Why vaccine diplomacy succeeded in the past and fails today

From the start of COVID-19, pandemic-related stories recounted experiences with past quarantines, Spanish Flu pandemic mortality and successful vaccine development and disease eradication campaigns.  

Although the advent of new vaccines was touted as an unprecedented scientific achievement, the international cooperation that was critical to previous public health successes did not repeat itself during the COVID-19 pandemic. Instead, people spoke of American, Russian or Chinese vaccines, ignoring the fact that we were fighting a common enemy and shared global health goals.

Why did the great powers unite against polio and smallpox during the Cold War but not act jointly on COVID-19, with the Cold War in the past and the world much more globalized? 

In the late 1950s/early1960s, the U.S.-developed Sabin polio vaccine went on large-scale trials in the USSR and Eastern Europe. These findings contributed to the official approval of the Sabin vaccine in the United States. The World Health Organization (WHO) smallpox eradication program was another empowering story of collaboration, where the USSR’s freeze-drying vaccine technology met U.S.-designed management in the global smallpox vaccination campaign. 

What often goes unnoticed is the type of life science cooperation conducted during the post-Cold war period changed to prevent the transfer of militarily critical technologies and resources to hostile countries or groups — especially to thwart the export of biological weapons-related materials and technology from former USSR scientific centers. The lack of cooperation on COVID-19 vaccine development can be partially explained by the reality that global health exists in the frame of security narratives. 

According to Henry Kissinger, in the post-Cold War world there is no longer a single threat, and “each country perceives its perils from its own national perspective,” compelling them “to assume greater responsibility for their own security.” Recently, global competition among states has been in the field of emerging technologies, including biotechnologies, driven by national security interests. 

COVID-19 vaccines are more sophisticated and technologically advanced than their Cold War counterparts. Moreover, COVID-19 vaccines are both a public health good and missiles against the biothreat to human and state security. States see vaccines as part of their national defense systems. Subsequently, vaccine cooperation and diplomacy narratives cannot be applied automatically to COVID-19. 

So-called ‘vaccine states’ like the U.S., China and Russia do not let other vaccines enter their markets. While the rest of the world recognizes the U.S. vaccines, Russia and China do not, and vice versa. Last week, theWHO granted emergency use listing for 10 vaccines — including the Chinese, United Kingdom and Indian COVID vaccines — yet these still do not have Russian authorization. The Russian Sputnik-V remains isolated; it lacks WHO authorization, not to mention Food and Drug Administration or European Medicines Agency authorization. The media supports the competition narrative by highlighting problems with logistics, transparency, vaccine efficacy, and states’ approaches to vaccine distribution, making the idea of competition more diffused. 

In general, high-income countries see pandemic victory in terms of using better vaccine technology to change pandemic strategy — not in creating diverse routes for access to vaccines and other pharmaceuticals or supporting different countries’ vaccine capacities. 

The situation is also far more complex because of the plurality of global health actors. The pharmaceutical industry we know today started evolving in the late 1990s from divestments of chemical and agrochemical holdings and mergers and acquisitions of businesses. During the Cold War, the main scientific and medical cooperation projects were state-driven as a part of their “soft power” strategies within a bipolar world with only two major powers. Now the world is multipolar and “soft power” diplomacy is not the same. 

Public-private relationships differ according to country. During COVID-19, many pharmaceutical companies were supported by states aiming to leverage and speed up national capacities in research and development, supplies and manufacturing of medications and vaccines for both domestic and international vaccine rollouts. To some extent, the interests of privately-owned pharmaceutical companies’ were married with vaccine competition and national security narratives during COVID-19.

The Russian case is a good illustration of the new framework of vaccine cooperation. In 2020, the Russian Health Ministry’s Gamaleya Institute created a COVID vaccine in a joint research project with the Russian Defense Ministry’s 48th Central Research Institute. That August, the U.S. Department of Commerce (and later Department of State) imposed sanctions on Russia. Washington accused the blacklisted institute of being associated with Russian chemical and biological weapons programs. This was the determining moment for further vaccine cooperation.

Last December, the United States added the Chinese Academy of Military Medical Sciences and 11 of its research institutes to a federal trade restriction list, accusing it of using biotechnology to support activities like “brain control weaponry.” The academy partnered with CanSino Biologics to develop a single-dose COVID-19 vaccine. Like Sputnik-V, it has not been authorized by WHO yet. 

That imposed difficulties for both countries to export viral vector vaccines comparable to the WHO-authorized Janssen (Johnson & Johnson) vaccine. The long-term implications of sanctions aimed at denying cutting-edge technologies and isolating another country’s science include disrupting the work’s credibility globally. That can fuel the growing anti-science movement and its side effects of vaccine hesitancy and denial worldwide.

There may be even more lasting implications. Countries with vaccine development capacities remain critical parts of the global pandemic response effort, given the demand for vaccines in low-income countries. Between COVID vaccine rivalry and vaccine-related health inequities, those countries may abandon shared global health goals and follow the false narrative that great powers cannot lead the world out of this crisis.

 No global entity, state or vaccine technology can fight the pandemic without cooperation. It is vital to preventing the spread of disease, achieving the best health outcomes and preventing geopolitical rivalry-driven misuse of science and technology.  

It is time to adopt a new mindset on vaccine cooperation. Suicidal competition in a globalized world needs to be contained. Countries should step up wisely in the name of national interests and step back from rivalry in the face of a global health disaster. 

Vaccine cooperation may be feasible if states can prioritize strategic global health interests over temporary national and geopolitical gains. 

Nataliya Shok, Ph.D., is a Kennan Fellow at the Wilson Center. The views expressed are solely her own and do not reflect those of The Wilson Center.