Aiming to ‘lead the world’ by winning the vaccine race

They weren’t just vaccine volunteers. They were “revolutionary comrades in arms,” nearly 200 mostly young, brave souls putting their bodies on the line for China and for the world.

“I’m not afraid,” said Zhang Jing, a vaccine trial volunteer, as she and her husband, Zhao Wei, rolled up their sleeves to receive injections, according to a report in the Communist Party newspaper People’s Daily. Zhao worried that their child would be orphaned if they didn’t survive. But Zhang said: “I believe in the motherland.”

Such is the heroic narrative Beijing is promoting as China, having largely contained the coronavirus outbreak within its borders – though fears of a second wave recently struck the capital – sets its sights on the ambitious goal of developing the first COVID-19 vaccine.

Just as the battle to beat the virus was framed as a “people’s war,” so the global race to create a vaccine is portrayed as a patriotic effort, part of a decades-long goal to prove China’s strength as an emerging scientifically advanced state.

The quest for a vaccine is a chance to salvage this country’s image from being the source of the virus to becoming a saviour to stem its spread. It is a critical time — especially as the United States withdraws from its leading role in many international institutions — to persuade the Chinese people, struggling with economic crisis and mass unemployment, that theirs is still a powerful nation.

The pressure to win is entangled in global politics driven by Chinese leader Xi Jinping and President Trump — strong nationalists whose relations have become increasing strained over the virus’ origins and its devastating impact across the planet.

“It’s almost a manhood type of competition between Trump and Xi Jinping,” said Lawrence Gostin, professor of global health law at Georgetown University and an advisor to the World Health Organization. “It’s a competition not just for health, but for national prestige, and for which system is a better system. So the stakes are extraordinarily high.”

More than 130 candidates for the vaccine are under development around the world, but only 10 of them have entered clinical trials, according to a recent update from the WHO. Half of those are Chinese.

“While scientists in China and abroad have kept up with mutual developments, China leads the world in the development of certain types of vaccines,” the State Council said in a white paper on China’s coronavirus response.

The highest-profile candidate is a vaccine developed by bio-pharmaceutical company CanSino Biologics in partnership with the Academy of Military Medical Sciences, which belongs to the Chinese military. The research team is led by an epidemiologist, virologist and major general named Chen Wei.

“A vaccine is the most powerful weapon to end the novel coronavirus,” said Chen, 54, in an interview on state TV in March. She often appears in the media wearing a military uniform and surgical mask and is called a “goddess” on Chinese social media.

“If China is the first to develop this weapon with its own intellectual property rights, it will demonstrate not only the progress of Chinese science and technology, but also our image as a major power,” she said.

CanSino is developing a virus vector vaccine, which uses a different virus to carry a piece of the coronavirus’ genetic material into the patient’s cells, teaching the patient’s body to recognize and react to it.

The results of CanSino’s Phase I trials were published in the Lancet, the medical journal, last month. They found that the vaccine was mostly safe and produced an immune system reaction in all 108 trial members – a preliminary but inconclusive sign that it could be effective. The vaccine created adverse reactions, including fever and fatigue. The symptoms didn’t last long, and the drug passed Phase I safety requirements.

CanSino now has 500 people in Phase II trials. It recently signed an agreement to manufacture and potentially continue clinical trials for the vaccine in Canada.

The other four Chinese candidates in clinical trials are working on a more traditional type of vaccine that uses a weakened or inactivated version of the coronavirus to trigger an immune response. One of those developers, Sinovac Biotech, signed an agreement last week to produce and test its vaccine in Brazil, where 9,000 volunteers have signed up for a Phase III trial in July.

Brazil, which has more than 800,000 infections, second only to the United States, could provide in ideal testing ground. In exchange, the Brazilian research partner, Instituto Butantan, will get to license the vaccine and ensure Brazilians’ access.

Another vaccine candidate by the University of Oxford and British-Swedish company AstraZeneca – supported by Operation Warp Speed, the Trump administration’s COVID-19 vaccine initiative – is also testing their vaccine on 2,000 volunteers in Brazil. An American vaccine candidate developed by Cambridge-based Moderna Inc. is, meanwhile, set to conduct phase III trials on 30,000 people in the US next month.

The incendiary rhetoric over the virus – Trump repeatedly blames China for the spread of the disease – is the latest turn in a new Cold War between Beijing and Washington. Comparisons of the vaccine race to a “Sputnik moment,” where China and the US vie for superiority, place pressure on scientists to lower safety standards for geopolitical interests, said Gostin, the advisor to the WHO.

“It is very dangerous to call it a race,” he said. “It’s playing with fire.”

But that is what it has become, with billions of dollars and prestige at stake across continents. China’s fast-tracking vaccine development has led to ramping up production capacity while allowing unconventional practices like combining the first two phases of clinical trials. Such moves can lead to safety risks.

Vaccine developers in the United States and Europe are taking similar shortcuts – conducting human trials before animal trials have been completed, for example – despite scientists’ warnings against compromise of safety standards.

US-China competition also hurts global efforts to coordinate vaccine development and ensure distribution goes those who need it most. In past outbreaks like H5N1 in 2007 and H1N1 in 2009, wealthy nations quickly bought up vaccines, leaving poorer countries empty-handed until much later.

The WHO and other international organizations are working to prevent such a scenario, and recently received $8.8 billion in global pledges for cooperative COVID-19 vaccine development. But beyond funding and rhetoric, the WHO needs commitments, especially from China and the US, to a needs-based distribution of vaccines.

The politics of a vaccine is just as complicated as the science. If China gets a vaccine first, the US is unlikely to use it because of distrust in Chinese data, said Bonnie Glaser, director of the China Power Project at the Center for Strategic and International Studies.

“People would be sceptical and concerned about the safety and efficacy of a Chinese vaccine,” she said. Even within China, recurrent vaccine and food safety scandals have caused a crisis of public confidence in regulatory authorities, despite their endorsement by the WHO.

But other countries, especially those in the developing world, would likely be “just fine with it,” she said.

Alice Su, Tribune News Service