The geopolitics of covid vaccines in Europe’s eastern neighbourhood – European Council on Foreign Relations

As vaccination schemes get under way around the world, Europe’s eastern neighbourhood is caught in a geopolitical dilemma about vaccine procurement. The countries of the region face choices about whether, how, and how vigorously to pursue the Western vaccines made by BioNTech–Pfizer, Moderna, and AstraZeneca – or accept offers of Sinovac from China or Sputnik V from Russia. All the countries of the region have a back-up in the shape of the World Health Organization programme COVAX – a multilateral initiative to assist less developed countries by providing vaccines for free. But the wait for those is long, and the programme will in any case supply only 20 per cent of a country’s population.

The Chinese vaccine is coming under increased scrutiny, while a rushed and politicised rollout of the Russian vaccine has generated distrust about its efficacy. But trust in vaccines aside, the procurement choices that European neighbours make often reflect their geopolitical alliances. Across eastern Europe and the Western Balkans, expectations are high that the European Union will help. But the queue for Western vaccines is long. So what will the EU’s neighbours in the east do? Will they turn in greater numbers to Sinovac and Sputnik V?

Russia’s stuttering Sputnik V

Russia was the first country in the world to develop and register a vaccine for domestic use, doing so as early as August 2020 and making great play of this step. The vaccine’s name – Sputnik V – invokes the space race between the United States and Russia in the 1950s.

But the hiccups came soon enough: the international science community published an open letter raising alarm about the fast rollout of Sputnik, citing an insufficient number of trials and the questionable nature of the data. That scepticism is echoed in Russia, though for different reasons:  medics may share the worries about insufficient testing and hidden side-effects, but the general population are distrustful because they see the government’s overall handling of covid-19 as prioritising its political agenda over a health agenda. As a result, 58 per cent of the population in Russia say they will not take the vaccine on offer, and 52 per cent of Russian medics say they do not trust the vaccine.

Nevertheless, widespread vaccinations started in early December, and the choice for Russians is simple: either Sputnik V or no vaccine at all, as the country is not importing any foreign-produced vaccines. Instead, Russia is trying to export its own vaccine, though here it was off to a slower start than it may have expected when it registered the vaccine. Only in late December did Belarus become the first country outside Russia to approve Sputnik V. Several more countries followed, including Argentina, Guinea, Serbia, and Bolivia. But others, like India and Brazil, refused to fast-track approval, saying that more tests are needed. In January, though, Hungary became the first EU country to approve the vaccine; and, by filing an application for registration with the European Medicines Agency Russia is seeking to further penetrate the European market.

Eastern Europe’s long queue

Russia’s neighbours are strikingly unenthusiastic about Sputnik V – with Belarus being the one exception. While Alyaksandr Lukashenka initially called the covid-19 pandemic a “psychosis”, Belarus took part in the clinical trials of Sputnik V and is now also planning to produce this vaccine itself. A free vaccination campaign began in January, but its first stage will cover only about 10 per cent of the population. In the middle of a major political crisis, Lukashenka is not diversifying his options by purchasing any other vaccines; in contrast, his main political opponent, Sviatlana Tsikhanouskaya, is negotiating vaccine supplies with EU representatives and the government officials of several European countries.

Ukraine and Moldova have tried hard to obtain Western vaccines. Ukraine sought the vaccine directly from the EU and the United States, but its diplomatic efforts have so far failed. Moldova, under its new president, Maia Sandu, managed to sign an agreement with Romania, which has promised 200,000 vaccines. Moldova is not currently considering using Sputnik V, but its recently ejected president, Igor Dodon, has engaged in a bout of ‘vaccine flattery’ in a quest for political survival. He stated that he wants the Russian vaccine and no other. He has also claimed that Western vaccines “were quickly cobbled together only to show that the West is not lagging behind Russia” and are therefore too risky.

When Russia offered Sputnik V to Ukraine, it flatly refused. Ukraine preferred to sign a contract for the Chinese vaccine Sinovac, which is still in the third stage of testing by the regulator, but Ukraine has ordered 1.9 million doses. Ukraine is also set to receive 8 million vaccines through COVAX, but these will not arrive before the spring. Moldova’s first batches will also come from COVAX. For now, there is no vaccine in either country yet, and the entire vaccination programme is only just being put in place.

The three countries of the South Caucasus, meanwhile, have also struggled to obtain Western vaccines. Sputnik V is not hugely popular: in what looks like a delaying tactic, Georgia is waiting for it to pass “necessary tests” and Armenia has ordered only a small batch, for groups most at risk. It has now also purchased some vaccines from AstraZeneca and hopes to receive vaccines through COVAX in the spring. Azerbaijan, on the other hand, has turned to Sinovac and has already purchased 4 million doses in case of its successful registration.

Competition in the Western Balkans

In the Western Balkans, hopes were high for receiving EU solidarity in a time of crisis. So the disappointment with the scarce help so far has been great, and vocal. While several countries in the region have managed to secure batches from Western manufacturers, they expect more from the EU itself. Impatient with the delay, they have redoubled their efforts to obtain vaccines on their own, rushing to do deals wherever they can. Leaders in the region are keen to dress up any success in political and nationalist rhetoric.

Serbia has been the most successful country in the region in terms of securing vaccines: it already has enough for its entire population. A first, small, batch of BioNTech–Pfizer vaccines reached the country as early as December, and Aleksandar Vucic and other leaders got the jab straight away. They have since used every opportunity possible to remind anyone who will listen that Serbia is ahead of its neighbours – the interior minister, for instance, proudly claimed that “Serbia is one of the rare countries where you can get vaccines from all world manufacturers”.

Albania has also managed to secure vaccines from BioNTech–Pfizer and it started vaccinating in January. The prime minister, Edi Rama, has stressed that the first vaccine delivery of half a million doses is intended for both Albanians and Kosovars; he and his team have also publicly accused the EU of leaving the Balkans “on their own”. Russian diplomats seized the opportunity to engage, using Twitter to offer Sputnik V – but Rama deemed the offer provocative and demanded an apology.

Kosovo secured 500,000 vaccines from Pfizer, which Albania will supplement for medical staff in the country. In one incident, Serbia sent about 50 of its first vaccines to Serb health workers in North Kosovo – who declined and instead offered them to the elderly. The Kosovo authorities, who had not been consulted, were furious at the interference from Serbia.

When it comes to EU solidarity, neighbouring Bulgaria has promised North Macedonia a donation from its own stock of vaccines. Even if more action is lacking, Bosnia and Herzegovina still relies mainly on EU solidarity and COVAX, yet not surprisingly Bosnia’s Republika Srpska is pursuing separate talks and opting for the Russian and Chinese vaccines. Montenegro had been relying solely on COVAX, but recently changed strategy and started intensive negotiations directly with vaccine manufacturers. Its health minister declared on 19 January that agreement had been reached with the Chinese manufacturer Sinopharm and vaccines are to be delivered at the end of January. Montenegro is also considering the Sputnik vaccine.

Turkey’s deal with China

Much of the world celebrated Ugur Sahin and Ozlem Tureci – the husband-and-wife team of Turkish-German scientists who created the BioNTech–Pfizer vaccine – as an uplifting immigrant success story at a time of global crisis. But, in their country of origin, the Turkish government opted for the Chinese vaccine. It is not clear if Ankara’s choice stemmed from economic reasons or a geostrategic lurch – likely a combination of both. Turkish officials claim that Sinovac has an efficacy rate of 91 per cent, and the government has ordered 50 million doses that are still to arrive – and the vaccine itself is still being tested. Mass inoculation is therefore yet to start in Turkey. The country has been badly hit by the covid-19 pandemic: while official figures put death toll at a little over 20,000, medical unions and others are certain the real numbers are much higher.

What can the EU do?

The EU will most certainly eventually donate millions of vaccines to other countries – but this is still some way off. It has collectively already bought in excess of its own needs: over 2 billion doses, from six different suppliers, including some vaccines yet to receive approval. It secured the extra doses as a safety net in case some of last year’s vaccine development trials did not work. Should they all succeed, EU states will be able to share the supplies with others.

But this promise of assistance is taking too long to materialise. A group of EU member states has requested that the European Commission speed up assistance for the Eastern Partnership countries, but the commission is prioritising internal pressures, as the member states are also struggling to kickstart vaccination programmes. Neighbouring countries and their leaders are under pressure, too, and are inevitably looking for help elsewhere.

Interestingly, the West is considering cooperating with Russia. For example, plans exist to test a combined use of the Sputnik and AstraZeneca vaccines. Vladimir Putin and Angela Merkel discussed joint production of vaccines, but the details – or feasibility – of this remain unclear for the time being. If this unlikely cooperation succeeds, it could be another good source of vaccines for the EU’s neighbours.

When covid-19 first struck in early 2020, the EU was criticised for its perceived inability to help neighbouring countries, while China and Russia made great show of delivering medical aid equipment and masks to Europe’s neighbours. It is important for the EU to not repeat the same mistake with vaccines. It needs to find a creative way to help partner countries in its neighbourhood to secure enough vaccines in a timely and equitable manner.