China Is Exploiting the Pandemic to Advance Its Interests, with Mixed Results

The Covid-19 pandemic has offered China an unprecedented opportunity to shore up its international influence by providing the world with much-needed public health goods. The CSIS China Power Project published a detailed study of China’s “Covid-19 diplomacy,” which assesses the scope and impact of China’s efforts to supply countries with medical aid and vaccines. The study developed a unique Chinese Covid-19 Diplomacy Index (CCDI), which brings together thousands of data points to score countries based on the extent to which China engaged them in medical diplomacy and vaccine diplomacy and how receptive they were to Chinese activities. The study and the index generate important insights into the strengths and weaknesses of China’s approach to Covid-19 diplomacy and the implications for the United States and its partners.

Q1: How has China engaged in Covid-19 diplomacy?

A1: Based on the study’s analysis of Chinese activities from January 2020 to the present, there are six main features of Beijing’s Covid-19 diplomacy:

1. China’s Covid-19 diplomacy is not primarily based on need or reciprocity. Political and strategic calculations—including the desire to strengthen existing relationships and forge new ones—figure prominently in Beijing’s decisions to provide medical aid or vaccines.


2. China’s provision of medical aid and vaccines has frequently come with strings attached. For example, where possible, Chinese embassies abroad requested that officials in recipient countries provide public displays of gratitude by participating in handover ceremonies to welcome Chinese medical supplies and vaccines. There is also evidence that Beijing paired its provision of vaccines with requests that recipient country governments defend Chinese stances on issues.


3. Beijing has sought to project the impression that its medical supplies and vaccines were donations. Yet more than 99 percent of China’s exports of personal protective equipment (PPE) in 2020 were sold, not donated, and about 96 percent of its vaccine exports were likewise sold.


4. While the United States and many other wealthy countries have donated large quantities of vaccines to COVAX (a global initiative to promote equitable access to Covid-19 vaccines), China predominantly engages countries bilaterally in order to augment its bilateral influence. Only about 16 percent of Chinese vaccine exports have been allocated to COVAX or other multilateral mechanisms, and much of this was in the form of sales.


5. With both medical supplies and vaccines, China has prioritized speed over quality in order to reap first-mover advantages.


6. China’s Covid-19 diplomacy has been accompanied by aggressive Chinese information and disinformation campaigns—a topic that the China Power team will cover in detail in its next feature.

Q2: Is China succeeding at advancing its interests through Covid-19 diplomacy?

A2: China has had mixed success in advancing its interests through its Covid-19 diplomacy.

The CCDI reveals that China’s activities likely earned Beijing goodwill and influence in several middle-income countries along China’s periphery (such as Kyrgyzstan, Cambodia, Mongolia, and Indonesia), in sub-Saharan Africa (including Comoros, Zimbabwe, and the Republic of Congo), and in Serbia. Two high-income countries—Hungary and Chile—also ranked highly in the CCDI, suggesting China had sizeable influence there.

These findings indicate Chinese activities could have improved Beijing’s image and helped strengthen its relationships with countries that sought, or already enjoyed, strong relationships with China. In some countries, there is some evidence that providing vaccines enabled Beijing to advance its foreign policy objectives. Hungary, for example, blocked EU statements criticizing China in April 2021, just a few weeks after the country purchased millions of doses of Chinese vaccines.

At the same time, there are examples of vaccine diplomacy not winning China foreign policy victories. Amid a painful Covid-19 outbreak, officials in Paraguay publicly toyed with switching official diplomatic ties from Taiwan to mainland China, but authorities in Asunción ultimately chose not to do so. Furthermore, Beijing’s heavy-handed approach may have worsened its relations with some countries, especially wealthy democratic countries.

A major limiting factor in China’s vaccine diplomacy has been Beijing’s preference to sell vaccines and to provide them bilaterally. Most of China’s vaccines have gone to middle-income countries, leaving many of the poorest countries highly vulnerable. This has limited Beijing’s reach and undercut its attempts to cast itself as a benevolent guarantor of global public health.

Finally, the overall impact of China’s vaccine diplomacy has been watered down by concerns about the efficacy and safety of Chinese vaccines. Health authorities in at least 10 countries have suspended the use of Chinese vaccines, recommended pairing them with non-Chinese booster shots, or pushed back on them in some other way due to safety and efficacy concerns. China’s provision of medical supplies was similarly hindered by quality concerns, as some Chinese exported products were found to be fake or counterfeit.

Q3: What are the implications of China’s Covid-19 diplomacy for the United States and its partners?

A3: These findings suggest three main implications for the United States and its allies and partners. First, China did not fully seize the opportunity it had after it contained Covid-19 at home in early 2020. There was tremendous international outpouring of public health aid to China in early 2020 and China did not capitalize on that to strengthen relationships globally. Instead, China’s heavy-handed public diplomacy polarized its relationships with a number of countries. For the international community, Beijing’s response to the pandemic is a lesson learned in how Chinese diplomatic efforts and capabilities may not match, or at times even support, its broader ambitions.

Second, the United States does not necessarily need to compete with China on the provision of vaccines globally or seek to match Chinese vaccines dose-for-dose. Fast and early Chinese exports of its vaccines abroad have neither guaranteed sustained Chinese influence (particularly as other non-Chinese vaccines became available) nor caused China to have outsized and undue influence over recipient countries. Countries respond to what Beijing delivers and they take into account the efficacy of Chinese vaccines. The United States and its allies and partners should focus on ensuring widespread availability of high-quality vaccines based on public health needs.

Third, China’s public health diplomacy is wanting in many ways and has not matched the image that China seeks to project regarding its global health leadership. The United States should encourage China to donate rather than sell more vaccines to countries. It should particularly encourage China to donate more vaccines to COVAX. Finally, Washington should call on China to drop its requests that recipient countries demonstrate public displays of gratitude to China or align themselves with Chinese foreign policy goals.

Bonny Lin is a senior fellow for Asian security and director of the China Power Project at the Center for Strategic and International Studies (CSIS) in Washington, D.C. Matthew P. Funaiole is an interim director with the iDeas Lab and senior fellow with the China Power Project at CSIS. Brian Hart is an associate fellow with the China Power Project at CSIS. Hannah Price is a program manager with the China Power Project at CSIS.

Critical Questions is produced by the Center for Strategic and International Studies (CSIS), a private, tax-exempt institution focusing on international public policy issues. Its research is nonpartisan and nonproprietary. CSIS does not take specific policy positions. Accordingly, all views, positions, and conclusions expressed in this publication should be understood to be solely those of the author(s).

© 2021 by the Center for Strategic and International Studies