Will vaccinations be a saviour for the Middle East?

Life continues as normal in Dubai, despite COVID-19 (Shutterstock)

How will Dubai fare in the long term? By those who live there, "very well", I'm told. "It's the best place in the world to be in", they say. And it's mostly to do with vaccinations. The Gulf Cooperation Council (GCC) countries have very effectively vaccinated much of the population, so they maintain. But how effective is the vaccination? The GCC countries have relied greatly on the Chinese vaccinations, Sinopharm in particular. Even the Chinese authorities have questioned its efficacy. What does it mean for these countries in the long-term? This article explains some issues that must be considered.

Low efficacy rates mar China's COVID diplomacy in Gulf states

After a top Chinese health official acknowledged that the Chinese-produced vaccines have lower efficacy rates, will Gulf states using the product turn to other providers?

Sabena Siddiqui for Al Monitor

April 30, 2021

While flight suspensions and vaccine-linked travel curbs continue to impact the states of the Gulf Cooperation Council, most of the latter have ramped up their vaccination campaigns. Nearby countries like India are in crisis and the Arab states would like to be risk-free zones.

The vaccine has been made virtually compulsory and, in some states, most leisure activities have been limited to those who have gotten the shot. Upgrading public health security, Abu Dhabi is even mulling measures to restrict the movement of some unvaccinated workers.

Saif al-Dhaheri, spokesperson for the National Emergency Crisis & Disaster Management Authority, announced April 21, "The vaccine is our best means to recover and return to a normal life." Having administered at least 3.8 million doses, Abu Dhabi has achieved a vaccination rate of 100.1 doses per 100 residents. The country is using multiple vaccines, each of which require two doses.

However, the vaccines' efficacy has become an emerging concern. Despite the mass inoculation, the UAE suddenly saw a spike with 1,903 new cases in one day in mid-April and there have been several fatalities recently. Due to easy availability and Beijing's "vaccine diplomacy," most of the GCC states had opted for Chinese vaccines last year. The UAE also started producing and distributing the Chinese brand Sinopharm's BBIBP-CorV vaccine.

Abu Dhabi has made the Pfizer-BioNTech vaccine available in the emirates as a second option to Sinopharm. Saudi Arabia has also been using more of the Pfizer product. The effectiveness of Chinese coronavirus vaccines is much lower than expected, confirmed Beijing's top disease control official.

Giving a presentation on Chinese COVID-19 vaccines and immunization strategies at an April 10 conference in Chengdu, Gao Fu, the director of the Chinese Center for Disease Control and Prevention, said, "We will solve the issue that the current vaccines don't have very high protection rates. It's now under consideration that we should use different vaccines from different technical lines for the immunization process."

Fu said that extra shots could be administered or different vaccines could be mixed to create boosters. China has exported the vaccines to 43 countries and donated doses to 69 developing countries. More than 60 countries have authorized the use of the Chinese vaccine.

Isaac Bogoch, an infectious diseases specialist at the University of Toronto, observed to Al-Monitor, "It was very interesting to hear senior Chinese scientists discuss the lower-than-expected efficacy of some locally developed vaccines."

"While transparent scientific dialogue is important, and while it is helpful to hear that they are working to improve vaccine efficacy, the current vaccines may not slow the pace of COVID-19 transmission in several countries that have accepted these products. This may unfortunately prolong the health and economic burden of the pandemic in these countries."

Having relied heavily on Chinese vaccines, several GCC states might have to rethink their health programs. Last month, a third shot of Sinopharm was advised in the UAE as the first two shots had failed to build sufficient antibodies. Versions by Sinovac and one by CanSino have been in use but neither is recognized by the World Health Organization.

In the recently released Phase 3 results, Sinovac's vaccine has underperformed in clinical as well as practical trials. Yielding an efficacy rate of 50.7% in trials conducted on health care workers in Brazil, the vaccine scored 49.6% in real-world trials. For asymptomatic cases, the figure dropped to just 35.1%.

In comparison, Pfizer-BioNTech and Moderna have reported efficacy rates of 97% and 94%, respectively.

Discussing the GCC's options, Lukasz Przybyszewski, West Asia analyst for the Asia Research Center at Warsaw's War Studies Academy, told Al-Monitor, "Some countries in the MENA might decide to switch to more reliable vaccines, at least until Chinese companies develop a more effective version. But one has to remember that in some cases politics and costs will be the key drivers behind the decision-making."

The matter could undo some of Beijing's vaccine diplomacy. Having formally announced a "Health Silk Road" to work in tandem with its Belt and Road Initiative objectives, China had planned regular vaccine exports to BRI partner countries.

According to Moritz Rudolph from the German Institute for International and Security Affairs, "China's health diplomacy is farsighted and strategic. Beijing has been linking measures to combat the COVID-19 pandemic in aid-recipient countries with the prospect of post-pandemic cooperation within the BRI framework. Above all, Beijing wants to be perceived internationally as a responsible great power."

Second, low-performance vaccines can complicate the ongoing health campaigns of the countries using them and China will need a broad-based strategy to manage booster programs in many different places. The countries using the Chinese shots will consider Western vaccines a better option and there may be trust issues.

In fact, China itself is also turning toward a German vaccine.

According to the latest reports, Beijing might authorize Germany's BioNTech SE and health officials are currently reviewing its clinical trial data. If it is cleared, it will be made available within the next 10 weeks, the first foreign COVID-19 vaccine used in China.

Finally, having opened up economic activities while most of the world was in the lockdown phase, China had gone back to normal at a time when the pandemic hit its peak in the West. As a result, the International Monetary Fund had forecast an 8% economic growth rate for China in 2021. But low-performing vaccines can slow down China's return to normalcy if the virus strikes again.

According to clinical trial registration data, Chinese researchers have already started testing a mixed booster shot by combining vaccines developed by CanSino Biologics and a unit of Chongqing Zhifei Biological products. If the concept does not work, Beijing might have to turn to mRNA shots that have better success rates.



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Wednesday, 12 May 2021