describes how the COVAX system wasn’t initially meant to facilitate donations from developed nations to underdeveloped ones. It was intended to distribute vaccines to all nations equitably. However, developed nations bypassed the system and bought up most of the initial batches of vaccines, only later to give away the leftovers in the form of donations. However, even if the system ran as intended, It is unclear whether Bangladesh could even afford to buy the expensive Pfizer and Moderna vaccines in similar bulk as the Chinese ones.

Since June 2021, the United States has donated 85,221,620 COVID-19 vaccine doses to Bangladesh. These include the majority of Bangladeh’s Pfizer, Moderna, and J&J stockpiles. All were donated via COVAX. There was an initial swell of publicity for the USA in Bangladesh when the bulk of the much sought-after mRNA vaccines started being administered. But the limited supply and expensive storage measures meant that most people did not have access to American Vaccines initially.  However, it should be noted that most people who are now getting their third dose of the vaccine are getting the Pfizer ones. The vaccine donations from the USA were also eventually approved to be used on the youngest members of the population. These generous donations undoubtedly played a large role in saving lives, and subsequent public perception among the people of Bangladesh has been very positive.

As vaccine administration during a global pandemic is a time sensitive issue, the dates of delivery are more important than the actual overall number. Analysing both the total number of vaccines administered and the timeline of administration, it becomes clear that the vaccines from China played the biggest role in curbing the effects of the second wave in Bangladesh. On August 17, 2021 the Government of Bangladesh signed a memorandum of understanding (MoU) with China’s Sinopharm and Bangladesh’s Incepta Vaccines Ltd., under which the local pharmaceutical company would produce 5 million Sinopharm COVID-19 vaccine doses per month. Meanwhile, Bangladesh began purchasing vaccines from China in bulk. According to a Daily Star report, the finance ministry used $741 million to buy 105 million vaccine doses from two Chinese drugmakers through COVAX. The main reason behind Bangladesh purchasing such large quantities of vaccines from China instead of India and the USA is easy to guess. The Chinese vaccines are relatively cheap and do not require complex cold storage facilities to keep them potent. This also makes them easy to distribute and administer in remote areas of Bangladesh. However, it should be clear that most vaccines bought from China were through the COVAX commercial channel.

Very little of it is donated. According to Chinese consulting firm BridgeBeijing, only about 15% of all vaccines supplied from China to the developing nations of South Asia were donations. The vaccines from China also tend to have lower efficacy in preventing COVID-19 compared to the western mRNA vaccines, as demonstrated in multiple tests conducted by the World Health Organisation. Even so, the timely supply of the Chinese vaccines to Bangladesh helped the nation escape its reliance on India and begin emergency administration as the second pandemic wave was already underway. From the public perspective, it may seem that China came to Bangladesh’s rescue in an hour of need. But, of course, things aren’t that simple.

One particular detail must be noted carefully regarding all the information above—the figure of $741million spent by Bangladesh to buy the vaccines from China. In fact, Bangladesh’s total budget for buying vaccines was $940 million. More than a quarter of the budget of the Padma Bridge. And the entire amount was a loan from the Asian Development Bank.

On 22 June 22 2021, when Bangladesh was in the middle of the vaccine drought, The Asian Development Bank (ADB) approved a loan package of $940 million for the Government of Bangladesh to purchase vaccines against the pandemic.

The package comprised a regular loan and a concessional loan of $470 million. It was a part of ADB’s $9 billion Asia Pacific Vaccine Access Facility (APVAX), launched in December 2020 to offer rapid and equitable vaccine-related support to ADB’s developing member countries.

Needless to say, this loan was a vital lifeline for Bangladesh, which was already heavily encumbered in self-funding multi-billion-dollar infrastructure projects. The loan also played a considerable part in ensuring Bangladesh’s economic sovereignty while navigating a complicated worldwide epidemic. Bangladesh came out of the pandemic with almost no geopolitical strings attached. By pure luck, or perhaps through complex under-the-table geopolitical gerrymandering, it would seem that Bangladesh was spared the fate of the 30 or so developing nations which had to entirely rely on vaccine donations and had to reject over 100 million donated doses as they are just too old and close to expiring.

At the time of writing, Bangladesh has managed to meet it’s targeted number of vaccinations for the first and second doses. The numbers for the third dose is significantly lower still as general awareness measures against COVID-19 has laxed. Ultimately, it is unclear if anyone actually won the vaccine diplomacy in Bangladesh. However, it would seem that Bangladesh is on the winning side for now.

Apon Zahir is a Research Associate in Centre for Governance Studies.

This article was originally published on Daily Asian Age.
Views in this article are author’s own and do not necessarily reflect CGS policy.