Scrutinizing the Political and Economic Dynamics of China's Distribution of Vaccines in Securitizing Health

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Christou Immanuel; Theo Gerald Parluhutan Napitupulu Scrutinizing the Political and Economic Dynamics of China’s Distribution of Vaccines in Securitizing Health

Scrutinizing the Political and Economic Dynamics of China’s

Distribution of Vaccines in Securitizing Health

Christou Immanuel; Theo Gerald Parluhutan Napitupulu 10.22146/globalsouth.63086 University of Indonesia Universitas Brawijaya, Indonesia [email protected]

In the previous Pandemic of the H5N1 virus, the world is facing an uneven distribution of the vaccine. The irony is that developed countries get more access to vaccines compared to the country with more cases especially the global south countries. Today, the world is facing another pandemic which is The Covid-19 Pandemic. The vaccine has been developed, but after the vaccine is successfully produced, there is no assurance that the vaccine will evenly be distributed as mandated by WHO. Based on these considerations, the researcher aimed to project the possibilities of vaccine distribution from China to Global South countries. Researchers want to analyze the influence of a country’s economic capacity and international politics on vaccine distribution, especially with China by using analytic qualitative research. We will compare the political and economic situation during the H5N1 pandemic and the political and economic situation during the Covid-19 pandemic. Countries used for comparison are Kenya, Yemen, the Philippines, and Indonesia. These four countries were chosen because they could represent different conditions of political and economic relations. The main finding is how North countries tend to prioritize South countries with a stronger political and economic bond to be the destination of its Covid-19 vaccine distribution.

Keywords: Vaccine Distribution; Healthcare Security; Political and Economic Condition

Introduction vaccine to combat the pandemic. However, The Pandemic of the H5N1 virus has after the vaccine is successfully produced, exposed the uneven distribution of the vaccine. there is no assurance that the vaccine will It is rather ironic that developed countries evenly be distributed as mandated by WHO have more access to vaccines compared to (Mellen, 2020). In the previous outbreak of the other countries with more confirmed cases, H5N1 virus, some developing countries cannot especially in the Global South. In 2020, the afford access to vaccines due to the insufficient world is facing another pandemic called The mechanism to ensure the availability of Covid-19 Pandemic. the vaccine. In 2009, when the H1N1 virus The Covid-19 vaccine was initially dispersed across state borders, the US has discovered by Russia, despite the lack of pre-ordered approximately 30% to 60% of the international trust. But on the other hand, world’s projected production of vaccines even China has the most potential to produce a before it was declared as a pandemic.

Global South Review 189 Christou Immanuel; Theo Gerald Parluhutan Napitupulu Scrutinizing the Political and Economic Dynamics of China’s Distribution of Vaccines in Securitizing Health

Based on these considerations, the between the authorities who promote each researchers aimed to project the possible other’s foreign policy interests through formal scenario of vaccine distribution from China cooperation or tacit understanding. However, to Global South countries. This is important diplomacy is not always carried out by as the vaccine distribution draws a great professional diplomats. Diplomatic activities concern over the south countries, considering can also be carried out by other authorities or its high impacts on the domestic economy. The private individuals under the direction of an authors would like to analyze the influence of a official or leader (Gurgu, 2016). Together with country’s economic capacity and international the Balance of Power, which is reflected and politics on vaccine distribution, especially strengthened, diplomacy is one of the most with China. To achieve this objective, we important institutions in a society. Bilateral and will examine the political and economic multilateral agreements are tools of diplomacy. situation during the Covid-19 pandemic while Diplomatic relations between countries can looking at several aspects and conditions in cover all sectors such as economy, health, the distribution of vaccines during the H5N1 security, environment, education, and others. It pandemic. To understand comprehensively the depends on the agreement between the parties political and economic aspects of the vaccine involved on what sector or theme to discuss. distribution, we would like to provide the The focus of diplomacy in this paper is health readers with several concepts such as health diplomacy. According to the World Health diplomacy, multilateral cooperation, bilateral Organization (WHO), the main objectives of and multilateral cooperation, health securities, health diplomacy are; 1) Better health and public as well as global north and south cooperation. health security, 2) improving relations between These factors would cover the political and countries and the commitment of various actors economic variables of the vaccine distribution. to work together and improve health quality, and 3) achievement of the proceeds from the Health Diplomacy proceeds will be used to support the goals of Diplomacy is an important political reducing poverty and increasing equity (World activity that acts as a major instrument of force Health Organization, n.d.). Health diplomacy and plays a significant role in the distribution can cover many things such as cooperation on of the vaccine. Sharp defines diplomacy as a public health, health security, health facilities, synonym for statecraft, foreign policy, and collaborative research and development of international relations, as well as the making of new vaccines, improving the quality of health foreign policy by practitioners (Sharp, 2003). human resources, and so on. Magalhaes sees diplomacy as defined through four prisms: (1) foreign policy instrument, Multilateral Cooperation foreign policy, international negotiations, and Multilateralism is a well-known term the activity of diplomat (Hart & Siniver, 2021). in the context of diplomacy. This is also a tool Diplomacy usually begins with communication used by several countries to help them provide

190 Global South Review Christou Immanuel; Theo Gerald Parluhutan Napitupulu Scrutinizing the Political and Economic Dynamics of China’s Distribution of Vaccines in Securitizing Health themself with vaccines. To make a clear that a country will pursue its national interests context on this paper, we take the definition to obtain maximum benefits and the only way of multilateralism from John Rugie (1992). to achieve this goal is to establish good and He defines multilateralism as an idea of “an sustainable relations between countries. architectural form” as well as an organizing In bilateral cooperation, the issue of principle of international life. Multilateral cooperation discussed is an issue that is shared is considered as a principal organizing by the two countries. In international relations, organization that involves cooperative the process of bilateral cooperation between activity between many countries. Multilateral two countries can be determined through three cooperation is a form of cooperation between main motives, namely: 1) maintaining national countries, ranging from three to an unspecified interests, 2) maintaining peace and, 3) improving number of countries. Not all cooperation is people’s welfare. Cooperation between the two multilateral, but all multilateral activities countries can cover various types of sectors require cooperation. such as economic, environmental, social, The urgency of this type of cooperation security, and health (Chinatsu, 2018). was motivated by the fact that some of the Bilateral cooperation will be carried problems that the world is facing cannot simply out if the cooperation has the potential to be solved alone. Pandemics, natural disasters, generate benefits that can be used to achieve development problems, and climate change are national interests. This cooperation usually some of the problems that need cooperation begins with a discussion of what cooperation between countries to solve. These problems to undertake and culminates in the signing and challenges demand collective action as they of a Memorandum of Understanding (MoU) only can be defeated if no one is left behind. and then enters the implementation stage. This is what underlies why multilateralism Subsequently, a supervisory team from the two plays a significant role? in this unprecedented countries will be formed to work together to era. We cooperate to combat our common monitor and evaluate the processes and outputs problem as well as cross-border threat. of the cooperation that has been carried out.

Bilateral Cooperation Health Securities Interactions between countries can take Security is a fundamental element the form of bilateral and multilateral relations. that determines the survival of an individual, These interactions made vaccine distribution community, organization, and state. This is possible. Bilateral cooperation itself is a concept that is strongly linked to vaccine cooperation between two countries. Bilateral distribution as the health securities are one of cooperation is a cooperative activity that is the core elements that the world leaders are directly supported by one country to another and attempting to protect by providing the vaccine. vice versa. Kishan S. Rana (2002) argues that When we talk about security, it is difficult to in bilateral diplomacy the main concept used is come up with a universal definition that is

Global South Review 191 Christou Immanuel; Theo Gerald Parluhutan Napitupulu Scrutinizing the Political and Economic Dynamics of China’s Distribution of Vaccines in Securitizing Health accepted by everyone. However, security can chemical disasters and radiation hazards. 7) lack be said as a condition that is free from threats. of food supply and, 8) poverty (Chiu et al., 2009) Barry Buzan (1991) states that security is a however, do not share a common definition of powerful tool for a political power to get the health security. This article aims to characterize attention that is the interest of a country or a the notions of health security in order to clarify certain group in the competition for government what constitutes the nexus of health and security. attention. At present, the focus on security The concept of health security has evolved issues has shifted from high political issues, over time so that it encompasses many entities. such as war, toward low political. The authors Analyzing the health reports of four multilateral pivot on health security issues. organizations (the United Nations, World Health becomes a security issue as a Health Organization, Asia-Pacific Economic result of the shifting focus of security from Cooperation, and the European Union. According military threats to long-term threats that are to WHO, the biggest threats to world health more widespread and visible after the Cold security are pandemics, health emergencies, and War. Other factors that make the health sector a weak health system which not only threaten become a security issue because the health human lives but have a far greater impact (World sector is universal global importance beyond Health Organization, 2018). political, cultural, and social interests. There are various definitions of health safety. In 1994, Global North and South Cooperation UNDP issued a Human Development Report To reach health security, several south and mentioned health safety in the report. In countries establish cooperation with north this report, health safety is aimed at ensuring countries. The term Global North and the protection from diseases and an unhealthy Global South itself are used to describe and lifestyle. In the Global South countries or differentiate two types of countries namely the developing countries, the main cause of death industrialized and rich countries in the North is infection. and the less industrialized and poor countries, The Commission on Human Security mainly in the Southern hemisphere of the earth. (CHS) in its 2003 report said that health is not Despite the geographical location, several North only free from disease, but also a complete mental, countries with a high level of industrialization physical, and social state, with good health as the located in the Southern hemisphere. This foundation of human security because security also applies to some of the less industrialized is about protecting human life (Commission on countries in the northern hemisphere. Human Security, 2003). Common themes that This division uses some parameters such fall into the scope of health security are: 1) new as productivity, life expectancy, unemployment, diseases such as Covid-19, 2) infectious diseases, and Gross Domestic Product (GDP) per head. 3) deliberate use of chemicals and biology, 4) Political reasoning also contributes to the violence, conflict, and humanitarian emergencies, division of North and South countries. The 5) environmental change and natural disasters, 6) Global South countries tend to form a coalition

192 Global South Review Christou Immanuel; Theo Gerald Parluhutan Napitupulu Scrutinizing the Political and Economic Dynamics of China’s Distribution of Vaccines in Securitizing Health since the developing countries mainly have a Current Vaccine Inventors and Distribution common history of colonization. Plan during Covid-19 Both North and South countries held Before the vaccines were authorized to cooperation. We can see clear cooperation be distributed, the Covid-19 vaccine candidates between North and South countries after World must pass several steps of development War II where the east and west block was trying (Corum et al, 2020). First, vaccine candidates to influence the newly independent countries. should be tested in animals to see the effect on Countries like the USA and the Soviet Union animals’ immunities. After a successful test gave aid to countries in the Global South since on animals, scientists will proceed to the next these Global South countries gained attention step which is the Phase 1 Safety Trials. In this amid the cold war. phase, scientists will test the vaccine on a small In the present day, cooperation group of people to measure the dosage, safety, between the North and the South is also and level of effectiveness of these vaccine driven by political and economic interests. candidates to stimulate the immune system. This cooperation generates dependency of the The third step will be the Phase 2 Expanded Global South countries on the Global North Trials. This phase similar to the previous phase. countries (Pollins, 1985). On the other hand, The Phase 2 Expanded Trials aims to test the this cooperation also helps the modernization vaccine’s safety and effectiveness, but the test of the Global South countries. This kind of subjects are hundreds of people split into groups cooperation is still essential since every country, of age to see how it affects people of different regardless of the North or the South country, ages. The last step before early approval is the holds a certain interest of other countries, not Phase 3 Efficacy Trials. This trial uses larger only for charity reasons. groups of tests. It can involve thousands of volunteers to see how many become infected. Precedent Vaccine Distribution This trial will also reveal rare side effects that The Covid-19 pandemic is not the first might not be found in previous trials. pandemic in the modern era. Previously, the After series of tests, the vaccine world was facing the H5N1 pandemic. In 2008, candidate will be eligible for approval. This the H5N1 virus outbreak spread across the world, approval splits into two types. First, the early or especially in Asia, Europe, and some parts of limited approval. This approval is given to the Africa. Due to the insufficient mechanism to vaccine candidates that are still waiting for the ensure the availability of the vaccine, some Phase 3 test result but due to the urgent need, developing countries could not afford access it will be distributed for limited use only. The to vaccines. Some developed countries had second type is Approval which is granted to the purchased the vaccine in advance and left the vaccine candidates that have already passed the developing countries like Indonesia, which had whole step of the vaccine test. Currently, China one of the largest amounts of a confirmed case, and Russia are the leading countries in the nothing to purchase (Kamradt-Scott, 2020). development of the Covid-19 vaccine. Russia

Global South Review 193 Christou Immanuel; Theo Gerald Parluhutan Napitupulu Scrutinizing the Political and Economic Dynamics of China’s Distribution of Vaccines in Securitizing Health is the fi rst country to register its Covid-19 the political relations between China and vaccine, namely the Sputnik V. Foreign Kenya, Yemen, Indonesia, and the Philippines scientists remain skeptical on the vaccine since as Global South countries which are used as there is no evidence from a large scale of tests, examples in this paper. or in other words, Russia skipped the Phase 3 The reason these four countries were Trials (Ellyatt, 2020). Meanwhile China, as a chosen to represent the global south country country where Covid-19 was fi rst reported, is in cooperation with China is that these four also leading the development of the vaccine. countries have various economic and political Several vaccines have already been relations and interests with China at different granted limited approval from the government. levels. In addition, the four countries have These vaccine candidates are on the Phase 3 different economic and political powers which Trials in several countries. China tested the will infl uence China’s willingness to cooperate vaccine candidates in some South countries with them. such as Argentina, Brazil, and Indonesia. These But fi rst, we need to see how big the countries are not leading on developing the economic strength of each country is. We can vaccine, but in great need of vaccine since they see the economic strength of each country from have a worsening case of Covid-19. The country the GDP annual growth rate from 2018 to 2020. that volunteered to be tested for the vaccine candidates will get more access to the vaccine. - China This is how cooperation can work and benefi t Figure 2.2. China’s GDP Annual Growth Rate both parties. Indonesia has already dealt with from 2018-2021 (Trading Economics, n.d.) China’s pharmaceutical companies like Cansino and Sinopharm which will provide vaccines in Chart 1. Indonesia starting in November 2020. China GDP Annual Growth Rate The United Arab Emirates government has approved Sinopharm’s vaccine for emergency use in health care workers by September 2020. In conclusion, the Russian vaccine development is faster than the development of vaccines by China in terms of vaccine registration and permit. While in the Source: Tradingeconomics.com other hand, the Russian vaccine obtains less trust from scientists. In 2019, China’s GDP is 14.34 trillion USD. The Chinese economy advanced 6.5 Political and Economic Relationship Between percent year-on-year in the December quarter, Countries (Kenya, Yemen, Indonesia, the after a 4.9 percent growth in the third quarter Philippines, with China) and above market consensus of 6.1 percent. The political relations seen here are The latest reading pointed to pre-pandemic

194 Global South Review Christou Immanuel; Theo Gerald Parluhutan Napitupulu Scrutinizing the Political and Economic Dynamics of China’s Distribution of Vaccines in Securitizing Health growth rates, with industrial output rising the Accommodation and food service most in 3-1/2 years in December. For full 2020, activity which includes the all-important tourism the country’s GDP expanded 2.3 percent, the sector remained severely affected (-57.9% vs slowest pace in more than four decades. Still, -83.2% in Q2), followed by education (-41.9% China is likely to be the only major economy to vs -56.2%) and professional, administrative avoid contraction due to the COVID-19 shocks activities (-12.3% vs -15.3%). Meanwhile, (Trading Economics, 2020). strong growth was recorded in agriculture In 2020, the primary sector went up (6.3% vs 7.3%); construction (16.2% vs 3.9%); 3 percent, with live pig inventory surging 31 mining & quarrying (18.2% vs 10%) and percent. Industry advanced 2.6 percent, with information & communication (7.3% vs 4.6%) manufacturing rising 3.4 percent, utilities 2 (Kenya National Bureau of Statistics, 2021). percent, and mining 0.5 percent. The tertiary sector expanded by 2.1 percent. Also, real estate - Yemen investment grew 7 percent, with residential rising Figure 4.4. Yemen’s GDP Annual Growth Rate 7.6 percent and offi ce building 5.4 percent. from 2018-2021 (Trading Economics, n.d.)

- Kenya Chart 3 Figure 3.3. Kenya’s GDP Annual Growth Rate Yemen GDP Annual Growth Rate from 2018-2021 (Trading Economics, n.d,)

Chart 2 Kenya GDP Annual Growth Rate

Source: Tradingeconomics.com

In 2019, Yemen’s GDP is 22.58 billion USD. The Gross Domestic Product (GDP) in Source: Tradingeconomics.com Yemen expanded 2.10 percent in 2019 from the previous year. Yemen is one of the poorest In 2019, Kenya’s GDP is 95.5 billion countries in the world. Its economy depends on USD. Kenya’s economy shrank 1.1% year- foreign aid and remittances from workers in on-year in the third quarter of 2020, following neighboring golf states. a downwardly revised 5.5% plunge in the The most important sector of the previous period. It marks the fi rst country’s economy is dwindling oil extraction, it accounts recession in nearly two decades, as the adverse for around 70 percent of government revenue effects of containment measures to curb and 25 percent of GDP. Agriculture is also very COVID-19 infections continued to be felt. important as it employs over 50 percent of the

Global South Review 195 Christou Immanuel; Theo Gerald Parluhutan Napitupulu Scrutinizing the Political and Economic Dynamics of China’s Distribution of Vaccines in Securitizing Health population. In recent years, the government has private consumption was somewhat sluggish engaged in efforts to diversify the economy (0.49% vs 4.7 in Q3), with fi xed investment from dependency on oil. slowing sharply (4.19% vs 8.45%). Meantime, As a result, there was a surge of government spending growth accelerated investment in the development of infrastructure strongly (27.15% vs 16.93%). for natural gas extraction. Yet, the political On the production side, activity fell for instability in 2011 has undermined development agriculture, forestry and fi sheries (-20.15% vs efforts, resulted in damage to infrastructure, 1.01%), manufacturing (-0.38 vs 5.25%), and rising unemployment, and high infl ation wholesale trade, retail (-0.87% vs -5.68%). (Trading Economics, 2020) In addition, output growth eased for mining (1.65% vs 1.72%), construction (3.48% vs - Indonesia 5.72%), and transportation and warehouse Figure 5.5. Indonesia’s GDP Annual Growth (5.08% vs 24.28%) (Badan Pusat Statistik, Rate from 2018-2021 (Trading Economics, n.d.) 2020)

Chart 4 - The Philippines Indonesia GDP Annual Growth Rate Figure 6.6. Philippines’ GDP Annual Growth Rate from 2018-2021 (Trading Economics, n.d.)

Chart 5 The Philippines Annual Growth Rate

Source: Tradingeconomics.co

In 2019, Indonesia’s GDP is 1.119 trillion USD. Indonesia’s economy unexpectedly contracted 0.42% QoQ in Q4 Source: Tradingeconomics.com 2020, a missing market consensus of a 0.7% growth and reversing from a record expansion of In 2019, the Philippines’s GDP is 5.05% in Q3, amid COVID-19 pandemic, with 376.8 billion USD. The Philippines economy authorities imposing a second round of mobility shrank 8.3% YoY in Q4 of 2020, following a curbs in capital Jakarta during September and marginally revised 11.4 plunge in the previous October 2020 (Trading Economic, n.d.) quarter and compared with market expectations External demand contributed of an 8.5% fall. This was the fourth straight negatively to the GDP, as exports rose by quarter of contraction in the economy, and the 2.41% (vs 12.14% in Q3) while imports grew smallest contraction since Q1, as the economy much faster by 16.28% (vs -0.08%). Besides, continued to recover from the COVID-19

196 Global South Review Christou Immanuel; Theo Gerald Parluhutan Napitupulu Scrutinizing the Political and Economic Dynamics of China’s Distribution of Vaccines in Securitizing Health shocks (Trading Economics, n.d.) In 1978, when President Daniel Arap Private consumption (-7.2% vs -9.2% in Q2) Moi came to power, diplomatic relations and fixed investment (-28.6% vs -37.1%) between the two countries developed rapidly. contracted less. Also, net external demand When President Moi stepped down as president contributed negatively to GDP, as exports in 2002, he and his government had successfully dropped by 10.5%, while imports fell faster established close ties with China. The era of (-18.8%). President Moi provided a basis for enhancing Meanwhile, government spending cooperation between the two countries and growth eased (4.4% vs 5.8%). On the smoothing investment flows. Diplomatic and production side, activity contracted mainly for political relations between Kenya and China mining and quarrying (-18.8%), manufacturing have been well established until now. One of (-4.3%), construction (-25.3%); transportation the two countries’ cooperation is in the fields and storage (-21.3%), wholesale and retail of economy, trade, and technology. Projects trade (-4.1%). Considering the full year of to improve the welfare of the Kenyan people 2020, the economy shrank by 9.5% YoY, the such as the Moi International Sports Center, steepest contraction since the series began in a generator-generating pit, the expansion 1946, reversing from a 5.9% growth in 2019. project of Eldret hospital, and the Gambogi- Serem Highway are shreds of evidence that the Relations between Kenya and China political relations between Kenya and China As the fourth country to recognize are well-established after the Kenyatta regime. Kenya’s independence, political relations between Kenya and China began when Kenya Relations between Yemen and China just declared its independence, on December The political relations between Yemen 12, 1963. On December 14, 1963, China and China go back a long time. China’s foreign immediately established political relations with policy vis-a-vis Yemen from October 1949 to the Kenya. Political relations between China and end of 1980 was influenced by the United States Kenya started on an unsettled basis. After 1965, and the Soviet Union (Hinnebusch, 2003). relations between the two countries became The financial and economic assistance tense and were lowered to the level of charge from China to Yemen was so substantial that it d’affaires (Tunai Mulati, 2019). exceeded the assistance offered by the Soviet The unfavorable relationship between Union so that the two countries became rivals China and Kenya during the Jomo Kenyatta with each other and the political relations regime (1963-1978) was influenced by the between China and the Soviet Union were Cold War which took place when the western fractured. In the 1980s, China reduced its bloc led by the United States tried to spread aid and presence in South Yemen due to the its liberalism ideology and the eastern bloc Soviet Union’s increasingly intense presence led by the Soviet Union with its ideology of in South Yemen. communism (Tunai Mulati, 2019). In the 1990s, China became a strong

Global South Review 197 Christou Immanuel; Theo Gerald Parluhutan Napitupulu Scrutinizing the Political and Economic Dynamics of China’s Distribution of Vaccines in Securitizing Health supporter of the merger of South Yemen and Party of Indonesia to take power. The New North Yemen into the Republic of Yemen. In Order government led by Soeharto suspended this period, the relationship between China and diplomatic relations with China on October Yemen was based on economic and political 30, 1967, and this continued for more than two interests. China’s interest is increasing, and decades (Van der Kroef, 1989). Yemen becomes one of the main suppliers of Diplomatic relations between Indonesia oil commodities to China. Currently, Yemen is and China returned to life on August 8, 1990. facing a civil war and the UN has determined The end of the Cold War was one of the factors that the civil war in Yemen is the worst causing the normalization of diplomatic humanitarian crisis in history. relations between the two countries. The China plays a role in supporting modernization policy that led to China’s political stability in Yemen. On July 13, 2017, rapid economic development succeeded in the Chinese government successfully delivered persuading the Soeharto government to return humanitarian assistance worth the US $ 22.5 to cooperate with China. million containing food and medical supplies After the 1998 reformation, relations through the Southern Yemeni port city of Aden between Jakarta and Beijing were getting (Ramani, 2017). The political relationship better because the Indonesian government between Yemen and China has been influenced saw the goodwill of the Chinese government by a variety of phenomena ranging from the for Indonesia. China’s quick assistance to Cold War to the current conflict in Yemen. Indonesia after the Tsunami on 26 December However, China’s role in Yemen has remained 2004 further increased favorable sentiment real over time. towards China. Currently, China is the third- largest investor in Indonesia after Singapore Relations between Indonesia and China and Japan. The cooperation that has been Political relations between Indonesia established covers various sectors, starting from and China have had their ups and downs. the economy, infrastructure, and health. Since Diplomatic relations between the two countries China has numerous investments in Indonesia, were first established on April 13, 1950 (Jie, China has a huge concern about its production 1994). President Soekarno’s foreign policy in Indonesia. This underlies the prioritization which was very anti-neocolonialism and of vaccine distribution to Indonesia. imperialism made Indonesia look for other “friends” besides Britain and the United States. Relations between the Philippines and China The close relationship between the two Diplomatic and political relations countries led to the formation of the Jakarta- between the Philippines and China were formed Beijing axis. Diplomatic relations between on June 9, 1975. Since then, the two countries Indonesia and China were cut off as a result have cooperated to unexpected levels in trade, of the September 30 Movement when China investment, agriculture, tourism, and others. was suspected of supporting the Communist Since 1975, the two countries have signed

198 Global South Review Christou Immanuel; Theo Gerald Parluhutan Napitupulu Scrutinizing the Political and Economic Dynamics of China’s Distribution of Vaccines in Securitizing Health nearly 100 bilateral agreements covering a vaccine distribution. Health diplomacy is one of wide scope - trade, infrastructure development, the activities carried out by state and non-state energy, tourism, culture, sister cities, and others actors to improve global health standards. If we (Clemente, 2017). In 2005, during President Hu talk about vaccine distribution, especially the Jintao’s state visitation to the Philippines, he Covid-19 vaccine, there is currently a myriad and President Gloria Macapagal-Arroyo agreed of discourse that postulates on the availability to establish strategic cooperation to ensure of the Covid-19 by 2021. peace and promote development between the Parties that are considered to have the Philippines and China. But relations between potential to produce vaccines are SINOVAC the Philippines and China have been turbulent, (China), Sinopharm (Wuhan Institute of with the presence of some controversy and Biological Product and Beijing Institute of disagreement. Biological Product, China), The ChAdOx1 During the reign of President Benigno (University of Oxford, United Kingdom), Ad5- Aquino (2011-2016), bilateral relations nCoV (Cansino Biologics INC, China), Sputnik between the two countries were accompanied V (Gameleya Research Institute, Russia), by maritime disputes regarding the South Novavax (USA), and BNT-162 (BioNTech, China Sea. At a time when the territorial Germany). The names of parties that are dispute was at its height, the Philippines considered to have the potential to produce faced the implementation of stricter trade and vaccines are already in phase 3, which is the commercial rules from the Chinese authorities last stage before the vaccine is declared safe for (Sudan Ravindran, 2012). production. When President Duterte came to power, The world health agency, WHO, said diplomatic and political relations between the that the distribution process of vaccines must Philippines and China began to improve. The be evenly distributed throughout the world “heating up” of bilateral relations after years at an affordable price and should not be of “freezing” was influenced by President monopolized by any country with its national Duterte’s pragmatic policies. President interests. However, we cannot deny that for Duterte’s policies are considered more lenient the state, national interests are more important and focus more on the economic and trade than international interests. Currently, vaccine aspects of the Philippines with China (Damping, diplomacy activities have been carried out by 2020). However, the relationship between the countries in the world. Vaccine diplomacy is Philippines and China is still accompanied by the most subtle form of state efforts to secure territorial disputes. the Covid-19 vaccine for itself. Indonesia itself is one of the countries Health Diplomacy in Manners of Multilateral that has initiated vaccine diplomacy. “The and Bilateral Cooperation main task of diplomacy is to open roads and Health diplomacy or better known as access commitments to supply vaccines, both Global Health Diplomacy affects the process of from bilateral and multilateral channels,” said

Global South Review 199 Christou Immanuel; Theo Gerald Parluhutan Napitupulu Scrutinizing the Political and Economic Dynamics of China’s Distribution of Vaccines in Securitizing Health

Indonesian Foreign Minister, Retno Marsudi affect their ability to carry out vaccine diplomacy. virtually, Thursday (22/10) when delivering As we know, the Covid-19 Pandemic hit the a statement regarding Indonesia’s diplomacy world economy. The lockdown that occurs performance for one year under Jokowi-Ma’ruf around the world holds the production and Working Cabinet. The Indonesian Minister distribution activities that obstruct the global of Foreign Affairs explained that Indonesia supply chain. The International Monetary Fund had obtained several commitments to supply (IMF) predicts that Kenya’s GDP will fall from vaccines, both through bilateral and multilateral 5.6 percent in 2019 to 1.0 percent in 2020. The channels. This commitment comes from three pandemic handling fund corruption scandal that vaccine manufacturers from China, namely recently rocked Kenya added to the problems Sinovac, Sinopharm, and CanSino. that the country is already facing. Besides, the Indonesia is also working with the government is struggling to pay off a sizeable G-42 technology company from the United national debt - nearly a third of the budget - Arab Emirates and with the UK’s leading leaving little fiscal space for a social safety net pharmaceutical company, AstraZeneca (The program, even if the global economy recovers Jakarta Post, 2020). In an interview with by 2021. Berita Satu journalists who were uploaded to Vaccine diplomacy carried out by the YouTube with the title “60 Minutes with Retno Philippines with other parties especially China Marsudi: Vaccine Diplomacy & Peace in a as the country with the most potential to produce Pandemic Period”, Retno Marsudi stated that vaccines is also not running as effectively as the vaccine diplomacy carried out by Indonesia Indonesia. The main obstacle faced by the succeeded in securing commitments from the Philippines is due to the bad sentiment it has state or vaccine makers of 20 to 30 million towards China due to the territorial conflict that doses of vaccine by the end of 2020. And for always accompanies the relations between the 2021, 290 to 340 million doses of vaccine have two countries. Diplomats from the Philippines been secured by Indonesia. felt that President Xi Jinping’s promise Overall, Indonesia has guaranteed regarding the Philippines to get priority access cooperation with 120 parties, namely 11 to the Covid-19 vaccine was one of China’s countries, 12 international organizations, and efforts to take over the West Philippine Sea. As 97 NGOs. As we are facing two choices of President Rodrigo Duterte said in a speech on approaches in obtaining vaccines, which are the State of the Nation Address 2020 which was bilateral and multilateral approaches, Indonesia broadcasted on the national television station chose both approaches to effectively fulfill the in July 2020, that there is no such thing as “free Indonesian needs of Covid-19 Vaccine. lunch”. President Duterte said that, Indonesia is intensively pursuing vaccine diplomacy, especially with China. “Chinese diplomats are not going to say: This is different from Kenya, Yemen, and the recognize our claims in exchange Philippines, whose domestic conditions greatly for vaccines, but the quid pro quo will

200 Global South Review Christou Immanuel; Theo Gerald Parluhutan Napitupulu Scrutinizing the Political and Economic Dynamics of China’s Distribution of Vaccines in Securitizing Health

be understood,” Poling said. “There’s Does the Status of Global North and South going to be an expectation that if you Countries Affect the Vaccine Distribution want early access to these vaccines, you Process? will avoid certain Chinese red lines. Currently, the development of Covid-19 And the South China Sea is one of vaccines is being led by North countries since them.” it has more advanced technology and science. The status of a country as a South country will If Kenya is affected by its low economic intervene in the access of respective countries capability and the Philippines is affected by to the Covid-19 vaccine. These countries have unfavorable political sentiment towards China little to zero technology to develop vaccines as one of the most potential parties to establish for themselves. As developing countries with a vaccine diplomacy, Yemen is well faced with a small income, these countries found difficulty devastated economy and an unstable domestic in purchasing vaccines since their high pricing political climate due to civil war. Yemen’s (United Nations, 2021). internal affairs have not been stable since the On the other hand, North countries civil war erupted in 2015, making it difficult for with more advanced technology have an Yemen to implement its foreign policy. Yemen interest in the Southern countries in several is one of the countries that desperately need an aspects, namely economy, moral obligation, even and unimpeded distribution of vaccines. and politics (Krüger, n.d.). These interests will However, Yemen can almost completely lead countries to help the South countries to depend on international assistance regarding access the Covid-19 vaccine. This condition the distribution of the Covid-19 vaccine and is related to the international cooperation and cannot carry out vaccine diplomacy and ensure economic benefit in the intellectual property the commitment of those who have the potential right which will be further elaborated in the to produce Covid-19 vaccines such as China. next part. Indonesia, Yemen, Kenya, and the So that based on the above-mentioned Philippines are countries that are included in exposure, vaccine diplomacy affects vaccine the Global South group although several parties distribution. The ability of a country to carry claim that Indonesia and the Philippines are out diplomatic vaccines is influenced by developed countries but there is no unanimous domestic factors such as the political and statement regarding the status of the two economic power possessed by the country (The countries. As has been explained above, the Conversation, 2021). Although the UN and economic and political conditions of the four WHO stated that vaccine distribution needed countries are different. Yemen and Kenya are to be carried out transparently and equitably, considered to have the weakest economic and this statement did not regulate the measures political conditions. Therefore, the domestic to enable states to secure the production of the problems they experience naturally affect their Covid-19 vaccine for their own countries. performance in carrying out health diplomacy activities and securing vaccine production for

Global South Review 201 Christou Immanuel; Theo Gerald Parluhutan Napitupulu Scrutinizing the Political and Economic Dynamics of China’s Distribution of Vaccines in Securitizing Health the national security of their country as has test before the global community” been done by Indonesia. However, the political António Guterres proposed the relations between Kenya and Yemen, and China establishment of an emergency task force by the are quite good. So, there is a possibility that the G20 countries to prepare and help implement the two countries will get vaccines from China, as global immunization plan. The task force will President Xi Jinping said, China promises to have the capacity to mobilize pharmaceutical distribute vaccine aid to developing countries, companies and key industry and logistics especially countries on the African continent actors. This is a WHO commitment so that the (Jingxi, 2020). distribution of the Covid-19 vaccine can be The Philippines has better economic carried out fairly regardless of the economic and political conditions than Kenya and and political strength of a country. Yemen. However, the condition of his political relationship with China, which is one of the Conclusion most potential actors to produce vaccines, is Based on the previous elaborated not going well. This of course is influenced by consideration, we conclude Political and territorial disputes which in the last 5 years, economic relations between countries can often accompany the relationship between the influence the distribution of the Covid-19 two countries. President Duterte considered vaccine. When a country has intense and that Xi Jinping’s statement stating that he mutually beneficial political relations with would grant special access to vaccines for the other countries, it is reasonable to establish Philippines was China’s attempt to use their cooperation, particularly in distributing soft power to claim Philippine territorial waters vaccines. If a North country has a huge (Abigail, 2020). On the other hand, there is interest in a South country, it is more likely Indonesia with the best economic and political for the North country to send vaccines to that conditions when compared to the previous particular South country. The next conclusion three countries. is that the economic dimension, which consists A large budget and relatively stable of investment and intellectual property right domestic political conditions enable Indonesia plays a significant role in the Covid-19 vaccine to carry out its health diplomacy activities to distribution. The more intense the foreign the fullest. This of course makes it easier and direct investment between the two countries if one can say guarantees Indonesia to get the or more, the higher the chances of getting a distribution of vaccines quickly and safely. vaccine. Based on these two considerations, WHO emphasized to the international we conclude that global South countries access community that the distribution of the to the Covid-19 vaccine depends on respective Covid-19 vaccine needs to be done fairly political and economic proximity to North and transparently. WHO Secretary-General, countries António Guterres said that “at this critical moment, vaccine equity is the biggest moral

202 Global South Review Christou Immanuel; Theo Gerald Parluhutan Napitupulu Scrutinizing the Political and Economic Dynamics of China’s Distribution of Vaccines in Securitizing Health

References man Security Now: Protecting and Em- Books powering People. https://reliefweb.int/ Hinnebusch, R. (2003). The Internation- report/world/human-security-now-pro- al Politics of the Middle East. Man- tecting-and-empowering-people chester University Press. https:// library.oapen.org/bitstream/han- Journal Article (retrieved online, with DOI) dle/20.500.12657/35008/341386.pd- Giles, J., Harimurti, P., Marzoeki, P., Rokx, C., f?sequence=1&isAllowed=y & Satriawan, E. (2010). New insights Pupavac, V. (2016). The Romance of Global into the provision of health services in Health Security. In Globalization, dif- Indonesia: A health workforce study. ference, and human security (pp. 140- Washington, DC, Colombia: World 151). New York, New York: ROUT- Bank. doi:10.1596/978-0-8213-8298-1 LEDGE. Gurgu, E. (2016). The Role of Public Diplo- World Intellectual Property Organization. macy in Internatonal Relations in Full (2016). Understanding Copyright and Process of Globalization. Annals of Related Rights. World Intellectual Spiru Haret University Economic Se- Property Organization. ries, 16 (2), 125-141. http://dx.doi. World Intellectual Property Organization. org/10.26458/16210 (2016). Understanding Industrial Prop- Hart, D., & Siniver. A. (2021). The Mean- erty. World Intellectual Property Orga- ing of Diplomacy. International Ne- nization. gotiation, 26, 1-25. http://dx.doi. org/10.1163/15718069-bja10003 Report/Thesis Pollins, B. (1985). Breaking Trade Dependen- Dayrit, D., Lagrada, L., Picazo, O., Pons, M., cy: A Global Simulation of Third World & Villaverde, M. (2018). The Philip- Proposals for Alternative Trade Re- pines health system review. New Delhi, gimes. International Studies Quarterly, New Delhi: WHO Regional Office for 29(3), 287-312. doi:10.2307/2600486 South-East Asia Chinatsu, T. (2018). The Contribution of Re- Journal Article (retrieved online, without public of Korea (ROK) Cultural Diplo- DOI or page numbers) macy on People’s Republic of China Caporaso. (1992). International Relations The- (PRC): Improving Bilateral Relations ory and Multilateralism: The Search for in Tourism Sector (2015-2017) [Pres- Foundations. International Organiza- ident University]. http://repository. tion, 599-632. Retrieved from: https:// president.ac.id/xmlui/bitstream/han- www.jstor.org/stable/2706990?seq=1 dle/123456789/516/016201400167.pd- Clemente, T. (2017). The Economic Dimen- f?sequence=1&isAllowed=y sion in China’s Foreign Relations: Commission on Human Secuirty. (2003). Hu- Reflections for China Studies in the

Global South Review 203 Christou Immanuel; Theo Gerald Parluhutan Napitupulu Scrutinizing the Political and Economic Dynamics of China’s Distribution of Vaccines in Securitizing Health

Philippines. Contemporary Chinese Licensing of Drugs and Pharmaceuti- Political Economy and Strategic Re- cal: Issues and Dilemma. Journal of In- lations: An International Journal, 3(3), tellectual Property Rights, 279-287. Re- 1173–1196. https://www.researchgate. trieved from: http://docs.manupatra.in/ net/publication/327047949_The_Eco- newsline/articles/Upload/3FB94432- nomic_Dimension_in_China’s_For- F6A8-44FD-8D4B-2EC49FABC703. eign_Relations_Reflections_for_Chi- pdf na_Studies_in_the_Philippines Krüger, L. (n.d.). North-North, North-South, Chiu, Y. W., Weng, Y. H., Su, Y. Y., Huang, and South-South Relations. Encyclope- C. Y., Chang, Y.C., & Kuo, K. N. The dia of Life Support System. Retrieved nature of international health security. from: https://www.eolss.net/sam- Asia Pac J Clin Nutr. 2009;18(4):679- ple-chapters/C13/E1-24-02-08.pdf 83. PMID: 19965365. Retrieved from: Mulati, L. T. (2019). China-Kenya Relations: http://apjcn.nhri.org.tw/server/AP- An Analysis of Its Nature since Inde- JCN/18/4/679.pdf pendence. International Journal of Re- Damping, G. (2020). Perubahan Kebijakan search and Innovation in Social Science Luar Negeri Filipina Terhadap China (IJRISS), III(X), 735-746. Retrieved di Bawah Kepemimpinan Presiden Ro- from: https://www.rsisinternational. drigo Duterte Terhadap China dalam org/journals/ijriss/Digital-Library/vol- Konflik Laut China Selatan. Journal of ume-3-issue-10/735-746.pdf?x49905 International Relations, 6(4), 619–628. Ruggie, J. (1992). Multilateralism: The Anato- http://ejournal-s1.undip.ac.id/index. my of an Institution. International Or- php/jihi ganization, 46 (3), 561-598. Retrieved Fidler, D. (2010). Negotiating Equitable Access May 22, 2021, from http://www.jstor. to Influenza Vaccines: Global Health org/stable/2706989 Diplomacy and the Controversies Sur- Sharp, P. (2003). Herbert Butterfield, the En- rounding Avian Influenza H5N1 and glish School and the Civilizing Virtues Pandemic Influenza H1N1. PLoS Med. of Diplomacy. International Affairs, 79 Retrieved from: https://journals.plos. (4), 855-878. Retrieved May 24, 2021, org/plosmedicine/article?id=10.1371/ from https://www.researchgate.net/ journal.pmed.1000247 publication/344339208_The_Mean- Jie, C. (1994). Shaking Off an Historical Bur- ing_of_Diplomacy den: China’s Relations with the ASE- Sudan, M. (2012). China’s Potential for Eco- AN-based Communist Insurgency in nomic Coercion in the South China Sea Deng’s Era. Communist and Post-Com- Disputes: A Comparative Study of the munist Studies, 24(4), 443–462. https:// Philippines and Vietnam. Journal of www.jstor.org/stable/45301909%0A Current Southeast Asian Affairs, 31(3), Kaur, A., & Chaturvedi, R. (2015). Compulsory 105–132. http://www.currentsoutheas-

204 Global South Review Christou Immanuel; Theo Gerald Parluhutan Napitupulu Scrutinizing the Political and Economic Dynamics of China’s Distribution of Vaccines in Securitizing Health

tasianaffairs.org/ plomasi untuk Penuhi Vaksin Covid-19. Tunai, L. (2019). China-Kenya Relations: An Retrieved from https://republika.co.id/ Analysis of Its Nature since Indepen- berita/qilxq5382/menlu-retno-diploma- dence. International Journal of Research si-untuk-penuhi-vaksin-covid19 and Innovation in Social Science, 3(10), Al-Moayyad, K. (2019, June 03). Health cri- 735–746. https://www.rsisinternational. sis in Yemen. Retrieved from https:// org/journals/ijriss/Digital-Library/vol- www.icrc.org/en/where-we-work/mid- ume-3-issue-10/735-746.pdf dle-east/yemen/health-crisis-yemen Van der Kroef, J. (1989). Hesitant “Normaliza- Ariesta, M. (2020, October 22). Menlu Ret- tion”: Indonesia’s Slow Boat to China. no Akui Diplomasi Vaksin Bukan Hal Asian Affairs: An American Review, Mudah. Retrieved from https://www. 16(1), 23–44. https://www.jstor.org/sta- medcom.id/internasional/asia-pasifik/ ble/30172106?seq=1 yNL4ADPN-menlu-retno-akui-diplomasi-vaksin-bukan-hal-mudah Audiovisual media (videos, music recordings, Bailey, R. (2021, February 02). COVID Vac- podcast, etc.) cine Nationalism: History Shows When Berita Satu. (2020, September 14). 60 Minutes Countries Act Selfishly, Everyone Los- with Retno Marsudi : Diplomasi Vaksin es. Retrieved from https://medicalx- & Perdamaian Di Masa Pandemi (In- press.com/news/2021-02-covid-vac- terview by Y. Adityarman).[Video file]. cine-nationalism-history-countries. Retrieved from: https://www.youtube. html com/watch?v=6ebGU1G9Lzw&t=36s Badan Pusat Statistik. (n.d,). Indonesia GDP Growth Rate. Retrieved from https:// Electronic source www.bps.go.id/ Abigail, N. (2020, December 9). Develop- Corum, J., Lee, S.-L., & Zimer, C. (2020). ing nations are first in line for China’s Coronavirus Vaccine Tracker. Retrieved Covid vaccines. Analysts question Bei- from https://www.nytimes.com/inter- jing’s intent. Retrieved from https:// active/2020/science/coronavirus-vac- www.cnbc.com/2020/12/10/covid-chi- cine-tracker.html na-may-be-using-its-vaccines-to-ex- Ellyatt, H. (2020, August 12). Russia Says pand-its-soft-power.html There Is a ‘Major Information War- Adhikari, S. (2019, December 23). 10+ Differ- fare’ Against Its Coronavirus Vaccine. ences between Bilateral and Multilater- Retrieved from https://www.cnbc. al Cooperation. Retrieved from https:// com/2020/08/12/russia-rejects-corona- www.publichealthnotes.com/10-differ- virus-vaccine-criticism.html ences-between-bilateral-and-multilat- Erondu, N., & Agogo, E. (2020, April 06). eral-cooperation/ What Factors Will Decide the Fate of Aini, N. (2020, October 22). Menlu Retno: Di- the Global South in Coronavirus Pan-

Global South Review 205 Christou Immanuel; Theo Gerald Parluhutan Napitupulu Scrutinizing the Political and Economic Dynamics of China’s Distribution of Vaccines in Securitizing Health

demic? October 24, 2020. Retrieved vaccine-diplomacy-offers-risks-and-re- from https://theglobalobservatory. wards-for-rising-superpow- org/2020/03/what-factors-will-de- er-20201007-p562zr.html cide-fate-global-south-coronavi- Mellen, R. (2020, November 12). Vaccines rus-pandemic/ have never been distributed equal- Green, A. (2020, June 30). COVID-19: Coun- ly. A coronavirus vaccine would be tries race to strengthen compulso- no different, history suggests. Re- ry licensing legislation. Retrieved trieved from https://www.msn.com/ from https://www.devex.com/news/ en-us/news/world/vaccines-have-nev- covid-19-countries-race-to-strength- er-been-distributed-equally-a-coro- en-compulsory-licensing-legisla- navirus-vaccine-would-be-no-dif- tion-97595 ferent-history-suggests/ Jingxi, M. (2020, May 25). Xi: China to share ar-BB1aVMfF?li=BBnbcA1 vaccine with world. Retrieved from Modeer, U., & Eziakonwa, A. (2011, Septem- China Daily: https://www.chinadaily- ber 11). Why Multilateralism Matters. hk.com/article/131589 Retrieved from United Nations Devel- Kamradt-Scott, A. (2020, August 18). Creating opment Programme: https://www.undp. a Covid-19 vaccine is only the first step: org/content/undp/en/home/blog/2019/ Manufacturing and distribution will why-multilateralism-matters.html take years. Retrieved from https://www. Mohiddin, A., & Temmerman, M. (2020, Oc- stuff.co.nz/national/health/coronavi- tober 13). COVID-19 exposes weak- rus/122490768/creating-a-covid19- nesses in Kenya’s healthcare system. vaccine-is-only-the-first-step-manufac- And what can be done. Retrieved from turing-and-distribution-will-take-years https://theconversation.com/covid-19- Kenya National Bureau of Statitics (2020, April exposes-weaknesses-in-kenyas-health- 28). Kenya GDP Annual Growth Rate. care-system-and-what-can-be-do- Retrieved from https://tradingeconom- ne-143356 ics.com/kenya/gdp-growth-annual Nugraheny, D. E. (2020, October 12). Vak- Lysachkina, D. (2020, April 22). Compulso- sin Covid-19 Tersedia di Indonesia ry Licensing in Russia in the view of pada November 2020. Retrieved from COVID-19. Retrieved from https:// Kompas.com: https://nasional.kompas. www.ilnipinsider.com/2020/04/com- com/read/2020/10/12/12023261/vak- pulsory-licensing-in-russia-in-the- sin-covid-19-tersedia-di-indonesia-pa- view-of-covid-19/ da-november-2020 Massola, J. (2020, October 10). Vaccine di- Olander, E. (2020, September 01). The New Era plomacy offers risks and rewards for of High-Risk, High-Reward “Vaccine rising superpower. Retrieved from Diplomacy” is Here. Retrieved from https://www.smh.com.au/world/asia/ https://chinaafricaproject.com/analysis/

206 Global South Review Christou Immanuel; Theo Gerald Parluhutan Napitupulu Scrutinizing the Political and Economic Dynamics of China’s Distribution of Vaccines in Securitizing Health

the-new-era-of-high-risk-high-reward- thejakartapost.com/news/2020/10/17/ vaccine-diplomacy-is-here/ indonesia-strengthens-vaccine-cooper- World Health Organization. (2018). Health ation-with-uk-and-switzerland.html. security. Retrieved from https://www. The Vaccine Alliance, G. (2020, March 24). who.int/health-topics/health-security/ The COVID-19 vaccine race. Re- World Health Organization. (2020). Eastern trieved from https://www.gavi.org/vac- Mediterranean Region. Retrieved from cineswork/covid-19-vaccine-race http://www.emro.who.int/health-top- Trading Economics. (n.d,). China GDP An- ics/health-diplomacy/index.html nual Growth Rate. Retrieved from The Jakarta Post. (2020, October 16). Anoth- https://tradingeconomics.com/china/ er kind of diplomacy. Retrieved from gdp-growth-annual https://www.thejakartapost.com/aca- Trading Economics. (n.d,). Kenya GDP An- demia/2020/10/16/another-kind-of-di- nual Growth Rate. Retrieved from plomacy.html https://tradingeconomics.com/kenya/ Ravelo, J. (2020, September 14). Corruption gdp-growth-annual allegations rock Philippine health insur- Trading Economics. (n.d,). Yemen GDP An- ance corporation amid COVID-19. Re- nual Growth Rate. Retrieved from trieved from https://www.devex.com/ https://tradingeconomics.com/yemen/ news/corruption-allegations-rock-phil- gdp-growth-annual ippine-health-insurance-corpora- Trading Economics. (n.d,). Indonesia GDP tion-amid-covid-19-98048 Annual Growth Rate. Retrieved from Simoneau, M., & Bliss, K. (2020, August https://tradingeconomics.com/indone- 28). Kenya’s Immunization Sys- sia/gdp-growth tem in the Post-Covid World. Re- Trading Economics. (n.d,). the Philippines trieved from https://www.csis.org/ GDP Annual Growth Rate. Retrieved features/kenyas-immunization-sys- from https://tradingeconomics.com/ tem-post-covid-world philippines/gdp-growth-annual The Conversation. (2021). Vaccine Diplomacy: United Nations. (2021). Low-income coun- how some countries are using COVID tries have received just 0.2 percent of to enhance their soft power. Retrieved all COVID-19 shots given. Retrieved from https://theconversation.com/vac- from https://news.un.org/en/sto- cine-diplomacy-how-some-countries- ry/2021/04/1089392 are-using-covid-to-enhance-their-soft- World Trade Organization. (n.d.). Compulso- power-155697 ry licensing of pharmaceuticals and The Jakarta Post. (2020, October 17). Indo- TRIPS. Retrieved from World Trade nesia strengthens vaccine cooperation Organization: https://www.wto.org/ with UK and Switzerland. Retrieved english/tratop_e/trips_e/public_health_ from The Jakarta Post: https://www. faq_e.htm

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