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Infections Rise in Mongolia, The place Sinopharm Is the Essential Vaccine

Coronavirus cases are surging in Mongolia, where more than half the population is fully vaccinated, prompting a new focus on the effectiveness of its main vaccine, developed by China’s Sinopharm.

Mongolia reported 1,312 new cases of the coronavirus on Wednesday as the country’s total infections neared 70,000, almost all recorded since January. New daily infections have risen more than 70 percent in the past two weeks, according to a New York Times database.

The landlocked nation has emerged as an outlier in the global scramble for vaccines among developing nations, securing enough doses for its eligible population thanks to its strategic location between Russia and China — two vaccine manufacturing giants with global ambitions. Mongolia has signed deals for 4.3 million doses of the Sinopharm vaccine and one million doses of Russia’s Sputnik V vaccine, although only 60,000 Sputnik doses have arrived so far.

Chinese vaccines, such as the ones made by Sinopharm and another company, Sinovac, use inactivated coronaviruses to trigger an immune response in the body. They have been shown in studies to be less effective than the vaccines developed by the pharmaceutical companies Pfizer and Moderna, which use newer mRNA technology.

Sinopharm’s vaccine initially came under scrutiny because of a lack of transparency in its late-stage trial data. The vaccine faced more questions after the island nation of the Seychelles, which relied heavily on Sinopharm to inoculate its population, also saw a spike in cases, although most people did not become seriously ill.

“Inactivated vaccines like Sinovac and Sinopharm are not as effective against infection but very effective against severe disease,” said Ben Cowling, an epidemiologist and biostatistician at the University of Hong Kong School of Public Health.

“Although Mongolia seems to be having a spike in infections and cases, my expectation is that there won’t be large number of hospitalizations,” he added.

And some virus variants may spread fast enough to cause concern even in countries where much of the population has vaccinations effective against them: Britain is dealing with a rise in cases linked to the Delta variant, despite having more than half of its adult population fully vaccinated, largely with shots from AstraZeneca and Pfizer.

Still, the wave of infections has raised questions in Mongolia over why the government relied on the Sinopharm shots instead of a vaccine proven to be more effective. It came as Mongolians headed to the polls on Wednesday to vote for president, the first election since the constitution was amended to limit the president to one six-year term. The prime minister is the head of government and holds executive power.

A year ago, Mongolia was among the few countries in the world that boasted no local coronavirus cases, but an outbreak in November changed that. A political crisis ensued and protests over perceived mishandling of the outbreak led the prime minister to resign in January.

The new prime minister, Oyun-Erdene Luvsannamsrai, has promised to revive a flagging economy and end social distancing restrictions that have hurt businesses. A fresh wave of cases could threaten this pledge.

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International locations Are Scrambling for Vaccines. Mongolia Has Loads.

Mongolia, a land of grassy hills, vast deserts, and endless skies, has a population not much larger than Chicago’s. The small democratic nation is used to living in the shadow of its powerful neighbors Russia and China.

But during a pandemic, there can be benefits to being a small nation sandwiched between two vaccine makers with global ambitions.

At a time when most countries are looking for coronavirus vaccines, Mongolia now has enough to fully vaccinate its entire adult population, thanks in large part to treaties with China and Russia. The officials are so confident that they promise citizens a “Covid-free summer”.

Mongolia’s success in obtaining the vaccines within a few months is a huge victory for a low-income developing country. Many poor countries have waited in line for shots, hoping for the best. But Mongolia, taking advantage of its status as a small geopolitical actor between Russia and China, was able to buy cans in a similar clip as it did in much richer countries.

“It speaks to the Mongolian ability to play against the two great powers and maximize their advantages even when they are walking a tightrope between the two countries,” said Theresa Fallon, director of the Center for Russia-Europe-Asia Studies in Brussels.

It’s also a win for China and Russia, which have extensive resource interests in Mongolia and ambitions to play a role in ending the pandemic, even if much of the world has expressed deep skepticism about their homegrown vaccines.

Mongolia is a buffer between Eastern Russia, which is resource-rich and largely uninhabited, and China, which is overcrowded and resource-hungry. While Russia and China are often aligned on the global stage, they have a history of conflict and are aware of mutual interests in Mongolia. These suspicions can be seen in their vaccine diplomacy.

“Putin is deeply concerned about what China is doing in its neighborhood,” Ms. Fallon said of Russian President Vladimir V. Putin.

Russia sold a million doses of its Sputnik V vaccine to Mongolia. China has provided four million doses of vaccine – the final shipment of the doses arrived this week. Mongolia’s most recent agreement with the state-owned Chinese Sinopharm Group was made a few days before the World Health Organization received the emergency approval.

Mongolia was late for Covid-19 vaccines worldwide. For almost a year, officials boasted that there were no local cases. Then there was an outbreak in November. Two months later, the political crisis sparked by the abuse of the virus resulted in the Prime Minister’s sudden resignation. The prospect of ongoing coronavirus restrictions threatened to plunge the country into further political turmoil.

The new prime minister, Oyun-Erdene Luvsannamsrai, pledged to restart the economy that had suffered from lockdowns and border closings, particularly in the south, where Mongolian truckers are hauling coal across the border with China’s steel mills. But these plans were complicated by the growing number of cases, with the daily number rising from hundreds a day to thousands.

“We were pretty desperate,” said Bolormaa Enkhbat, an economic and development advisor to Mr. Luvsannamsrai.

Mongolia turned to China and Russia first, the foreign minister said in hopes that longstanding economic ties with each country would help put it at the forefront of vaccine-looking countries. Officials simultaneously explored diplomatic and private channels, soliciting donations from rich countries and the world’s largest vaccine manufacturers.

Updated

May 19, 2021, 8:11 p.m. ET

They contacted award-winning middlemen, international health organizations and vaccination alliances for poorer countries. An intermediary offered to sell Pfizer-BioNTech’s Covid vaccine for $ 120 per shot, which is nearly a quarter of the average monthly salary, Ms. Enkhbat said. Covax, the global vaccine sharing alliance that Mongolia signed in July 2020, promised doses in the fall or winter.

With each breakthrough from Russia, negotiations with China moved faster.

At the beginning of February, Mongolia approved the Russian vaccine Sputnik V. Three days later, the Chinese Sinopharm Group received approval for its Vero Cell vaccine. Soon after, China donated 300,000 doses of its Sinopharm vaccine to Mongolia, citing a “deep traditional friendship” as motivation.

The opening of the border between China and Mongolia was also part of the vaccine discussions, Chinese and Mongolian officials said in Chinese state media. Mongolia needs China to buy its coal – exports to the country account for almost a quarter of Mongolia’s annual economic growth. The revenue helped add a quarter to Mongolia’s budget last year.

After a month of back and forth, in March the Mongolian government also signed a contract with the Russian Gamaleya Research Institute for one million doses of the Sputnik vaccine. Days later, Mongolia entered into an agreement to purchase 330,000 additional doses of the Sinopharm vaccine.

When last-minute problems arose with delivery of the purchased Chinese vaccines, a phone call between China’s Prime Minister Li Keqiang and Mongolian Prime Minister Luvsannamsrai on April 7 helped smooth things out and reassure both sides. Until then, it was unclear whether Mongolia could rely on China or whether it would have to return to Russia for more vaccines.

“That paved the way for the rest of the business,” Ms. Enkhbat said of the call, Mr. Luvsannamsrais first with Mr. Li. “We set out the situation and said that we are betting on Chinese vaccines, at one time that the rest of the world is not. “

Mongolia has also received commitments from AstraZeneca and Pfizer-BioNTech. So far, it has only received 60,000 Sputnik vaccines due to manufacturing delays. But the Chinese vaccine will account for a large part of the Covid-19 shots for the Mongolian population.

“We are grateful to our partners, especially China, for providing us with vaccinations when they need them for home use,” said Battsetseg Batmunkh, Mongolia’s Foreign Minister.

The Chinese and Russian embassies in Mongolia did not respond to requests for comment.

in the UlaanbaatarIn the capital of Mongolia, 97 percent of the adult population have received a first dose and, according to government statistics, more than half are fully vaccinated. Across the country, more than three quarters of Mongolians have already received a shot.

The country’s vaccination efforts still face hurdles. Mongolia is economically dependent on China and many of its citizens continue to fear its power and influence. When tensions arose in the past, China closed its border and stopped buying Mongolian coal.

The Mongols also preferred the Russian Sputnik vaccine. To get the population to take the Sinopharm shot, the government has offered each citizen 50,000 tugriks – about $ 18 – to get fully vaccinated. The median monthly salary in 2020 was $ 460.

The terms and prices of the Sinopharm and Sputnik deals were not made public and the Mongolian Foreign Ministry declined to comment on the prices. Representatives from the Gamaleya Research Institute and Sinopharm did not respond to requests for comment.

While some global health experts have questioned whether Sinopharm can continue to meet its overseas commitments, it has delivered all of the cans Mongolia ordered. China has announced it will deliver up to five billion doses by the end of the year, despite officials warning the country is struggling to get enough shots for its citizens.

There is also evidence that governments that have chosen the Sinopharm vaccine may have to introduce a third booster shot earlier than expected.

For its part, China could play a long game, said Julian Dierkes, an associate professor at the University of British Columbia who specializes in Mongolian politics. Although many Mongolians still do not trust China, the Mongolian government will remember how it made their vaccines available at a critical moment.

“We could coin a sentence here: ‘The opportunity of smallness’,” he said.