America’s Vaccine Diplomacy Is AWOL in the Middle East

China and Russia are spreading their vaccines—and forging new ties—to some of Washington’s closest allies.

Cook-Steve-foreign-policy-columnist4
Steven A. Cook
By , a columnist at Foreign Policy and the Eni Enrico Mattei senior fellow for Middle East and Africa studies at the Council on Foreign Relations.
The first Saudi citizen preparing to receive the Pfizer-BioNTech COVID-19 coronavirus vaccine in the capital Riyadh on Dec. 16, 2000, as part of a vaccination campaign by the Saudi health ministry.
The first Saudi citizen preparing to receive the Pfizer-BioNTech COVID-19 coronavirus vaccine in the capital Riyadh on Dec. 16, 2000, as part of a vaccination campaign by the Saudi health ministry.
The first Saudi citizen preparing to receive the Pfizer-BioNTech COVID-19 coronavirus vaccine in the capital Riyadh on Dec. 16, 2000, as part of a vaccination campaign by the Saudi health ministry. FAYEZ NURELDINE/AFP via Getty Images

In the last few years, Egypt has spent more money on Russian defense equipment than it has since the early 1970s. Cairo has also forged a substantial economic relationship with Beijing. In 2017, Turkey purchased Russia’s S-400 air defense system and has expanded its commercial and diplomatic relations with China. Saudi Arabia and the United Arab Emirates rolled out their red carpets in 2019 for Vladimir Putin, while in 2018 Chinese President Xi Jinping spent three days in the UAE.

Everyone in Washington who is paying attention knows that America’s partners in the Middle East have been dallying with its rivals. Beijing and Moscow have been investing, selling weaponry, and, in the case of Russia, intervening directly in conflicts to advance their interests in the region. More recently, however, they have added a new instrument of influence: the coronavirus vaccines.

Last spring, the term “mask diplomacy” gained popularity to describe the way in which China sought to advance its global influence through the provision of personal protective equipment to countries in need. Now we have “vaccine diplomacy,” with a fair number of America’s Middle Eastern partners signing up for Russian or Chinese products. No one knows for sure whether Sputnik V or the vaccines that Sinopharm and Sinovac have developed are effective, or their adverse effects, but for China and Russia those issues may be beside the point.

In the last few years, Egypt has spent more money on Russian defense equipment than it has since the early 1970s. Cairo has also forged a substantial economic relationship with Beijing. In 2017, Turkey purchased Russia’s S-400 air defense system and has expanded its commercial and diplomatic relations with China. Saudi Arabia and the United Arab Emirates rolled out their red carpets in 2019 for Vladimir Putin, while in 2018 Chinese President Xi Jinping spent three days in the UAE.

Everyone in Washington who is paying attention knows that America’s partners in the Middle East have been dallying with its rivals. Beijing and Moscow have been investing, selling weaponry, and, in the case of Russia, intervening directly in conflicts to advance their interests in the region. More recently, however, they have added a new instrument of influence: the coronavirus vaccines.

Last spring, the term “mask diplomacy” gained popularity to describe the way in which China sought to advance its global influence through the provision of personal protective equipment to countries in need. Now we have “vaccine diplomacy,” with a fair number of America’s Middle Eastern partners signing up for Russian or Chinese products. No one knows for sure whether Sputnik V or the vaccines that Sinopharm and Sinovac have developed are effective, or their adverse effects, but for China and Russia those issues may be beside the point.

It is possible to read too much into these shifts. The novel coronavirus has brought countries to their knees, though the Middle East has fared better than most people initially believed. And some leaders in the region may be calculating that less expensive vaccines produced in both Russia and China are better than nothing, even if the scientific data is far from complete. Still, it is hardly a stretch to see how receptivity to the Sputnik V and Chinese-made vaccines among U.S. friends in the region connects to the broader changes underway in the regional order.

A short tour through the Middle East will bring the extent of vaccine diplomacy into sharp relief. In late December, Egypt began vaccinating health care workers with a Sinopharm vaccine. Seeing as no one really knows how far and wide the virus has affected Egyptian society, it makes sense for President Abdel Fattah al-Sisi to take help where he can get it, but given the size of Beijing’s investment in the country, the Egyptian leadership has every reason to maintain strong ties with China—including deploying one of its marquee products. Egypt’s swift acceptance of the Sinopharm vaccine is also part of Cairo’s push to become a regional hub for vaccine production and distribution, including Russia’s Sputnik V.

In the true style of Gamal Abdel Nasser-era “positive neutralism,” in which the Egyptians sought to play off the great powers to extract maximum resources from each, Cairo is also set to receive 50 million doses of the Pfizer and AstraZeneca vaccines. This reflects the way in which the Egyptians see their overall relationships with China, Russia, the United States, and Europe. They don’t want to be asked to pick a team because they no longer see a need to choose a side.

Like its antagonist across the Mediterranean, Turkey has also begun inoculating its citizens with a Chinese-made vaccine. The Phase 3 trials of the Sinovac product won’t end until February, but the Turkish government changed its regulations on vaccines in order to hasten the process. It suggests that things in Turkey are worse than the government is willing to let on and comes at a time when Ankara is alienated from its traditional partners in Europe and the United States. Though Turkey is getting a modest batch of the Pfizer vaccine, the government in Ankara seems more eager to work with Russia and China. A few weeks after the Sinovac announcement, Turkey announced that it would produce Sputnik V domestically. Turkish officials have not yet committed to using the vaccine on their citizens, but that is clearly the direction in which they are moving. Appearing with his Russian counterpart after a meeting in Sochi, Turkish Foreign Minister Mevlut Cavusoglu indicated that it was only a matter of receiving the technical data on Sputnik V before it may be used.

It is true that Turkey and Russia are on opposite ends of a variety of regional conflicts, but they have managed to contain and compartmentalize those differences in the service of their larger goals; notably, Ankara’s desire to be independent of the West and Moscow’s interest in weakening the Western alliance and sowing division in the European Union. That the Turks and Russians are working together on the vaccine will likely save lives, but it also advances strategic goals. When it comes to China, like virtually everyone else in the world, Turkish officials want to benefit from commercial ties and a potential counterweight to the United States, even if it means compromising on its principles regarding the Uighurs.

It is a mixed bag among U.S. partners in the Gulf. The Saudis have sourced the Pfizer vaccine, and the Qataris are using both the Pfizer and Moderna shots. Oman and Kuwait are using the Pfizer vaccine, but Bahrain has also moved forward with a Sinopharm product, as have the Emiratis. The ruler of Dubai, Sheikh Mohammed bin Rashid Al Maktoum, was photographed receiving the Sinopharm vaccine. There is little doubt that the Bahrainis and Emiratis can afford the more expensive Pfizer and Moderna products, and they will likely use them as well, yet the fact that both countries have moved forward fairly quickly with the Sinopharm vaccine seems to reflect what is happening broadly in the Gulf. Countries are hedging against a U.S. withdrawal and the polarization of American politics that makes Washington a less effective diplomatic, military, and economic partner, leaving China and Russia as plausible alternatives.

Maybe in the grand scheme of things vaccine diplomacy does not mean much. Countries have to get control over the virus, and the Russians and Chinese are offering cost-effective solutions. Yet even when the United States pursued controversial policies in the Middle East, it was still regarded as the gold standard in terms of education, health care, research and development, and technology that made people’s lives better. Never before has anyone really wanted Russian or Chinese products, but that no longer seems to be the case, at least with these vaccines. If Americans are worried about the Chinese and Russian challenge, the absence of the United States in battling the coronavirus in a variety of important places, including the Middle East, is glaring. It seems as if controlling and then working to wipe out infectious disease would be low-hanging fruit with which to win hearts and minds in the region—and to outmaneuver Moscow and Beijing in the process.

Steven A. Cook is a columnist at Foreign Policy and the Eni Enrico Mattei senior fellow for Middle East and Africa studies at the Council on Foreign Relations. His latest book is False Dawn: Protest, Democracy, and Violence in the New Middle East. Twitter: @stevenacook

More from Foreign Policy

Soldiers of the P18 Gotland Regiment of the Swedish Army camouflage an armoured vehicle during a field exercise near Visby on the Swedish island of Gotland on May 17.
Soldiers of the P18 Gotland Regiment of the Swedish Army camouflage an armoured vehicle during a field exercise near Visby on the Swedish island of Gotland on May 17.

What Are Sweden and Finland Thinking?

European leaders have reassessed Russia’s intentions and are balancing against the threat that Putin poses to the territorial status quo. 

Ukrainian infantry take part in a training exercise with tanks near Dnipropetrovsk oblast, Ukraine, less than 50 miles from the front lines, on May 9.
Ukrainian infantry take part in a training exercise with tanks near Dnipropetrovsk oblast, Ukraine, less than 50 miles from the front lines, on May 9.

The Window To Expel Russia From Ukraine Is Now

Russia is digging in across the southeast.

U.S. President Joe Biden and Secretary of State Antony Blinken participate in a virtual summit with the leaders of Quadrilateral Security Dialogue countries at the White House in Washington on March 12.
U.S. President Joe Biden and Secretary of State Antony Blinken participate in a virtual summit with the leaders of Quadrilateral Security Dialogue countries at the White House in Washington on March 12.

Why China Is Paranoid About the Quad

Beijing has long lived with U.S. alliances in Asia, but a realigned India would change the game.

Members of the National Defence Training Association of Finland attend a training.
Members of the National Defence Training Association of Finland attend a training.

Finns Show Up for Conscription. Russians Dodge It.

Two seemingly similar systems produce very different militaries.