Calls are mounting for the Biden administration to extend its ‘vaccine diplomacy' to Latin America, where some experts say the United States has fallen behind China in terms of providing assistance to local health systems.

Facing pressure to do more to help other countries, on Monday Biden administration officials announced that they will make up to 60 million doses of AstaZeneca vaccine available to other countries, provided that federal regulators deem the doses safe. The move came after President Joe Biden spoke to Prime Minister Narendra Modi of India, which is facing a growing humanitarian crisis.

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At the moment, it remains unclear how many of the soon-to-be-released vaccines will go to Latin America. Some US politicians, however, have explicitly asked that the government direct some of its assistance to Latin America.

"I respectfully but strongly call on the Biden Administration to release millions of AstraZeneca vaccine does to countries hardest-hit by the spread of Covid-19, including India, Argentina and potentially others," Illinois congressman Raja Krishnamoorthi said in a statement.

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In an interview with LPO, Dr. Richard Reithinger, the Vice President of Health at RTI International, a non-profit research institute, said there are a number of criteria the US government will have to contend with before determining where to send vaccines.

"One criteria, of course, is where the virus is currently causing the largest burden...vaccination efforts should focus on where the burden is greatest. One example is India, and you could even argue that the United States at one point a few months ago represented a large driver of the Covid pandemic. Of course, there are also countries like Brazil that are still very much experiencing transmission, or new ways of transmission."

In terms of vaccine diplomacy, the US faces stiff competition from China, which by the beginning of March had pledged roughly half a billion doses to more than 45 countries. Chinese vaccines have already been sent to - or promised - to several Latin American countries, including Argentina, Chile, Brazil, Mexico and others. 

Having multiple countries providing vaccines, Dr. Reithinger warned, can sometimes complicate local public health efforts and the wider global effort to control Covid-19.

 In terms of vaccine diplomacy, the US faces stiff competition from China, which by the beginning of March had pledged roughly half a billion doses to more than 45 countries

"Vaccine diplomacy has undermined our global response," he said. "It's clear that for some countries, vaccine donations are done for reasons that maybe have more to do with geopolitical goals than public health. Of course, that leaves some countries that have less political clout on the sidelines."

On the other hand, Dr. Reithinger said that the gravity of the pandemic means that any available vaccine is helpful.

"Any vaccine that has proven its efficacy and been fully registered, authorized and approved by the global entities like the WHO, and in-country drug administration agencies, is welcome," he added.

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In a separate interview with LPO, Evan Ellis, a research professor of Latin American studies at the US Army War College Strategic Studies Institute, said that initially, the US fell behind China as far as vaccine diplomacy, largely as a result of the Chinese being able to "prioritize production for export".

"They could ramp up their production capability and they had a more limited need, at least initially, at home," he added.  

Vaccine diplomacy has undermined our global response

However, Ellis noted that in some Latin American countries that have so far relied heavily on Chinese vaccines - such as Argentina, Peru, Venezuela, Brazil and the Dominican Republic - the strategy "may backfire".

"The big issue right now, as Chile is finding out, is the efficacy of those vaccines," he explained. In April, a study from the University of Chile found that the first Sinovac vaccine was only 3% effective against infection, rising to 56.5% two weeks after the second jab.

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"Because China was able to ramp up its vaccines to Chile before Pfizer, Chile ended up doing the vast majority of its vaccines through the Chinese," he said. "But then they discovered, when everyone took off their masks, relaxed and thought the crisis was over, that there was a still a rapid spread of the virus despite having vaccinated a substantial amount of the population."

For the Chinese government, Ellis noted that vaccine diplomacy forms part of a wider effort to achieve geopolitical and economic goals, such as the establishment of Chinese-provided 5G networks. This was the case in Brazil, where in March the New York Times reported that China was able to use vaccines to change the Bolsonaro administration's mind with regards to a potential ban on allowing Huawei to help build Brazil's 5G networks. 

For the Chinese government, Ellis noted that vaccine diplomacy forms part of a wider effort to achieve geopolitical and economic goals, such as the establishment of Chinese-provided 5G networks.

Additionally, Ellis also said that he believes that at least a portion of the 60 million AstraZeneca vaccines pledged by the Biden administration would head to Latin America.

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Ultimately, according to Ellis, controlling the pandemic in Latin America will ultimately help America meet its own foreign policy and security challenges in the hemisphere, such as preventing instability, combating crime and stemming the flow of migrants north to the US.

"The broader issue is that Covid itself, over the long term, is putting the region under enormous stress. There is no other region with which the United States is more connected in terms of its prosperity and security," he said. "As we've seen with the refugee crisis, what happens and conditions in the region directly affect the United States."