富國疫苗民族主義 造就中國疫苗外交

 <轉載自2020年10月27日 明報 社評>

全球疫情愈演愈烈，不少人將希望寄託於疫苗，國家科技部上周表示，年底前相信將有內地新冠疫苗完成第三期臨牀測試，審批合格後便能全面投入使用。西方對中國新冠疫苗的效力、安全以至緊急使用等處理，有很多質疑，然而中國疫苗的3期臨牀測試，大多在外國進行，若有嚴重問題，外國合作伙伴不可能不知道，至於不等測試完成有限度緊急使用，亦不違反世衛規定。國際社會抗疫缺乏合作，發達國與發展國矛盾愈益尖鋭，明年即使陸續有疫苗在歐美面世，絕大部分都會先供西方發達國家使用，其他地區很可能都要依賴中國疫苗，所有人都得面對此客觀現實，香港亦不例外，若說這是中國「疫苗外交」的機會，某程度也是西方疫苗民族主義所造就。

西方質疑內地疫苗 多國測試未見異樣

專家再三指出，「疫苗一出疫情速平」是不切實際想法，可是對很多疫情失控國家來說，疫苗已成扭轉乾坤的希望。目前全球約有10款新冠疫苗進入第三期臨牀試驗階段，當中4款來自中國，包括北京科興生物的滅活疫苗、國藥旗下兩款滅活疫苗，以及解放軍軍事科學院與中國康希諾生物合研的基因重組新冠疫苗。國家科技局上周表示，4款新冠疫苗在多國做3期臨牀試驗，已有6萬人接種，迄今沒收到嚴重不良反應報告，證明安全度良好，倘若一切順利，年底前將有疫苗完成測試。當局預計疫苗接種效用可達一年，日後定價會以成本為基礎，全國新冠疫苗產能，年底將達到6.1億劑水平，明年更可提升至年產10億劑以上。

各國新冠疫苗研究如火如荼，從3期臨牀測試進度來看，中國跑在國際前列。疫情加深國與國的成見分歧，中國與西方關係緊張，發展國與發達國矛盾重重，疫苗則成為一系列矛盾的交匯點。疫苗民族主義體現在兩個層面，一是自私自利囤積、懶理他國死活；二是疫苗都是自家的好，別人的都是次貨。西方對中國新冠疫苗有很多懷疑，當中既有科學水平的質疑，亦有政治動機的猜度；富國財雄勢大，紛紛與跨國藥廠簽下巨額疫苗訂購協議，窮國能有多少疫苗可用，亦令不少人關注。

中國疫情緩和，所有3期臨牀試驗，都要在外國高發疫區進行。西方質疑中國疫苗研發欠透明，數據交代不充分，然而中國3期疫苗臨牀試驗有否大問題，外國合作伙伴一定了解，由印尼、土耳其到阿根廷和巴西，未聞有異常狀况。巴西聖保羅布坦坦研究所本月中才表示，與科興生物合作的後期臨牀實驗，初步結果顯示安全。聖保羅州長多里亞還表示，正在巴西做測試的所有疫苗中，科興滅活疫苗的不良反應率最低，是最有希望成功的疫苗。最近巴西對是否採購中國疫苗態度反覆，一大原因是多里亞與總統博索納羅屬政敵，無論如何，巴西國家衛生監督局上周五已批准聖保羅州進口600萬劑科興與布坦坦合作的疫苗。

中國研發的新冠疫苗有10多款，包括最傳統的滅活疫苗、病毒載體類疫苗，以至基因重組疫苗、核酸疫苗。有人質疑中國幾款領先的滅活疫苗，科技含量不及西方的基因重組或核酸疫苗，然而正如一些西方疫苗專家所言，傳統方法有其好處，疫苗有效才是關鍵，不在於趕時麾。中國以緊急接種計劃方式，在3期臨牀試驗未完下，為逾35萬高風險人士，包括需要出國的民眾接種，惹來西方質疑，然而這其實是世衛一向允許的做法，中國亦有徵得世衛同意。

富國搶購疫苗窮國愁 中國擴產能顧己及人

除了中國，阿聯酋、俄羅斯等均有類似緊急接種計劃，印尼還打算以這種方式，年底開始為數百萬人接種中國新冠疫苗。如此緊急接種規模，聽起來的確很大，可是放在印尼近3億人口，比例並不高。在美國，華府其實也想引入緊急接種計劃，只是西方發達國家在藥物註冊及應用規則方面向有自己一套，比世衛要求的限制多，所以才未能推行。平情而論，若說緊急接種計劃有爭議，英國為了加快疫苗研究，找健康者接種再刻意安排他們感染病毒，道德爭議也不見得小。

全球疫苗產能有限，樂施會研究顯示，發達國家佔全球人口13%，卻已優先預購全球過半數的新冠疫苗。世衛等牽頭COVAX全球新冠疫苗計劃，盼助疫苗公平分配，然而富國參與未算積極，法德等都只是有限度參與，美國更杯葛計劃，反觀中國已決定參與COVAX，非西方國家及地區若想早日為民眾大規模接種，很難不依靠中國疫苗。最近西方關注中國向東南亞、非洲及拉丁美洲推動「疫苗外交」，質疑北京施援「動機不純」，可是若非西方富國自利為先，中國也不會有多少「疫苗外交」空間，西方富國應反問自己，願意為窮國做多少事。

以往中國內地疫苗亂象多，一大原因是很多中小疫苗商未達安全標準，濫竽充數。新冠疫苗由幾間大藥廠牽頭研發生產，亦要通過世衛獨立檢測，符合各種指定要求，方能取得世衛「Ｑ嘜」認證，對北京而言，這正是整頓內地疫苗產業、提升水平的機會。當然，中國疫苗產能雖大，是否足以滿足全球龐大需要，仍是一大疑問，中國不能打腫臉充胖子，不顧自身需要，不過內地疫情受控，己欲達而達人，迴旋空間始終較大。

China's vaccine diplomacy

The COVID-19 global pandemic has become more and more severe. Quite a lot of people have pinned their hopes on vaccines. China's Ministry of Science and Technology said last week that some mainland vaccines would complete the third clinical trial by the end of the year. They could be put into full use after getting approved. There is a lack of co-operation in the international community regarding the fight against the pandemic, and conflicts between developed and developing countries are sharpening. Even if vaccines can be rolled out next year successively in Europe and America, most of them will be supplied to Western developed countries. Other regions probably will have to rely on Chinese vaccines. This is the reality that all must face, and Hong Kong is no exception. If such a situation presents an opportunity for China to pursue ''vaccine diplomacy'', to a certain extent the West's vaccine nationalism will be the making of it.

Currently about ten COVID-19 vaccines have entered the third phase of their clinical trials. Of them, four are from China. The Ministry of Science and Technology said last week that the four COVID-19 vaccines had been clinically tested in the third phase in many countries, and 60,000 people had been vaccinated. Up to now there has not been a serious adverse drug reaction reported, which is good proof of the vaccines' safety. If everything goes well, some vaccines will have their testing completed by the end of the year. The authorities estimate that the vaccines can confer immunity for a year and will be priced based on their cost. China will have the capacity to produce 610 million doses of vaccines by the end of the year, and a yearly capacity of more than one billion doses starting next year.

Vaccine nationalism has two aspects: first, the act of stockpiling supplies selfishly and disregarding the well-being of other countries; second, the view that home-grown vaccines are the best and the others are all inferior. Western countries harbour many suspicions about the Chinese vaccines for COVID-19. Regarding their suspicions, there are ones about the vaccines' scientific standards and ones about China's political motive. Prosperous and powerful countries have signed huge procurement contracts with multinational drugmakers one after another. How many would be left for poor countries? Many people are concerned about the matter.

As the pandemic in China has eased off, all phase 3 clinical trials have to be conducted in foreign areas with high infection rates. The West suspects that China's vaccine development lacks transparency and its data release is insufficient. However, China's foreign partners must know if there are major issues concerning the phase 3 trials of the COVID-19 vaccines. From Indonesia to Turkey, and Argentina to Brazil, there have not been any abnormalities reported.

The worldwide capacity for producing vaccines is limited. A study by Oxfam shows that developed countries, which comprise 13% of the world population, have already pre-ordered more than half of the world's COVID-19 vaccines. COVAX, a global COVID-19 programme initiated by organisations including the WHO, is aimed at helping distribute vaccines fairly. But participation by the rich countries cannot be said to be active. France and Germany have only participated in the scheme partially. The US has even boycotted it. Contrary to them, China has decided to join COVAX. If non-Western countries and regions would like to get their people vaccinated on a large scale as soon as possible, it would be hard not to rely on Chinese vaccines. Recently Western countries have paid attention to China's pursuit of ''vaccine diplomacy'' in South East Asia, Africa and Latin America. They doubt whether Beijing's aid has come without ulterior motives. if Western rich countries had not prioritised self-interests, China would not have much room for vaccine diplomacy. They should ask themselves how much they are willing to do for the poor nations.

富國疫苗民族主義 造就中國疫苗外交

全球疫情愈演愈烈，不少人將希望寄託於疫苗，國家科技部上周表示，年底前相信將有內地新冠疫苗完成第三期臨牀測試，審批合格後便能全面投入使用。國際社會抗疫缺乏合作，發達國與發展國矛盾愈益尖銳，明年即使陸續有疫苗在歐美面世，絕大部分都會先供西方發達國家使用，其他地區很可能都要依賴中國疫苗，所有人都得面對此客觀現實，香港亦不例外，若說這是中國「疫苗外交」的機會，某程度也是西方疫苗民族主義所造就。

目前全球約有10款新冠疫苗進入第三期臨牀試驗階段，當中4款來自中國。國家科技部上周表示，4款新冠疫苗在多國做3期臨牀試驗，已有6萬人接種，迄今沒收到嚴重不良反應報告，證明安全度良好，倘若一切順利，年底前將有疫苗完成測試。當局預計疫苗接種效用可達一年，日後定價會以成本為基礎，全國新冠疫苗產能，年底將達到6.1億劑水平，明年更可提升至年產10億劑以上。

疫苗民族主義體現在兩個層面，一是自私自利囤積、懶理他國死活；二是疫苗都是自家的好，別人的都是次貨。西方對中國新冠疫苗有很多懷疑，當中既有科學水平的質疑，亦有政治動機的猜度；富國財雄勢大，紛紛與跨國藥廠簽下巨額疫苗訂購協議，窮國能有多少疫苗可用，亦令不少人關注。

中國疫情緩和，所有3期臨牀試驗，都要在外國高發疫區進行。西方質疑中國疫苗研發欠透明，數據交代不充分，然而中國3期疫苗臨牀試驗有否大問題，外國合作伙伴一定了解，由印尼、土耳其到阿根廷和巴西，未聞有異常狀况。

全球疫苗產能有限，樂施會研究顯示，發達國家佔全球人口13%，卻已優先預購全球過半數的新冠疫苗。世衛等牽頭COVAX全球新冠疫苗計劃，盼助疫苗公平分配，然而富國參與未算積極，法德等都只是有限度參與，美國更杯葛計劃，反觀中國已決定參與COVAX，非西方國家及地區若想早日為民眾大規模接種，很難不依靠中國疫苗。最近西方關注中國向東南亞、非洲及拉丁美洲推動「疫苗外交」，質疑北京施援「動機不純」，可是若非西方富國自利為先，中國也不會有多少「疫苗外交」空間，西方富國應反問自己，願意為窮國做多少事。