Calling the Shots through Health Diplomacy: China’s World-Wide Distribution of Anti-Covid Vaccines and the International Order

The donation and sale of vaccines are diplomatic tools that have impact well beyond health policies. May Chinese Covid-related vaccine diplomacy be understood beyond reactive terms vis-à-vis power disputes with the West, in particularly the United States? We then scrutinize the drivers of China’s vaccine diplomacy, assessing whether Beijing privileged the expansion of its diplomatic leverage in the Global South. By employing logit and tobit models in the analysis of a cross-sectional dataset covering 213 countries, we examine the probability of countries receiving vaccines from China. We find that low-income states, in particular, and middle-income ones and those with more Covid deaths were more likely to receive vaccines through either donations or purchases. For donations, states that integrate the Belt and Road Initiative (BRI) and/or oppose the United States at the United Nations General Assembly (UNGA) were also privileged. China’s vaccine diplomacy has therefore a twofold purpose. First, the expansion of the country’s soft power in the Global South. Second, the consolidation of the BRI bilateral ties and an anti-US allied network. Hence, current global health initiatives cannot be detached from debates on the contestation of the liberal international order (LIO) and China’s dual role as a responsible stakeholder and most successful emerging power that has the potential to challenge American hegemony. Moreover, the findings also suggest that bilateral donor-recipient flows may be less politicized than what prior works on development aid and health diplomacy have claimed.