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China's New Global Health Governance

Published online by Cambridge University Press:  23 January 2023

Jingyuan Zhou ,
Yilin Wang ,
Ngozi S Nwoko  and
Saeed Qadir
Jingyuan Zhou*
Affiliation:
Chongqing University School of Law, China
Yilin Wang
Affiliation:
Graduate Institute Geneva, Switzerland
Ngozi S Nwoko
Affiliation:
University of Victoria Law School, Canada
Saeed Qadir
Affiliation:
CAREC Institute, China
*
Corresponding author. E-mail: joeyzhoulaw@cqu.edu.cn
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Abstract

This article analyses China's global health governance (GHG) practices and GHG legal infrastructure in the wake of COVID-19. It posits that China has pursued a mix of bilateral and multilateral strategies during the pandemic to promote global cooperation and domestic regulation to shape an effective GHG response. It demarcates China's proactive role in norm-setting to respond to the global health crisis. It first considers China's responses to COVID-19 and its interaction model with multilateral institutions including WHO and GAVI. It then examines China's bilateral health strategies, taking its interactions with African countries as an example, before analysing and comparing existing norms and practices on the ‘right to regulate’ under the rules of the World Trade Organisation and treaties that China participates in that call for more regulatory recognition. The article then proceeds to examine China's new initiatives in shaping GHG strategy during COVID-19. Finally, it concludes and calls for a coordinated multilateral approach to handle global health crises.

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Type
Article
Information
Asian Journal of Comparative Law , Volume 18 , Special Issue 1: China's Global Capital and the Coronavirus: Views from Comparative Law and Regulation , April 2023 , pp. 38 - 59
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the National University of Singapore

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Footnotes

*

Assistant Researcher, Chongqing University School of Law, China. This author wants to acknowledge that her work is part of Project No. 2022CDSKXYFX009 supported by the Fundamental Research Funds for the Central Universities.

**

Post-Doctoral Researcher (Swiss National Science Foundation), Graduate Institute Geneva, Switzerland.

***

Ph.D. Candidate, University of Victoria Law School, Canada.

****

Former Senior Research Officer, CAREC Institute, China.

References

1 World Health Organisation, ‘WHO Director-General's opening remarks at the media briefing on COVID-19’ (11 Mar 2020) <https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020> accessed 1 Dec 2022.

2 World Health Organisation, ‘International Spread of Disease Threatens Public Health Security: The world health report 2007 focuses on building a safer future’ (8 Dec 2010) <https://www.who.int/news/item/08-12-2010-international-spread-of-disease-threatens-public-health-security> accessed 1 Dec 2022.

3 International Health Regulations (2005) (3rd edn, WHO 2008) https://apps.who.int/iris/bitstream/handle/10665/246107/9789241580496-eng.pdf?sequence=1> accessed 1 Dec 2022 [hereinafter ‘IHR 2005’].

4 Henry Farrell & Abraham Newman, ‘Will the Coronavirus End Globalization as We Know It?’ (Foreign Affairs, 16 Mar 2020) <https://www.foreignaffairs.com/articles/2020-03-16/will-coronavirus-end-globalization-we-know-it> accessed 1 Dec 2022. However, some have found resilience in existing legal forms and international governance structures relating to health, including through trade and investment regulations. See eg, Caroline Freund et al, ‘How natural disasters reshape supply chains: Lessons for the COVID-19 crisis’, (VoxEU CEPR, 18 Aug 2021) <https://voxeu.org/article/how-natural-disasters-reshape-supply-chains> accessed 1 Dec 2022.

5 UN Doc A/HRC/WG2/21/2 (17 Jan 2020), art 3(f).

6 ibid art 1.

7 ibid art 13.

8 There is a growing literature that deals with China's engagement with international organisations. See generally, Lanteigne, Marc, China and International Institutions: Alternate Paths to Global Power (Routledge 2007) ch 4Google Scholar; Kong, Qingjiang & Ping, Xiaojuan, ‘International Law and International Institutions: Implications for a Rising China’ (2016) 1 The Chinese Journal of Global GovernanceCrossRefGoogle Scholar; Kent, Ann, ‘China's Participation in International Organisations’, in Zhang, Yongjin & Austin, Greg (eds), Power and Responsibility in Chinese Foreign Policy (Australian National University Press 2013) 132–166Google Scholar.

9 ‘WHO Issues Rare Rebuke to China for Delaying Virus Team’, (Bloomberg, 1 Jan 2021) <https://www.bloomberg.com/news/articles/2021-01-06/who-issues-rare-rebuke-to-china-for-delaying-virus-origins-trip> accessed 26 Jan 2022; Paul Adepoju, ‘China Sidesteps COVAX Vaccine Donations’ (Healthpolicy-Watch, 27 May 2021) <https://healthpolicy-watch.news/china-vaccine-donations-africa-pandemic/> accessed 26 Jan 2022.

10 Yen Nee Lee, ‘The US will be a “formidable competitor” to China in COVID vaccine diplomacy, professor says’ (CNBC, 10 Jun 2021) <https://www.cnbc.com/2021/06/10/covid-expert-on-us-china-competition-in-vaccine-diplomacy.html> accessed 26 Jan 2022. China denies such accusations. China International Development Cooperation Agency China International Development Cooperation Agency, ‘China International Development Cooperation Agency Spokesperson Tian Lin Interviewed by CGTN [国际发展合作署新闻发言人田林接受中国环球电视网采访实录]’ <http://www.cidca.gov.cn/2021-08/19/c_1211337750.htm> accessed 8 Dec 2022.

11 ‘China's Relationship with the World Health Organization (WHO)’ <https://www.fmprc.gov.cn/web/wjb_673085/zzjg_673183/gjs_673893/gjzz_673897/sjws_674137/gx_674141/> accessed 26 Jan 2022; World Health Organisation, ‘Our contributors’ <https://www.who.int/about/funding/contributors> accessed 26 Jan 2022. According to the WHO, China has donated $89 million to WHO for the 2018/2019 biennium, ranking 17th among all contributors.

12 For example, the WHO criticised China for covering up the SARS virus in 2003 which invited intense international scrutiny. Moreover, the WHO has also been an important debate forum for Taiwan, a politically sensitive topic in China. To date, China has successfully blocked many proposals to include Taiwan as a member of the WHO.

13 ‘Ambassador Chen Xu Announced in Geneva That China Has Decided to Donate Another $30 Million to the WHO’ (24 Apr 2020) <http://geneva.china-mission.gov.cn/eng/zgyqtgjzz/202004/t20200424_8197169.htm> accessed 26 Jan 2022.

14 Yanzhong Huang, ‘Vaccine diplomacy is paying off for China’ (Foreign Affairs, 11 Mar 2021) <https://www.foreignaffairs.com/articles/china/2021-03-11/vaccine-diplomacy-paying-china> accessed 26 Jan 2022.

15 World Health Organisation, ‘Towards a Health Silk Road’ (18 Aug 2017) <https://www.who.int/director-general/speeches/detail/towards-a-health-silk-road> accessed 26 Jan 2022.

16 ‘Full Text: Speech by President Xi Jinping at Opening of 73rd World Health Assembly’ (XinhuaNet, 18 May 2020) <http://www.xinhuanet.com/english/2020-05/18/c_139067018.htm> accessed 26 Jan 2022.

17 ‘Xi Jinping: Joining Hands to Build a Green, Healthy, Intelligent, and Peaceful Silk Road [习近平：携手打造绿色、健康、智力、和平的丝绸之路]’ (Mission of the People's Republic of China, 22 June 2016) <https://www.fmprc.gov.cn/web/gjhdq_676201/gj_676203/yz_676205/1206_677052/xgxw_677058/201606/t20160622_9305225.shtml> accessed 26 Jan 2022.

18 World Health Organisation, ‘New vision and strengthened partnership for WHO and China’ (21 Aug 2017) <https://www.who.int/news/item/21-08-2017-new-vision-and-strengthened-partnership-for-who-and-china> accessed 26 Jan 2022.

19 ‘Towards a Health Silk Road’ (n 15).

20 ‘Towards a Health Silk Road’ (n 15).

21 National Health and Family Planning Commission of the People's Republic of China, ‘Director Li Bin Met with Health Ministers of Relevant States during the Belt and Road High Level Meeting for Health Cooperation: towards a Health Silk Road [李斌主任在“一带一路”暨“健康丝绸之路”高级别研讨会期间会见相关国家卫生部长]’ (23 Aug 2017) <http://www.nhc.gov.cn/libin/tpk/201708/15aa7c9f207e4ceca320f159d7537684.shtml> accessed 26 Jan 2022; Wang Bin, ‘The Belt and Road High Level Meeting for Health Cooperation: towards a Health Silk Road Passes the Beijing Communique [“一带一路”暨“健康丝绸之路”高级别研讨会通过《北京公报》]’ (18 Aug 2017) <http://m.xinhuanet.com/2017-08/18/c_1121507317.htm> accessed 26 Jan 2022.

22 The COVID-19 Solidarity Response Fund for the WHO was announced by Tedros in March 2020 to enable all countries with the weakest health systems to invest in preparedness efforts and respond to COVID-19: World Health Organisation, ‘COVID-19 Response Fund’ <https://www.who.int/emergencies/diseases/novel-coronavirus-2019/donate> accessed 26 Jan 2022.

23 World Health Organisation, ‘China Population Welfare Fund to Channel Donations from Chinese Companies, Charities, and Individuals towards COVID-19 Solidarity Response Fund for WHO’ (20 May 2020) <https://www.who.int/china/news/detail/20-05-2020-china-population-welfare-fund-to-channel-donations-from-chinese-companies-charities-and-individuals-towards-covid-19-solidarity-response-fund-for-who> accessed 26 Jan 2022.

24 Gavi, ‘The Bill & Melinda Gates Foundation’ <https://www.gavi.org/operating-model/gavis-partnership-model/bill-melinda-gates-foundation> accessed 26 Jan 2022.

25 Gavi, ‘About Our Alliance’ <https://www.gavi.org/our-alliance/about> accessed 26 Jan 2022.

26 Gavi, ‘Gavi Board’ <https://www.gavi.org/our-alliance/governance/gavi-board> accessed 26 Jan 2022. For instance, in 2020, the Gavi Board had representatives from government donor countries and from developing countries including France, Germany, Netherlands, Italy, Norway, Canada, Ghana, India, Pakistan, Afghanistan and Laos: Gavi, ‘Gavi Alliance Governance Committee Meeting’ (10 Dec 2020) <https://www.gavi.org/sites/default/files/document/2021/Gov-2020-Mtg-08-Minutes%20POSTED.pdf> accessed 26 Jan 2022; Gavi, ‘Board composition’ <https://www.gavi.org/governance/gavi-board/composition> accessed 26 Jan 2022.

27 Gavi, ‘Donor Profiles’ <https://www.gavi.org/investing-gavi/funding/donor-profiles> accessed 26 Jan 2022.

28 ibid.

29 Gavi, ‘China Donor Profile’ <https://www.gavi.org/investing-gavi/funding/donor-profiles/china> accessed 26 Jan 2022.

30 ibid.

31 ibid.

32 Historical data shows that China falls behind some major developed economies in donations to WHO, but is ahead of other developing countries. For instance, the US pledged a donation of US$10 billion to COVAX. See World Health Organisation, ‘Our Contributors’ <https://www.who.int/about/funding/contributors> accessed 26 Jan 2022.

33 Gavi, ‘COVAX Facility’ <https://www.gavi.org/covax-facility> accessed 26 Jan 2022.

34 ‘The Gavi COVAX AMC Explained’ (Gavi, 15 Feb 2021) <https://www.gavi.org/vaccineswork/gavi-covax-amc-explained> accessed 26 Jan 2022.

35 ‘World Leaders Unite to Commit to Global Equitable Access for COVID-19 Vaccines’ (Gavi, 2 Jun 2021) <https://www.gavi.org/news/media-room/world-leaders-unite-commit-global-equitable-access-COVID-19-vaccines> accessed 26 Jan 2022.

36 ‘China Pledges US$ 100 Million towards Equitable Access to COVID-19 Vaccines for Lower-Income Countries’ (Gavi, 6 Aug 2021) <https://www.gavi.org/news/media-room/china-pledges-us-100-million-towards-equitable-access-COVID-19-vaccines> accessed 26 Jan 2022.

37 Julia Hollingsworth, ‘COVAX Signs Deal for 550 Million Chinese COVID-19 Vaccines amid questions over efficacy’ (CNN, 13 Jul 2021) <https://edition.cnn.com/2021/07/13/asia/covax-china-vaccines-intl-hnk/index.html> accessed 26 Jan 2022.

38 ‘GAVI in Talks with China's Sinopharm, Other Vaccine Makers for COVAX Doses’ (Reuters, 10 May 2021) <https://www.reuters.com/business/healthcare-pharmaceuticals/gavi-talks-with-chinas-sinopharm-other-vaccine-makers-covax-doses-2021-05-10/> accessed 26 Jan 2022.

39 ‘China's COVID-19 vaccine to become global public good when available: Xi’ (XinhuaNet, 18 May 2020) <http://www.xinhuanet.com/english/2020-05/18/c_139066851.htm> accessed 26 Jan 2022.

40 According to China's own account, as of October 2021, it has provided 1.5 billion doses of vaccine to 106 countries and regions. In contrast, COVAX had distributed 435 million doses out of 7.5 billion administered worldwide as of early November 2021. ‘China to Provide 2 Billion Doses of Vaccine to World This Year (Global Times, 5 Aug 2021) <https://www.globaltimes.cn/page/202108/1230714.shtml> accessed 26 Jan 2022; cf WTO-IMF COVID-19 Vaccine Trade Tracker (showing that China has exported over 1.3 billion doses of vaccines as of October 2021) (updated 19 Nov 2021) <https://www.wto.org/english/tratop_e/covid19_e/vaccine_trade_tracker_e.htm> accessed 26 Jan 2022. The WTO-IMF COVID-19 Vaccine Trade Tracker further shows that as of October 2021, vaccines supplied via COVAX either through contracted supply or donations only stands at 451.1 million doses, falling far behind those supplied via bilateral deals (2,238.7 doses).

41 UN Doc E/C12/2000/4 (11 Aug 2000) ‘The right to the highest attainable standard of health (article 12 of the International Covenant on Economic, Social and Cultural Rights)’.

42 UN Declaration on the Right to Development, UN Doc A/RES/41/128 (adopted by General Assembly on 4 Dec 1986), art 8.

43 United Nations Office of the High Commissioner for Human Rights, ‘COVID-19 and the Right to Development: We Are All in This Together, 45th session of the Human Rights Council Biennial Panel discussion on the Right to Development’ (17 Sep 2020) <https://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=26254&LangID=E> accessed 26 Jan 2022.

44 Diane Desierto, ‘Equitable COVID Vaccine Distribution and Access: Enforcing International Legal Obligations under Economic, Social, and Cultural Rights and the Right to Development’ (EJIL:Talk!, 2 Feb 2021) <https://www.ejiltalk.org/equitable-covid-vaccine-distribution-and-access-enforcing-international-legal-obligations-under-economic-social-and-cultural-rights-and-the-right-to-development/> accessed 26 Jan 2022.

45 United Nations Office of the High Commissioner for Human Rights, ‘The 21st Session of the Working Group on the Right to Development’ <https://www.ohchr.org/EN/Issues/Development/Pages/21stSession.aspx> accessed 1 Dec 2022.

46 Right to development: Report of the Secretary-General and the United Nations High Commissioner for Human Rights, UN Doc A/HRC/45/21 (23 Jul 2020).

47 ‘Joint Statement Delivered by H.E. Ambassador Chen Xu at the Interactive Dialogue with the Expert Mechanism on the Right to Development at the 48th Session of the Human Rights Council’ (16 Sep 2021) <http://www.china-un.ch/eng/dbtxwx/202109/t20210917_9899530.htm> accessed 26 Jan 2022.

48 Permanent Mission of the People's Republic of China to the United Nations Office at Geneva and Other International Organisations in Switzerland, ‘Opening Remarks by Ambassador Chen Xu at the Intersessional Seminar on the Contribution of Development to the Enjoyment of All Human Rights’ (29 May 2021) <http://www.china-un.ch/eng/dbtyw/rqsw/202105/t20210529_9129797.htm> accessed 26 Jan 2022.

49 One of the objectives of the Bandung Conference that was held in Indonesia was to consider problems of mutual and special interest to Asian and African peoples such as national sovereignty, racism, and colonialism. See Appadorai, A, ‘The Bandung Conference’ (1955) 11 India Quarterly 207CrossRefGoogle Scholar.

50 In this article, we use the geographical, economic, and political phraseology ‘Third World’ advisedly. This is at the backdrop of the fact that there are persuasive arguments in law and international political economy literature to the effect that the category is no longer apposite in light of the widening gulf in industrialisation and development between Asian countries such as China and India on the one hand and African and some Caribbean countries such as Mauritania and Jamaica on the other hand. Also, it has been argued that there is a ‘Third World’ within the ‘First World’ and that the converse is true. See eg, Mittelman, James H & Pasha, Mustapha Kamal, Out from Underdevelopment Revisited: Changing Global Structures and the Remaking of the Third World (1997 edn, Palgrave Macmillan 1996)Google Scholar. On the argument for the continued relevance of ‘Third World’, see Rajagopal, Balakrishnan, ‘Locating the Third World in Cultural Geography’ (1999) 15 Third World Legal Studies 2Google Scholar. See also Mutua, Makau & Anghie, Antony, ‘What Is TWAIL?’ (2000) 94 Proceedings of the Annual Meeting of the American Society of International Law 31Google Scholar (arguing that the term ‘Third World’ is different from ‘less-developed’, ‘crisis-prone’, ‘industrialising’, ‘developing’, ‘underdeveloped’, or ‘the South’ because it correctly captures the oppositional dialectic between the European and the non-European and identifies the plunder of the latter by the former. That it places the state of the crises of the world on the global order that the West has created and dominates); Karin Mickelson, ‘Rhetoric and Rage: Third World Voices in International Legal Discourse’ (1998) 16 Wisconsin International Law Journal 353.

51 Matthew S Erie, ‘Introduction to the Symposium on Legal Dimensions of Chinese Globalization: China and Global Health Governance’ (2020) 8 The Chinese Journal of Comparative Law 281 (arguing that Third World and Marxist-Leninist ideologies are essential characteristics of Chinese economic globalisation); Suzanne Ogden, ‘Sovereignty and International Law: The Perspective of the People's Republic of China’ (1974) 7 New York University Journal of International Law and Politics 1; Tin Hinane El Kadi & Sophie Zinser, ‘Beijing's Vaccine Diplomacy Goes Beyond Political Rivalry’ (Chatham House – The Royal Institute of International Affairs, 22 Feb 2021) <https://www.chathamhouse.org/2021/02/beijings-vaccine-diplomacy-goes-beyond-political-rivalry> accessed 30 Aug 2021.

52 Partha Chatterjee, ‘The Legacy of Bandung’, in Eslava Luis, Fakhri Michael & Nesiah Vasuki (eds), Bandung, Global History, and International Law: Critical Pasts and Pending Futures (Cambridge University Press 2017) 657–674 (arguing that such claim is an exaggeration and that the present invocation of Bandung is not the regurgitation of a mythical story, but the declaration of a contemporary set of demands of global politics).

53 Lai-Ha Chan, China Engages Global Health Governance: Responsible Stakeholder or System-Transformer? (Palgrave Macmillan 2011).

54 ‘China Donates Federal Staff Hospital/ China-Nigeria Friendship Hospital’ (China Aid Data, 2017) <https://china.aiddata.org/projects/30629/> accessed 7 Jun 2020. See also Embassy of the People's Republic of China in the Federal Republic of Nigeria, ‘China-Assisted Hospital Commissioned in Nigeria’ (29 Jan 2013) <http://za.china-embassy.gov.cn/eng/zfgxss/ca00/201301/t20130129_7688639.htm> accessed 7 Jan 2020. ‘China Constructs Sierra Leone-China Friendship Hospital’ (China Aid Data) <https://china.aiddata.org/projects/2254/> accessed 27 Aug 2021.

55 Lekki Port, ‘Nigeria's Deepest Sea Port’ <https://lekkiport.com/> accessed 10 Dec 2022.

56 Olufunmilayo B Arewa, ‘Constructing Africa: Chinese Investment, Infrastructure Deficits, and Development’ (2016) 49 Cornell International Law Journal 101; Global Development Policy Centre – Boston University, ‘China's Overseas Development Finance’ <http://www.bu.edu/gdp/chinas-overseas-development-finance/> accessed 30 Aug 2021.

57 African Union, ‘Groundbreaking and Unveiling Ceremony for Africa CDC HQ’ (14 Dec 2020) <https://au.int/en/pressreleases/20201214/ground-breaking-and-unveiling-ceremony-africa-cdc-hq> accessed 28 Aug 2021. Donald Trump's US government had peddled a data theft theory about the Chinese funding of the Africa CDC construction project and opposed it. Their claim and opposition to it were never substantiated with concrete evidence. See Katrina Manson & David Pilling, ‘US Warns Over Chinese “Spying” on African Disease Control Centre’ (Financial Times, 6 Feb 2020) <https://www.ft.com/content/cef96328-475a-11ea-aeb3-955839e06441> accessed 28 Aug 2021.

58 ‘Nigeria Losing $1B Annually to Medical Tourism, Authorities Say’ (Voice of America, 10 May 2019) <https://www.voanews.com/a/nigeria-health-care-medical-tourism/4912005.html> accessed 12 Jul 2020; Emmanuel Akinwotu, ‘Nigeria's President Draws Criticism for Seeking Medical Care Abroad’ (The New York Times, 8 May 2018) <https://www.nytimes.com/2018/05/08/world/africa/nigeria-president-buhari-health.html> accessed 12 Jul 2020.

59 Africa CDC, ‘Africa Identifies First Case of Coronavirus Disease: Statement by the Director of Africa CDC’ (15 Feb 2020) <https://africacdc.org/news/africa-identifies-first-case-of-coronavirus-disease-statement-by-the-director-of-africa-cdc/> accessed 19 Jul 2021.

60 Established in 2016, Africa CDC is a specialised technical institution of the African Union that supports public health initiatives of Member States and strengthens the capacity of their public health institutions to detect and manage disease outbreaks. See Africa CDC, ‘Our History’ <https://africacdc.org/about-us/our-history/> accessed 17 Mar 2022.

61 Africa CDC, ‘Coronavirus Disease 2019 (COVID-19): Latest updates on the COVID-19 crisis from Africa CDC’ <https://africacdc.org/COVID-19/> accessed 17 Mar 2022.

62 Africa CDC, ‘COVID-19 Vaccination: Latest Updates from Africa CDC on Progress Made in COVID-19 Vaccinations on the Continent’ <https://africacdc.org/COVID-19-vaccination/> accessed 17 Mar 2022.

63 OECD/International Labour Organisation, Tackling Vulnerability in the Informal Economy (OECD Publishing 2019) ch 1 <https://www.oecd-ilibrary.org/deliver/939b7bcd-en.pdf?itemId=/content/publication/939b7bcd-en&mimeType=pdf> accessed 1 Dec 2022 (That, the COVID-19 pandemic and the consequential public health restrictive measures have exacerbated poverty among the low-income population in a continent where 85.8% of workers are in the informal sector).

64 Economist Intelligence Unit, ‘Africa Faces Major Obstacles to Accessing COVID Vaccines’ (2021) <https://www.eiu.com/n/africa-faces-major-obstacles-to-accessing-COVID-vaccines/> accessed 22 Aug 2021; ‘Togo Receives China-Donated Sinovac Vaccines’ (Xinhua, 24 Apr 2021) <http://www.china.org.cn/world/Off_the_Wire/2021-04/24/content_77435517.htm?f=pad&a=true> accessed 28 Aug 2021; Liu Yang & Zhao Jing, ‘50 African Diplomats Visit Chinese Coronavirus Vaccine Maker’ (CGTN, 16 Oct 2020) <https://news.cgtn.com/news/2020-10-16/50-African-diplomats-visit-Chinese-coronavirus-vaccine-maker-UDKAcH773O/index.html> accessed 31 Aug 2021.

65 Forum on China-Africa Cooperation, ‘Xinhua Commentary: Timely Vaccine Arrivals in Africa Show China Honoring Its Commitment to Global COVID-19 Vaccination’ (26 Feb 2021) <https://www.fmprc.gov.cn/zfhzlt2018/eng/zfzs_1/t1856527.htm> accessed 28 Aug 2021; Forum on China-Africa Cooperation, ‘Cameroon Receives First Batch of COVID-19 Vaccines from China’ (13 Apr 2021) <https://www.fmprc.gov.cn/zfhzlt2018/eng/zfgx_4/rwjl/t1868363.htm> accessed 28 Aug 2021.

66 Africa CDC, ‘COVID-19 Vaccination’ <https://africacdc.org/COVID-19-vaccination/> accessed 11 Nov 2021. Some of the countries that have benefitted from the COVID-19 bilateral pact with the Chinese government include Ethiopia, Tunisia, Algeria, Mozambique, Kenya, Libya, Uganda, Angola, Cote d'Ivoire, Mauritius, Sudan, Tanzania, Rwanda, Niger, Somalia, Guinea, Benin, Lesotho, Zambia, Mauritania, Congo Republic, Namibia, Sierra Leone, Comoros, Chad, Gabon, Cape Verde, Seychelles, Botswana, Djibouti, Senegal, Equatorial Guinea, Egypt, Togo, Morocco, Nigeria, and Cameroon.

67 ‘China COVID-19 Vaccine Tracker’ (Bridge Consulting 2021) <https://bridgebeijing.com/our-publications/our-publications-1/china-COVID-19-vaccines-tracker/> accessed 11 Nov 2021.

68 Hans Von Der Burchard, ‘Borrell: EU's “Insufficient” Vaccine Donations Open Door for China’ (POLITICO, 30 Jul 2021) <https://www.politico.eu/article/josep-borrell-eu-vaccine-donations-insufficient/> accessed 15 Aug 2021.

69 Darren Choi & Sean Janke, ‘“Vaccine Diplomacy”? – China's Global Vaccine Efforts and Controversies’ (University of Alberta China Institute, 21 Jul 2021) <https://www.ualberta.ca/china-institute/news/the-latest/2021/july/vaccine-diplomacy.html> accessed 18 Aug 2022.

70 Ministry of Foreign Affairs of the People's Republic of China, ‘Wang Yi and Egyptian Foreign Minister Sameh Shoukry Attend the Ceremony Marking the Joint Production of One Million Doses of COVID-19 Vaccine in Egypt’ (19 Jul 2021) <https://www.fmprc.gov.cn/mfa_eng/zxxx_662805/t1893144.shtml> accessed 7 Aug 2021.

71 ‘Africa Faces Major Obstacles to Accessing COVID Vaccines’ (n 64).

72 ‘Spotlight: China's Medical Teams Help Cement China-Africa Friendship Amid COVID-19’ (XinhuaNet, 18 Aug 2020) <http://www.xinhuanet.com/english/2020-08/18/c_139299532.htm> accessed 27 Aug 2021.

73 ‘Chinese Medical Experts Arrive in Algeria to Help Fight COVID-19’ (XinhuaNet, 15 May 2020) <http://www.xinhuanet.com/english/2020-05/15/c_139057565.htm> accessed 7 Aug 2021.

74 Nigerian Federal Ministry of Health, ‘FG: Chinese Government Donates Items to Fight COVID-19’ <https://www.health.gov.ng/index.php?option=com_k2&view=item&id=630:fg-chinese-government-donates-itemsto-fight-COVID-19> accessed 8 Aug 2021.

75 China International Development Cooperation Agency, ‘Chinese Medical Supplies for 18 African Countries Arrive in Ghana’ (6 Apr 2020) <http://en.cidca.gov.cn/2020-04/06/c_470880.htm> accessed 28 Aug 2021.

76 Lori Hinnant, Maria Cheng & Aniruddha Ghosal, ‘Vaccine inequity: Inside the cutthroat race to secure doses’ (Associated Press, 19 Jul 2021) <https://apnews.com/article/coronavirus-vaccine-inequality-dac9c07b324e29d3597037b8dc1d908a> accessed 1 Dec 2022 (quoting Strive Masiyiwa, the African Union's envoy for vaccine acquisition lamenting that it's like a famine in which ‘the richest guys grab the baker’).

77 Office of the President and Cabinet (OPC), ‘President Hails China for Vaccines’ (15 Feb 2021) <http://www.theopc.gov.zw/index.php/627-president-hails-china-for-vaccines> accessed 5 Aug 2021.

78 Obijiofor Aginam, ‘Between Isolationism and Mutual Vulnerability: A South-North Perspective on Global Governance of Epidemics in an Age of Globalization’ (2004) 77 Temple Law Review 297.

79 Obijiofor Aginam, ‘Global Village, Divided World: South-North Gap and Global Health Challenges at Century's Dawn’ (2000) 7 Indiana Journal of Global Legal Studies 603 (arguing that global health policies must, by necessity, focus on health disparities between poor and rich nations). Amitav Acharya, ‘A “Third Way” for World Order After COVID-19’ (Council on Foreign Relations, 21 Jul 2021) <https://www.thinkglobalhealth.org/article/third-way-world-order-after-covid-19> accessed 29 Aug 2021.

80 Mo Jingxi, ‘Nigeria Appreciates Chinese Support in COVID-19 Fight’ (China Daily, 9 May 2020) <http://global.chinadaily.com.cn/a/202005/09/WS5eb5fed9a310a8b241154601.html> accessed 11 Jul 2020; Jerry Omondi, ‘Chinese Built Health Facility Ready to Aid Nigeria's COVID-19 Fight’ (CGTN Africa, 13 May 2020) <https://africa.cgtn.com/2020/05/13/chinese-built-health-facility-ready-to-aid-nigerias-COVID-19-fight/> accessed 10 Jul 2020.

81 Ministry of Foreign Affairs of the Peoples Republic of China, ‘Second Batch of Anti COVID-19 Donation from Jack Ma and Alibaba Foundation Arrives in Juba’ (19 Apr 2020) <https://www.fmprc.gov.cn/mfa_eng/wjb_663304/zwjg_665342/zwbd_665378/t1771208.shtml> accessed 27 Aug 2021; African Union, ‘Receiving of 3rd Consignment of Medical Supplies from Jack Ma Foundation’ (29 Apr 2020) <https://au.int/en/newsevents/20200429/receiving-3rd-consignment-medical-supplies-jack-ma-foundation> accessed 28 Aug 2021.

82 African Union, ‘China Donates Medical Supplies to African Union Commission’ (23 Oct 2020) <https://au.int/en/pressreleases/20201023/china-donates-medical-supplies-african-union-commission> accessed 28 Aug 2021.

83 Ministry of Commerce of the People's Republic of China, ‘Elaboration on the Eight Major Initiatives of the FOCAC Beijing Summit’ (19 Sep 2018) <http://english.mofcom.gov.cn/article/policyrelease/Cocoon/201809/20180902788698.shtml> accessed 22 Aug 2021.

84 Barney Walsh & Hubert Kinkoh, ‘COVID-19 and the Conundrum of China-Africa Relations’ (King's College London, 30 Apr 2020) <https://www.kcl.ac.uk/COVID-19-and-the-conundrum-of-china-africa-relations> accessed 28 Aug 2021.

85 Joyce Lau, ‘China Moves to Smooth Relations with African Students’ (Times Higher Education, 20 Apr 2020) <https://www.timeshighereducation.com/news/china-moves-smooth-relations-african-students> accessed 29 Aug 2021; ‘China: COVID-19 Discrimination Against Africans’ (Human Rights Watch, 5 May 2020) <https://www.hrw.org/news/2020/05/05/china-COVID-19-discrimination-against-africans> accessed 29 Aug 2021.

86 ‘President Hails China for Vaccines’ (n 76). Forum on China-Africa Cooperation, ‘Ambassador Li Jie Attends Handover Ceremony for China-Donated COVID-19 Vaccines to Zambia’ (10 Aug 2021) <http://www.focac.org/eng/zfgx_4/rwjl/t1898307.htm> accessed 19 Aug 2021; Embassy of the People's Republic of China in the Republic of Seychelles, ‘The Sinopharm Vaccines Donated by the Chinese Side Arrived in Seychelles’ (25 Jun 2021) <http://sc.china-embassy.org/eng/zxhd/t1886911.htm> accessed 8 Aug 2021.

87 Other scholars have adopted similar definition. See Catharine Titi, The Right to Regulate in International Investment Law (Nomos/Hart 2014) 33. Prominent legal scholars have opposed the right to regulate in the international investment law context, arguing that instead of relying on the unworkable right to regulate vis-à-vis investment protection, states are better off terminating investment treaties. M Sornarajah, Resistance and Change in the International Law on Foreign Investment (Cambridge University Press 2015) chs 6–7.

88 Draft Convention (n 5) art 13.

89 Scholars also refer to this as ‘law positive’. See Matthew Erie, ‘China, Law and Development’ (2021) 62 Harvard Journal of International Law 51, 60.

90 United Nations Conference on Trade and Development, ‘Investment Trends Monitor’ (27 Oct 2020) 1 <https://unctad.org/system/files/official-document/diaeiainf2020d4_en.pdf> accessed 26 Jan 2022; World Trade Organisation, ‘Services trade recovery not yet in sight’ (26 Jan 2021) <https://www.wto.org/english/news_e/news21_e/serv_26jan21_e.htm> accessed 26 Jan 2022; Chad P Bown, ‘COVID-19: Demand spikes, export restrictions, and quality concerns imperil poor country access to medical supplies’, in Richard E Baldwin & Simon J Evenett (eds), COVID-19 and Trade Policy: Why Turning Inward Won't Work (CEPR Press 2020).

91 Marrakesh Agreement Establishing the World Trade Organisation, Preamble.

92 Panel Report, Russia – Measures Concerning Traffic in Transit, para 7.76, WTO Doc WT/DS512/R (adopted 26 Apr 2019).

93 For a more detailed discussion, see Jingyuan Zhou, ‘Navigating International Services Trade during Health Emergencies: A Scientific Approach to Emergency Measures’ (2022) 23 Oregon Review of International Law 25. There is, however, an exception to this statement, namely, Article XI clause 8, which allows governments to impose temporary quantitative restrictions when facing short stock.

94 GATT1994, art XI:2(a).

95 Panel Reports, ‘China – Raw Materials’, para 7.213, affirmed by Appellate Body Report, ‘China – Raw Materials’, WT/DS394/AB/R, WT/DS395/AB/R, WT/DS398/AB/R.

96 Prior to COVID-19, on only one occasion did a WTO member – Canada – invoke the special compulsory licensing system that grants compulsory licenses for export purposes to Rwanda.

97 Britain Eakin, ‘Brazil's Senate Passes COVID Vaccines License-Waiver Bill’ (Law360, 12 Aug 2020) <https://www.law360.com/articles/1412275/brazil-s-senate-passes-COVID-vaccines-license-waiver-bill> accessed 12 Aug 2021.

98 China's clear support for IP waiver on COVID vaccines came during a 17 May Foreign Ministry Press Briefing, where the spokesperson Zhao Lijian stated that ‘China fully understands and is supportive of the developing world's call for an IPR waiver for COVID-19 vaccines’: Ministry of Foreign Affairs of the People's Republic of China, ‘Foreign Ministry Spokesperson Zhao Lijian's Regular Press Conference on May 17, 2021’ (17 May 2021) <https://www.fmprc.gov.cn/mfa_eng/xwfw_665399/s2510_665401/2511_665403/202105/t20210517_9170745.html> accessed 26 Jan 2022. Since then, China has consistently supported WTO vaccine waiver discussions.

99 Council for Trade-Related Aspects of Intellectual Property Rights, ‘Waiver from Certain Provisions of the TRIPS Agreement for the Prevention, Containment and Treatment of COVID-19: Communication from India and South Africa’, World Trade Organization, IP/C/W/669 (2 Oct 2020) paras 12, 13 <https://docs.wto.org/dol2fe/Pages/SS/directdoc.aspx?filename=q:/IP/C/W669.pdf&Open=True> accessed 26 Jan 2022.

100 World Trade Organisation, ‘Members to continue discussion on proposal for temporary IP waiver in response to COVID-19’ (10 Dec 2020) <https://www.wto.org/english/news_e/news20_e/trip_10dec20_e.htm> accessed 26 Jan 2022.

101 Hannah Monicken, ‘U.S., EU oppose WTO effort to waive IP protections amid pandemic’ (World Trade Online, 20 Oct 2020) <https://insidetrade.com/daily-news/us-eu-oppose-wto-effort-waive-ip-protections-amid-pandemic> accessed 26 Jan 2022.

102 Office of the United States Trade Representative, ‘Statement from Ambassador Katherine Tai on the COVID-19 Trips Waiver,’ (5 May 2021) <https://ustr.gov/about-us/policy-offices/press-office/press-releases/2021/may/statement-ambassador-katherine-tai-COVID-19-trips-waiver> accessed 26 Jan 2022.

103 World Trade Organisation, ‘Members welcome Quad document as basis for text-based negotiations on pandemic IP response’ (10 May 2022) < https://www.wto.org/english/news_e/news22_e/gc_10may22_e.htm> accessed 14 Jul 2022; Ministerial Decision on the TRIPS Agreement, WT/MIN(22)/30 (22 Jun 2022).

104 Ministry of Commerce of the People's Republic of China, ‘Give play of China's Important Role and Accelerate RCEP Negotiations’ (1 Sep 2014) <http://english.mofcom.gov.cn/article/newsrelease/significantnews/201409/20140900720384.shtml> accessed 26 Jan 2022.

105 RCEP, Preamble.

106 RCEP, art 11.4.

107 RCEP, art 11.8.

108 United Nations Economic and Social Commission for Asia and Pacific, ‘Asia-Pacific Trade Agreement (APTA) <https://www.unescap.org/apta> accessed 26 Jan 2022. The current membership of APTA includes Bangladesh, China, India, Lao PDR, Republic of Korea, Sri Lanka, and Mongolia. See United Nations Economic and Social Commission for Asia and Pacific, ‘Mongolia accedes to the Asia-Pacific Trade Agreement as its seventh member’ (29 Sep 2020) <https://www.unescap.org/news/mongolia-accedes-asia-pacific-trade-agreement-its-seventh-member> accessed 26 Jan 2022.

109 United Nations Economic and Social Commission for Asia and Pacific, ‘A Note on the Status of APTA Trade in Healthcare Sector Related Products in the Context of the Response to the COVID-19 Pandemic’ (27 Apr 2020) 2–4 <https://www.unescap.org/sites/default/d8files/knowledge-products/APTA-trade-and-COVID19.pdf> accessed 26 Jan 2022.

110 The Multilateral Agreement on Investment (Report by the Chairman of the Negotiating Group), DAFFE/MAI(98)17 (4 May 1998), Annex 3, art 3 <http://www1.oecd.org/daf/mai/pdf/ng/ng9817e.pdf> accessed 1 Dec 2022.

111 See UNCTAD, ‘US Model Treaty (2012)’ <https://investmentpolicy.unctad.org/international-investment-agreements/treaty-files/2870/download> accessed 1 Dec 2022.

112 Ministry of Commerce of the People's Republic of China, ‘China FTA Network [中国自由贸易区服务网]’ <http://fta.mofcom.gov.cn/> accessed 26 Jan 2022.

113 According to the official account, as of 2 September 2021, China has signed 205 MOUs with 171 states and international organisations: ‘China has Signed 205 Cooperation Documents on the Joint Construction of BRI [我国已签署共建“一带一路”合作文件205份]’ (Belt and Road Portal, 30 Jan 2021) <https://www.yidaiyilu.gov.cn/xwzx/gnxw/163241.htm> accessed 26 Jan 2022.

114 China-Cambodia FTA reported to be voted on by the Cambodian National Assembly soon, see Hin Pisel, ‘Ratification of FTA with China in sight’ (The Phnom Penh Post, 5 Jul 2021) <https://www.phnompenhpost.com/business/ratification-fta-china-sight> accessed 26 Jan 2022.

115 Ministry of Commerce of the People's Republic of China, ‘China-Mauritius FTA takes effect today’ (1 Jan 2021) <ttp://fta.mofcom.gov.cn/article/zhengwugk/202101/44124_1.html> accessed 26 Jan 2022.

116 They are China-Mauritius FTA (first FTA between China and an African country), China-Georgia FTA (first FTA with an Eurasia country; a first FTA since the BRI was initiated), China-Australia FTA, China-ASEAN FTA (in the services trade agreement), China-Pakistan FTA (in the services trade agreement), and China-New Zealand FTA.

117 ibid China-Mauritius FTA.

118 China-Singapore FTA, art 58.

119 ibid (emphasis added).

120 China-ASEAN FTA.

121 They are China-Australia FTA, China-South Korea FTA, China-Switzerland FTA, China-Costa Rica FTA, China-Chile FTA, China-Peru FTA, and China-Georgia FTA.

122 They are China-Australia FTA, China-South Korea FTA, China-Switzerland FTA, China-Costa Rica FTA, China-Georgia FTA, and China-Chile FTA.

123 EU-China Comprehensive Agreement on Investment, Preamble <https://trade.ec.europa.eu/doclib/docs/2021/january/tradoc_159341.pdf> accessed 19 Sep 2021. As noted before, this echoes the EU's own approach to the right to regulate.

124 China-Chile Free Trade Agreement, Annex A (Expropriation), art 3(b): ‘Except in rare circumstances, non-discriminatory regulatory actions by a Party that are designed and applied to protect legitimate public welfare objectives, such as public health, safety, and the environment, do not constitute indirect expropriations.’ Such exemption can also be seen in the US-Chile FTA (Annex 10-D).

125 ‘International Investment Policies and Public Health’ (IIA Issues Note no 2, Jul 2021) 2 <https://unctad.org/system/files/official-document/diaepcbinf2021d5_en.pdf> accessed 26 Jan 2022.

126 See Gregory Shaffer (ed), Emerging Powers and the World Trading System: The Past and Future of International Economic Law (Cambridge University Press 2021). See also Erie (n 82).

127 China-Costa Rica FTA, ch 3 (National Treatment and Market Access for Trade in Goods), art 10.

128 See eg, China-Costa Rica FTA, ch 9 (Investment, Trade in Services and Temporary Entry of Business Persons), art 103 (Grant of Temporary Entry): ‘Each Party shall grant temporary entry to business persons who comply with immigration measures applicable to temporary entry and other related measures, such as those relating to public health and safety and national security, in accordance with this Chapter.’

129 Gregory Shaffer & Henry S Gao, ‘A New Chinese Economic Law Order?’, in Gregory Shaffer (ed), Emerging Powers and the World Trading System: The Past and Future of International Economic Law (Cambridge University Press 2021); Zhou, Jingyuan, ‘A New Multilateralism? A Case Study of the Belt and Road Initiative’ (2020) 8 The Chinese Journal of Comparative Law 384CrossRefGoogle Scholar.

130 Since an earlier part of this article has described the interaction between China and the WHO, including before and during the current health emergency, this subsection will focus on China.

131 National Health Commission of the People's Republic of China, ‘A Three Year Implementation Plan for Advancing BRI Health Cooperation (2015–2017) [国家卫生计生委关于推进“一带一路”卫生交流合作三年实施方案（2015-2017）]’ <http://www.nhc.gov.cn/ewebeditor/uploadfile/2015/10/20151023161915772.docx> accessed 19 Sep 2021.

132 National Health Commission of the People's Republic of China, ‘Belt and Road High Level Meeting for Health Cooperation: Towards A Health Silk Road’ <http://en.nhc.gov.cn/Beltandroadforumforhealthcooperation.html> accessed 19 Sep 2022.

133 ‘Grand Opening of the Belt and Road High Level Meeting for Health Cooperation: towards a Health Silk Road [“一带一路”暨“健康丝绸之路”高级别研讨会隆重开幕]’ <http://www.ihecc.org.cn/news.html?_=1503045803306> accessed 26 Jan 2022. IHECC is a unit within the National Health Commission of the People's Republic of China.

134 National Health Commission of the People's Republic of China, ‘Beijing Communiqué of The Belt and Road Health Cooperation & Health Silk Road’ <http://en.nhc.gov.cn/2017-08/18/c_72257.htm> accessed 26 Jan 2022. Its principles of cooperation are ‘peace, cooperation, openness, inclusiveness, transparency, equality, mutual learning, mutual benefit and mutual respect in strengthening cooperation on the basis of extensive consultation, joint efforts, shared benefits, the rule of law and equal opportunities for all.’

135 IHECC, ‘Training Course on COVID-19 Diagnosis and Treatment for BRI Countries Held in Beijing [“一带一路”国家新冠肺炎诊疗技术培训班在京举行]’ (26 Apr 2021) <http://www.ihecc.org.cn/news.html?_=1619074490221> accessed 26 Jan 2022.

136 IHECC, ‘China Africa Health Cooperation’ <http://www.ihecc.org.cn/health-cooperation.html?_=1001> accessed 26 Jan 2022.

137 See generally ‘APEC Ministers Responsible for Trade Meeting Joint Statement 2021’ (5 Jun 2021) <https://www.apec.org/Meeting-Papers/Sectoral-Ministerial-Meetings/Trade/2021_MRT> accessed 26 Jan 2022. See also European Union, ‘Rome Declaration’ (21 May 2021) <https://global-health-summit.europa.eu/rome-declaration_en> accessed 26 Jan 2022.

138 Ministry of Foreign Affairs of the People's Republic of China, ‘Wang Yi Presides over Asia and Pacific High-level Video Conference on Belt and Road Cooperation’ (23 Jun 2021) <https://www.fmprc.gov.cn/mfa_eng/topics_665678/kjgzbdfyyq/202106/t20210624_9171076.html> accessed 19 Sep 2021.

139 United Nations Development Programme, ‘Global Dashboard for Vaccine Equity’ <https://data.undp.org/vaccine-equity/> accessed 19 Sep 2021.

140 See repeated calls from WHO and UN respectively: World Health Organisation, ‘Vaccine inequity undermining global economic recovery’, (22 Jul 2021) <https://www.who.int/news/item/22-07-2021-vaccine-inequity-undermining-global-economic-recovery> accessed 19 Sep 2021; ‘COVID vaccines: Widening inequality and millions vulnerable’ (UN News, 19 Sep 2021) <https://news.un.org/en/story/2021/09/1100192> accessed 19 Sep 2021.

141 Ministry of Foreign Affairs of the People's Republic of China, ‘Xi Jinping Attends the General Debate of the 76th Session of the United Nations General Assembly and Delivers an Important Speech’ (22 Sep 2021) <https://www.fmprc.gov.cn/mfa_eng/topics_665678/kjgzbdfyyq/202109/t20210923_9591806.html> accessed 27 Sep 2021. At the same event, US President Joseph R Biden called for a ‘new mechanism to finance global health security that builds on our existing development assistance, and Global Health … [Threat Council].’ ‘Remarks by President Biden Before the 76th Session of the United Nations General Assembly’ (The White House, 21 Sep 2021) <ttps://www.whitehouse.gov/briefing-room/speeches-remarks/2021/09/21/remarks-by-president-biden-before-the-76th-session-of-the-united-nations-general-assembly/> accessed 27 Sep 2021.

142 ibid; Ministry of Foreign Affairs of the People's Republic of China, ‘Xi Jinping Attends the General Debate of the 76th Session of the United Nations General Assembly and Delivers an Important Speech’ (22 Sep 2021) <https://www.fmprc.gov.cn/mfa_eng/topics_665678/kjgzbdfyyq/202109/t20210923_9591806.html> accessed 27 Sep 2021.

143 ‘Action in Solidarity for a Shared Future’ (China Daily, 1 Nov 2021) <http://epaper.chinadaily.com.cn/a/202111/01/WS617f227aa31019b029ba16e6.html> accessed 6 Nov 2021.

144 ibid.

145 ibid. The six prongs include strengthening joint vaccine R&D cooperation; fair, equitable, and just distribution of vaccines; a WTO decision on vaccine waiver, encouraging the voluntary transfer of vaccine knowledge to and production in developing countries; scaling up and smoothening trade in vaccines and related raw and auxiliary materials; fair treatment of WHO-recognised vaccines; and provision of financial support to developing countries at the G20 Summit.

146 See African Union, ‘Agenda 2063: The Africa We Want’ <https://au.int/en/agenda2063/overview> accessed 26 Jan 2022.

147 Brautigam, Deborah, The Dragon's Gift: the Real Story of China in Africa (Oxford University Press 2009)Google Scholar.

148 Ministry of Foreign Affairs of the People's Republic of China, ‘Building Consensus and Synergy For a Bright Future of Global Development -- Address by State Councilor Wang Yi At the Sustainable Development Forum 2021’ (26 Sep 2021) <https://www.fmprc.gov.cn/mfa_eng/wjdt_665385/zyjh_665391/202109/t20210926_9580295.html> accessed 26 Jan 2022 (stating that the DGI ‘will form synergy with other initiatives including the Belt and Road Initiative’).

149 Ministry of Foreign Affairs of the People's Republic of China, ‘Initiative for Belt and Road Partnership on COVID-19 Vaccines Cooperation’ (24 Jun 2021) <https://www.fmprc.gov.cn/mfa_eng/wjdt_665385/2649_665393/202106/t20210624_9170568.html> accessed 26 Jan 2022.

150 ‘Promoting Investment in Health Post-Pandemic: A Global Trend?’ (UNCTAD, Issue 11, Jul 2021) 7–8, <https://unctad.org/system/files/official-document/diaepcbinf2021d4_en.pdf> accessed 26 Jan 2022. See also World Health Organisation, ‘WHO provides technical support for Kilinto Pharmaceutical Industry Park (KPIP) in Ethiopia on preparing a roadmap that meets international standards’ (22 Jul 2020) <https://www.who.int/news/item/22-07-2020-who-provides-technical-support-for-kpip-in-ethiopia> accessed 26 Jan 2022.

151 World Trade Organisation, ‘WTO-IMF COVID-19 Vaccine Trade Tracker’ <https://www.wto.org/english/tratop_e/covid19_e/vaccine_trade_tracker_e.htm> accessed 1 Dec 2022. Note that as of 31 May 2022. China has exported 1,986.4 million doses of vaccines, accounting for 32.2% of the total of world exports.

152 ibid (showing that worldwide, supply through bilateral deals far outweigh all other means including via COVAX, direct donations, and via AVAT).

153 ‘US-China coronavirus vaccine diplomacy heats up but can donations sway allegiances?’ (South China Morning Post, 13 Oct 2021) <https://www.scmp.com/news/china/diplomacy/article/3152098/us-china-coronavirus-vaccine-diplomacy-heats-can-donations> accessed 6 Nov 2021.

154 Mallapaty, Smriti, ‘China's COVID vaccines are going global — but questions remain’ (2021) 593 Nature 178CrossRefGoogle ScholarPubMed.

155 ‘The U.S. will be a ‘formidable competitor’ to China in COVID vaccine diplomacy, professor says’ (CNBC, 10 Jun 2021) <https://www.cnbc.com/2021/06/10/COVID-expert-on-us-china-competition-in-vaccine-diplomacy.html> accessed 6 Nov 2021.