[EAI International Conference]

YouTube Link: https://www.youtube.com/watch?v=aMl0gW088UM

The East Asia Institute (EAI) held an international conference on December 11 and 12 titled “Security Challenges and Responses After COVID-19: Climate Change, Infectious Diseases, Economic Security, and Cyber Security.” The session on “Health Security and the Global Vaccine Supply Chain” featured a presentation by Yanzhong Huang, Senior Fellow at the Council on Foreign Relations, who discussed China's epidemic prevention policies and the implications of its vaccine diplomacy. This was followed by a presentation by Sunyoung Kim, Professor at Seoul National University, on the changing landscape of the global vaccine supply chain after COVID-19, and a presentation by Tae-Gyun Kim, Professor at Seoul National University, comparing the vaccine diplomacy strategies of China and India towards Global South countries. Discussions were led by Sunju Kang, Professor at the Korea National Diplomatic Academy; Man-ki Song, Deputy Director General of the International Vaccine Institute; and Hye-young Chang, Professor at Chung-Ang University.

■ Contact and Editing: Han-soo Park EAI Researcher

Contact: 02 2277 1683 (ext. 204) | hspark@eai.or.kr

Video Transcript

This session, uh, the title of this session is Health Security and the Global Vaccine Supply Chain. Uh, so our topic is, uh, is focused, um, on, uh, the global health and, uh, uh, global vaccine supply chain. Um, you know, uh, we, uh, we have, uh, you know, experienced, uh, COVID-19, uh, for the past few, uh, years. Uh, it, um, the disease actually claimed, uh, many lives, uh, almost 7 million, uh, maybe more than that, uh, and, uh, it, uh, impacted, uh, on economy, on democracy, on public health, uh, of course, and on, on food security, uh, on governance, political

governance, uh, you know, it is huge. And, uh, many experts, including experts here, uh, say that it will come back, uh, for, uh, you know, uh, years to come. So, uh, the W, the whole world, uh, and also individual countries need to prepare. Um, and in, in prepar, during, uh, the next rounds of infectious disease, uh, you know, one key, uh, element is, uh, vaccines. We are talking about vaccines and how to, uh, manage, uh, global, uh, you know, vaccine, uh, production lines, etc. So, uh, you know, we, in this session, we, uh, will discuss how countries are responded to, uh, you know,

vaccine, uh, you know, provision and vaccine supply. Uh, and we, uh, focus on China, India, and other countries. Um, and second, uh, we want to, uh, discuss, uh, global vaccine governance, uh, or global health governance, uh, broadly. And, uh, the key issue, as a, uh, think tank, a policy think tank, um, East Asia Institute, you know, we really want to know how to, uh, I mean, explore how to improve, uh, global vaccine supply chains and how to improve, uh, global, um, health, uh, governance, um, in the years to come. So, uh, with those, uh, you know, topics, uh, in mind, I would like

to, uh, uh, introduce our, uh, panelists. We have, uh, three, uh, distinguished, uh, experts, uh, you know, on my left, uh, Dr. Huang, uh, Yanzhong, um, uh, Senior Fellow, uh, the Council on Foreign Relations, um, and, uh, next is, uh, uh, Professor, uh, Sun Kim, uh, Seoul National University, um, and, uh, Professor, uh, Tun Kim, also from, uh, Seoul National University. Uh, after, uh, you know, three presentations from these three scholars, we turn to, uh, discussion, uh, and discussion will be in, in, in this order, uh, starting, uh, from, uh, Dr. Kang, Professor, uh, Kang, Sanju, Kang, Korea National

Diplomatic, uh, Academy, uh, and, uh, moved to Dr. Man-ki Song, from International Vaccine Institute, um, and last but not least, uh, Professor Chang, Hye-young, uh, uh, from, uh, Chung-Ang University, South Korea. Uh, we have a mix of, uh, political scientists and, uh, real scientists, uh, so, uh, it'll be a, a very, uh, interesting discussion. Um, we are fake political scientists and fake scientists in today's term. Um, so, uh, what, uh, Professor Huang, why don't you start? Um, well, thank you, uh, Professor Su, um, that, uh, for inviting me, um, to this conference. I remember, uh, two

years ago, I was in Seoul attending the, uh, World Emerging Threat Forum hosted by the Ministry for Foreign Affairs here. That was one of the first in-person conferences I, uh, attended since the, uh, beginning of the pandemic. Uh, at that time, you know, there were few people, the airport, you know, I had to, uh, take the PCR test, and in fact, I had to stay in the hotel room before the test results were available. You know, everybody on the street, you know, were wearing masks, masks, you know, and now the acute stage of the pandemic is over, but

the shadow of COVID is indeed long. You know, we still have, you know, uh, some here are still wearing masks, right? The, um, and if you look at China, but this, cons, um, conspiratory disease outbreak, you know, I'm sorry, not conspiratory, respiratory, sorry, respiratory disease outbreak, you know, the, uh, in the country, but the National Health Commission just yesterday, you know, they issued new guidelines on masking. That reminds us, you know, that the looming threat of another pandemic, right? The, so the question is, you know, that if indeed

another pandemic hits now, you know, can we do better? Right? And given China's involvement in the COVID pandemic, it is worth asking, right? The question, would the results be any different if a similar novel dangerous pathogen, you know, with pandemic potential occurred, uh, in the country again? So I'm asked to talk about three issues. The first is the future of China's Zero-COVID policy, and the second is the, uh, global vaccine supply chain challenges and China's role, and third, the, uh, the COVID pandemic and US-China

strategic competition. I'm going to start with the first question, right? The China Zero-COVID policy. We know, right, that the Zero-COVID policy, you know, with all its miracles and failures, right, that they have, uh, uh, um, uh, essentially traumatized China's economy and society, reversed the gains that accumulated for the first one and a half years of pandemic response. Uh, but looking back, it also provided proof of concept for a surveillance state in China, right? If you look at, right, the post-COVID era, that China abolished

itinerary codes, you know, but not the health code, because the health code used to assess individuals' risk level, you know, based on their travel history, residence, and medical record. They still stockpiled, you know, the massive data set on such information. And indeed, uh, this lack of strong public resistance and government's ongoing efforts to enhance infrastructure and organization of the digital governance in the post-COVID era, uh, seems to, um, suggest that, uh, you know, this surveillance state is here to stay. Right? The health codes evolved into

service codes in certain localities in China to facilitate people's dealing with the government agencies. And on December 1st, last week, right, they reactivated, uh, the health code in many provinces in response to this respiratory diseases outbreak in the country. And also, if you look at the draft of the re, the, uh, the revised infectious disease law in China, it appears to legitimize many aspects of the Zero-COVID policy. Uh, uh, this key Zero-COVID measures, including quarantines, lockdowns, PCR testing, health codes are included in

the proposed amendment. And the, uh, uh, also, right, just, I think last week, uh, the, uh, the PCR testing on inbound travelers, uh, were reintroduced in some Chinese airports, you know. So it's not so difficult to envision that, you know, if China is faced with a new dangerous pathogen, uh, they might, uh, you know, easily revive, you know, this surveillance operators, you know, relying heavily on this non-pharmaceutical measures, you know, to identify, you know, track, quarantine, and isolate carriers and their close contacts. So that is my first, the, uh, uh

uh prediction. Uh, the second is on global vaccine supply chain. Uh, the, uh, uh, we know that one of the main challenges in the global vaccine supply chain during the, uh, the pandemic was the inequality by vaccine distribution, um, which, you know, can be viewed as a structural component or consequences of this uneven R&D and manufacturing capacities, especially between the Global North and the South. But we know that vaccine nationalism also played a crucial role, right? Wealthy countries stockpiled vaccines that left

poor nations, uh, struggling for, uh, access. Uh, actions by some countries like China, like the US and India, right, they imposed export support banks, restrict, imposed restrictions on vaccines and ingredients to prioritize their own populations. They made the situation even worse. And there's certainly the IP, uh, the intellectual property rights issue, right? The, uh, uh, even though the pandemic met the criteria for the, uh, TRIPS, right, where under WTO, took nearly two years for WTO members to agree on limited terms for COVID-19 vaccine

waiver, uh, and, uh, um, but here it also highlights the importance of China. Actually, the importance to engage China, right? Uh, in early 2020, I, China was the first to develop a COVID-19 vaccine, and until 2021, it was the world's biggest COVID vaccine exporter, right? Uh, China also collaborated with some developing countries to enhance their vaccine production capacities. Well, in that sense, they helped mitigate, right, the global vaccine disparity, right? But, uh, in the meantime, why that we know that the, uh

Chinese vaccines are not, right, as the leaders claim, the global public goods, but in fact, you know, 15% of their vaccines, you know, uh, delivered globally actually, uh, for donation, 85% for commercial sale. Chinese vaccines are clearly, right, less effective in dealing with the highly transmissible, uh, variants compared with the mRNA vaccines. They also used the sort of the, um, uh, uh, the APIs, you know, the active pharmaceutical ingredients, by the, uh, threatened to weaponize the APIs during the pandemic, you know, potentially

a risk factor for the global vaccine supply chain. Uh, they practiced vaccine diplomacy, right, that invited US countermeasures, further exacerbating, right, the inequality issue. So what are the solutions to the problem? I think, given the vast R&D and manufacturing capacity of China, right, it should be allowed to play a significant role in the future of global vaccine supply chain. Uh, you know, there's, you know, several, uh, um, you know, I think proposed actions. The first, I think we should consider developing new, uh, um, consensus

by partnerships, uh, collaboration mechanisms for technological transfer and R&D. And secondly, I think OECD countries, including Korea, right, should, um, boost this compulsory provisions at the WHO, including by encouraging by China, uh, to use the flexibilities afforded by the Doha Declaration on TRIPS and public health. And, uh, third, I think China should be encouraged, right, to integrate its bilateral health assistance into a COVAX-like, uh, multilateral framework. Um, finally, uh, the geopolitical considerations, right? The question here

is, how likely is the prospect of cooperation between China and the US, the two geopolitical rivals? Uh, if you look at the COVID pandemic, there were three problems, right? The first is that during the COVID pandemic, ideological, right, competition for the first time was introduced into the pandemic response. But as, uh, uh, Professor, Professor Huang pointed out, this, this competition for legitimacy, right, uh, you know, both countries try to frame, you know, this as a competition between authoritarianism and liberal democracy.

right? The second problem is politicization of the pandemic's origin issue, right? There was all this allegations, conspiracy theories like the US and China became entangled, uh, in a vortex of, you know, suspicion, disinformation, and diplomatic disputes that politicized the scientific request for the pandemic's origins. And in the United States, this perception of China as the pandemic's origin, by its initial missteps, disruption to the global vaccine, global supply chain, feud caused among politicians in the country, you

know, for a hard decoupling, uh, uh, from China. The third problem is securitization of pandemic response, right? Uh, concerns about the dependency on Chinese pharmaceuticals, for example, uh, spurred the US to, uh, diversify its sources to allies and friendly countries, right? Uh, we call, you know, friendly, friendly showing, right? Um, also might encourage the US to bring some production back home, increase stockpiles, and the mask and vaccine diplomacy by the both countries, they sought to use the provision of vaccines and medical supplies to

compete for strategic influence. So in the Cold, uh, post-Cold War era, you would expect, right, that they would, uh, uh, you know, sort of pursue a global health détente, right? But that didn't happen, right? There was that clear, there is a lack of interest, right, in cooperation over global health security, right? Uh, uh, we saw, right, during the Biden and Xi Summit in San Francisco, right, health security was not a key topic there, right? Uh, in the US, right, COVID-19's link to China remains politicized, right? The Biden administration seems to be very

reluctant, right, to step out of this comfortable zone, right? Uh, uh, we cooperate only with like-minded countries, right? And, uh, you know, to reach out to geopolitical rivals like China. But paradoxically, I think China's stringent Zero-COVID policy has slowed, right, its economy, right? And if you look at all this, you know, revised, you know, forecasts about China's, uh, GDP growth in the long run, right, suggested that it may take much longer for the, for China to, to, um, overpass, to the, the overtake the US

by this number one, uh, the, uh, the economic power status, right? And survey data also indicate China's limited effectiveness, uh, in gaining the lasting soft power or substantial clout during the pandemic. Uh, so even though it is premature to declare China's ascent at its peak, especially as the United States is facing similar, uh, you know, domestic challenges, right? The, uh, China's trajectory to a power on power on par with the United States is likely to be very prolonged, you know. Uh, but in the meantime, but this

altered, you know, power dynamics, you know, might shape both countries' strategic preferences and choices, and hopefully, uh, you know, this, uh, might generate additional incentives, right, for both countries to work together, right, in pandemic prevention and, uh, preparedness. Thank you. Thank you. Um, thank you. Thank you, Dr. Huang. Uh, very, uh, interesting, uh, presentation. Uh, you seem to, uh, uh, be critical of, uh, of, uh, China's, uh, behavior, uh, during the COVID as the world's largest, uh, vaccine manufacturer, on facade, it, uh

the country, uh, I mean, the leaders talked about the, you know, vaccines as public goods, but actually, you said that only 15% are provided, maybe categorized as public goods, but, uh, you know, overwhelmingly, it is very much, uh, strategic mercantilist, um, um, so, uh, that's, uh, the point. And second, nonetheless, uh, in the future, we need to engage China, and you provided, uh, several ways to engage, um, and it's actually the suggestions for the Chinese government, as well. And finally, implications for US-China

uh, competition. So, um, thank you very much, and let's turn to, uh, Professor Kim, please. Uh, by the way, uh, I forgot, uh, to mention, this, uh, presenters have 15 minutes, uh, and, uh, discussions, uh, maybe 8 to, uh, 10 minutes, uh, for, uh, your present, your, uh, discussion. Okay? Please go ahead. I'm Sun-kyung Kim from Seoul National University. My specialty is global health policy. So, the, I'm, yeah, the, I'm, I'm very, the honor, I feel honored to be invited to, uh, give a talk on this very important topic, uh, the global vaccine supply chain after the

COVID-19, uh, pandemic. Uh, so the title of my talk, uh, says that, uh, I will talk about prospects and challenges for Korea, uh, from the global health security perspective. But, uh, as you will see, um, the role of Korea, the, uh, the, the pro, the weight for, um, the weight given, uh, to the role of Korea, that is not that, uh, broad, actually. And then, uh, uh, I want to talk about, uh, this issue of a global vaccine supply chain, uh, basically, the why, um, the it is very important to, uh, develop, uh, the global vaccine supply

chain, uh, during this interpandemic period, uh, through, uh, global level efforts, not by one country, but still, the, I think, the Korea has its role, and I hope the Korea has the leading role in advancing global health, the, in, uh, the Asian region. So, okay, uh, this is the, uh, very, uh, rough, the overview of my talk, uh, and then, uh, I'd like to, uh, start, uh, by reviewing, um, the very basic concept of global health security. Yeah, okay. So, the, uh, I think that, uh, uh, all of the audience, audiences already know the what, uh, health security

means, uh, and what, uh, global health security means. But, uh, uh, let me just very briefly, uh, the review, uh, because, uh, uh, I think this, uh, uh, the concept visualization of the global health security is, uh, the very important, and actually, the motivation of this talk. Um, as you know, the health security is a field within, uh, human security, uh, with the six other components suggested by the UNDP in, uh, 1994, that is, um, the concept emerged after the Cold War, uh, the human security concept, uh, encompasses activities and measures that

take place across national borders to mitigate all kinds of public health threats to ensure the health of all people. Um, examples of the public health threats include infectious diseases, antimicrobial resistance, foodborne diseases, chemical accidents, nuclear accidents, and environmental diseases. Uh, I actually want to emphasize, um, the, uh, public health, the threat, um, because, um, the one of the myths during the pandemic was that, um, the health security is a, seeking measure against infectious diseases, but

uh, the, as many of you, many of you already know, the, it's not so. Health security and global health security, uh, include the separate, uh, various types of threats, and then the, of course, including infectious disease threats, but, uh, that is only one type of, uh, public health threats. So, uh, COVID-19 was, uh, um, COVID-19 came with, uh, the, uh, infectious disease, uh, pathogen, but, uh, the next, uh, public health emergency or crisis, uh, might have the different type of, you know, the threats. Okay? Um, the global health security refers to a, the

shared responsibility that that requires a coordinated effort from countries around the world, uh, to protect the health of all people. Um, but, uh, again, the, I'd like to highlight, uh, the definition by WHO, that is, WHO defines, uh, global health security as activities to protect the health of all people, uh, that encompasses, uh, both preventive and reactive aspects, uh, to minimize the risk and impact of acute public health, uh, events, uh, that endanger people across the geographic region and national borders. Um, with rapid globalization,

the mobility of people and goods has increased, and economic interdependence has grown as a result. Among the various types of global health security threats, infectious disease-related threats are becoming increasingly the important, uh, in terms of frequency and scale. Okay? Um, so up to here, the, I'd like to, uh, very briefly overview the, uh, the original, the concept and definition of global health security, uh, and then I want to move to, uh, to, uh, very briefly, the review, uh, the importance of vaccines, uh, in the context of the global

health security. Um, the, we almost, uh, all of us agree, I think, uh, that, uh, vaccines, uh, beyond, uh, their health and life benefits against vaccine-preventable infectious diseases, uh, can also yield societal benefits in terms of global economy and security, particularly during a pandemic or, uh, outbreaks. Um, then, uh, now, let's move to, uh, overview the characteristics or main features of the vaccine, um, supply chains. Before we, uh, dive into the, uh, specific characteristics of the vaccine, uh, supply chains, the, let's briefly

review, uh, the general supply chain, uh, concepts. The, generally, supply chains are networks of organizations and business processes that, um, collaborate, that work together to deliver a product or service from its inception to the end user. Uh, they connect suppliers, manufacturers, warehouses, retailers, and customers, facilitating the flow of products and services from source to consumption. In the supply chains, materials, information, and, uh, payment flow in both directions. Uh, supply chains represent

very complex systems that can be challenging to manage. However, it is essential for businesses or industries to effectively manage their supply chains in order to be successful. Uh, I mean, effective management of supply chains is a, uh, crucial for businesses, uh, to, uh, enhance efficiency, reduce costs, and the boost their customer satisfaction. Uh, so similarly, or analogously, uh, we can imagine that, uh, vaccine supply chains can be thought of as the organization and processes that are used to develop, produce, distribute,

and administer vaccines. Uh, vaccine supply chains are equally complex, uh, necessitate meticulous planning, coordination, and collaboration between various stakeholders, and the stakeholders of vaccine supply chains include, um, suppliers, manufacturers, distributors, wholesalers, immunization providers, and public health agencies. Is here, uh, you can see, uh, the, uh, slight differences between, uh, general supply chains and vaccine supply chains. I mean, uh, with the vaccine supply chains, uh, actually, um, the, the, the very

last two steps, which are immunization, uh, providers, uh, and the public health agencies' roles are the very, very important, and they are particularly, uh, critical in, uh, less developed countries. However, the, uh, which should be noted that, uh, vaccine supply chains have some characteristics that differ from the general supply chains. Uh, the first, uh, difference is that, uh, vaccine supply chains, uh, uh, requires, uh, very rigorous, the, uh, safety and quality controls. So, the, uh, I guess you might have heard a lot, uh, from

multinational, uh, manufacturing, uh, pharmaceutical companies that the R&D cost of, uh, the pharmaceuticals, including vaccines, are particularly high, due to rigorous safety and, and, uh, quality control. But, uh, this is a, okay, yeah, okay, um, okay, the, uh, I will wrap up, uh, very briefly. Um, yeah, uh, the main difference, uh, uh, of vaccine supply chains include, uh, difficulty in forecasting and planning for production and distribution, and limited, the number of vaccine developers and producers, and a long distribution

chains, and strict regulation and certification, and the need for public education and campaigns. Uh, the next is the need for data management systems. Uh, the last is the need for international cooperation. Um, but still, the, I think, the some of the differences may overlap with the characteristics of the general supply chains. Uh, then let's think about the, uh, why vaccine supply chains matter. Uh, that's because, uh, um, the, while the many, uh, people, uh, or scholars say that the vaccines are public goods, uh, I think

actually, the vaccine supply chains, uh, uh, can be public goods, the, um, the, uh, fulfilling, um, the requirements of non-rival and non-exclusiveness. Uh, so the, because the vaccine's pivotal role is, uh, well known, we can also easily imagine, uh, the very crucial role of vaccine supply chains, uh, to, uh, produce vaccines and deliver them, uh, effectively and efficiently. Um, the, I want to highlight on one thing, um, the currently, the, uh, discussions, uh, among, uh, governments is going on to develop, uh, a pandemic treaty

and then the global supply chain of pandemic-related products, uh, that has emerged as one of the key issues, the, in agreeing with the pandemic treaty. Uh, okay. Um, so, uh, the next, uh, I want to briefly mention the current challenges with the global vaccine supply chains. Um, so the, um, uh, to name just a few, the, I can list, uh, the production capacity and distribution inequalities. The second, raw material and supply shortages. Third, regulatory and, uh, bureaucratic hurdles. Fourth, the lack of funding and investment, and, uh, the

fifth in my list is vaccine hesitancy and, uh, misinformation. Um, so, but, uh, these are just the, the, uh, only a part of it. Uh, the, uh, challenges the current, uh, global vaccine supply chains face. So to address these challenges, um, the, we will require a multi-pronged approach. Uh, so the, uh, let me just, uh, wrap up my talk in one minute. I'm sorry for using one more minute. Um, okay, the next I wanted to, the mention that the, uh, how the global, uh, supply chains that have been realigned, uh, after the COVID-19 pandemic. Um, so for example, the

regionalization of supply chains, diversification of supply chains, and digitalization of the supply chains, uh, can be the, uh, main realignment characteristics. Um, so the, finally, um, the, uh, organizer of this session wanted, uh, me to, uh, think about, uh, the challenges and the tasks for Korea. Um, I think the Korea has world-class competitiveness in the field of vaccine production and supply, but, uh, the our country still faces several challenges under the current situation of, uh, realignment of global supply

chains. So in this regard, um, I think, uh, the Korea should focus on establishing and improving its, uh, uh, domestic, sorry, yeah, domestic vaccine supply chain, leveraging its competitiveness in vaccine production and supply. Uh, the second point is that, uh, leveraging its established expertise and experience in vaccine supply chain development. Korea should do, um, play a key role in contributing to the production and supply of COVID-19 or any future, uh, pandemic vaccines, while also supporting the, uh, enhancement of the

supply chains and infrastructure in developing countries. Uh, furthermore, uh, I hope and I think Korea should strive for a leadership role in enhancing global vaccine acceptability through active international cooperation. So it is also necessary to aim for a leading role in improving, uh, global vaccine, the acceptability. Okay, the, uh, and then thank you for your attention. Thank you very much. Uh, Professor Kim, uh, uh, she, uh, I think, uh, she needs more time. Um, uh, she provided, uh, you know, context for, uh, global, um, health

security, uh, provided some concepts, clarified, and, uh, uh, vaccine supply chains, as well, and, uh, some key challenges to, to, uh, vaccine supply chains, and, uh, provided, uh, two, uh, recommendations for, uh, Korea. So I think, uh, we, uh, will discuss, uh, this issue, uh, in, uh, the later, uh, discussion session. Next is, uh, Professor Kim, Tun. I'm very, uh, it's kind of, uh, great honor for me to, uh, be part of the today very important, the workshop. So the, I should be, uh, because I'm not an expert on the health security or the global supply

chain for the vaccine, but I'm trying to do, uh, from the perspective of the Global South, what kind of competition or complementarity, uh, particularly between India and China, um, I mean, when it comes to the, what kind of the global supply chain for vaccine, the production, as well as distribution in the longer term. So the, today, um, I'm going to talk about some, the, um, Global South challenges to the current, the landscape of global health security, especially China and India, how different, uh, those two, uh, you know, the

vaccine providers from the Global South is quite different or similar, similar, and how we can the build up together to make some kind of the, uh, our, the future roadmap for better, I think, the governance for health security. So, um, I'm going to the, uh, finish up because the, uh, everyone is very getting hungry, and, and, um, the last speaker today, so the, I'm going to definitely finish some my presentation, uh, in 15 minutes, less than that, okay? So first of all, it's kind of introduction, global pandemic and vaccine inequality and competition

for global supply chains. I think that everyone just well understands what's going on, especially during or after the Corona pandemic. So that I'm not going to go into detail, but one thing I'm going to highlight for the first slide is the global health governance did not work, especially WHO. So that's why there are lots of criticisms from the US and other, you know, the G7 about the, uh, activities of all the, uh, predecessors of the WHO in dealing with COVID-19 at the time. Uh, but we have some kind of global efforts to tackle

infectious disease uh and vaccine production so there are many examples examples like the the co C sepi and the Coalition for epidemic depop Innovations and coac is very well known like the international the initiative and finally the covid-19 vaccine delivery partnership uh launched in the January last year but having said that I think the more important point we have to the analyzed what is the weaknesses of the global supply chain for health security that's the uh how many countries now can produce by themselves

so the I think the 30 States take the lead of covid-19 vaccine production uh uh through the three different kinds of methods so first one is the ins short the cdmo the contract development manufacturing organization and its own facility and final technology transfer so I think the uh cdmo is kind of outsourced mechanism so the if you take the the cdmo as the main method for the production and Manufacturing you need partner you need some the other you know kind of manufacturing companies or the other states but if you take the its own

facility you now have the kind of the national uh facility to produce so it's a very powerful mechanism so if you look at the uh Global South only two countries now have you know the its own their own facility that's India and China so that's why I'm going to take a look at the India and China in more detail and how they competing with each other by using its own facility so if you look at the the map there's geographical location vaccine production by type of manuf urer so the dark blue is like the own facility and bright blue

is cdmo and then the yellow color is technology transfer so if you look at the global South uh All Nations have some kind of Technology uh transfer rather than cdmo rather than its own facility only two countries that's the China and India that's why we have to the pay attention to those two countries what kind of mechanism what kind of the strategies they have uh to support all the some kind of negate the current set of the global supply chain and then if you look at the next you know the chart

uh it is a top 10 vaccine uh production location time number of the manufacturers so number one is us us also has its own facilities and Germany has just only one facility but if you look at India uh three facilities they have and the China is six I think the the number of the uh facilities National facilities I think China is number one so that's why China has relative speaking from my p uh personal view very powerful and then they have very high level of influence by Pro producing the um vaccines and they can be Distributing

vaccin for their own propose there for the for their own sake uh for the over the global South so the uh maybe we can just the uh integrate all the activities of India and China by using vaccine uh there is vaccine diplomacy so the vaccine diplomacy of China and India probably aim to the improve their is on the Diplomatic uh influences or relationships to Target countries by using vaccines so the we have to the analyze what kind of patterns of vaccine diplomacy and its effects on supply chain resilience uh differentiated uh

across China and India so that's why the first case China we can just highlight the key characteristics of Chinese the vaccine diplomacy I can say like own facility Center the vaccine diplomacy so I'm not going to the detail but the first uh you know the point I would like to highlight that's the vaccine Chinese vaccine diplomacy built on the cornerstones very big big like their own kind of discourses and then the grand strategy such as the Cen Pink's 3zs the global development initiative Global

Security initiative Global decivilization initiative and also have a sec Ro that's part of the brri um and then also the the first Speaker highlighted the China is the categorized the vaccine Supply uh train is like the public goods so the it could be used for um their own the purpose as well as the common goals of the um Humanities so eight vaccines are now currently the uh approved by the China so it's now the the producing the eight different vaccines also Distributing those vaccin to over the the global South I think the

two points we have to highlight and remember in the case of China's the vacine diplomacy that first one is the bilateral and second is the its own facility based centered in know production line they have so very powerful in a sense is not rather than the multilateral they focus on bilateral relationship and also they can useing like this on the grand straty such as the brri by you know Distributing what kind of the criteria they Distributing the uh vaccines first of all the some the global something I mean the G 3G uh

Global development initiative and other ini as well as the V and also the they can just the manufacture their own vaccine through the its own companies its own the facilities so if you look at the next slide here this is the So-Cal brand line uh this line is like distinction between the glob North and Global South uh they're made by the V brand uh back in 1980 the former Chancellor of the west of Germany bil Grant he made this kind of line and still available so the let me wrap up the China case maybe three key

characteristics first one producing vaccine through the own facilities second bilateral distribution rather than multilateral uh distribution and third one vaccines AS Global public goods as well as the uh good instrument for China's the grand strategy and the next slide is like the Bri I mean along with the vaccine distribution so you can just recognize some the key Hub partner countries through and the along with the Bri and there some the focusing area for the distribution of the vaccines also is

very the uh closely connected to Bri okay and the next one is India so the I just summarize India case is the mixed bag of the cdmo and own facility so cdmo means once again outsourced so the India has some the key partner countries world old manufacturing the companies in the west and also they just they highlight the power and then the the function of the its own facilities as well at the same time so the as well known the India is among the world's largest pharmaceutical manufacturers almost like 6% of the world vaccines by

B volume and then they have very close close relationship with the astroica and Oxford University so they are very uh smartly using some CDM mechanism as well as they participa in the Cox I mean multilateral the initiative as well as they just using some in the bottom the last point of the slide but at the biotech that's the national facility so they just increase like volumes and then some uh good vaccines through the its own company it's on the uh facility uh production line so let me the Highlight

some the key points in the case of India by using this slide so they once again the three key characteristic in the case of India's the vaccine supply chain firstly producing vaccine through the cdmo and on on is on the facilities so it's kind of mixed back so they they have some connection with the west and connection with the national you know industry um and then the another one is the um the neighborhood first policy so they focus on the neighboring country first so the when it comes the how they

distribute their vaccines so Sri Lanka and the Mal sorry the Bangladesh some the South asiia countries as Southeastern Asia and then they extend further to the African countries so it's a little bit different like strategies they have in comparison with the China's the vaccine the diplomacy so the key question I think that we can raise this kind of question China and India complimentary or competing so so far we cannot the judge the those two countries now competing with each other or complementary with

each other is quite the uh we need I mean more time to take a look at what kind of relation between two but the obvious thing is like um they have different strategies and they have different I think the national interest in the making or expanding some the their the uh some national strategy for the vaccine diplomacy so I think the last point I'm going to highlight the um even though the China India differ in their strategies and tactics they do operate in the same region just like in the Pacific their vaccine diplomacy can

intersect with the other dimensions particularly where they are more competitive or even confrontational so in the Pacific area it's kind of common area they just put a lot lots of the vaccines in order to make the all the sustain the HM power over the global South probably some kind of Confrontation we can expect between two different countries by using the vaccine diplomacy so two more slides uh so just in time first is just in case it's not my story it is the article published by the foreign policy the early of this year so just

time just in time supply chain model is kind of current set of the uh supply chain model globally so the the meaning is like uh this approach PRI uh prioritize the supply chain efficiency through cost cutting and waste reduction measures encouraging suppliers to eliminate redundancy and rep uh sorry rep uh replenish uh inventory only when reserves went low but when we just the um think of the the global South how we can supply the vaccines for the global South maybe through the China all through the India all through the whole

the global governance has governance we have to change we have to reform the current stat of the uh just in time supply chain into the justtin case supply chain that's the key message from the that article so the the meaning is just in case approach um we need more resilient to price the uh vitility and the geopolitical instability and climate related disruptions by maintaining stock piles of the critical medicines or raw materials so in advance we can just uh maintain stock piles for the case of the

crisis or the instability so the is quite the important kind of the model but the thing is how we can just put together different like supply chain into one single integrate you know the supply chain so it's a very hard thing uh so the uh especially for the case of the uh low and middle income countries they have many different like this some the factors uh for the making the supply chain very the uh you know fluctuated all the uh unstable because of the um the uh underdeveloped Transportation networks and shortage of skill labor and

so on so uh just in case Supply how we can prepare together uh for the um you know the Stock B of the critical medicines raw materials Al so that is like kind of the future road map but the thing is is the last slide how to strengthen a supply chain resilience to safeguard the health in the global South so there's no answer I mean for now because the my job is very prary research on the the general kind of perview of global global supply chain in the case of the India and China and then over the global South but the thing is

we one thing I can just draw some kind of from my presentation that is proactively embracing India as a hub of connectivity with the global South as well as the global North I think the India is kind the only country in the global South to connect both sides the global South and Global North at the same time so the how South Korea approach the India as key partner especially for the purpose of the enhancing the collabora collaborative the Rel partnership with global North and Global South all together so once

again I don't have any uh idea very critical and mean the good answer for that question but probably the India should be differently treated by the South Korea or other G7 countries as a key partner for the better I think the set of the global supply chain thank you very much uh Professor Kim tun um uh you know takes two uh big uh countries India uh and China as cases uh to provide uh their strategies compare uh and contrast and uh I mean there and then uh the relationship between the two uh in in

vaccine diplomacy uh maybe largely competitive rather than comp elentary and uh he close uh by uh providing some policy implications for uh South Korea uh now let's turn to uh discussion but uh we only have 30 minutes uh so uh please uh reduce I mean confine your uh discussion to 8 minutes please and um this is a designated discussion so uh Professor Kong to uh Dr hang in this way so yes thank you very much for inviting me to this conference it is my uh it is I am very honored to take part in this

conference uh my job in this session is to make a comments on Dr huang's presentation um Dr huang's uh presentation helped us understand the current state of health security which has been driven um or under the influence of uh the US China competition and China's domestic politics and he I believe uh I believe he cautiously forecast a neutral or slightly pessimistic uh future of health and security given the direction of the US China uh competition is likely to uh head I largely uh agree with Dr hang

regarding the past present and the future of Health security never nevertheless I'd like to fulfill my role as a discussant by adding a few things to Dr huang's presentation especially the causes of the and health insecurity and the world experienced during the covid-19 pandemic and how they will relate to health Security in the future uh we can find the causes of the uh covid-19 pandemic at two Dimensions the First Dimension is the virus itself or the medical dimension the covid-19 virus was new and its pathology was unknown

however given the fact that covid-19 vaccines were developed quickly within a year which was on Tenth of the usual time required to develop a vaccine the virus itself didn't uh seem to be the most sign significant cause of the pandemic and health insecurity the state of medicine in 2020 was sufficiently Advanced that it was able to tackle the new virus th the novelty of the of the covid-19 was not a sufficient condition for it to become a pandemic the real significant cause of the pandemic lay somewhere else and was more significant

for the pandemic than pandemic than the novelty of the covid-19 virus the covid-19 be became a pandemic because of politics which is is the second dimension of the pandemic the pandemic behind the covid-19 pandemic had uh politics behind the covid-19 pandemic had a few sources the United stat uh us China competition was not the only politics involved the pandemic broke out because of failure in disease surveillance with functioning surveillance systems and robust information sharing among countries a

noval virus be uh can easily become a pandemic in the age of globalization failure in disease surve surveillance and information sharing is largely driven by domestic politics in the country where a new virus starts this was well shown by China the second source of uh politics behind the covid-19 pandemic was the World Health Organization the World Health Organization lacks meaningful enforcement mechanisms needed to assure compliance with directives upon uh pandemic outbreak and the uh W uh World

Health Organization Falls at the whim of member states uh this was well shown too by his delic uh delicate and diplomatic uh dealings with China in the wake of the uh pandemic so the covid-19 uh covid-19 virus became a pandemic because the because the three kinds of politics were compounded seeing that uh politics matters more for health security than the novelty of virus we can assess the future of Health security more realistically at one time health related collaborations were viewed as politically acceptable and shielded from

politics but the panic and confusion be around covid-19 upended this tradition in the era of a great power competition it becomes difficult to prepare for or respond to future pandemics if competition between the United States and China continues and neither China nor the United States provides clear opportunities for collaboration the chances of tackling new pandemics will be diminished however advancing Health security often Falls beyond the purview of any single country a multi multinational Partnerships are

required uh specifically uh they underscores the importance of continued engagement of uh engagement by uh two of the world greatest to economic and technological Powers as well as the need to find ways to continue collaborations in smart informed geopolitically sensitive and M uh mutually beneficial manners to build collaboration between the United States and China there are two needs upon which to focus a more nuanced narrative regarding the United States uh United States and uh China relations and a clear set of

collaborative Endeavors uh most importantly The Narrative must make plain uh that uh us China relations in health are not part of a josm game where one side wins and the other and the other loses in thinking about global Public Health Mutual self-interest in Washington and Beijing can drive progress on areas of uh transpor health issues it is possible to build uh for the United States and China uh it is possible for the United States and China to uh build Partnerships that run uh complimentary uh complimentary uh even

if they have different opposite and political systems and ideologies um uh the uh health problems confronting the humanity demands that the United States and China work together even only in this Limited in context and lastly it is critical to emphasize Mission driven uh collaboration between the United States and China okay uh this ass say uh The Joint initiative is possible that are clear in their Global health goals that related to National Security and detaches from politics at home they include agreements for exchange of data

and information uh information that are shaped and managed by managed in a way that both countries might accept for instance on on a pandemic early warning systems or collaboration in the case of Third Country humanitarian responses such as the cooperation during the West Africa Evol Evol EP mic in 2015 I guess thank you for your uh listening okay thank you very much for inviting me so I think uh I'm will talk about Professor sang gim's discussion about the perspect and challenges for Korea from the global Health security

perspective I think I should give a great summary about the what the global Health security and also vaccines are public goods and she emphasized the Korea need to have a domestic production for Global supply chain and also uh it need to uh having the supporting the infrastructure of the lmis like that so I think uh I'm not actually uh in this area in this field so I think this uh I'm here learning a lot of new point of view uh uh viewing the vaccine supply chain because I'm developing vaccine by

myself in the laboratory so many of the I scientists who dealing with this inequity issues they are now in Rwanda because now in Africa many low income countries they wanted to develop their own vaccine so I think many ivi scientists are now uh helping in Africa and also I decide to make African vaccine initiative uh to help their own vaccine development so most of the expert and scientist are now in stain Africa uh so today I'm talking about our experience during the covid and how with Korea uh have experienced and uh what's

the new uh plan for uh how can I say contributing for the global public health and also especially in vacine uh manufacturing for from the lmic actually uh during the covid as you remember Korea also uh mostly we imported the vacine for each need you know the from Moda or FAA or NOC something like that but Korea also uh produced as a te Professor tun mention like a CDM or CMO production Asen or nox or Samsung also the F finish for Mona vaccin so and also we exported a lot of vaccines Asen NOA because uh as I

remember more than 100 million doses Korea also EXP ported uh because we our capacity was quite enough to uh mass production so I think we also contributed uh that and also you remember Korea also make a success our own vaccines it's SK bio science so uh they this vacine it's a global coll through the global collaboration Gage foundation and sepi and GSK uh also the vaccine come from University Washington University so that vaccine uh as a first vaccine as I remember as a Korean vaccine uh after got mfds approval they

got UK MH approval and and then finally also they got the wh eul so authorized so uh we quite successfully developed our own vacine but unfortunately uh this one is a recombinant protein vaccine and how can I say a little bit delayed compared to the other messenger vacine so uh it's not uh in our Supply right now but anyway so I think Korea actually uh quite very strongly wanted to deel our own vaccine I think it started year 2010 you remember there are pandemic influenza at the time Korea minister of

Health and Welfare uh he traveled to get secured the vaccine implant the vaccine but unfortunately he cannot get uh single dose of vaccine because at the time vaccine nationalism was really serious so I think from that time Korea decide okay vaccine is not just economy vaccine is a self-independence I mean it's a sovereign sovereignty isssues so from that time Korea Government very uh strongly decide to develop our own vac inside Korea I think at the time only 20 20% of vaccine were produced in Korea

which we are using so that time government decide up to 80% we want to we need to produce inside Korea so at the time from that time I think a huge amount of money at the bin field uh start to support it as I remember 200 million dollar for research money from MW and also almost same amount money from Minister miti minister of industry for building GMP facility special vaccines andong and for bacteria or cell based vaccines and many other activities so they want to support uh vaccine production in Korea I think that also we

benefit uh during this Corona pandemic and also Korea I think we are very strong in mass production as you knew M antibodies in globally Korea one of the top country like Samsung biology 6 and celon uh they are producing like a huge amount of monoc antibody so it's bio similar Korea very short time became very strong and you know in mass produ mass producing globally so we are very strong on the uh in mass production but unfortunately the vaccine design and uh vaccine develop itself you are quite

behind compared to the USA or the uh uh many developed countries so I think we need to uh also focus on that kind of you know vaccine design or structural VY or you know more advanced technology because uh we already uh having mass production systems because many private sectors they start uh investment and also uh I think Korea also during the covid and through the covid we realized uh we can also support lmis country so uh together with MW and W2 Korea Government started the gthp program Global uh training h of biom

manufacturing uh you know the uh I think uh wh uh also started the wh Mach jna training Hub because really many Lis countries and this time they really wanted to produce a vaccine by themselves I think uh Global Supply Chain is very important but also they I mean at they didn't receive the bacine on time so really many people died because of the they cannot have the vaccine so this time they are very serious so I think I traveled many countries and they started uh their own develop vacine develop facility using

the messeng something like this so and uh many U Advanced country uh and com commercial and Gau foundation and wh they start helping also IBI also participating that kind of self-development activities so actually uh so actually ivi we had a bology course every year at normally it's I mean uh we have like 100 audience but during the covid we cannot have that program because of this covid they banned all the travel so we open that program in online I think it was year 2001 normally 100 but at the time in

globally more than 7,000 people apply the program and around uh 30,000 program they finished the program quite well so I think we discussed this kind of inm in developing vaccine by themselves and having uh training program so together with MW Korea run the program I think it already two years and more than 100 and 300 uh from the admic they are trained in Korea I think are now in sh new campus uh they are training for vinology course and also uh GXP course including GMP I think Korea Government will extend

this program to Global bio campus so they'll having the more GMP facility and they also training U 100 people over there so I think Korea Government wanted to contribute by training in globally that kind of fromis I think that's that's all thank you very much for having me today actually I got my call so that please just just understood my kind of sort of the bad uh voice condition okay as actually I'm not an expert of the health security and Global healthy issue however I actually learn a lot about this Global

healthy issue particularly the supply chain particularly the vaccine supply chain so as I actually designated my discount from the professor kimun but also I actually learned a lot PR the professor hang the comment and uh the the point about this the what kind of the position is China actually have in case of the the vaccine uh supply chain issue as well as the professor Kim actually provided a lot of the overview very generous of the overview about the why the vaccine supply chain actually differentiated

from the other the traditional the supply chain uh I actually have uh several how to say this a question I the comment the regarding the the VAC supply chain issue the first of the when actually I read this article from the professor Kim tun I already actually think about okay vaccine diplomacy as well as the vaccine nationalism lot of people already very much familiar with the vaccine diplomacy as well as the vaccine nationalism even the 2020 and 2021 I believe lot of people very much criticized about the vaccine National

ISM as well as more like very aggressive the activity from the vacine diplomacy in somehow negative portion however nowaday right here right this moment I think that the vaccine diplomacy as well as the VAC nationalist more like how to say just a common situation right so in this Cas is my first question okay based on based on this vaction nationalism as well as the vacine diplomacy is become much more the common phenomena and how we are going to distribute this vaccine but more accural vaccine distribution in other words the more

accur vaccine distribution is possible under the vaccine diplomacy is very much inactive as well as the VAC nationalism is kind of sort of the common situation right here at this moment the second situation is here okay right here this China and India became more and more influential stakeholder not only developed the vaccine but also distribution of the the vaccine in global scale in this case my second question is can China and India create or exert the some kind of the solidarity linkage with the global

South because the global South it cannot be the uh the homogeneous group global South could be the heterogeneous group and within Global South there are tons of different types of the the global Sal is country there individual Global Sal country has a different types of the the needed so how in the world we are going to creating some kind of AKA Global solidarity within this Global South because whenever we talk about the global solidarity we always talk about the global North and Global South solidarity but what about the global

South's solidarity because we always assume Global South always have their own Global South spirit and without any big question Global South could be somehow how to say just the one voice or the unified voice in the international society which is not true because the professor Kim already mentioned about China and India had very much difference strategy on the the uh implementing there on the vaccine diplomacy as well as the vaccine development or the other types of strategy in order to uh expand

their own influence through this vaccine issue so in this case my third question is I think that is more like the fundamental question can vaccine and vaccine supply chain be a global the public good or private good with SP special need I believe everybody just assume the vaccine particularly the covid-19 vaccine could be the global uh public but which is not quite sure about it because the the professor K actually mentioned about this what's the the major point of the the public right and the non as uh sorry as well as the

non-exclusion but when you actually look at is the the the vaccine development as well as the vaccine supply chain you cannot say so so still there are a lot of somehow competition among this very influential pharmaceutical and the international pharmaceutical within this realm of the vaccine distribution as the vaccine development also at the same time non-exclusion meaning if you if we actually look more like closely into the direction supply chain you cannot say say that this is whole the non exclusion

the principle can be solely applied into vaccine supply chain so in that case can we can we actually talk about this vaccine as the public good and Global public good the reason why I should make this final question because I believe this is going to be the fundamental question whether we are going to develop our vaction supply chain in much more modified way or the much more improved way for the better quality of the global health care or the global Health security so without the last the questions answer I think that our whole

conversation is somehow kind of sort of a heating around the bush in case of the the the big gap between Global North and Global South so I would like actually raise the one final question can we consider the vaccine and vaccine supply chain be a global public good or can we consider this vaccine particularly in the future any types of the the vaccine could be a private good with the special needed thank you very much for that thank you uh thank you very much now uh uh I think uh before um getting back

to uh presenters uh let me host one or two questions from the floor question quick question for for thank you uh any any other questions okay uh we are uh almost time so uh uh I think uh you could any anyone can respond uh uh maybe uh Professor kimun you you uh you should respond uh to several questions so before are you preparing for that uh uh Dr hang would you want to uh respond well sure I'd like to comment uh the vaccine developed by General Chang way you know that we know that you know based on the Chinese media

reports she seems to be the first that develop a uh effective covid vaccine you know that was in a way even early than the US you know that uh but you know my understanding that the vaccine once developed was first used in the Chinese military uh we don't know how the the the vaccine rate uh the vaccination rate was and how effective it was this is like seems to be a top secret and never being revealed by the government but we do know that later by That vaccine was never widely used in China you know the uh the U the two you

know the uh because the vaccine she developed was the adino virus vaccine not the inactivated uh the uh vaccine developed by sovac or you know the uh sopam so that is still like pretty much a mystery you know why is that the case you know even though that the government also you know give her you know a lot of awards you making himself sort of like a national hero but ironically that vac was never has never been widely used in China it's never uh the Des in a way it's not even the designated vaccine in

the country during the the campaign um thank you for all the comments very helpful and as I mentioned thei the um today presentation is based upon the very prary uh the kind of sketch about the uh India and China's the diplomacy so very helpful so thank you so I think the your question from the audience already the answered by Dr hang so uh thank you for Dr hang and then the I didn't you know the support like the Chinese vaccines is very effective and useful like the uh cases for um you know covid-19 because just

the take a look at my paper I just lay out all eight different the um the vaccines uh used by the Chinese government and the very few number of the countries like the use do doses so it's very very negative I guess the response from the I think the ran country in the global sou as well so please refer to that and then the some the responses from to the professor ch's comment especially the second in a question can China India create some kind of the global solidarity with the global South um in my understanding the after the the

end of Cold War there's know any the genuine kind of pattern of solidarity uh among Global South countries so after that they just follow kind of the national interest like uh calculations for their own survivors so they can easily support with the us at the same time with China and India so the I think the you know Global solidarity or Global South you know solidarity consideration is kind of the political rhetoric uh so that's why they they very uh you know rigorously calculate the loss and gains uh in

relation to some the providers of you know India and China so the um I mean to the second question I'm very negative position and then the the last one the global public goods it is very important question to um to Global Governors as well as United Nations so the back in 1990s United Nations they had a big big project how the how to define what is the public a global public it's not domestic public goods so the nonexcludability non competition and so on that's kind of the key component of the national public goods but at the

global level we cannot apply the those two two component to the public goods at Global level so un just the officially declared if just satisfy one kind of component against the other we can call Global public good so probably there's some different the definition we have to use for understanding you know the vaccine supply chain can be you know the understood as the you know glob public goods um but in theory it's impossible I guess but in reality uh we can do some kind of the one integrate kind of

channel for the global supply for vaccines um Sometimes using the India in connection connectivity and also some the Chinese production line but the thing is how we can make kind of consensus I already talk about Dr H did uh you know touch on some the global consensus on the future kind of collaboration among some the stakeholders in the making and the implementing and distributing the vaccines for the uh Global agenda so I I'll stop here thank you very much uh yes uh we are overtime so uh uh let me

uh conclude but uh I don't really think that I need to uh uh I need a conclusion uh uh but one thing uh compared to uh you know other three uh topics uh that we uh uh are dealing uh with in this conference uh this uh public health issue uh seems relatively easier to cooperate than other things uh unfortunately uh this issue really need an international cooperation but it happened at a time when we really need but uh we were split and fractured um and uh this is uh I mean that past uh three years uh you know

could be a lesson uh for uh the global community and uh maybe the next round comes then uh you know we might be uh better prepared than before uh so uh even in the case of us China strategy competition uh Dr hang you uh correctly mentioned that this issue was not mentioned at all uh but uh this is I think uh one of the better uh areas where uh two great Powers Plus other countries uh you know would be able to cooperate so with that uh let me uh conclude and uh so today's session uh conference um ended uh and we will have

uh uh a conference uh tomorrow as well we had two more uh sessions to go so uh please uh come back again thank you very much