As cases of coronavirus once again soar in Pakistan, volunteers are accepting shots of an experimental Chinese vaccine.
Thousands of participants are being recruited to trial a vaccine from Chinese manufacturer CanSinoBio as part of an agreement that will reportedly see Pakistan receive millions of doses of any successful shots.
Pakistan and other countries in Asia and Africa are used to receiving huge Chinese investment to build highways, ports, railways and powerplants. Now the Covid-19 pandemic has provided Beijing with a new soft power tool, as it uses its medical expertise to bolster global ambitions.
Under this vaccine diplomacy, countries are helping Chinese scientists host vaccine trials in return for sharing the finished drugs when they are available.
China has also joined a United Nations-backed global scheme for the distribution of Covid-19 vaccine, which has been shunned by US president Donald Trump - it is not clear yet whether President Elect Joe Biden will change tact and sign up.
Recent polling has shown growing public suspicion of China in the West, partly amid accusations it bungled or covered up the early stages of the pandemic. There has also been growing scepticism of China's Belt and Road initiative to build a twenty first century Silk Road across Asia.
The country's vaccine programmes have offered a new opportunity to build trust in the developing world and secure its own people, said Yu Jie, senior research fellow on China at the Chatham House think tank.
“We know from this pandemic, that no country is alone, China itself cannot completely eliminate Covid-19. Imported cases always come from neighbouring countries of China.
“In a way yes, China is conducting vaccine diplomacy, but to some extent China is also helping itself because if all the neighbouring countries get out of this pandemic, then China will be safer.”
China's early success quashing the coronavirus outbreak, which first emerged in Wuhan, has also left vaccine developers with the problem of needing to conduct efficacy trials in countries where volunteers stand a chance of catching the disease.
Trials of Chinese vaccines are underway in Pakistan - where officials have said they will in return receive millions of doses on a priority basis - as well as Brazil, Russia, Mexico and Saudi Arabia.
China has a well established drug manufacturing sector but until now has not been a leading vaccine maker, said Ben Cowling, professor of public health at Hong Kong University.
He said Chinese Covid-19 vaccine development had stuck to tried and tested methods of using inactivated virus, rather than some of the new genetic technologies used by Pfizer and Moderna. As a result, its vaccines may not work as well, but they were likely to be cheap and straightforward to manufacture.
“They really do represent possibilities in terms of vaccinating in Pakistan, other parts of the world, Asia, Central Asia, the Middle East, South America.
“I think a lot of countries will be very interested in getting hold of these Chinese vaccines and Chinese vaccine manufacturers will be very interested in opening up those markets to their vaccines.”
China's manufacturing might will be invaluable for creating the vast volumes of vaccine needed in the coming months, he said. As many as 10 billion doses could be needed in the next two years and Western manufacturers would not be able to cope, said Prof Cowling.
“So the Chinese manufacturing capacity is going to be valuable, not necessarily for Europe, but for places, like Pakistan, Africa and other parts of the world.”
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