China may have played a role in hampering Taiwan’s ability to receive COVID-19 vaccines from abroad. Taiwan’s Health and Welfare Minister and Central Epidemic Command Center (CECC, 中央流行疫情指揮中心) head, Chen Shih-chung (陳時中), revealed on February 17 that in December of last year, Taipei was on the verge of announcing a deal to purchase 5 million doses of the Pfizer-BioNTech COVID-19 vaccine from Germany’s BioNTech, when the German firm abruptly pulled out of the deal. During a media interview, Chen expressed concern about “potential intervention by outside forces,” and said, “Certain people don’t want Taiwan to be too happy,” hinting at potential Chinese pressure and interference. Hours after Chen’s comments to the media, BioNTech stated that it still planned to provide vaccines to Taiwan. As Taiwan’s population has yet to be vaccinated, Beijing appears to be weaponizing the COVID-19 vaccine—in particular, by seizing on delays and setbacks for delivery—and using United Front tactics to inflict damage on Tsai Ing-wen’s (蔡英文) administration. Indeed, Taipei’s procurement of foreign supplies of the COVID-19 vaccine has become a new front in cross-Strait tensions and a test of Taiwan’s foreign diplomacy.
Taiwan’s Vaccine Procurement
The most recent estimate of Taiwan’s current foreign vaccine procurement lies between 30 million and 45 million doses, according to Minister Chen. This includes 10 million doses from British drug maker AstraZeneca, 5.05 million doses from US firm Moderna, an unconfirmed supply of 10 million doses from undisclosed sources, and 4.76 million doses from the COVAX global vaccine-sharing platform co-led by the World Health Organization (WHO), the Coalition for Epidemic Preparedness Innovations (CEPI), and GAVI, the Vaccine Alliance. The CECC confirmed in early February that Taiwan has been allotted 200,000 doses of the AstraZeneca vaccine from the first round of the COVAX program, which has allocated more than 1 million AstraZeneca doses for distribution to countries and territories that are not United Nations members.
Completion of the deal with BioNTech, whose initial pull-out had sparked controversy, could yield an additional 5 million doses, according to Taiwanese health officials. Minister Chen indicated that a potential reason for BioNTech’s sudden U-turn could have been Shanghai Fosun Pharmaceutical Group’s (上海復星醫藥公司) objection to the vaccine delivery. In March 2020, BioNTech signed a deal with Shanghai Fosun to develop and sell COVID-19 vaccines, granting the Chinese firm exclusive rights to distribute the vaccines to mainland China, Hong Kong, Macau, and Taiwan. However, the CECC has indicated that it is trying to negotiate directly with BioNTech to procure the vaccines, in an effort to bypass Shanghai Fosun’s exclusive rights to sell to Taiwan.
Taiwan also requested Germany’s help in securing vaccines for the island after Taipei had responded to Berlin’s request for assistance with automobile semiconductor chips. In January 2021, German Economic Affairs and Energy Minister Peter Altmaier sent a letter to Taiwan’s Ministry of Economic Affairs seeking help from global chip making giant Taiwan Semiconductor Manufacturing Company (TSMC, 台灣積體電路製造股份有限公司) and other Taiwanese chip manufacturers to alleviate a global chip shortage, which has adversely impacted auto production by German carmakers such as Volkswagen. In response, Taiwan’s Minister of Economic Affairs Wang Mei-hua (王美花) said that Taiwanese manufacturing executives agreed to help Germany. She also made a request during a meeting with Thomas Prinz, the German representative in Taipei, for Berlin’s help in obtaining COVID-19 vaccines for the island. While Minister Chen claimed that the two requests were unrelated, the CECC seems amenable to the prospect of selling Taiwanese semiconductor chips in exchange for COVID-19 vaccines from foreign distributors.
Meanwhile, Taiwan’s domestically produced COVID-19 vaccines are currently in Phase 2 clinical trials. Once approved by regulators, Taiwan’s United Biomedical (UBI, 聯亞) and Medigen (高端) vaccines are expected to contribute approximately 10 million doses to the national stockpile. These domestically produced vaccines could be administered as early as July of this year. Furthermore, after meeting domestic demand for the vaccines, Taiwan could possibly produce and export additional vaccines to aid developing countries and friendly nations.
Chinese Vaccine Diplomacy and Cross-Strait Tensions
China’s global “vaccine diplomacy” has been in full swing after promising half a billion Chinese-made vaccine doses to more than 45 countries, including giving priority access to developing countries in Southeast Asia and Africa. China’s COVID-19 vaccines have been developed by Chinese firms Sinopharm (中國醫藥集團), CanSino Biologics (康希諾生物), and Sinovac Biotech (北京科興生物製品). Thus far, Chinese vaccines have been administered in more than 25 countries, raising concerns not only about the safety of these vaccines, but also China’s expansion of influence and soft power in recipient countries. Beijing’s vaccine diplomacy reportedly played a role in Guyana’s decision in early February to revoke a prior agreement with Taipei to establish a Taiwan Office in Georgetown. Likewise, Chinese vaccine shipments to Turkey have been linked to a Chinese-Turkish extradition agreement that could send Uyghurs living in Turkey back to China.
The Chinese government is also seeking “political unity” by strategically inoculating Taiwanese businesspersons working and living in China. A Reuters article in January found that Beijing was prioritizing Taiwanese citizens in China to receive vaccines free of charge. State media and propaganda departments featured interviews with Taiwanese recipients of the shots praising the vaccine program. According to Chinese Communist Party (CCP) leader Wang Yang (汪洋), the inoculation drive was aimed at encouraging Taiwanese residents in China to aid in the “reunification with the motherland.”
However, Taiwan’s health officials have reiterated the government’s policy not to purchase any Chinese COVID-19 vaccines, including those from the COVAX program. Taiwan currently bans imports of Chinese vaccines, citing health concerns and lack of public data on the vaccines’ safety and efficacy. Taiwanese nationals who receive the vaccines in China are still subject to the mandatory 14-day quarantine when returning to the island. Furthermore, a February 2021 poll conducted by Taiwanese magazine Global Views Monthly (遠見雜誌) found that only 1.3 percent of Taiwanese would accept Chinese-made COVID-19 vaccines.
In response to Minister Chen’s veiled reference to Chinese interference on the BioNTech deal, officials in Beijing have accused the Tsai administration of politicizing the use of Chinese-made vaccines and have cast doubt on Tsai’s ability to successfully procure foreign vaccine deliveries in time. On February 25, Taiwan Affairs Office (TAO, 台灣事務辦公室) spokesperson Ma Xiaoguang (馬曉光) faulted the Democratic Progressive Party (DPP, 民進黨) government for failing to rapidly obtain vaccines, seemingly to create panic and stoke fears that the Taiwanese public will not have access to available vaccines. Ma also argued that the DPP government was disregarding the health and well-being of the people, seeking to shift Minister Chen’s blame for the vaccine setback back onto Tsai’s administration.
Kuomintang Critiques and Support for Chinese Vaccines
Amid the rise in cross-Strait tensions over vaccine procurement, the opposition Kuomintang (KMT, 國民黨) has also criticized the Tsai government’s stance on Chinese vaccines as purely motivated by ideology. KMT politicians have urged the government to at least provide the public an option of getting Chinese vaccines. There have also been political attacks against the popular CECC head Chen, who enjoys high public approval ratings. KMT Legislator Lin Wei-chou (林為洲) criticized Chen for not understanding how advanced China is, pointing to ideological differences for Chen’s argument not to purchase Chinese vaccines. In addition, KMT Legislator Fai Hrong-tai (費鴻泰) called on Chen to step down, citing accusations that the health minister had lied during the BioNTech vaccine procurement process.
Former president Ma Ying-jeou (馬英九) has also stepped into the fray, arguing that Taiwan “should not reject the Chinese vaccine.” Ma pointed to the Cross-Strait Cooperation Agreement on Medicine and Public Health Affairs (兩岸醫藥衛生合作協議)—which includes a cooperative mechanism on infectious disease prevention—that both sides signed in 2010, when he was president. He supported the notion that the Chinese vaccines could help reduce cross-Strait tensions. However, with the frequent People’s Liberation Army (PLA) incursions into Taiwan’s airspace, it is difficult to imagine that Chinese vaccines—as opposed to the reduction of Chinese military and political pressure on Taiwan—could actually improve cross-Strait relations. Nonetheless, KMT politicians have politicized the vaccine procurement issue to inflict political costs on the Tsai government for its handling of both foreign and Chinese vaccine issues.
An Urgency to Get Shots?
Arguably, Taiwan’s successful COVID-19 prevention efforts have made the immediate vaccination of its population less urgent at the present moment. The island has had only 10 deaths and fewer than 1,000 confirmed COVID-19 infection cases, with the majority of cases imported from abroad. Local transmission cases began to resume after a New Zealand pilot for EVA Airways was blamed for breaking the island’s 253-day streak of no new local transmission in late December of last year, which was followed by an outbreak at a Taoyuan hospital earlier this year.
However, future mass vaccinations of Taiwan’s population will eventually be needed for the island to open its doors to foreign tourists and resume international exchanges. As countries around the world are discussing a digital health passport, or travel pass, indicating that travelers have received COVID-19 vaccines, Taiwan’s participation in such a scheme would require Taiwanese residents to get immunized, according to a doctor at National Taiwan University Hospital. Also, for Taiwan to be included in travel bubbles between countries with low COVID-19 infection rates, vaccinating the public will be key, said the doctor.
Taiwan’s external vaccine procurement process has highlighted many new features of cross-Strait relations and Taipei’s foreign diplomacy. Chinese-made vaccines have become a United Front tactic to win over the Taiwanese business community in China, while Beijing officials have used delays and setbacks in Taiwan’s vaccine procurement plans to criticize the Tsai government. Yet despite Chinese pressure and Taiwan’s exclusion from the WHO, the island has been able to successfully negotiate with several foreign vaccine distributors. In addition, the COVAX global vaccine-sharing platform is one notable mechanism that is inclusive and open to Taiwan and other countries or territories that are not UN members. Finally, Taiwanese diplomacy has also carefully leveraged its comparative advantages—such as in semiconductor chip production—and foreign relationships to help the island stockpile vaccines for its population.
The main point: China has sought to utilize delays and setbacks in Taiwan’s vaccine procurement to inflict political damage on Tsai Ing-wen’s administration, while also leveraging the Chinese-made vaccines to promote its political unity agenda vis-à-vis Taiwan.