Keywords

COVID-19 vaccine diplomacy has become apparent in international politics. Many states highlight the use of vaccine supplies as a tool of soft power projection and facilitation of positive ties with the other states. In a world where COVID-19 has been taking a terrifying human and financial toll, vaccine supplies promise relief and interact with pre-existing politics and foreign policy priorities (Woertz & Yellinek, 2021). China is using the COVID-19 vaccines as an important diplomatic tool to enhance its cooperation and understanding with the rest of the world. About 2.7 billion Chinese vaccines have been administered in China, while around 1 billion Chinese vaccine doses have been distributed to 110 other countries.

Although China was the first state where COVID-19 originated, the country successfully constrains the spread of the pandemic. The COVID-19 pandemic has swept the world in the past two years and caused over 250 million infections and five million deaths. China is the only state that successfully understood and contained the new pathogen. China had only 0.05% of the total number of global cases despite making up 19% of the whole world’s population. China defines the success of limiting and preventing the COVID-19 as the success of the “China Model” and the “progressiveness of the Chinese political system” (Yao, 2021). By mobilizing public mask wearing, hand washings, social distancing, and restriction of public gatherings and traveling, China believes that its responses to the COVID-19 successfully show the “political structural advantages,” which could be the major expression of the “Chinese Model” that for the rest of the world to learn from.

On the one hand, China attributes the success of preventing the COVID-19 to its political structure led by the Chinese Communist Party. As a coherent communist party, the Chinese Communist Party is the center of the political system and enjoys the highest authority for the decision-making process in China. According to Chinese Communists, the fundamental advantage is “mobilizing all national sectors, pooling all national resources, and coordinating all national efforts to complete a key task.”

After the COVID-19 was found in Wuhan in late 2019, China mobilized the whole state to contain the pandemic. More than 42,000 healthcare workers were mobilized toward Wuhan within three months, and dozens of healthcare centers were established. Therefore, the Chinese Communist Party’s strong leadership was interpreted as the key to preventing the COVID-19.

On the other hand, China believes that other states, primarily developing states, can learn its successful example of preventing the COVID-19. A nucleic acid testing system, personal data collection system, and vaccine research and production capabilities help China contain COVID-19. By organizing massive rapid nucleic acid testing, it is possible to diagnose patients as early as possible, detect asymptomatic infections, and assess the potential risk to the entire population. By tracing the personal data, especially the traveling records, it is possible for the health establishments to find the potential patients and to cut the COVID-19 transmission channels. Vaccination is a determinant of success, and China organizes major medical companies such as Sinovac and Sinopharm to research and produce many vaccines for the public.

1 China’s COVID-19 Vaccines Assistance to the Middle East

China believes it is necessary to help the Middle Eastern states prevent the COVID-19 epidemic. After the COVID-19 was successfully prevented in mid-2020, China gradually noticed the expansion of COVID-19 in the rest of the world. The spread of COVID-19 in the Middle East could threaten China’s epidemic prevention. Every year tens of thousands of Chinese Muslims visit the Middle East, especially to Mecca and Medina of Saudi Arabia, for Ramadan. In June 2020 and 2021, the Chinese Islamic Association suspended the annual organized pilgrimage to Mecca and Medina due to the rapidly growing COVID-19 cases in Saudi Arabia. From late 2020, China suspends airline flights from Beijing, Shanghai, Chengdu, Hangzhou, and Guangzhou to Middle Eastern destinations, including Istanbul, from Abu Dubai and Muscat, to prevent importing COVID-19 cases from the Middle East.

Given that Istanbul, Doha, Abu Dubai, Bagdad, Tehran, Cario, and Muscat are all important transferring airports from China to the Middle East, Europe, and Africa, the suspension of flights made international trips very difficult. The COVID-19 also negatively affected China’s goods imported to Middle East markets. Few foreigners were permitted to visit China due to the strict COVID-19 procedure. For example, the major Chinese miscellaneous goods exporting city, Yiwu, became empty and quiet, while the exporting data to the Middle East significantly declined.Footnote 1

In March 2020, China organized an online medical experts conference to share its experience of preventing COVID-19 with Middle Eastern states, including medical experts from Egypt, Algeria, Palestine, Lebanon, Kuwait, Qatar, Saudi Arabia, the UAE, Tunisia, and Morocco. In April 2020, China also organized an online medical conference with experts from member states of the League of Arab States to discuss the expansion of COVID-19 in the Middle East. Meanwhile, China also organized an online bilateral conference between Chinese experts and Middle Eastern states to discuss the prevention of COVID-19.

China hopes to encourage direct cooperation with Middle Eastern states through COVID-19 prevention and vaccine donation. When the COVID-19 outbreak in Wuhan, several Middle Eastern states expressed condolence and sent donations to China. As the state cherishes the spirit of “repaying an obligation” (bao en), just as Chinese President Xi Jinping stresses: “the friendship and assistance provided by the international society at the difficult moment would be always be remembered by China, and China would do our best to help other states.”Footnote 2

China sent several medical teams to Middle Eastern states to share expertise and experience with local medical ministries and establishments. In March and April of 2020, China sent medical teams to Iran, Iraq, and Saudi Arabia, to direct the COVID-19 prevention. The medical team from China to Iran shared the Chinese prevention experience to Iran and transferred tons of medical goods to Iran medical ministry. The Chinese medical team to Iraq visited Bagdad, Basra, Kirkuk, and Erbil with medical facilities and established a nucleic acid testing lab for Iraq. Under the advice of the Chinese medical team, the Iraqi government imposed a curfew to suspend the COVID-19 expansion. A medical team visited Saudi Arabia at the invitation from Saudi Arabia, shared China’s COVID-19 prevention experience with local hospitals, and constructed a cooperative mechanism with Saudi Arabia medical institutions.

China also assisted the COVID-19 prevention of Middle Eastern states by providing medical goods and materials waves. China sent several medical supplies to Iran, Iraq, and Saudi Arabia with the visits of Chinese medical teams in March and April of 2020. Chinese medical facilities and supplies were also sent to Algeria, Afghanistan, Syria, Tunisia, Lebanon, and Egypt in April and May 2020. Chinese local governments, companies, and social groups also donated to Middle Eastern states. Shanghai donated medical gloves and masks to Rabat of Morocco and Istanbul of Turkey. At the same time, China Railway Construction Corp, China State Construction Engineering Corporation, and Jack Ma Foundation bought several tons of medical facilities and goods to Sudan, Jordan, Algeria, Kuwait, and other Middle Eastern states. Chinese Association in Algeria bought a Nucleic acid detection reagent in China and transferred it to Algerian Red Crescent via flight.

Finally, China hopes to depict a blueprint of new international order by sharing fairly of the vaccines. After the spread of COVID-19, distribution of vaccine doses becomes a sensitive issue. On the one hand, very few states in the world have the capabilities to research and produce vaccines, while most states, especially most developing states, have to import vaccines from other states. On the other hand, most developing states have neither enough financial capabilities nor proper channels to import highly needed vaccines and other medical supplies to prevent COVID-19. In the Middle East, many states cannot contain the COVID-19 due to the rapid population increase rate and the poor medical treatment conditions. Just as Amnesty international criticizes the “wealthy countries” do not bear their “international obligations by waiving intellectual property rules for vaccines, tests, and treatments, and sharing lifesaving technology, G-7 leaders have opted for more of the same paltry half-measures.”Footnote 3

China maintains that the vaccines should be distributed fairly globally regardless of poor states or rich states, developed or developing states. Chinese leader Xi Jinping stresses that China would take measures to make vaccines accessible to both developing and developed states, and “will honor our commitment of giving assistance and support to other developing countries, and work to make vaccines a global public good accessible and affordable to people around the world.”Footnote 4

China has donated more than 100 million doses of vaccines to Pakistan, 1.7 million doses to Afghanistan, 114 million doses to Iran, 31.4 million doses to Turkey, 2.3 million doses to Iraq, 0.8 million doses to Syria, 0.3 million to Palestine, 0.7 million doses to Lebanon, 0.8 million doses to Jordan, 3 million doses to the UAE, and 0.1 million doses to Oman. These donating vaccine doses come from two major Chinese medical companies, Sinovac and Sinopharm. Donation of vaccine doses become an important component of China’s soft power, a tool used to deepen friendships abroad and vie for recognition over its archrival, the US, despite festering disputes, could help boost China’s image in vaccine-recipient countries that cannot easily source doses from other channels.

In order to help Middle Eastern states to produce more vaccines and upgrade their medical structures, China encouraged overseas manufacturers of Chinese vaccines together with Chinese medical firms. In the Global Health Summit of 2021, Chinese President Xi Jinping reiterated that China supported its vaccine companies and researching establishments to share vaccine technologies to other developing states and to carry out joint production in the developing states.Footnote 5 Currently, most joint productions undertake only the “fill-and-finish” processes of manufacturing the vaccines, though further discussions on technology transfer have been discussed. Chinese CanSinoBio works with the Pakistani National Health Institution to produce 36 million Chinese vaccines per year in Pakistan. In the UAE, Chinese Sinopharm works together with Gulf Pharmaceutical Industries and Group to produce more than 200 million vaccines per year. In Turkey, Chinese Sinovac establishes a producing center. China’s Sinovac works with Egyptian Vacsera to produce 200 million vaccines per year in Egypt. In Algeria, China’s Sinovac works with Algerian Saidal to produce 96 million vaccines per year, while in Morocco, China’s Sinopharm works with Sothema to produce 60 million vaccines per year.

2 China’s Motivations of Vaccines Diplomacy

China’s COVID-19 vaccine diplomacy can be understood against China’s internal social circumstances and China-US competition. The rise of China became the priority concern of the US and the Western world. The competition between China and the US is becoming increasingly more serious during uncertainty and instability. By China’s understanding, the US rejects the Chinese Communist Party’s legitimacy and aims to isolate China from the world. Therefore, it is necessary for China to take measures to defeat US offensives over COVID-19 issues, both at home and abroad.

The COVID-19 prevention is a major turning point for the Chinese Communist Party’s political legitimacy. When the COVID-19 broke out in Wuhan in November 2019, the Chinese government’s slow response, poor management, and bureaucratism were strongly criticized by the Chinese public. Thanks to the 7th Military World Games were held in Wuhan, whose opening ceremony was attended by Chinese President Xi Jinping and was described as an exercise for the 2022 Beijing Winter Olympic Games. Wuhan city government ignored the early alarming from local hospitals over “an unknown virus” and delayed the timely prevention of COVID-19 in Wuhan. Even after the order of “city-lockdown” was declared in early 2021, the order was leaked. Several hundreds of thousands of residents in Wuhan fled to other provinces and cities with possibilities of further spreading COVID-19. Even during the lockdown period of Wuhan, the local government’s poor management system was criticized for lack of food, ill coordination, and failures of duties. Many Chinese in Wuhan held the memorial ceremony to Dr. Li Wenliang, the first doctor in Wuhan to publish the “unknown virus.” They passed away due to the COVID-19 in February of 2021.Footnote 6

From China’s perspective, the US utilized the COVID-19 as a tool to challenge the Chinese Communist Party’s political legitimacy. China is always alert to the possible political transition from communism to “western democracy” mobilized and encouraged by the US, just as what happened in Arab Spring of 2011. It was only after the COVID-19 prevention took effectiveness in March and April of 2020, and especially after the COVID-19 swept the rest of the world, that the opinions inside China toward the government fundamentally shifted. The poor management of COVID-19 prevention destroyed the image of the “paradise” of US and western states in the minds of the Chinese and further enhanced the Chinese Communist Party’s legitimacy.

By China’s understanding, the relations between China and the US have entered the period of “competition of all directions and all levels” (Chen, 2020; Wang, 2020), and Trump’s requirements of China’s accountability for human and economic costs due to the slow response of Chinese local government toward the outbreak of COVID-19 are rejected as baseless and rude. From China’s perspective, the US is trying to stigmatize China’s image through COVID-19 and isolate China from the international industrial chain through sanctions and compensations toward China. Therefore, China needs to show the world its efforts over COVID-19 prevention and enthusiasms of assistance toward other states by providing vaccines to deal with the pressure from Washington.

After China’s largely successful prevention of COVID-19, Washington’s call for international sanctions against China further consolidates Beijing’s competitive attitudes. China believes that the relations with the US have fundamentally changed since the administration of Donald Trump and maintains that US hostilities toward China are increasing irreversibly. Given that Joe Biden administration is calling for a “democratic alliance” against China and calls for international sanctions against China by Beijing’s polity in Xinjiang and Hongkong, China must get support from the “non-western world,” especially from the Middle Eastern states that suffer the US interventions and occupations.

China’s COVID-19 vaccine diplomacy should not be understood as China’s willingness to intervene in Middle Eastern regional affairs. China has neither enough knowledge nor willingness to intervene in the Middle Eastern regional affairs deeply, and China defines the Middle East as “graveyard of global powers” (daguo fenchang), given the histories of the Soviet Union’s lesson in Afghanistan and the US’ lesson in Afghanistan and Iraq (Wang, 2016).

From Beijing’s view, China’s image in Middle Eastern states has been long fabricated. It is an important opportunity for China to construct a positive image in the Middle East by sharing its successful experience of COVID-19 prevention and providing assistance to Middle Eastern states. China’s image is defined as “Muslim oppressor” and “religion oppressor” by some media, and many maintain that China is implementing “ethnic cleaning” in Xinjiang against Uyghur ethnic groups. China rejects the accusation and maintains that it eliminates “Islamic extremism” and terrorism in Xinjiang. Therefore, China must offer assistance and help to Middle Eastern states to improve the ties and image in the region.

Meanwhile, China is criticized by the US as a “free rider” without bearing enough international responsibilities. The descriptions of China’s development by the US and China are different. The US defines China as a developed state with the second strongest economy globally. In contrast, China defines itself as a developing state with very low GDP per capita and low gross national income per capita. Therefore, for the US and other western states, China should uphold more international duties by assisting the rest of the world, especially in arms control, energy development, fighting terrorism, and environment protection (Johnston, 1996; Richardson, 2011). With the advocation of the Belt and Road initiative in 2013, China realizes the importance of setting up the new image as a “global responsible power.” Therefore, providing medical assistance to the Middle Eastern states is an opportunity for China to improve its image in the Middle East and set up a new image of a responsible power.

China’s COVID-19 vaccine diplomacy in the Middle East aims at cultivating friendship with regional states to get their support over China’s internal policies, especially over the Taiwan issue, Xinjiang issue, and the cooperation under the Belt and Road initiative. Many Middle Eastern countries provided help to China by sending medical aid or messages of solidarity in early 2020 at the pandemic’s outbreak. China returned the favor by offering medical aid and dispatching medical experts to help these countries fight against the contagious disease. The anti-pandemic cooperation continued mainly in the form of China’s donating the much-needed COVID-19 vaccines for the Middle Eastern countries. By vaccines donations to the Middle East and joint research and producing vaccines with Middle Eastern states, China successfully improves ties with the Middle Eastern states, especially those Muslim-majority states. Despite the pressure from Washington, most Middle Eastern states do not recognize the statehood of Taiwan, do not criticize China’s policies in Xinjiang in public, and are still active to facilitate the cooperations with China under the Belt and Road initiative.

3 Challenges of China’s Vaccines Diplomacy

China donated and exported a large quantity of COVID-19 vaccines to Middle Eastern countries in dire need of them, at a time when Western countries largely stockpiled vaccines for their good. The vaccine cooperation between China and Middle Eastern countries, which helped stabilize the epidemic situation in the region, has sublimated their friendship, deepened mutual trust, and opened up new areas of cooperation. However, the challenges of China’s vaccines diplomacy are apparent.

First, the effectiveness of the Chinese vaccine is not widely recognized by western states. Different from US-made vaccines, Chinese vaccines are inactivated vaccines. The effectiveness of the Chinese vaccine is always a debatable topic. As the leading Chinese vaccine makers, Sinovac and Sinopharm have been approved by the World Health Organization for the use against COVID-19. Both Sinopharm and Sinovac are inactivated vaccines, and they are safer theoretically than adenovirus vaccines. The Sinovac and Sinopharm vaccines have a major advantage over other COVID vaccines. They are easy to store and only need normal refrigeration.

However, the effectiveness of inactivated vaccines is doubted widely. The inactivated vaccines use killed virus to inject into people; the vaccines may not be as effective as Pfizer-BioNTech vaccines that use adenovirus technology. Even after China’s vaccination rate reaches 80% (nearly 2.7 billion dozes) in December of 2021, new waves of the COVID-19 epidemic can penetrate China. Researches show that the immunity and protection capabilities wane within a half year after Sinopharm and Sinovac vaccines are injected, while Sinopharm and Sinovac are tested inadequately against Omicron.Footnote 7

There are also discussions inside China about whether Chinese vaccines are effective, although the World Health Organization reports that Sinopharm’s effectiveness reaches 79%.Footnote 8 In 2021, waves of variants of the COVID-19, including the Delta variant and Omicron variant, swept several provinces in China, including Beijing, Shanghai, Jiangsu, Guangdong, Guizhou, Yunnan, Shaanxi, Inner Mongolia, and Henan. Due to the principle of “zero tolerance of local transmission,” Chinese local governments launched rounds of provincial nucleic acid tests, while local transportation, business, and travel were forbidden. Some opinions maintained that “we should stop nucleic acid tests” and start “COVID-19 resistance tests” nationally to test the effectiveness of the vaccines. Some opinions even doubt whether it is necessary to inject vaccines nationwide.

Middle Eastern states realize that Sinopharm and Sinovac vaccines might not effectively prevent the variants of COVID-19. Israel chooses US Pfizer-BioNTech rather than Sinopharm and Sinovac in its vaccination campaign. The United Arab Emirates and Bahrain choose Pfizer-BioNTech as the booster shot for those initially immunized with vaccines developed by China’s Sinopharm and Sinovac. As a new variant of the coronavirus ravaged the UK, India, South Africa, and other parts of the world, more Middle Eastern countries seem likely to follow Bahrain and the UAE’s example.

Second, the experience of China’s COVID-19 prevention could not be learned directly by Middle Eastern states. China’s political system could not be copied directly into the Middle East. China concludes its successful experience of preventing the COVID-19 as the “leadership of Chinese Communists.” At the same time, the Chinese Communist Party stresses that the success of COVID-19 prevention “proves the progressiveness of Chinese political system.” Although Chinese assertive COVID-19 prevention measures prove successful, it is very costly and leads to more social and economic problems. For example, when the COVID-19 Omicron variant swept Xi’an, the capital city of Shaanxi of Northwestern China, in December of 2021, the local government declared a lockdown. More than 10 million residents were forbidden to leave their communities, and several rounds of nucleic acid tests were organized every 48 h for all of these 10 million residents. The lockdown led to economic suffering and social disputes. Only under the strong leadership of the Communist structure that the assertive lockdown and significant economic losses could be tolerated.

Meanwhile, China’s success in preventing COVID-19 depends largely upon the strict measures of local governments. China’s COVID-19 control systems are more localized rather than centralized. Although top officials set priorities and norms, especially the “zero-tolerance principle” to the COVID-19 cases, local cities organize their own separate rules and regulations over COVID-19 prevention, use different versions of the health apps and date selection systems that display their testing and vaccination status, and often have problems sharing individual data with other provinces and cities. Someone traveling or even moving between cities may experience difficulties transferring their information that take days or weeks to fix.

Economically, China’s measures of COVID-19 prevention and works to be fully vaccinated are unaffordable for many Middle Eastern states. The “zero-tolerance of local transmission” policy becomes very costly for China, especially local governments. The successful containment has also left China’s population almost entirely vulnerable, and thus the country needs to persist with strong public health measures until population immunity is established through vaccination. China from early 2020 upholds the principle of “preventions of both COVID-19’s external penetration and internal spread” (wai fang shuru, nei fang kuosan). The prevention measures isolate China from the rest of the world. Chinese visitors are difficult to visit foreign states due to the complicating prevention measures, while imports are difficult to reach China due to the strict testing procedures. China’s economic growth has been significantly slowed down due to the COVID-19 epidemic and the strict prevention measures. For Middle Eastern states, China’s “zero-tolerance” toward COVID-19 seems difficult or impossible to achieve, and China’s experience over COVID-19 prevention, especially collecting personal data and traces, might lead to a political crisis.

Finally, China’s image is still negative in some Middle Eastern societies due to the COVID-19 origin discussion. There are many cases that Chinese visitors in the Middle East are called as “virus,” including Iran, Iraq, and Turkey. Some videos uploaded by Chinese travelers to the TikTok show that Middle Eastern people have negatively labeled China’s image in the Middle East. The callings of Chinese as “virus” anger many Chinese, and many discussions on the internet question whether China should continue to help these Middle Eastern states.

China’s images in Middle Eastern societies are under criticism. China’s policy in Xinjiang is defined and described by many media in Middle Eastern states as “anti-Islam” or “ethnic cleanings.” According to some accusations, China organizes harsh population-control measures to “require Muslims to renounce Islam and pledge loyalty to the Communist Party.”Footnote 9 China has always rejected the accusations in Xinjiang and defines the accusations as baseless and fake, and several Middle Eastern states support China’s policies in Xinjiang. Saudi Arabia Crown Prince Mohammed bin Salman visited China in 2019 and praised China’s “counter-terrorism and de-extremism efforts,” while the statement made by the Organization of Islamic Cooperation also praised China for “providing care to its Muslim citizens.” Egypt, the UAE, and Saudi Arabia expelled and arrested the Uyghur activities and deported them back to China. Iran, Qatar, and Turkey are also express support to China’s “counter-terrorism” efforts.

However, different from their governments’ official attitudes, many people across the Middle Eastern states choose to believe these accusations and strongly criticize China. Many Chinese travelers to Middle Eastern states asked by residents, especially in Iran and Turkey, about the fates of Uyghurs and Chinese Muslims and the “concentration camps in Xinjiang.” Middle Eastern societies’ misunderstandings toward Xinjiang lead to worries from Beijing. Therefore, China hopes to change the attitudes of Middle Eastern societies through COVID-19 assistance, especially the vaccines donations and joint producing efforts the construct a positive image in the Middle East.

4 Conclusion

China takes the COVID-19 vaccine as an important tool to expand cooperation with Middle Eastern states. First, China hopes to construct close connections with Middle Eastern states, especially Qatar, the UAE, and Egypt, by setting up R&D branches and sharing medical technologies to resist the COVID-19. Second, China hopes to show the success of the “China Model” that successfully constrain the COVID-19 to the Middle East. By describing itself as the successful example of limiting the COVID-19 and the US and Europe as the failed examples, China hopes to show the “progressiveness” of its political system. Third, China hopes to show its “international responsibilities” by providing vaccines to the Middle East, especially Palestine, Iraq, Syria, and Egypt.

The influence of China’s COVID-19 vaccine diplomacy toward the Middle East should not be overestimated. Due to the financial difficulties, China cannot meet all the demands of Middle Eastern states’ needs for vaccines. China is under serious financial and economic problems at home, although China’s GDP is still growing. Due to both the “trade-war” from Washington and the COVID-19, China’s economic growth rate significantly declined, while the unemployment rate increased rapidly in 2021. Although China produced the inactivated vaccines by Sinopharm and Sinovac, Chinese medical technologies are still far from independent. Most of the medicines and medical facilities in Chinese hospitals are imported from the US, Japan, and Europe. China’s medical assistance to the Middle Eastern states could be limited to vaccines, nucleic acid testing facilities, and China’s “experience of COVID-19 prevention.”

China’s vaccine diplomacy treats the Middle East as a whole region without consideration of regional divisions and might lead to distrust of regional states toward China. Chinese donations of vaccines toward the Middle East could further lead to regional geopolitical divisions against China’s interests in the Middle East. In Beijing’s view, China is competing with the US to gain support from Middle Eastern states’ sympathies toward Beijing’s “One China Principle.” Therefore, China has to offer support to any Middle Eastern state, which requires the demands over vaccines from China. Against the backdrop of geopolitical complexities between Saudi Arabia, Qatar, UAE, Israel, Turkey, and Iran, China’s assistance to certain Middle Eastern states might lead to distrust from another Middle Eastern state. For example, China’s donations of COVID-19 to the Syrian government and Iran could be defined by Israel as “allies with enemies.” At the same time, Qatar could describe China’s joint production of vaccines with the UAE with suspicion.

The Middle Eastern states realize China’s growing role in the region, while China also expresses great interest in developing ties with regional states. Through COVID-19 vaccine diplomacy, China successfully maintained and upgraded positive ties with regional states. However, most Middle Eastern states are still keen to see the US and the EU play a more active part in international vaccine distribution and administration. At the same time, China’s image, ideology, culture, and claims are still unfamiliar to these regional states.