China’s COVID-19 vaccines are here—for better or worse

This is the web version of Eastworld, Fortune’s newsletter focused on business and technology in Asia. Subscribe here to get future editions in your inbox.

Grady McGregor here filling in for Clay Chandler.  

On Tuesday, the world rejoiced as 90-year-old British grandmother Margaret Keenan became the first person in the world to be injected with a fully-tested COVID-19 vaccine from Pfizer and BioNTech.

But the U.K. was not the only country to roll out a foreign vaccine candidate this week.

On Wednesday, the United Arab Emirates approved the vaccine by Chinese state-owned drugmaker Sinopharm for widespread domestic distribution and claimed that Sinopharm’s vaccine was 86% effective in preventing COVID-19 infections after analyzing data from phase III trials.

The move was a signal that Chinese vaccine makers are not far behind their Western counterparts—Pfizer, Moderna, AstraZeneca—which appeared to cross the finish line first by releasing promising phase III trial data.

But among scientists, the UAE’s announcement has raised more questions about Sinopharm’s vaccine than answers. The UAE did not disclose the phase III trial data to the public and, in stark contrast to Western vaccine makers, Sinopharm did not even acknowledge publicly that its vaccine was approved. A spokesperson for a Sinopharm affiliate in Hong Kong declined Fortune’s request for comment and a spokesperson in Beijing hung up on the New York Times when it called about the news.

Sinopharm is a state-owned enterprise that seemingly has little interest in transparency and openly flouts adherence to some international vaccine development standards. In October, Sinopharm Chairman Liu Jingzhen proclaimed that the company had already distributed its vaccine to nearly 1 million people in China before the conclusion of clinical trials as part of China’s controversial emergency-use program.

One of Sinopharm’s Chinese counterparts, the private vaccine maker Sinovac, is more transparent, but it may have a different set of issues to overcome.

Sinovac is currently testing its candidate in phase III trials in Brazil, Indonesia, and Turkey, and has pledged to adhere to scientific protocols. The company also published its phase II trial results in a peer-reviewed medical journal, something Sinopharm has not done. But Sinovac’s stock has been suspended on Nasdaq for over a year as part of a drawn-out corporate governance battle. And in 2016, Sinovac’s founder Yin Weidong admitted to paying bribes to top Chinese drug regulator Yin Hongzhang in exchange for approval of Sinovac’s drug applications. Yin Hongzhang was sentenced to ten years in prison for corruption, but Sinovac was not charged for its role in the bribery case.

But for all of Sinopharm and Sinovac’s flaws, they may fill in the gaps left by Western vaccine makers.

Sinovac and Sinopharm’s vaccines are all based on inactivated forms of the virus, meaning they can be stored at roughly the temperature of a home refrigerator (2 to 8 degrees Celsius) and are more accessible to lower-income countries like Indonesia, where setting up pricey ultra-cold shipping and storage networks appears all but impossible. British pharmaceutical giant AstraZeneca’s vaccine also doesn’t require cold chain networks for distribution, but even after AstraZeneca published its phase III interim data in a peer-reviewed medical journal this week, scientists say continuing questions over the vaccine’s efficacy may force the company to conduct more trials before its candidate can be widely used.  

In November, the Nikkei Asian Review published a map showing 26 countries that have struck deals with Chinese vaccine makers or have agreed to conduct phase III trials of Chinese vaccines. It’s a constellation of mostly developing nations across Asia, South America, the Middle East, and North Africa, perhaps foreshadowing a split among countries—those that use Chinese vaccines versus those that rely on Western-developed ones.

“I expect we will see a divided world in terms of vaccine use,” Yanzhong Huang, senior fellow for global health at the Council on Foreign Relations, told Fortune in October. “You will find that [Organization for Economic Cooperation and Development] countries will prefer U.S.-made vaccines, and many developing countries will have no other choice but to use Chinese-made vaccines.”

More Eastworld news below.

Grady McGregor
grady.mcgregor@fortune.com

This edition of Eastworld was curated and produced by Naomi Xu Elegant. Reach her at naomi.elegant@fortune.com

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