Give but also take: China’s Covid-19 vaccine aid

  • Fall 2022 ∕  Winter 2023
Give but also take: China’s Covid-19 vaccine aid

Tingxuan (Diana) Zhu is a PhD student in the Department of Political Science studying comparative politics and international relations. Her research interests include political economy of development, patterns of international cooperation, and the global impact of China.

FALL 22/Winter 23 :: précis Student Feature :: Tingxuan (Diana) Zhu
Tingxuan (Diana) Zhu
March 5, 2023

Soon after the World Health Organization (WHO) declared Covid-19 a global pandemic, China’s president Xi Jinping pledged at the World Health Assembly to make the Covid-19 vaccine “a global public good” once it was developed and available in China. By the end of May 2022, more than one year since its first vaccine donation dispatch, China had already provided over 2.1 billion doses of Covid-19 vaccines to over 100 countries. 

Although China’s ministry of foreign affairs (MFA) repeatedly emphasized that its vaccine assistance was “doing humanitarian work,” “comes with no geopolitical agenda or political strings,” and that China “will not use vaccines to influence or lead the world,” China’s vaccine aid allocation has shown patterns that seem to contradict the stated objectives.[1] The top recipient of China’s vaccine aid, Myanmar, for example, received 532 times the number of doses than Guyana received, even though Guyana had more than three times the Covid-19 cases per million people at the end of 2020.[2] Given the wide variation in China’s vaccine aid allocation, what motivations, other than humanitarian concerns, explain China’s aid distribution?

To make sense of the underlying motivations of China’s vaccine aid program, I analyze data on bilateral vaccine distribution and the events around these vaccine dispatches between February 2021 and March 2022. Contrary to Beijing’s claim of a humanitarian and need-driven program, I find that China’s aid allocation is primarily driven by strategic considerations to strengthen its political influence and facilitate economic interests in the context of great power competition. More specifically, I argue that China seeks to consolidate bilateral political ties, strengthen its international reputation, and facilitate economic gains through its use of aid.

Why do states provide foreign aid?

Vaccine aid is a part of a vibrant and growing pool of foreign assistance resources. On the question of why states provide aid to other countries, scholars have offered various explanations ranging from the donor’s strategic interests and policy concessions to the recipient’s humanitarian and developmental needs. A classic argument proposed by Morgenthau (1962) is that foreign aid, especially economic and development aid, tends to be a political pretext or is a diplomatic bribe in disguise.[3] Later scholars further formalize the “aid-for-policy” framework, arguing that donor countries use aid finance to exchange for policy concessions, advance the donor’s diplomatic interests, and strengthen the public image of the donor among the recipient’s public.[4]

Compared to the countries that did not receive aid from China, aid recipients generally have less developed economies and fewer Covid-19 cases. They trade less with China, are more autocratic, more likely to be a signatory of China’s Belt and Road Initiative, and more likely to be previous beneficiaries of Chinese aid projects.

In recent years as aid finance from non-Western countries has begun to rise, more attention has been devoted to the role and implications of new donors’ aid programs. However, because of issues like data transparency and aid standard mismatch between the new and traditional donors, scholars have yet to reach a consensus on the patterns and motivations of aid provision by new donors like China. While many scholars argue that China allocates more aid to countries with worse political institutions and better natural resource endowment to extract political support and economic gains, others have also demonstrated that Chinese aid is no more strategically minded than its western counterparts and sometimes provides a needed alternative to the limited western aid financing.[5]

The unsatisfactory answer we have on understanding why and how new donors like China provide foreign aid makes the analysis of Covid-19 vaccine aid a necessary and appropriate case study. Unlike most Chinese aid programs analyzed in previous studies, China’s Covid-19 vaccine outreach serves as an instance of foreign aid that is clearly defined in its scope and composition, measurable in terms of recipient needs and donor contributions, and accessible with sufficient public data. More importantly, China’s bilateral donation of Covid-19 vaccines largely resembles the pattern of past Chinese official development assistance. Therefore, examining the patterns of and analyzing the motivations behind this recent Covid-19 aid initiative can reveal important insight into the broader study of Chinese foreign aid and advance our understanding of non-Western donors’ aid agenda.

Where does China’s vaccine aid flow to?

Starting on February 1, 2021, Beijing began its extensive vaccine aid distribution to other countries, with Pakistan receiving 500,000 doses of Sinopharm vaccines as the first recipient of China’s vaccine donation. By March 2022, China had donated over 114 million doses of vaccines to 92 countries according to the Vaccine Tracker data. So, who are the recipients of Chinese bilateral vaccine aid? Out of the 92 aid recipients, 41 countries are in Africa, 28 in Asia, 14 in the Americas, 5 in Europe, and 4 in Oceania. Although Africa has the highest number of aid recipients, Asian countries are by far the largest beneficiary of vaccine aid with an average aid size of 2.6 million doses per Asian recipient (compared to 0.7 million doses per African country). 

Several trends emerge from the aid distribution data. Compared to the countries that did not receive aid from China, aid recipients generally have less developed economies and fewer Covid-19 cases. They trade less with China, are more autocratic, more likely to be a signatory of China’s Belt and Road Initiative, and more likely to be previous beneficiaries of Chinese aid projects. A regression analysis that tests what political or economic factors of the recipient are associated with China’s vaccine allocation shows that China provides significantly more aid to countries that are more politically aligned with China in UN General Assembly (UN) voting records and those that purchase more vaccines from China. Contrary to Beijing’s claim that the aid allocation is a need-based, humanitarian effort to equalize vaccine access, the aid allocation pattern does not show that countries more severely impacted by the pandemic, measured by the normalized total Covid cases on December 31. 2020, received more aid from China. Together, the substantial variations in China’s aid allocation suggest that China’s vaccine aid provision prioritizes political ties and economic interests over the humanitarian needs of the recipient country.

The political motivations: To consolidate ties & strengthen reputation

Given the preliminary empirical evidence that suggests China may use aid to enhance political ties with recipients, how does the donor translate aid provision into bilateral diplomatic affinity? Looking at the diplomacy around China’s aid allocation, I find that China uses aid delivery to create positive publicity by celebrating bilateral friendship. More specifically, Beijing capitalizes on the aid recipients’ ceremonial expressions of gratitude and solidarity to demonstrate and consolidate its close bilateral relations, especially countries with which it previously had strong ties. 

One prevalent feature across most of China’s early vaccine deliveries is a formal handover ceremony attended by both the Chinese ambassador and high-ranking political officials of the recipient countries. These aid transfer ceremonies often become a major symbolic showcase of close bilateral ties between China and the recipient orchestrated by Beijing. At these aid receptions, the recipient politicians often express gratitude towards China’s generosity and discuss plans of incorporating aid into local vaccine rollout. These expressions of appreciation are then subsequently emphasized by the Chinese ambassadors, who often frame the aid transfer as a grand celebration of the bilateral ties and evidence of China’s commitment to supporting its friends in trying times. 

China’s aid to Pakistan, for example, vividly demonstrates how China translates aid allocation into celebrating friendship and strengthening ties. At the aid transfer ceremony for China’s first donation of 500,000 doses on February 1, 2021, the Pakistani foreign minister expressed gratitude for the Chinese people and the government who stood “shoulder-to-shoulder” with Pakistan in the fight against the pandemic. Subsequently, the Chinese ambassador echoed and added to this celebratory comment, saying that the vaccines were a “new manifestation of the ‘iron brotherhood’ between the two countries” and that the friendship between the two countries was “higher than the mountain, deeper than the sea, and sweeter than the honey.”[6] Soon after the handover event, both envoys were interviewed by local media where they again commented on the strong bilateral ties between China and Pakistan; and Pakistan’s special assistant to the prime minister on health took to Twitter after the event to further thank China for the aid.

Strengthening bilateral ties is not the only political motivation for China’s vaccine aid. Because aid provision is generally recognized as a good deed, scholars have argued that aid donors can capitalize on the act of aid provision to establish a strong and positive public.[7] With its reputation tarnished by the Covid-19 outbreak, China did not let this opportunity slip away. Throughout the past two years, Beijing has made a conscious effort to publicize its contribution to the Covid-19 recovery effort and take advantage of the aid-induced publicity to enhance its international image as a responsible and humanitarian-minded great power. To make sure that China’s contribution to the global Covid recovery is widely recognized, key leaders like President Xi Jinping and Foreign Minister Wang Yi have played an active role in publicly announcing each step of China’s vaccine aid program. At the May 2020 World Health Assembly Xi pledged to make Chinese vaccines a global public good, and since then Xi has announced most of China’s major contributions to the vaccine aid initiative in front of international audiences. In many subsequent public speeches and press conferences, Minister Wang and the Ministry of Foreign Affairs (MFA) spokespersons repeatedly quoted Xi’s commitment to cooperation in the equitable distribution of vaccine resources and applied the slogan of “a community of shared future for mankind” in different contexts to showcase China as an active, generous, and global-minded power in this public health crisis. These public appearances in front of key international audiences demonstrate China’s opportunistic use of leadership diplomacy to turn aid contribution into an advertising platform.

The economic motivations: Aid to facilitate economic gains 

China also uses aid to facilitate commercial gains and pursue future economic cooperation. More specifically, aid deliveries are closely correlated with economic deals that allow the donor to deepen cooperation with and strengthen influence over the recipients. In many vaccine-recipient countries, China either initiated or furthered programs of economic cooperation with the recipients within weeks of the vaccine donations. For example, the Dominican Republic signed an Agreement on Economic and Technical Cooperation on March 21. 2021, with China to extend the bilateral partnership, only four days after it received the first batch of 50,000 doses of vaccine aid from China on March 17, 2021.[8] Though the terms of the agreement and the negotiation process remain unclear, the Chinese ambassador cited the abundance of aid as evidence of China’s generous support for the country that had strengthened the bilateral partnership and promoted cooperation. Similarly, four days before China donated 200,000 doses of vaccines to Guinea on March 3, 2021, the two countries signed an Agreement on Economic and Technical Cooperation on February 27, alongside an announcement that China agreed to partially waive Guinean loans it owed to China. The debt relief signaled a generous gesture by China to assist the economic recovery of these aid recipients, and the signing of economic agreements ensured further economic engagements between the dyads. Together, these agreements suggest that China has linked aid to economic cooperation.

Vaccine sales are another economic benefit China has achieved through its aid provision. An empirical analysis of the aid distributions shows that, among all Chinese aid recipients, countries that received a larger amount of aid tend to purchase more vaccines from China. Overall, China is estimated to provide an additional 20,000 doses of vaccine aid for each additional million doses of vaccine purchased; this estimate resembles a 2% “aid back” deal for the vaccine purchases countries make. Compared to the 21 countries that purchased Chinese vaccines without China’s aid incentives, the average amount of vaccines sold to aid beneficiaries is 9.35 million doses, more than three times the average sale of 3.1 million doses sold to a non-aid recipient. This sharp contrast between the purchase amount of aided and non-aided states provides some evidence that China may provide vaccine aid to either reward or incentivize purchases. 


The study of why donors, especially non-traditional donors like China, provide aid has been a central focus among international cooperation scholars. China’s Covid-19 vaccine aid provides a prime case study for this question. Combining quantitative and qualitative analysis, I find that China’s vaccine aid largely reflects its strategic motivations as a rising power and aims to enhance its political influence and facilitate economic gains for its national economy. Contrary to the Chinese MFA’s claims, China does not distribute aid based on the need of recipients. Instead, it uses aid strategically to gain diplomatic affinity, promote a positive public image, and further economic engagements with the recipient countries. As countries prepare themselves for a post-pandemic world, case studies like China’s vaccine aid should help us better understand the new normal of cooperation and competition in public health and beyond.

[1]  MFA. 2021. “Foreign Ministry Spokesperson Hua Chunying’s Regular Press Conference on May 11, 2021.” Ministry of Foreign Affairs of the People’s Republic of China. May 11, 2021.

[2]  Bridge Consulting. “Tracking China’s COVID-19 Vaccine Distribution.” Bridge Consulting (blog), March 5, 2021.

[3]  Morgenthau, Hans. 1962. “A Political Theory of Foreign Aid.” The American Political Science Review 56 (2): 301–9.

[4]  Alesina, Alberto, and David Dollar. 2000. “Who Gives Foreign Aid to Whom and Why?” Journal of Economic Growth 5 (1): 33–63.

Milner, Helen V., and Dustin H. Tingley. 2010. “The Political Economy of U.s. Foreign Aid: American Legislators and the Domestic Politics of Aid.” Economics & Politics 22 (2): 200–232.

[5]  Naím, Moisés. 2007. “Rogue Aid.” Foreign Policy, April 2007.

Bräutigam, Deborah. 2011. “Aid ‘With Chinese Characteristics’: Chinese Foreign Aid and Development Finance Meet the OECD-DAC Aid Regime.” Journal of International Development 23 (5): 752–64.

Dreher, Axel, Andreas Fuchs, Roland Hodler, Bradley C. Parks, Paul A. Raschky, and Michael J. Tierney. 2019. “African Leaders and the Geography of China’s Foreign Assistance.” Journal of Development Economics 140 (September): 44–71.

Strange, Austin, Axel Dreher, Andreas Fuchs, Bradley Parks, and Michael J. Tierney. 2017. “Tracking Underreported Financial Flows: China’s Development Finance and the Aid–Conflict Nexus Revisited.” Journal of Conflict Resolution 61 (5): 935–63.

Dreher, Axel, and Andreas Fuchs. 2015. “Rogue aid? An empirical analysis of China’s aid allocation.” Canadian Journal of Economics/Revue canadienne d’économique 48 (3): 988–1023.

[6]  Xinhua. 2021. “China-Donated Covid-19 Vaccines Handed over to Pakistan - Xinhua | English.News.Cn,” February 1, 2021.

[7]  Goldsmith, Benjamin E., Yusaku Horiuchi, and Terence Wood. 2014. “Doing Well by Doing Good: The Impact of Foreign Aid on Foreign Public Opinion.” SSRN Scholarly Paper ID 2361691. Rochester, NY: Social Science Research Network.

[8] PRC Embassy in Dominican Republic. 2021. “中国和多米尼加签署经济技术合作协定.” March 23, 2021.