Vaccine Diplomacy and the Pitfalls of American Foreign Policy

Why pressuring Brazil to reject Russia’s Sputnik V vaccine is a bad look for American foreign policy.

The competition for a vaccine that will bring an end to the COVID emergency has, it would seem, once and for all globalized public health and made it into a visible flashpoint of the tug-o-war between state actors. Whether it is the AstraZeneca vaccine becoming entangled in the politics of Brexit, Israel’s blockade hindering the shipment of vaccines to the Gaza strip, or the Director-General of WHO invoking the term “vaccine apartheid” in reference to the slow process of globally distributing vaccines, the Coronavirus pandemic and the response thereto is a subject of international relations, and a heated one at that.

This is especially true for US-Russia relations, which has seen US attempts to suppress a global rollout of the Sputnik V vaccine. According to the 2020 Annual Report of the US Health & Human Services (HHS) department, the Office of Global Affairs (OGA) directed its Health Attaché office to “persuade Brazil to reject the Russian COVID-19 vaccine” as part of a larger concerted effort to dissuade countries in the Americas from accepting aid offered by so-called “ill-intentioned states.”

Combatting malign influences in the Americas: OGA used diplomatic relations in the Americas region to mitigate efforts by states, including Cuba, Venezuela, and Russia, who are working to increase their influence in the region to the detriment of US safety and security. OGA coordinated with other U.S. government agencies to strengthen diplomatic ties and offer technical and humanitarian assistance to dissuade countries in the region from accepting aid from these ill-intentioned states. Examples include using OGA’s Health Attaché office to persuade Brazil to reject the Russian COVID-19 vaccine, and offering CDC technical assistance in lieu of Panama accepting an offer of Cuban doctors.” (Page 48, 2020 Annual Report)

As of writing this article, the report is no longer accessible on the official website, though it can still be retrieved via internet archives such as the ‘Wayback Machine’.

In the aftermath of mainstream media catching on to this admission, the US embassy in Brazil released a statement on Twitter, claiming that no such consultations ever took place. The Washington Post interviewed an HHS official who said that the department was not in a position to “discourage Brazil or any other nation from accepting vaccines that have been authorized by their respective regulators.” Deliberate or not, this statement did not address the accusations that the US advised Brazil against Sputnik V, since it implied the vaccine had already been approved by Brazil’s regulatory agency, which is not the case as the aforementioned Washington Post article points out.

Indeed, Brazil’s Health Regulatory Agency (Anvisa) has yet to approve the Sputnik V vaccine, even after the Brazilian government secured a contract for ten million doses in March of this year, and the Brazilian Health Ministry announced it was evaluating the possibility of domestically producing Sputnik V doses. The question stands: why? If it was not because the US advised Brazilian officials against the use of Sputnik V, which seems all but certain, what other reasons might they have?

The trouble with the Vaccine(s)

The Sputnik V vaccine, like its Johnson & Johnson and AstraZeneca competitors, inserts a deactivated adenovirus vector into the human body which contains genetic instructions for the expression of spike proteins. These spike proteins are then recognized by the immune system, preparing it to create the antibodies needed to combat the Coronavirus if and when it is encountered (Source: New York Times).

Defending its decision against Sputnik V, Anvisa has claimed that the adenovirus particles contained in the vaccine batches it received are not deactivated, but rather replication-competent, which is to say, instead of acting as a mere carrier the adenovirus itself is able to proliferate in the body. Inoculation could therefore potentially cause sickness, most likely a common cold, posing risks to immune-compromised and otherwise vulnerable patients.

Sputnik V and Gamaleya Center, the research center behind the vaccine, have repudiated Anvisa’s claims, stating that all doses are subject to a rigorous quality control and purification process that aims to identify potential issues, including but not limited to replication-competent adenoviruses. On its website, Sputnik V cites real-world data from the Hungarian, Mexican, and Argentinian governments, all of which have verified Sputnik V’s safety and efficacy vis-à-vis other vaccines. According to Statista, as of May 18th, 29 countries have either ordered or agreed on domestic production of Sputnik V doses, and overall some 68 countries have approved the vaccine after 19 clinical trials since last summer.

Additionally, a peer-reviewed study published in The Lancet in February found the Sputnik V vaccine to be 91.6% effective, putting it on par with the Moderna, Pfizer-BioNTech, and Johnson & Johnson alternatives. An open letter in response to this study was published by outside Researchers on May 12, wherein it is claimed that there are some discrepancies in the reporting of findings.

Crucially, other vaccines have not been wholly immune to controversy either. The US-produced Johnson & Johnson vaccine – which Brazil’s Anvisa approved for emergency use in late March – has been linked to a series of statistically rare, but in some instances life-threatening, cases of blood clotting. Dr. Tom Shimabukuro, head of the CDC’s Covid-19 vaccine safety monitoring work, told reporters in a recent NBC interview that current evidence "suggests a plausible causal association" between the J&J vaccine and the aforementioned cases of thrombosis with thrombocytopenia syndrome. As of May 12, the CDC has identified a total of 28 such cases.

Vaccination Sphere of Influence

At the present moment, what we are left with is the scientific equivalent of he-says-she-says. According to its detractors, the safety and efficacy of Sputnik V remain indeterminate, whilst its defenders claim the vaccine to be as good as its biggest competitors. Although scientific opinions paint an inconclusive picture, the political dimension is much less forgiving.

During the height of the US-Venezuela rivalry under the Trump administration, then-National Security Advisor John Bolton proudly proclaimed “the Monroe Doctrine is alive and well”, referring to the foreign policy of the 5th President of the United States, James Monroe, who vehemently opposed a European presence in South America. What came to be known as the Monroe Doctrine ultimately encompassed a form of imperialism that sought to maintain an American political and military sphere of influence over the entire western hemisphere, serving as a justification for a long list of US interventions in Latin American affairs.

We return then to the Health & Human Services report, which laid bare the political overtones of America’s current vaccine diplomacy: in 2020 the US advised Brazil, a South American country with one of the highest rates of daily new COVID-19 cases in the world (Source: OurWorldInData), to turn down vaccine doses from a perceived geopolitical rival of the US. Yet, even into the new administration, the US has been unable to provide Brazil with a much-needed substitute, despite demand within the US decreasing and AstraZeneca shipments sitting unused, awaiting FDA approval for export (Source: VoiceOfAmerica). Meanwhile, Brazil continues to experience a vaccine shortage, as well as a slow roll-out of whatever vaccines are available, with 8.4% of Brazil’s population being fully vaccinated as of May 19th.

There is also a local political element in Anvisa’s continued decision to block Sputnik V. Sergio Machado Rezende, Brazil’s former Minister of Science and Technology and currently the coordinator of a group of 9 states in Northeastern Brazil (the Northeast Consortium) pursuing their own COVID policy, told Universo Online – a Brazilian news agency – in an April 28 interview that he believes it to be no coincidence that Anvisa is blocking the Northeast of the country from getting the vaccines it wants and needs, as current President Jair Bolsonaro previously won fewer votes in the Northeast than in other regions. In early April, the Northeast Consortium announced its intention to import 66 million doses of Sputnik V, which would be enough to cover more than half of the Northeast’s population of 56 million (Sputnik V is a two-dose vaccination, unlike the newer one-dose ‘Sputnik Light’ also developed by the Gamelaya Center in Russia).

As of May 17, President Joe Biden has declared the US would scale up its commitment to global vaccine distribution, after calls to do so from within and without. However the fact of the matter remains, whilst the US was inoculating its citizens and advising countries in its backyard to wait on American aid, Russia – experiencing a comparatively lower rate of infection throughout the pandemic (Source: OurWorldInData) – began exporting Sputnik V doses to hard-hit but often forgotten places like the Palestinian territories, South America and Central Asia, at the same time that the Russian population was being vaccinated.

Brazilians may want to ask themselves if the US knows what is best for Brazil, and if they are content to wait for the leftovers of the US vaccine roll-out instead of pursuing more immediate alternatives. Furthermore, what we must all ask ourselves is if we will let our individual health become a battlefield in the new cold war.

Julian Fisher is a Policy Analyst at the Russian Public Affairs Committee (Ru-PAC).