How China’s Pledge to Give Its Virus Vaccine Could Go

(Bloomberg) --

Chinese President Xi Jinping has pledged to make any effective vaccine against the coronavirus that is developed by China accessible and affordable globally as a “public good.” His vow came after some drug makers suggested that countries providing funding for their work will get first dibs, spurring a debate over “vaccine nationalism.” If successfully executed, China’s move could help defuse criticism of its early response to a disease, now called Covid-19, that first emerged in the Chinese city of Wuhan and has since killed more than 315,000 people around the world. It also could boost China’s global standing, especially among poorer countries, as U.S. President Donald Trump threatens to cut off American funding for the World Health Organization.

1. What’s the status of China’s vaccine development effort?

China is a frontrunner in developing coronavirus vaccines. As of mid-May, it had five candidates in human trials and over 2,000 people enrolled in phase II trials, which are meant to show if the vaccine is safe and can elicit an immune response from the body. No serious side effects had been reported as of that point, according to Zeng Yixin, vice minister of the National Health Commission. The vaccines are being developed by Chinese companies in partnership with academic institutions and backed by state resources, including the military. To gauge its efficacy, a vaccine will need to go through phase III testing in a place where the coronavirus is still spreading rapidly to see if it keeps vaccinated people free of infection compared to those who didn’t get shots. Since the spread has apparently been checked in China, two Chinese developers, CanSino Biologics and Sinovac Biotech Ltd., are in talks with other countries including Canada to conduct testing.

2. How would China distribute a vaccine globally?

China has worked with the WHO and Gavi, a global non-profit organization focused on vaccine delivery that’s backed by the Gates Foundation, to become an influential player in international vaccination programs in the past decade. But before they would distribute it, any Covid-19 vaccine must first get a WHO stamp of approval known as “pre-qualification,” which assures developing nations that the vaccine has been deemed safe and effective. The amount of time that takes varies case by case.

3. Has China done something of this scale before?

The closest China may have come to global vaccine distribution on this scale is the 30 million doses of Japanese encephalitis shots it supplied from 2014 to 2018 through Gavi to countries such as Cambodia and Nepal. It also delivers more than 700 million shots per year at home. Up to 95% of vaccines administered in China are produced domestically, reflecting its vast manufacturing capacity. It also has recent experience in developing a vaccine for a novel disease and then rapidly administering it widely -- in chickens. In 2017, China’s successful vaccination program to immunize hundreds of millions of poultry against the H7N9 virus saw cases of infection drop by over 90% and helped stop the spread of the disease to humans.

4. What are the challenges?

A 2018 scandal that uncovered instances of Chinese vaccine-makers cutting corners in production has undermined public confidence and given the industry a bad global reputation. After the incident, Beijing passed new laws carrying hefty fines to police the industry. There’s also the question of finding other countries willing to allow phase III testing. Several times Chinese vaccine efforts went nowhere because the diseases they targeted were stamped out or never broke out widely within China. For example, efforts by China National Biotec Group and Sinovac to develop a SARS vaccine fizzled when the virus disappeared after infecting more than 8,000 people in 2003.

5. What happens if China isn’t first?

It could still play a big role. A promising effort by American drug maker Moderna Inc. employs an experimental method in which the vaccine carries the genetic sequence of the virus in order to stimulate the body’s immune response. There’s no precedent involving this technique, however, so it’s unclear if such a vaccine could be manufactured at scale quickly to meet demand. In contrast, most of the five Chinese vaccines in development are based on inactivated viruses -- a relatively low-tech and time-tested method for which significant production capacity already exists. Even if China does not cross the finish line first, it may still find it easier and faster to churn out millions of doses for global distribution.

The Reference Shelf

• WHO document on Covid-19 vaccine candidates.
• A 2014 paper on China’s entry into the global vaccine market.
• WHO standards to prequalify vaccines for the UN.
• Study of China’s chicken vaccination program to eliminate H7N9.
• Bloomberg’s tracker of the drugs and vaccines being developed for coronavirus.
• A QuickTake review on what is and isn’t known.

©2020 Bloomberg L.P.

With assistance from Bloomberg