The World-System of Vaccine Distribution
Global Inequalities and Geopolitical Conflicts During the COVID-19 Pandemic
DOI:
https://doi.org/10.5195/jwsr.2024.1173Keywords:
China, Vaccine Diplomacy, Vaccine Nationalism, COVAX, PeripheryAbstract
This article analyzes spatial hierarchies and geopolitical conflicts during the COVID-19 pandemic from a world-systems perspective. Drawing on data on global vaccine production and distribution, we argue that the trimodal structure of the capitalist world-system—core, semi-periphery, and periphery—has been reproduced through unequal access to vaccines, constituting hierarchically structured “vaccine worlds”. These vaccine worlds are geopolitically contested, as Chinese companies compete with American and European corporations for influence and markets. Against this background, we outline the Chinese state-led vaccine internationalization strategy with its focus on the global South, and discuss its achievements and contradictions.
References
Acharya, Krishna Prasad, Tirth Raj Ghimire and Supram Hosuru Subramanya. 2021. “Access to and equitable distribution of COVID-19 vaccine in low-income countries.” npj Vaccines 6(54): 1–3.
Altindis, Emrah. 2022. “Inequitable COVID-19 vaccine distribution and the intellectual property rights prolong the pandemic.” Expert Review of Vaccines 21(4): 427–30.
Amin, Tahir and Aaron S. Kesselheim. 2022. “A global intellectual property waiver is still needed to address the inequities of COVID-19 and future pandemic preparedness.” INQUIRY: The Journal of Health Care Organization, Provision, and Financing 59: 1–6.
Amnesty International. 2021. “A Double Dose of Inequality: Pharma Companies and the Covid-19 Vaccines Crisis.” London: Amnesty International. Retrieved February 16, 2023 (https://www.amnesty.org/en/documents/pol40/4621/2021/en/).
Arrighi, Giovanni. 1994. The Long Twentieth Century: Money, Power and the Origins of Our Times. London: Verso.
______. 2007. Adam Smith in Beijing: Lineages of the Twenty-First Century. London: Verso.
Arrighi, Giovanni and Beverly J. Silver. 1999. “Introduction.” Pp. 1–36 in Chaos and Governance in the Modern World System, edited by A. Giovanni and B. J. Silver. Minneapolis: University of Minnesota Press.
Arrighi, Giovanni, Beverly J. Silver and Brewer, Benjamin D. 2003. “Industrial convergence, globalization, and the persistence of the North-South divide.” Studies in comparative international development 38: 3–31.
Arrighi, Giovanni and Jessica Drangel. 1986. “The Stratification of the World-Economy. An Exploration of the Semiperipheral Zone.” Review (Fernand Braudel Center) 10(1): 9–74.
Babones, Salvatore. 2005. “The Country-Level Income Structure of the World-Economy.” Journal of World-Systems Research 11(1): 29–55.
______. 2012. “Position and mobility in the contemporary world-economy: A structuralist perspective.” Pp. 327–35 in Routledge Handbook of World-systems Analysis, edited by S. Babones and C. Chase-Dunn. London/New York: Routledge.
______. 2017. American Tianxia: Chinese money, American power and the end of history. Bristol: Policy Press.
Basak, Palash, Tanvir Abir, Abdullah Al Mamun, Noor Raihani Zainol, Mansura Khanam, Md. Rashidul Haque, Abul Hasnat Milton, and Kingsley Emwinyore Agho. 2022. “A Global Study on the Correlates of Gross Domestic Product (GDP) and COVID-19 Vaccine Distribution.” Vaccines 10(266): 1–13.
Birley, Lewis M. 2023. “Cycles and Transformation: China’s State-Capitalism as Adaptive Strategy in the Arc of Capitalist Governance.” Journal of World-Systems Research 29(2): 505–23.
Blinder, Daniel, Lautaro Zubeldía and Sofya Surtayeva. 2021. “Covid-19 and Semi-Periphery: Argentina and the Global Vaccines Research and Development.” Journal of World-Systems Research 27(2): 494–521.
Bollinger, Robert, Stuart Ray and Lisa Maragakis. 2022. “COVID Variants: What You Should Know.” Baltimore: Johns Hopkins Medicine. Retrieved February 16, 2023 (https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/a-new-strain-of-coronavirus-what-you-should-know).
Bridge Beijing. 2023. “China COVID-19 Vaccine Tracker.” Beijing: Bridge Consulting (Beijing) Co., Ltd. Retrieved November 30, 2023 (https://bridgebeijing.com/our-publications/our-publications-1/china-covid-19-vaccines-tracker/).
Chase-Dunn, Christopher, Yukio Kawano and Benjamin D. Brewer. 2000. “Trade Globalization since 1795: Waves of Integration in the World-System.” American Sociological Review 65(1): 77–95.
Chatterjee, Niladri, Zaad Mahmood and Eleonor Marcussen. 2021. “Politics of Vaccine Nationalism in India: Global and Domestic Implications.” Forum for Development Studies 48(2): 357–69.
Collins, Anna L. 2013. Inequalities in global health: a world-system analysis, 1945-present. Manhattan: Kansas State University.
de Bengy Puyvallée, Antoine and Katerini Tagmatarchi Storeng. 2022. “COVAX, vaccine donations and the politics of global vaccine inequity.” Globalization and Health 18(26). Retrieved February 26, 2023 (https://doi.org/10.1186/s12992-022-00801-z).
Duke Global Health Innovation Center. 2022. “Launch & Scale Speedometer.” Durham, NC: Duke Global Health Innovation Center. Retrieved February 16, 2023 (https://launchandscalefaster.org/).
Elling, Ray H. 1981. “The capitalist world-system and international health.” International Journal of Health Services 11(1): 21–51.
Fröbel, Folker, Jürgen Heinrichs and Otto Kreye. 1978. “The New International Division of Labour.” Social Science Information 17(1): 123–42.
Hopkins, Terence K. and Immanuel Wallerstein, eds. 1982. World-Systems Analysis: Theory and Methodology. Beverly Hills/London/New Delhi: SAGE Publications.
Hung, Ho-fung. 2016. The China Boom: Why China Will Not Rule the World. New York: Columbia University Press.
Huang, Yanzhong. 2022. “The Health Silk Road: How China Adapts the Belt and Road Initiative to the COVID-19 Pandemic.” American Journal of Public Health 112(4): 567–69.
Kampfner, John. 2021. “Vaccine competition may now be the world’s best bet.” Chatham House. London: Chatham House. Retrieved February 16, 2023 (https://www.chathamhouse.org/2021/06/vaccine-competition-may-now-be-worlds-best-bet).
Kampmark, Binoy and Petar Kurečić. 2022. “Vaccine nationalism: Competition, EU parochialism, and COVID-19.” Journal of Global Faultlines 9(1): 9–20.
Karataşlı, Şahan Savaş. 2017. “The Capitalist World-economy in the Longue Durée: Changing Modes of the Global Distribution of Wealth, 1500–2008.” Sociology of Development 3(2):163-96.
Kobierecka, Anna. 2023. “Post-covid China: ‘vaccine diplomacy’ and the new developments of Chinese foreign policy.” Place Branding and Public Diplomacy 19(2): 280–93.
Lee, Kwangkun. 2009. “Towards a Reformulation of Core/Periphery Relationship: A Critical Reappraisal of the Trimodality of the Capitalist World-Economy in the Early 21st Century.” Perspectives on Global Development and Technology 8(2–3): 263–94.
Lee, Seow Ting. 2023. “Vaccine diplomacy: nation branding and China’s COVID-19 soft power play.” Place Branding and Public Diplomacy 19(1): 64–78.
Li, Minqi. 2016. China and the Twenty-first-Century Crisis. London: Pluto Press.
McMenamin, Martina E., Joshua Nealon, Yun Lin, Jessica Y. Wong, Justin K. Cheung, Eric H. Y. Lau, Peng Wu, Gabriel M. Leung, and Benjamin J. Cowling. 2022. “Vaccine effectiveness of two and three doses of BNT162b2 and CoronaVac against COVID-19 in Hong Kong.” The Lancet Infectious Diseases 22(10): 1435–43.
Ng, Oon Tek, Kalisvar Marimuthu, Nigel Lim, Ze Qin Lim, Natascha May Thevasagayam, Vanessa Koh, Calvin J. Chiew, et al. 2022. “Analysis of COVID-19 Incidence and Severity Among Adults Vaccinated With 2-Dose mRNA COVID-19 or Inactivated SARS-CoV-2 Vaccines With and Without Boosters in Singapore.” JAMA Network Open 5(8). Retrieved February 16, 2023 (https://doi.org/10.1001/jamanetworkopen.2022.28900).
Nhamo, Godwell, David Chikodzi, Hlengiwe Precious Kunene, and Nthivhiseni Mashula. 2021. “COVID-19 vaccines and treatments nationalism: Challenges for low-income countries and the attainment of the SDGs.” Global Public Health 16(3): 319–39.
Olliaro, Piero, Els Torreele and Michel Vaillant. 2021. “COVID-19 vaccine efficacy and effectiveness–the elephant (not) in the room.” The Lancet Microbe 2(7): E279–80.
Our World in Data. 2023. “Coronavirus (COVID-19) Vaccinations.” Oxford: Our World in Data. Retrieved December 30, 2022 (https://ourworldindata.org/covid-vaccinations).
Rudolf, Moritz. 2021. “Chinas Gesundheitsdiplomatie in Zeiten von Corona: Die Seidenstraßeninitiative (BRI) in Aktion.” SWP-Aktuell 2021/A 05. Retrieved February 16, 2023 (https://www.swp-berlin.org/publikation/chinas-gesundheitsdiplomatie-in-zeiten-von-corona).
Shandra, John M., Jenna Nobles, Bruce London, and John B. Williamson. 2004. “Dependency, democracy, and infant mortality: a quantitative, cross-national analysis of less developed countries.” Social Science & Medicine 59(2): 321–33.
Silver, Beverly J. 2003. Forces of Labor. Workers’ Movements and Globalization since 1870. Cambridge: Cambridge University Press.
Sparke, Matthew and Orly Levy. 2022. “Competing Responses to Global Inequalities in Access to COVID Vaccines: Vaccine Diplomacy and Vaccine Charity Versus Vaccine Liberty.” Clinical Infectious Diseases 75(S1): 86–92.
Suzuki, Mao and Shiming Yang. 2022. “Political economy of vaccine diplomacy: explaining varying strategies of China, India, and Russia’s COVID-19 vaccine diplomacy.” Review of International Political Economy 30(3): 865–90.
UNICEF. 2023. “COVID-19 Vaccine Market Dashboard.” Copenhagen: UNICEF Supply Division. Retrieved November 22, 2023 (https://www.unicef.org/supply/covid-19-vaccine-market-dashboard).
Usher, Ann Danaiya. 2021. “A beautiful idea: how COVAX has fallen short.” The Lancet 397 (10292): 2322–25.
U.S. Department of State. 2023. “COVID-19 Vaccine Donations.” U.S. Department of State. Retrieved November 30, 2023 (https://www.state.gov/covid-19-recovery/vaccine-deliveries/).
Vaccines Europe. 2021. “The EU Vaccine Industry in Figures.” Brussels: Vaccines Europe. Retrieved February 16, 2023 (https://www.vaccineseurope.eu/about-us/the-eu-vaccine-industry-in-figures).
Vadlamannati, Krishna Chaitanya and Yoo Sun Jung. 2023. “The political economy of vaccine distribution and China's Belt and Road Initiative.” Business and Politics 25(1): 67–88.
Veugelers, Reinhilde, Niclas Poitier and Lionel Guetta-Jeanrenaud. 2021. “A world divided: global vaccine trade and production.” Brussels: Bruegel. Retrieved February 16, 2023 (https://www.bruegel.org/blog-post/world-divided-global-vaccine-trade-and-production).
Waitzkin, H. 1978. “A Marxist view of medical care.” Annals of Internal Medicine 89(2): 264–78.
Wallerstein, Immanuel. 1974. The Modern World-System I: Capitalist Agriculture and the Origins of the European World-Economy in the Sixteenth Century. New York: Academic Press.
______. 1979. The Politics of the World-Economy: The States, the Movements and the Civilizations. Cambridge: Cambridge University Press.
______. 1995. Historical Capitalism with Capitalist Civilization. New York: Verso.
______. 2000. The Essential Wallerstein. New York: The New Press.
______. 2004. World-Systems Analysis: An Introduction. Durham, NC: Duke University Press.
WHO. 2021a. “COVAX Joint Statement: Call to action to equip COVAX to deliver 2 billion doses in 2021.” Geneva: WHO. Retrieved February 16, 2023 (https://www.who.int/news/item/27-05-2021-covax-joint-statement-call-to-action-to-equip-covax-to-deliver-2-billion-doses-in-2021).
______. 2021b. “Vaccine Equity.” Geneva: WHO. Retrieved February 16, 2023 (https://www.who.int/campaigns/vaccine-equity).
______. 2022a. “The Janssen Ad26.COV2.S COVID-19 vaccine: What you need to know.” Geneva: WHO. Retrieved February 16, 2023 (https://www.who.int/news-room/feature-stories/detail/the-j-j-covid-19-vaccine-what-you-need-to-know).
______. 2022b. “The Sinopharm COVID-19 vaccine: What you need to know.” Geneva: WHO. Retrieved February 16, 2023 (https://www.who.int/news-room/feature-stories/detail/the-sinopharm-covid-19-vaccine-what-you-need-to-know).
______. 2022c. “The Sinovac-CoronaVac COVID-19 vaccine: What you need to know.” Geneva: WHO. Retrieved February 16, 2023 (https://www.who.int/news-room/feature-stories/detail/the-sinovac-covid-19-vaccine-what-you-need-to-know).
______. 2022d. “The Oxford/AstraZeneca (ChAdOx1-S [recombinant] vaccine) COVID-19 vaccine: What you need to know.” Geneva: WHO. Retrieved February 16, 2023 (https://www.who.int/news-room/feature-stories/detail/the-oxford-astrazeneca-covid-19-vaccine-what-you-need-to-know).
______. 2022e. “The Pfizer BioNTech (BNT162b2) COVID-19 vaccine: What you need to know.” Geneva: WHO. Retrieved February 16, 2023 (https://www.who.int/news-room/feature-stories/detail/who-can-take-the-pfizer-biontech-covid-19--vaccine-what-you-need-to-know).
______. 2022f. "The Moderna COVID-19 (mRNA-1273) vaccine: what you need to know." Geneva: WHO. Retrieved February 16, 2023 (https://www.who.int/news-room/feature-stories/detail/the-moderna-covid-19-mrna-1273-vaccine-what-you-need-to-know)
Wong, John, Chun Wu, Wen Xie, and Srikant Vaidyanathan. 2020. “Competing in China’s Booming Biopharma Market.” Munich: BCG GmbH. Retrieved February 16, 2023 (https://www.bcg.com/publications/2020/competing-in-chinas-biopharma-market).
World Bank. 2022. “Countries and Economies.” Washington, D.C.: World Bank. Retrieved December 30, 2022 (https://data.worldbank.org/country).
WTO. 2022. “WTO-IMF Vaccine Trade Tracker.” Geneva: WTO. Retrieved December 30, 2022 (https://www.wto.org/english/tratop_e/covid19_e/vaccine_trade_tracker_e.htm).
Zhou, Yanqiu Rachel. 2022. “Vaccine nationalism: contested relationships between COVID-19 and globalization.” Globalizations 19(3): 450–65.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Philipp Köncke, Stefan Schmalz
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
- Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
- The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
- Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site;
- The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
- Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
- The Author represents and warrants that:
- the Work is the Author’s original work;
- the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
- the Work is not pending review or under consideration by another publisher;
- the Work has not previously been published;
- the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
- the Work contains no libel, invasion of privacy, or other unlawful matter.
- The Author agrees to indemnify and hold Publisher harmless from Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.
Revised 7/16/2018. Revision Description: Removed outdated link.
Funding data
-
Deutsche Forschungsgemeinschaft
Grant numbers SFB TRR 294/1–424638267 -
Deutsche Forschungsgemeinschaft
Grant numbers 447723986