The King of Morocco Mohamed VI was vaccinated last week with the Chinese Sinopharm vaccine Last Sunday the Hungarian Prime Minister Viktor Orban had done it. Turkey has bought 100 million from another China, Sinovac, which is also the one received by Chilean President Sebastian Piñera. And last Monday, displaying scientific patriotism, the head of the Indian government Narendra Modi received the first dose of Covaxin, developed 100% in India. In the absence of western pharmaceutical vaccines, the less developed countries (and many of the developed ones) are pricking themselves with those that come from the east.
The Russian vaccine is called Sputnik V, created by the Gamaleya Moscow National Research Center for Epidemiology and Microbiology. On March 1, Slovakia authorized its use and that same day the first 200,000 doses of the million contracted arrived that same day. Hungary was already playing it and the Czech Republic is thinking about it. Even Austria has shown interest. Czechs and Slovaks are among those with the highest per capita mortality rates in the world. So the authorities have not waited for new shipments of the three Western vaccines approved by the European Union. The European Medicines Agency (EMA) has just started the review of the Russian inoculate, but you have not authorized it yet.
Slovak Prime Minister Igor Matovic told a press conference at the foot of the plane carrying the first shipment that “they could speed up the vaccination process by 40%” thanks to Russian vaccines, according to Reuters. So far they had received some 300,000 Western doses, mostly from Oxford / AstraZeneca and Pfizer / BioNTech. The weight of the pandemic and slow distribution partly explain why Sputnik V is filling the void. The historical ties between former members of the Warsaw Pact have also weighed on. According to the Russian Fund for Direct Investment, which has financed Sputnik V, 39 countries (see maps) in which more than 1,100 million people live have authorized it or are already tapping it.
Due to its technology, Sputnik V is also the most western of the vaccines that come from the east. Such as those of Oxford / AstraZeneca and Janssen, which are imminently approved in the EU, uses the viral vector technique. It resorts to other viruses (human adenovirus) unable to replicate to carry the instructions that teach cells to produce the coronavirus spike protein. This is what activates the immune system.
Of the ten oriental inoculations already in use, only the Gamaleya and one of the Chinese (CanSino) use this system, the human adenovirus. The rest have been created using the coronavirus itself or parts of it, a technique out of use in Western countries. “These vaccines require cultivating the virus itself in the laboratory, inactivating it by exposing it to chemicals,” explains Adelaida Sarukhan, a researcher in emerging viruses at the Institute for Global Health (ISGlobal).
The coordinator of the covid-19 vaccine project at the Hospital Clínic-IDIBAPS in Barcelona Felipe García recalls that in the West “there is a tendency not to investigate in this field, since they present a series of problems.” On the one hand there is security, since “you have to be very sure that the virus is completely deactivated”. On the other hand, he adds, “as the virus is dead, its ability to activate the immune system is reduced.”
But what García and Sarukhan question most is the lack of transparency and public scrutiny of their essays. None of the eastern inactivated virus vaccines have published the results of their latest clinical trials or have been reviewed by other scientists. Only the CoronaVac of China Sinovac publicized those of its first human trials in the magazine The Lancet. But, if official statements and statements are heeded, their effectiveness ranges from 50% to 79%. “Their levels are more modest, but the latest results are yet to be known,” recalls Sarukhan.
Despite this, more than 50 countries have bought one of the three Chinese vaccines or the Indian Covaxin, all of inactivated virus. And they have their advantages: it is a mature technology in which China and India have experience. Industrial-scale production is simpler and cheaper, and both countries have the infrastructure to produce millions of doses every day. In addition, they do not need the extreme cold that they demand, for example, RNA vaccines from Moderna and Pfizer. The temperature problem is causing these two Westerners to barely distribute themselves in sub-Saharan Africa.
The founder of SciTech Africa, Uwagbale Edward-Ekpu, argues that of Western immunizations, “AstraZeneca’s is the most suitable covid-19 vaccine for the continent, since it is cheaper and African countries already have the chain infrastructure of cold of 2-8 degrees centigrade that it requires ”. In fact, it is the one that COVAX is distributing on the African continent. This initiative, promoted by the Coalition for Innovations in Preparedness for Epidemics, the GAVI Vaccination Alliance and the World Health Organization (WHO), has already begun to distribute the vaccines and they expect to distribute 75 million until May of the 2,000 million that will be delivered between this year and next year.
But COVAX only finances the vaccination of 20% of the population, the rest of the vaccines have to be bought. That is why Edward-Ekpu, also a collaborator of the Milken Institute’s Covid surveillance platform in Africa, believes that Orientals have their place in Africa: “Despite initial skepticism, several African countries had already opted for the Chinese Sinopharm vaccine and Russia’s Sputnik due to lack of access to Western vaccine. With more data showing that they are effective and safe, combined with the diplomatic effort that Russia and China are making to promote their vaccines in Africa, I believe that more African nations will end up buying them from Chinese and Russians whether or not they have access to Western vaccines. “
Sinopharm, a Chinese state company, has already shipped batches of its vaccines throughout the African continent, from Morocco in the north to Zimbabwe in the south, via Senegal or Equatorial Guinea. There are countries like Egypt that have bought 20 million doses. And in Asia, the Chinese government is donating it in lots of 100,000 to a dozen countries.
Leaving aside the cases of Peru and Argentina, which have agreements with Sinopharm to receive 38 and 30 million doses respectively, the one that triumphs in Latin America is another Chinese one, that of Sinovac, with contracts with a dozen countries. Like the previous one, it is a company controlled by the Chinese government. It has been tested in Chile and Brazil, countries that have entrusted a large part of their vaccination plan to this vaccine. For example, the Andean country, set as a model of success in immunization, has bought 60 million doses of CoronaVac from Sinovac and they do not reach 20 million inhabitants. Brazil has taken over 100 million, but it has 10 times more population than Chile, according to data collected by UNICEF. In third place appears that of CanSino, the only Chinese that uses adenovirus technology. Mexico has bought 35 million doses from them.
Darkened by the pervasiveness of Russian and Chinese vaccines, India appears in the background. But it is likely that, when everyone is vaccinated, the relative majority of those vaccines will have been Indian, especially in emerging and less developed countries. The pharmaceutical companies of the subcontinent produce 60% of the vaccines that are put in the world. The largest, the Serum Institute, has a production capacity of 1.5 billion doses a year and is building another plant to add another 1 billion. The main Westerners are already packaging their formulations on the subcontinent.
But original to Indian science is Covaxin, another inactivated virus vaccine and, again, coming out of a public company called Bharat Biotech. Although they have not been reviewed by the scientific community, the results of its clinical trial point to an efficacy of 81%. However, despite being approved in a dozen countries, the leading role is taken by Covishield, the Serum Institute vaccine. It is actually none other than the AstraZeneca manufactured under license. The COVAX platform has already committed 1.1 billion doses with an option to another 900 million and many countries are buying from the Serum Institute instead of AstraZeneca. By the way, the pharmaceutical company incia is carrying out a trial with Russian Sputnik V and could manufacture it on a massive scale.
María Belén Herrero is a researcher at the Latin American Faculty of Social Sciences in the field of international health and sanitary sovereignty. For her, vaccines from the east “are competing for the stage against large western pharmaceutical companies.” In fact, he says “in Latin America they would not have been able to start the vaccination processes if it weren’t for these vaccines.”
But Guerrero warns that Russian, Chinese and Indian vaccines will not be enough. “They confirm the individualistic logic that has prevailed since the beginning of the pandemic, who for himself”. What they have served for is to highlight “the importance of promoting and strengthening public production.” Not surprisingly, only two of the ten oriental vaccines in use are the result of private companies. In the West, no vaccine is public, although it is financed with public money. Finally, the Argentine sociologist misses global mechanisms that work.
That global mechanism was to be COVAX. As Virginia Rodríguez, an expert in political advocacy at ISGlobal, recalls, “the initial idea was to create a mechanism to distribute vaccines globally in an equitable way”. But by imposing the individualistic logic outlined by Guerrero, “the richest countries have prioritized their interests: immunize their population first.” When the states with more resources began to buy and hoard, “it was seen that COVAX, due to its purchasing aggregation, became a tool for middle-income countries. The poorest depend on donations to the system and surplus vaccines and they will take a long time to arrive ”. Here, Rodríguez concludes, “is where the gap opens for Russian and Chinese vaccines.”
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