tag:theconversation.com,2011:/ca-fr/topics/vaccine-diplomacy-104073/articlesVaccine diplomacy – La Conversation2021-11-07T19:14:59Ztag:theconversation.com,2011:article/1707732021-11-07T19:14:59Z2021-11-07T19:14:59ZAs Papua New Guinea struggles with COVID, Australia must step up its ‘vaccine diplomacy’<p>As our nearest neighbour, Papua New Guinea, struggles to contain a <a href="https://www.aspistrategist.org.au/covid-19s-toll-on-papua-new-guinea/">rampaging COVID outbreak</a>, the question arises of how much Australia is doing to help. Is the emergency assistance Australia offers enough in a country whose health infrastructure was already under siege before the pandemic?</p>
<p>An ancillary question is whether Canberra’s <a href="https://www.stuff.co.nz/national/politics/126350699/covid19-vaccine-diplomacy-swings-in-pacific-nations-favour">“vaccine diplomacy” in the Indo-Pacific</a> is losing ground against an aggressive Chinese push to make available its Sinovac and Sinopharm vaccines across the region.</p>
<p>This is a classic case of a health emergency meeting soft diplomatic power in Australia’s own strategic backyard.</p>
<p>China has <a href="https://www.bbc.com/news/58808889">distributed more than 1 billion doses</a> of its vaccines to some 100 countries, with a particular focus on Asia and the Pacific. Something like 400 million doses have been distributed in Southeast Asia and around 300,000 in the Pacific.</p>
<p>Australia’s contribution in its own region stands at about 6 million doses of its AstraZeneca stockpile. But there is much work to be done:
<a href="https://graphics.reuters.com/world-coronavirus-tracker-and-maps/countries-and-territories/papua-new-guinea/">just 1.7%</a> of adults in PNG are fully vaccinated.</p>
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Read more:
<a href="https://theconversation.com/the-pacific-went-a-year-without-covid-now-its-all-under-threat-158963">The Pacific went a year without COVID. Now, it's all under threat</a>
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<p>The Morrison government insists it is doing all it reasonably can to help its neighbour in what are dire circumstances for a country beset with development issues.</p>
<p>Zed Seselja, minister for international development and the Pacific, says in an interview that Australia has been “moving heaven and earth” to assist PNG with the supply of vaccines and has deployed Australian Medical Assistance Teams (AUSMAT) to help on the ground.</p>
<p>Late last month, Canberra <a href="https://www.foreignminister.gov.au/minister/marise-payne/media-release/covid-19-partnership-papua-new-guinea-strengthened#:%7E:text=Australia%2520will%2520continue%2520to%2520partner,beyond%2520the%2520immediate%2520emergency%2520efforts.">despatched its sixth AUSMAT</a> to PNG since the COVID-19 crisis began, to help lift the flagging vaccination rates. </p>
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<img alt="" src="https://images.theconversation.com/files/430408/original/file-20211104-16-1l2888e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/430408/original/file-20211104-16-1l2888e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=388&fit=crop&dpr=1 600w, https://images.theconversation.com/files/430408/original/file-20211104-16-1l2888e.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=388&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/430408/original/file-20211104-16-1l2888e.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=388&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/430408/original/file-20211104-16-1l2888e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=488&fit=crop&dpr=1 754w, https://images.theconversation.com/files/430408/original/file-20211104-16-1l2888e.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=488&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/430408/original/file-20211104-16-1l2888e.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=488&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Minister Zed Seselja says Australia has ‘moved heaven and earth’ to assist PNG with COVID vaccines.</span>
<span class="attribution"><span class="source">Darren England/AAP</span></span>
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<p>This <a href="https://theconversation.com/png-and-fiji-were-both-facing-covid-catastrophes-why-has-one-vaccine-rollout-surged-and-the-other-stalled-169356">contrasts with Fiji</a> where more than 80% of the eligible population – those over 18 – has been fully vaccinated with Australian assistance.</p>
<p>While the comparison between Fiji (population 900,00) and PNG (8 million) may not be fair, in the sense that the former is facing nowhere near the development problems and geographical constraints of the latter, the contrast between the two could hardly be more telling.</p>
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<a href="https://theconversation.com/png-and-fiji-were-both-facing-covid-catastrophes-why-has-one-vaccine-rollout-surged-and-the-other-stalled-169356">PNG and Fiji were both facing COVID catastrophes. Why has one vaccine rollout surged and the other stalled?</a>
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<p>No-one pretends getting vaccines to remote areas in PNG, wide swathes of which lack electricity and, therefore, refrigeration for vaccine storage, is anything but a huge challenge. However, overlaying the PNG situation is the problem of vaccine hesitancy – perhaps better described as “vaccine phobia”.</p>
<p>According to a survey among university students, <a href="https://devpolicy.org/vaccine-hesitancy-in-png-results-from-a-survey-20210624/">just 6% believed they needed to get vaccinated</a>. One explanation for the level of vaccine hesitancy among educated Papua New Guineans is a <a href="https://theconversation.com/png-and-fiji-were-both-facing-covid-catastrophes-why-has-one-vaccine-rollout-surged-and-the-other-stalled-169356">low level of confidence</a> in PNG’s public institutions, according to former Australian ambassador to Port Moresby Ian Kemish. </p>
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<p>Perhaps most troubling of all is that many Papua New Guineans have developed a fatalistic belief that COVID is just another health challenge to add to the litany of other serious problems facing the country, including maternal mortality, malaria and tuberculosis.</p>
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<p>Health professionals on PNG’s COVID-19 front line paint a disturbing picture of the challenges they are facing.</p>
<p>Dr Glen Liddell Mola, professor of medicine and a veteran gynaecologist and obstetrician in PNG, describes an overflow of patients into “tent wards” in the car park of Port Moresby General Hospital as medical facilities struggle to cope with the influx of COVID-19 sufferers. He told me:</p>
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<p>I am 50 years into medical practice and not many illness scenarios challenge or frighten me anymore; but watching young people die from severe COVID disease had a very big impact on me. They literally die from laboured breathing respiratory failure: they just do not have the strength to take another breath.</p>
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<p>Seselja says the government is mindful of the huge health challenges facing PNG, but levels of vaccine hesitancy are “very, very high”.</p>
<p>Sejelsa defends the government against suggestions it could have done more. He points out that since the COVID-19 crisis hit in early 2020, Australia has allocated $532.2 million to the countries of the Indo-Pacific to access and roll out vaccines. </p>
<p>It has made a $130 million contribution to the global World Health Organisation-managed COVAX facility as its share of a vaccine procurement program for less developed countries. Australia has pledged $100 million under the Quad Vaccine Partnership with the US, Japan and India to support vaccine delivery in Southeast Asia. Australia is also sharing 40 million vaccine doses with the region from its own AstraZeneca stockpile.</p>
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<span class="caption">Fiji and PNG faced a similar catastrophic problem with COVID, but have gone in opposite directions in terms of vaccinating the population: in Fiji, over 80% have had two doses.</span>
<span class="attribution"><span class="source">Aileen Torres-Bennett/AP/AAP</span></span>
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<p>Of that 40 million stockpile, 2.2 million has gone to Indonesia, 1.5 to Vietnam, 861,000 to Fiji, 577,850 to Timor-Leste, 213,000 to the Solomon Islands and 144,970 to PNG, among others.</p>
<p>Asked why more vaccines had not gone to PNG, given its proximity to Australia and Australia’s own historical responsibilities, Seselja replied: </p>
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<p>PNG’s absorptive capacity for vaccines is just not there.</p>
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<p>He would seem to have a point. PNG recently <a href="https://covid19.info.gov.pg/png-shares-covid-19-vaccines-with-viet-nam/">“re-gifted” 30,000 doses to Vietnam</a> because it could not deploy them before their use-by date.</p>
<p>Diplomatic competition in the Pacific has been reflected in testy moments between Canberra and Beijing. At one stage, China accused Australia of <a href="https://www.abc.net.au/news/2021-07-06/china-accuses-australia-papua-new-guinea-covid-vaccinations/100269320">interfering with its attempts to supply vaccines to the region</a>.</p>
<p>In July, China’s nationalist Global Times berated Canberra for “sabotaging” China’s aid programs with Pacific nations using “political manipulation” to interfere in vaccine rollouts.</p>
<p>The newspaper said Australia had been “planting” consultants in PNG to obstruct the authorisation of Chinese-supplied vaccines. A Chinese Foreign Ministry spokesman said:</p>
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<p>Some people in Australia use the vaccine issue to engage in political manipulation and bullying, which is a disregard for the life and health of Papua New Guinea people, goes against the basic humanitarian spirit, seriously interferes with the overall situation of global co-operation against the pandemic.</p>
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<p>Seselja rejects China’s claims, saying it is “absolutely not the case”.</p>
<p>All that said, vaccine diplomacy competition between Canberra and Beijing is evident in efforts by the former to counter China’s attempts to increase its influence among Pacific nations.</p>
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Read more:
<a href="https://theconversation.com/chinas-push-into-png-has-been-surprisingly-slow-and-ineffective-why-has-beijing-found-the-going-so-tough-140073">China's push into PNG has been surprisingly slow and ineffective. Why has Beijing found the going so tough?</a>
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<p>Finally, Australia’s COVID assistance program should be set against its annual aid allocations to PNG and the Pacific more generally as part of its <a href="https://www.dfat.gov.au/geo/pacific/engagement/stepping-up-australias-pacific-engagement">Pacific “Step-Up” policy</a>.</p>
<p>In <a href="https://www.dfat.gov.au/sites/default/files/partnerships-for-recovery-australias-covid-19-development-response.pdf">2020-21, Australia allocated $491.1 million</a> in aid to PNG, or more than 10% of its total $4 billion aid budget. This was slightly less than Port Moresby received in 2019-20 due to completion of work on an undersea cable between PNG and the Solomon Islands.</p>
<p>PNG’s allocation accounts for about half of funds provided to Pacific island countries. On top of the annual aid budget, Canberra set aside $304.7 million over two years for what it called the <a href="https://www.dfat.gov.au/publications/development/covid-19-response-package-design-framework">COVID-19 Response Package for the Pacific and Timor-Leste</a>.</p>
<p>These funds are being deployed, but it is in Australia’s interests to do more to help PNG.</p><img src="https://counter.theconversation.com/content/170773/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tony Walker does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Struggling with a a fragile healthcare system, remote populations and widespread fear of the vaccine, COVID is running rampant in PNG. Australia has done much to help, but is it enough?Tony Walker, Vice-chancellor's fellow, La Trobe UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1643032021-09-01T15:42:45Z2021-09-01T15:42:45ZCOVID-19: why it’s time for the UK to start sharing its vaccine doses<figure><img src="https://images.theconversation.com/files/418261/original/file-20210827-6105-1dwi3hz.jpg?ixlib=rb-1.1.0&rect=249%2C0%2C4301%2C2711&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/manchester-united-kingdom-2-august-2020-1791096446">estherpoon/Shutterstock</a></span></figcaption></figure><p>As soon as the UK’s vaccination strategy started proving successful earlier this year, <a href="https://theconversation.com/the-uk-should-share-the-vaccine-with-the-other-countries-but-only-after-all-the-vulnerable-have-been-vaccinated-154351">arguments</a> in favour of sharing excess COVID-19 vaccines with other countries began to <a href="https://theconversation.com/covid-vaccines-rich-countries-have-bought-more-than-they-need-heres-how-they-could-be-redistributed-153732">appear</a>. Yet over six months later, barely any vaccines have been sent overseas from Britain, despite it having ordered over <a href="https://launchandscalefaster.org/covid-19/vaccinepurchases">half a billion doses</a> – many, many more than it needs to fully vaccinate its population.</p>
<p>This is puzzling. The UK’s COVID-19 vaccine coverage is <a href="https://ourworldindata.org/covid-vaccinations">among the highest</a> in the world. Meanwhile, other countries are suffering from vaccine shortages and are <a href="https://www.nature.com/articles/d41586-021-01762-w">calling for help</a>.</p>
<p>Besides the humanitarian issue, the UK is failing to gain an international advantage from its speedy vaccine rollout. In contrast, <a href="https://launchandscalefaster.org/blog/taking-closer-look-vaccine-donations">China</a> and <a href="https://www.statista.com/statistics/1123927/sputnik-v-exports-from-russia-by-country/">Russia</a> have been using “<a href="https://theconversation.com/vaccine-diplomacy-how-some-countries-are-using-covid-to-enhance-their-soft-power-155697">vaccine diplomacy</a>” to enhance their soft power abroad. Some western countries, <a href="https://www.independent.co.uk/news/world/americas/us-politics/biden-covid-vaccine-abroad-where-b1895935.html">such as the US</a>, are now joining in.</p>
<p>Britain, meanwhile, has not pursued any meaningful pandemic-alleviation policy overseas. Its support of Covax, the global vaccine-sharing programme, has been in word not deed. The nation’s <a href="https://www.gov.uk/government/news/uk-begins-donating-millions-of-covid-19-vaccines-overseas">financial contribution</a> to Covax stands at around <a href="https://www.bbc.co.uk/news/business-52663523">0.18% of pandemic-related borrowing</a>, and while 100 million vaccine doses have been promised to Covax, <a href="https://www.gov.uk/government/news/uk-begins-donating-millions-of-covid-19-vaccines-overseas">only 9 million</a> have been sent.</p>
<p>This inertia isn’t limited to the government. While some <a href="https://theconversation.com/most-people-support-sharing-vaccines-with-other-countries-new-study-159109">survey-based research</a> indicates public support for vaccine sharing, other data on public preferences – such as <a href="https://petition.parliament.uk/petitions/565462">petitions</a> – suggest limited interest in vaccine giving, with slightly higher support for <a href="https://actions.oxfam.org/international/covid-19-vaccine/petition/">waiving vaccine patents</a> than for <a href="https://act.unicef.org.uk/page/79450/petition/1?locale=en-G">sharing actual vaccines</a>.</p>
<p>There is a tension between the British public’s and government’s declared commitment to vaccine diplomacy and their actual behaviour, which indicates indifference or perhaps even hostility to the issue.</p>
<h2>Time for change</h2>
<p>There are several reasons why vaccine-sharing needs to be stepped up. Above all, many people are still vulnerable to COVID-19 at a time when cases are <a href="https://covid19.who.int/">peaking once again</a>. Allowing cases to carry on surging overseas also risks COVID-19 returning in places where it has been suppressed and provides the conditions for <a href="https://www.theguardian.com/world/2021/jul/05/will-uk-rising-covid-cases-increase-risk-of-vaccine-evasive-variants">dangerous new variants to emerge</a>.</p>
<p>The UK also <a href="https://theconversation.com/the-uk-should-share-the-vaccine-with-the-other-countries-but-only-after-all-%20the-vulnerable-have-been-vaccinated-154351">owes it to younger people</a> to send doses overseas. Being at a low risk of severe COVID-19, young people have gained the least and lost the most as a result of restrictions to contain the virus. For the sake of intergenerational justice, we should aim to return the world to normal as quickly as we can. </p>
<p>There’s also a more subtle influence that I think sharing vaccines could have. Britain’s pandemic response has been characterised by the introduction of emergency measures – a process known as “<a href="https://pandemipolitics.net/baele/">securitisation</a>” – where the rules of ordinary, well-established politics have been put aside in order to deal with the extraordinary threat of COVID-19.</p>
<p>This has demanded exceptional tactics such as lockdowns and furlough, which have come at a cost. Emergency politics have a tendency to <a href="https://link.springer.com/article/10.1057%2Fpalgrave.jird.1800030">usurp what is politically good</a>, prioritising survival over democratic decision-making.</p>
<p>In the UK, for instance, they have resulted in the <a href="https://www.ft.com/content/ca80611a-d020-4f17-ba99-c75350e1bed1">revoking of</a> competitive tendering rules for government contracts. They’ve also narrowed what can be said about COVID-19 in the public sphere, <a href="https://blogs.lse.ac.uk/medialse/2020/12/17/coronavirus-and-harm-in-broadcast-content/">limiting free speech</a> on the issue. It’s therefore best to end emergency politics as soon as they aren’t needed – though <a href="https://www.jstor.org/stable/41681477">transitioning out</a> of them is often a <a href="https://link.springer.com/article/10.1057/jird.2013.22">tricky and drawn-out</a> process.</p>
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<span class="caption">Sending excess vaccines abroad will signal that it’s time to stop thinking of the UK’s COVID-19 situation as an emergency.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/london-uk-13-february-2021-covid19-1917178850">cktravels.com/Shutterstock</a></span>
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<p>On the grounds of what we know about <a href="https://journals.sagepub.com/doi/10.1177/0032329205285406">emergency politics in general</a>, I think that donating vaccines overseas could be a useful way of signalling that it’s time for the UK to stop focusing singularly on the extraordinary threat of COVID-19. Doing so might just help the UK exit its emergency thinking and return to something like normality.</p>
<p>Of course, this is secondary to the direct impact that donating vaccine doses would have. They would make a crucial difference to people’s lives around the world by protecting them from what can be a deadly disease. But if the UK did decide to increase its COVID-19 vaccine donations, it might find that it enjoys some additional benefits.</p><img src="https://counter.theconversation.com/content/164303/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kamila Stullerova does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>As well as protecting a great number of people, giving vaccines away can raise the UK’s influence abroad and perhaps even change how the country perceives the pandemic.Kamila Stullerova, Lecturer in International Politics, Aberystwyth UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1606942021-05-12T06:11:34Z2021-05-12T06:11:34ZHow China used the media to spread its COVID narrative — and win friends around the world<figure><img src="https://images.theconversation.com/files/400203/original/file-20210512-23-1l2ix8k.jpg?ixlib=rb-1.1.0&rect=49%2C107%2C5483%2C3451&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">An official from the Chinese embassy in Zimbabwe greeting a plane carrying Sinopharm COVID-19 vaccines from China.</span> <span class="attribution"><span class="source">Tsvangirayi Mukwazhi/AP</span></span></figcaption></figure><p>At the height of the COVID-19 pandemic, Chinese President Xi Jinping enjoyed prime real estate in the centre of Serbia’s capital, Belgrade: his face plastered across a <a href="https://www.euractiv.com/section/china/news/serbia-sets-the-stage-for-beijings-mask-diplomacy/1450727/">billboard</a> with the words “Thank you brother Xi”. </p>
<p>The sign, courtesy of the pro-government tabloid Informer, was in response to China sending COVID-19 medical supplies to Serbia. It joined a long list of pro-China offerings of thanks from nations around the world during the pandemic in the form of overt propaganda or more subtle media messages.</p>
<p>A new <a href="https://www.ifj.org/fileadmin/user_upload/210512_IFJ_The_Covid_Story_Report_-_FINAL.pdf">report being published today</a> by the International Federation of Journalists (IFJ), which I co-authored with Louisa Lim of the University of Melbourne and Johan Lidberg of Monash University, has found Beijing’s global image has benefited from the pandemic, despite its origin in the Chinese city of Wuhan.</p>
<p>Over half of the 50 nations surveyed at the end of 2020 reported coverage of China had become more positive in their national media since the onset of the pandemic, while less than a quarter reported it had become increasingly negative. </p>
<p>The change was most favourable in Europe, which scored 6.3 on a scale of one to ten, where one is the most negative and ten is the most positive. China’s image plummeted in North America, coming in at 3.5. </p>
<p>The overall increase in positivity coincided with an uptick in Chinese outreach. Three-quarters of the journalists we surveyed said China had a visible presence in their national media, compared to 64% in a previous survey <a href="https://www.ifj.org/media-centre/news/detail/category/press-releases/article/inside-chinas-strategy-to-influence-the-worlds-media.html">we conducted for IFJ</a> in 2019.</p>
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<h2>Spreading propaganda through content-sharing agreements</h2>
<p>China has long attempted to seed positive narratives of itself in foreign media, while blocking unfavourable coverage and redirecting the world’s attention onto Western failures. </p>
<p>To do so, Beijing taps into foreign media ecosystems with tailored offers of access and resources. It exports its propaganda to foreign media organisations through <a href="http://www.xinhuanet.com/english/2019-03/23/c_137917481.htm">content-sharing agreements</a> and memoranda of understanding with state-sponsored media outlets like Xinhua and China Daily.</p>
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Read more:
<a href="https://theconversation.com/how-china-is-controlling-the-covid-origins-narrative-silencing-critics-and-locking-up-dissenters-152751">How China is controlling the COVID origins narrative — silencing critics and locking up dissenters</a>
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<p>For example, Italy’s state-run news agency ANSA now publishes 50 Xinhua stories a day on its news wire, with Xinhua taking editorial responsibility for the content.</p>
<p>Beijing has also offered <a href="http://bj.cri.cn/thematic/silumingren#section5">all-expenses paid tours</a> to global journalists.</p>
<p>The desired outcome is for international media to amplify Chinese messages in their own languages in the pages of their own news outlets.</p>
<p>In this, COVID-19 acted as a catalyst. China activated its media dissemination channels overseas, inundating foreign outlets with domestic and international news offerings in local languages in a bid to seed positive stories about its management of the pandemic.</p>
<p>It also updated its toolkit with new tactics such as disinformation and misinformation, while clamping down on foreign reporting inside China through <a href="https://www.theguardian.com/world/2020/sep/07/china-refuses-to-renew-press-cards-for-us-journalists-as-media-row-deepens">visa denials</a> and journalist expulsions. </p>
<p>This vacuum in coverage of China by the foreign media created demand for stories from Chinese state channels. And this is being filled with state-sponsored content already available through content-sharing agreements. </p>
<h2>New disinformation campaigns</h2>
<p>As one of the first countries struck by the pandemic last year, Italy was the target of an aggressive Chinese disinformation campaign. </p>
<p><a href="https://www.globaltimes.cn/content/1209646.shtml">State-sponsored disinformation blamed Italy</a>, not China, for instance, as the site of the initial outbreak of the new coronavirus. </p>
<p>Chinese foreign ministry spokesmen and ambassadors also shared on social media footage purporting to show Italians on their balconies <a href="https://www.youtube.com/watch?v=GNjQdZ2yvQg">applauding Chinese COVID aid</a> as the Chinese national anthem was sung in the background. The footage was doctored from scenes that originally showed Italians clapping for their own medical workers. </p>
<p>As one Italian journalist commented during an IFJ roundtable discussion,</p>
<blockquote>
<p>This fake news arrives even more rapidly than the virus.</p>
</blockquote>
<p>More than 80% of the countries we surveyed expressed concern about disinformation in their national media. Respondents blamed China at about the same rate as Russia and the US. However, almost 60% of countries were unsure who was responsible for disseminating the false and misleading content.</p>
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<em>
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Read more:
<a href="https://theconversation.com/behind-chinas-newly-aggressive-diplomacy-wolf-warriors-ready-to-fight-back-139028">Behind China's newly aggressive diplomacy: 'wolf warriors' ready to fight back</a>
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<p>Since the start of the pandemic, Chinese disinformation efforts have become a new part of the Chinese Communist Party’s propaganda tactics. State actors nicknamed “<a href="https://theconversation.com/behind-chinas-newly-aggressive-diplomacy-wolf-warriors-ready-to-fight-back-139028">wolf warrior diplomats</a>” took to social media platforms banned inside China, such as Twitter, to pump out a succession of conspiracy theories. These were then amplified by an army of Chinese ambassadors, foreign ministry spokesmen, and paid trolls. </p>
<p>This coordinated campaign to shift the COVID narrative across Western tech platforms has also been deployed to discredit democratic institutions, including the 2020 US presidential elections and the <a href="https://www.youtube.com/watch?v=v_XI-aiCa34">BBC’s reporting on China’s treatment of the Uyghur minority in Xinjiang</a>.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1347005117199904768"}"></div></p>
<h2>How propaganda seeps into mainstream media</h2>
<p>In Serbia, the Digital Forensic Center <a href="https://dfcme.me/en/dfc-finds-out-a-botnet-arrived-in-serbia-along-with-coronavirus/">identified 30,000 tweets</a> originating from Serbian accounts containing the keywords “Kina” (China) and “Srbija” (Serbia). These tweets praised Chinese aid and lambasted the European Union for its lack of assistance during the pandemic. </p>
<p>More than 70% of the content was produced by a huge pro-Serbian government network of bot accounts. During an IFJ roundtable discussion, one Serbian journalist said the government of President Aleksandar Vučić “does the work for China”.</p>
<p>Throughout the pandemic, Chinese medical aid was <a href="https://docplayer.net/199606584-Getting-on-the-radar-china-s-rising-media-presence-in-south-east-europe.html">touted through mainstream Serbian media</a> as “gifts”, despite the Serbian government’s refusal to reveal whether it had paid for the aid. Such coverage has a clear, positive impact on China’s image. </p>
<figure class="align-center ">
<img alt="Billboard in Serbia promoting Chinese friendship." src="https://images.theconversation.com/files/400202/original/file-20210512-23-14uppe2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/400202/original/file-20210512-23-14uppe2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=372&fit=crop&dpr=1 600w, https://images.theconversation.com/files/400202/original/file-20210512-23-14uppe2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=372&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/400202/original/file-20210512-23-14uppe2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=372&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/400202/original/file-20210512-23-14uppe2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=468&fit=crop&dpr=1 754w, https://images.theconversation.com/files/400202/original/file-20210512-23-14uppe2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=468&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/400202/original/file-20210512-23-14uppe2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=468&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">An office building in Belgrade with a billboard showing Serbian and Chinese flags reading, ‘Iron friends, together in good and evil!’</span>
<span class="attribution"><span class="source">Darko Vojinovic/AP</span></span>
</figcaption>
</figure>
<p><a href="https://www.danas.rs/drustvo/rusija-i-dalje-najveci-prijatelj-srbije-zahvaljujuci-vucicu-a-kina-najveci-donator/">One study by the Institute for European Affairs</a> found as many as 40% of Serbian citizens believed China to be the country’s largest donor of medical aid. Only 17% correctly named the EU. </p>
<p>Our report for the IFJ also found nations receiving China’s COVID-19 vaccine were more likely to cover China’s handling of the pandemic in a positive light. </p>
<p>Two-thirds of recipient nations reported coverage had become more positive over the past year. The dominant narrative in their national media, they said, was “China’s fast action against COVID-19 has helped other countries, as has its medical diplomacy”.</p>
<hr>
<p>
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Read more:
<a href="https://theconversation.com/china-enters-2021-a-stronger-more-influential-power-and-australia-may-feel-the-squeeze-even-more-150943">China enters 2021 a stronger, more influential power — and Australia may feel the squeeze even more</a>
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<p>Despite this, most respondents cited Chinese attempts to control their national media as clumsy and ineffective. </p>
<p>In Italy, journalists talked about how the country has “the necessary antibodies” to identify fake news, while in Tunisia, they said China has “no impact on journalistic content”. And in Serbia, Chinese propaganda was deemed irrelevant. </p>
<p>But China’s efforts are making a real difference in many countries around the world, slowly but steadily redrawing the narrative landscape one story at a time.</p><img src="https://counter.theconversation.com/content/160694/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Julia Bergin does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Over half of the 50 nations in the International Federation of Journalists survey said coverage of China had become more positive in their national media since the onset of the pandemic.Julia Bergin, Researcher, The University of MelbourneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1571592021-05-10T16:58:39Z2021-05-10T16:58:39ZSmall countries and Covid-19 vaccination: the example of Serbia<figure><img src="https://images.theconversation.com/files/399184/original/file-20210506-14-1vbhxlu.jpg?ixlib=rb-1.1.0&rect=0%2C2%2C1500%2C994&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">In Belgrade, Serbia, residents and visitors queue to be vaccinated against the Covid-19 virus (March 28, 2021). </span> <span class="attribution"><span class="source">Oliver Bunic/AFP</span></span></figcaption></figure><p>With the development of a wide range of Covid-19 vaccines, countries large and small have been accelerating their vaccination efforts. <a href="https://www.srbija.gov.rs/vest/en/166398/mass-vaccination-in-serbia-starts-today.php">Serbia launched its campaign</a> on January 19, and has since positioned itself as the <a href="https://ourworldindata.org/covid-vaccinations">eighth globally and third in Europe</a> for the share of population that has received at least one dose, reaching nearly one third of its citizens. The country also has the highest fully vaccinated population share in Europe, 20%.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/397920/original/file-20210429-14-1mvt5n6.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/397920/original/file-20210429-14-1mvt5n6.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=424&fit=crop&dpr=1 600w, https://images.theconversation.com/files/397920/original/file-20210429-14-1mvt5n6.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=424&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/397920/original/file-20210429-14-1mvt5n6.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=424&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/397920/original/file-20210429-14-1mvt5n6.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=532&fit=crop&dpr=1 754w, https://images.theconversation.com/files/397920/original/file-20210429-14-1mvt5n6.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=532&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/397920/original/file-20210429-14-1mvt5n6.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=532&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Serbia positions itself among the leading countries for the fully vaccinated share of the total population.</span>
<span class="attribution"><span class="source">Our WorldinData</span></span>
</figcaption>
</figure>
<p>As with other countries, fluctuating infection numbers continue to shadow Serbia’s efforts. At the start of the immunisation process, the average daily number of new Covid-19 cases was 1,500. It rose to <a href="https://covid19.rs/">more than 5,000</a> in March and has since dropped to average of 2,500 in April. Some of the responsibility goes to the country’s desire to open up its economy. While most of its European neighbours were in lock-down this winter, Serbian ski resorts received record numbers of visitors. Even as late as March 22, restaurants and coffee shops <a href="https://www.euronews.com/2021/03/13/are-rising-cases-in-vaccination-leading-serbia-a-warning-to-the-uk">continued to welcome the public</a> without restrictions.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/392057/original/file-20210327-13-1k4lxqw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/392057/original/file-20210327-13-1k4lxqw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/392057/original/file-20210327-13-1k4lxqw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/392057/original/file-20210327-13-1k4lxqw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/392057/original/file-20210327-13-1k4lxqw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/392057/original/file-20210327-13-1k4lxqw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/392057/original/file-20210327-13-1k4lxqw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Cable car crowds at the Kopaonik ski resort, which received unprecedented number of guests this year.</span>
<span class="attribution"><span class="source">Goran Vesic/official Facebook page</span></span>
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</figure>
<p>While Serbia’s Covid-19 infection rate continues to be worrisome, the country has shown the ability to vaccinate a higher proportion of its population than many other European nations. This article examines some of the factors in their success.</p>
<h2>Securing a diversified vaccine portfolio</h2>
<p>Key challenge for any country in this challenging moment is to secure sufficient quantity of vaccines. Rich nations such as UK or Canada have an upper hand in vaccine procurement, as <a href="https://theconversation.com/3-ways-to-vaccinate-the-world-and-make-sure-everyone-benefits-rich-and-poor-155943">November 2020 study</a> showed: “Just over half of the 7.48 billion ordered doses will go to the 14% of the world’s population who live in high-income countries”.</p>
<p>Serbia approach from the start was to pursue a highly diversified vaccine portfolio, relying on its global trade relations and diplomatic ties. The country has so far received vaccines from <a href="https://www.slobodnaevropa.org/a/kineska-vakcina-dominantna-u-srbiji/31163198.html">four different suppliers</a>: Pfizer-BioNTech (United States), Sinopharm (China), Sputnik V (Russia) and Oxford-AstraZeneca (United Kingdom). </p>
<p>Serbian foreign policy has traditionally been characterized by its balancing position between the West and the East. On one hand, Serbia is the EU member candidate and remains <a href="https://www.bbc.com/news/world-europe-55931864">strategically committed to the EU accession</a>. In addition, the bloc is its leading investor and largest trading partner, and the <a href="https://thediplomat.com/2021/02/why-serbia-embraced-chinas-covid-19-vaccine/">majority of the donations</a> in the Serbian health care over the past years originated from the EU.</p>
<p>However, with the rising number of coronavirus cases and <a href="https://www.aljazeera.com/news/2021/2/10/left-out-by-eu-western-balkans-go-to-russia-china-for-vaccines">no clear timeline</a> on when vaccines from the COVAX system and EU procurement scheme would be available for the non-EU members, Serbia used its traditionally <a href="https://www.theguardian.com/world/2021/feb/19/coronavirus-vaccine-diplomacy-west-falling-behind-russia-china-race-influence">warm relations with Moscow and Beijing</a> to secure vaccines.</p>
<p>This is how it became the first European nation to allow the use China’s Sinopharm vaccine – 1 million doses arrived at Belgrade airport on <a href="https://thediplomat.com/2021/02/why-serbia-embraced-chinas-covid-19-vaccine/">January 16</a>. Since then, the country was supplied with 2.5 million doses in total and a new order for additional 2 million <a href="https://www.aa.com.tr/en/europe/china-to-send-more-covid-19-vaccine-doses-to-serbia/2157428">has been confirmed</a>.</p>
<p>Similar approach on a lower scale was evident with Russia’s vaccine. Serbia has so far received nearly <a href="https://www.republicworld.com/world-news/europe/serbia-receives-100000-doses-of-russian-vaccine.html">400,000 doses of Sputnik V</a>, with the latest contingent of 100,000 doses delivered on <a href="https://www.srbija.gov.rs/vest/en/169735/100000-more-doses-of-sputnik-v-vaccine-arrive.php">March 23rd</a>.</p>
<h2>Vaccine diplomacy – what risks?</h2>
<p>Needless to say, China and Russia aren’t neutral sources for vaccines. The two countries seized the opportunity to practice <a href="https://www.bruegel.org/2021/04/vaccine-diplomacy-soft-power-lessons-from-china-and-russia/">“vaccine diplomacy”</a> in Central and Eastern Europe and the Balkans, and even stirred things up among the EU members. Slovakian prime minister Igor Matovic and several members of his cabinet resigned in March due to the revelation of a <a href="https://www.euronews.com/2021/03/28/slovakia-s-prime-minister-to-step-down-amid-sputnik-v-vaccine-scandal">secret deal</a> to buy 2 million doses of Sputnik V vaccine, which is not yet authorized in the EU.</p>
<p>The growing Chinese and Russian influence in the Western Balkans during the pandemic has also initiated some <a href="https://www.euractiv.com/section/enlargement/news/bring-western-balkans-back-on-the-agenda-urge-nine-eu-member-states/">calls to action from the EU</a>. Nine EU foreign ministers urged the union to <a href="https://www.bruegel.org/2021/04/vaccine-diplomacy-soft-power-lessons-from-china-and-russia/">“take a strategic look at the Western Balkans”</a>. In a <a href="https://www.euractiv.com/section/enlargement/news/letter-to-hrvp-borrell-on-western-balkans/">letter</a> addressed to Joseph Borrell, high representative of the union for foreign affairs and security policy, they indicated that “the pandemic had exacerbated existing trends, with their geopolitical implications”. The ministers also suggested that “other actors are ready to step into regional affairs, often at our expense”.</p>
<h2>Produce your own vaccines</h2>
<p>One of the ways how low- and middle-income countries can secure sufficient doses is to <a href="https://theconversation.com/3-ways-to-vaccinate-the-world-and-make-sure-everyone-benefits-rich-and-poor-155943">produce their own Covid-19 vaccines</a>.</p>
<p>Serbia’s ambitious plans to produce both Chinese and Russian vaccines have recently been announced. By taking part in a joint Greenfield partnership with the UAE and China, Serbia will build a production site for China’s Sinopharm vaccine. The factory is expected to be operational from mid-October and roll out <a href="https://seenews.com/news/serbia-to-produce-24-mln-doses-of-chinas-sinopharm-vaccine-annually-deputy-pm-734789">24 million shots annually</a> to cater to the needs of the Serbian population, as well as regional countries.</p>
<p>Furthermore, the launch of the <a href="https://www.ekapija.com/en/news/3203937/popovic-serbia-to-produce-four-million-doses-of-sputnik-v-vaccine-in">local production of the Sputnik V</a> vaccine in Serbia by the Torlak Insitute is anticipated in June, with estimated production capacity of 4 million doses in the first phase. So far, there has been no official reaction from the EU on these announcements.</p>
<p>If these plans come to life, this will not only allow vaccine self-sufficiency for the country, but will also enable Serbia to exercise its own <a href="https://theconversation.com/vaccine-diplomacy-how-some-countries-are-using-covid-to-enhance-their-soft-power-155697">“vaccine diplomacy”</a>. The country has already donated vaccines to <a href="https://apnews.com/article/europe-serbia-coronavirus-pandemic-northmacedonia-aleksandar-vucic-92093d27112edad3cc7e7faa427e11ad">North Macedonia</a>, <a href="https://www.reuters.com/article/health-coronavirus-serbia-bosnia/serbia-donates-covid-19-vaccines-to-bosnias-bosniak-croat-federation-idUSL2N2L00ZU">Bosnia and Herzegovina</a>, <a href="https://www.euractiv.com/section/politics/short_news/serbia-secures-5000-vaccines-for-republika-srpska-postpones-donation-to-north-macedonia/">Republika Srpska</a> and <a href="https://seenews.com/news/montenegro-receives-2000-doses-of-sputnik-v-vaccine-from-serbia-731699">Montenegro</a>. However, as with Russian and China’s “vaccine diplomacy”, Serbian generosity in Covid-19 vaccines <a href="https://balkaninsight.com/2021/04/01/serbias-vaccine-diplomacy-isnt-as-benign-as-it-looks/">may not be as benign as it seems</a> – that its real ambition is to extend its influence in the region.</p>
<h2>Ease of access</h2>
<p>To ensure mass roll-out of the vaccination campaign in Serbia, it was essential to <a href="https://www.euro.who.int/en/countries/serbia/news/news/2021/3/serbias-covid-19-vaccination-campaign-off-to-a-strong-start">create simple and easy access to vaccines</a> and facilitate vaccine distribution.</p>
<p>Thanks to a <a href="https://euprava.gov.rs/usluge/6224">digital platform</a>, all stakeholders in the immunization circle – citizens, call-center and medical staff, warehouse and supply-chain workers – have access to the necessary information. Using the platform, Serbian as well as <a href="https://www.srbija.gov.rs/vest/en/170035/vaccination-of-foreign-citizens-to-start-tomorrow.php">foreign nationals</a> can express their interest in vaccination by filling out a <a href="https://imunizacija.euprava.gov.rs/#novaprijava">questionnaire</a>.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/392058/original/file-20210327-13-14q6cg3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/392058/original/file-20210327-13-14q6cg3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/392058/original/file-20210327-13-14q6cg3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/392058/original/file-20210327-13-14q6cg3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/392058/original/file-20210327-13-14q6cg3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/392058/original/file-20210327-13-14q6cg3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/392058/original/file-20210327-13-14q6cg3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Foreign nationals with or without residency in Serbia can get vaccinated, providing they book an appointment via Serbia’s portal.</span>
<span class="attribution"><span class="source">BBC</span></span>
</figcaption>
</figure>
<p>So far, Serbia is the only European country where people can <a href="https://www.euronews.com/2021/02/24/which-vaccine-should-i-choose-serbia-gives-citizens-choice-of-four-coronavirus-jabs">choose the vaccine</a> they wish to receive.</p>
<p>Furthermore, the form collects information on current medical condition (if any), and whether there are medical conditions that do not permit the person to leave their home. The input is then integrated in the system and made available to relevant stakeholders in the vaccination process, who consequently organize and manage different stages – from registration of the immunization, issuing vaccination certificates, vaccine procurement and distribution, management of the vaccination sites and staff, to reporting and monitoring. The vaccination appointments are <a href="https://www.forbes.com/sites/markminevich/2021/02/05/serbia-and-key-international-sovereigns-lead-with-data-and-ai-to-become-vaccination-champions/?sh=4e2d46c97a1f">scheduled automatically by an algorithm</a> several days in advance.</p>
<p>Another element is availability of sufficient number of vaccination sites. Since February, the vaccination is organized in <a href="https://b92.tv/video/vesti.php?yyyy=2021&mm=02&dd=05&nav_id=1806697">more than 400 sites</a> throughout the country. While the health care institutions are central to the process, event venues are also being used, allowing vaccination to progress relatively quickly. The government has also put in place <a href="https://www.euronews.com/2021/05/05/serbia-in-world-first-as-citizens-offered-25-to-have-covid-vaccine">financial incentives</a> for citizens to be vaccinated: those 16 or older who has received at least one dose or who will have their first shot by May 31 will receive an equivalent of 25 euros.</p>
<p>Given that Serbia is actively working to build significant vaccine production capacity and allows foreigners to be vaccinated, this has opened door for a new form of “medical tourism”. By the end of March, <a href="https://dailynewshungary.com/if-you-want-to-get-a-vaccine-right-away-go-to-serbia/">more than 22,000 foreign nationals</a>, mostly from the region, visited Serbia in order to be vaccinated.</p>
<h2>In short…</h2>
<p>While Serbia has shown resourcefulness in procurement and management of the vaccination process, its efforts in keeping the pandemic under control are more debatable. Finding the right balance between health and economy has proven to be difficult even for developed and far richer nations, let alone a small middle-income country.</p>
<p>As with other nations, Serbia’s ambition is to vaccinate enough of its population to reach the elusive <a href="https://www.who.int/news-room/q-a-detail/herd-immunity-lockdowns-and-covid-19">“herd immunity”</a>. Until then, the main challenges are keeping up the momentum of the immunization while simultaneously managing the virus’ spread. Failure to do so risks undercutting the excellent head start it has in the vaccination race.</p><img src="https://counter.theconversation.com/content/157159/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jovana Stanisljevic ne travaille pas, ne conseille pas, ne possède pas de parts, ne reçoit pas de fonds d'une organisation qui pourrait tirer profit de cet article, et n'a déclaré aucune autre affiliation que son organisme de recherche.</span></em></p>While Serbia’s Covid-19 infection rate continues to be worrisome, the country has shown the ability to vaccinate a higher proportion of its population than EU nations.Jovana Stanisljevic, Professor in International Business, Department People, Organization, Society, Grenoble École de Management (GEM)Licensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1605512021-05-07T10:45:55Z2021-05-07T10:45:55ZCuba’s push for coronavirus vaccine sovereignty<p><em>This is a transcript of episode 14 of The Conversation Weekly podcast ‘<a href="https://theconversation.com/cubas-race-to-make-its-own-coronavirus-vaccine-podcast-160324">Cuba’s race for a coronavirus vaccine + making life’s big decisions</a>’. In this episode, how Cuba is pushing ahead with developing its own coronavirus vaccines – and could be nearing “vaccine sovereignty”. And we hear from a researcher about what he learned from asking hundreds of people about the biggest decisions of their lives.</em></p>
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<p><em>NOTE: Transcripts may contain errors. Please check the corresponding audio before quoting in print.</em></p>
<p>Gemma Ware: Hello and welcome to The Conversation Weekly.</p>
<p>Dan Merino: This week, how Cuba is pushing ahead with the development of its own coronavirus vaccines, and could be nearing vaccine sovereignty.</p>
<p>Amilcar Pérez Riverol: They say, “We can do this, we have been doing this for a long time, so at least we should try.” </p>
<p>Gemma: And we hear from a researcher about what he learnt from asking hundreds of people about the biggest decisions of their lives.</p>
<p>Adrian Camilleri: Many people indicated they spent years thinking about the self-development decisions. </p>
<p>Dan: I’m Dan Merino in San Francisco. </p>
<p>Gemma: And I’m Gemma Ware in London. You’re listening to The Conversation Weekly, the world explained by experts.</p>
<p>Dan: COVID-19 first arrived in Cuba in early March 2020, when three tourists from Italy tested positive for the virus.</p>
<p>Gemma: Throughout last year, Cuba was able to limit the spread of the disease across the island. But case numbers have been increasing in 2021. Currently around 1,000 new cases are being recorded every day.</p>
<p>Dan: By the start of May, Cuba had registered <a href="https://www.statista.com/statistics/1104709/coronavirus-deaths-worldwide-per-million-inhabitants/">675 deaths from COVID</a>. That’s a death rate of 60 people per million, which is pretty good compared to 1,751 per million here in the US, or 1,904 per million in the UK.</p>
<p>Gemma: The pandemic has hit Cuba hard in other ways though, and it’s economy shrunk 11% in 2020. As well as the loss of tourism, an important source of foreign currency for the island, other structural issues, including the strengthening of some US sanctions, have <a href="https://theconversation.com/cubas-economic-woes-may-fuel-americas-next-migrant-crisis-158260">caused a severe economic crisis</a>, which has led to food shortages.</p>
<p>Dan: Now, with cases rising, there’s an urgent need to get people vaccinated. But instead of relying on other countries’ vaccines, Cuba has decided to go it alone. </p>
<p>Gemma: Yeah, Cuba has a strong biotechnology and healthcare sector, and it’s been investing public money in a handful of different candidate vaccines for COVID over the past year.</p>
<p>Dan: For this episode, I’ve spoken to three experts, to help explain how Cuba’s race for a coronavirus vaccine is going, and where it fits into the wider picture of global vaccine diplomacy.</p>
<p>Dan: This is a story about a small country, that despite living under a very restrictive US trade embargo, could be on the cusp of making its own vaccine. But it also illustrates a bigger story about who controls access to pharmaceuticals, and how this makes it much harder for people in the global south to get the vaccines and drugs they need.</p>
<p>Dan: A few months into the pandemic in May 2020, the Cuban president, Miguel Díaz-Canel, began pushing for his country to develop its own COVID-19 vaccine. The country’s biotech sector moved quickly into action, and today there are number of vaccines candidates, and a few are almost ready for use. </p>
<p>Amilcar: Cuba is working with five different a vaccine candidate for COVID-19, two of them in phase 3 of clinical trials. We should refer to as vaccine candidate because they don’t have yet the data related to efficacy and also they don’t have, emergency use authorisation or full use authorisations.</p>
<p>Dan: This is Amilcar Pérez Riverol. He’s a postdoctoral researcher at the University of São Paolo State and a former professor of virology at the University of Havana in Cuba. He has been closely watching the progress of the five vaccine candidates. </p>
<p>Amilcar: Soberena 01, 02 and Soberena plus are being developed by the Finlay Institute of Vaccines. </p>
<p>Dan: The Finlay Institute was set up in the late 90s and is part of BioCubaFarma, a state-run holding company that includes more than 30 research institutes and pharmaceutical manufacturers. In the late 1980s, a precursor to the Finlay Institute developed the world’s first vaccine against meningitis B. Today, the institute produces ten vaccines routinely used within Cuba, but also sends hundreds of millions of doses abroad. </p>
<p>It’s the Finlay Institute which is making Cuba’s three Soberena vaccines. The name Soberena is pregnant with meaning. In Spanish, it means sovereign.</p>
<p>Amilcar: And then you have Abdala and Mambisa, which are being developed mainly by the Center of Genetic Engineering and Biotechnology, Havana.</p>
<p>Dan: Public money is being poured into the development of these vaccine candidates, which involve collaborations between a range of different institutions.</p>
<p>Amilcar: Most of them belonging to BioCubaFarma. </p>
<p>Dan: All five of Cuba’s candidate vaccines are what are called subunit vaccines. Subunit vaccines work by directly injecting a small piece of the targeted virus – a subunit – into a persons body. The body then generates an immune response against the subunit. This is different from mRNA vaccines, like Moderna’s and Pfizer’s – as well as adenovirus vaccines, like Johnson & Johnson and Astrazeneca’s, both of which deliver genetic material into the body and then a person’s own cells produce parts of the virus. </p>
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<a href="https://theconversation.com/how-are-covid-19-vaccines-made-an-expert-explains-155430">How are COVID-19 vaccines made? An expert explains</a>
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<p>Amilcar: Cuba have a great expertise in working with subunit vaccines. Most of the vaccines that are currently being using are based in the whole spike protein. In the case of Cuba vaccine, they use just part of this protein. </p>
<p>Dan: The specific part of the spike protein used in Cuba’s vaccines is called the RBD - or the receptor binding domain. This is the subunit in the subunit vaccines. </p>
<p>Amilcar: So the idea is that you produce the RBD, and then you immunise people with the RBD so these people are able to produce specific antibodies against the RBD and neutralise the virus. </p>
<p>Dan: Two of Cuba’s vaccine candidates have begun stage three clinical trials, and remember that’s the final stage before a drug or intervention is approved by medical regulators. </p>
<p>Amilcar: So they are running these classic phase 3 clinical trials. And for Soberana 02 they have 44,000 people in the trial, and in the case of Abdala they have 48,000 people. But also they are running a study, they call it intervention study with 150,000 people for Soberana 02. And the number is quite similar for Abdala. And they are particularly running this study with healthcare workers. This is, let’s say a non-classical approach. So far we don’t see this for any other candidate for COVID 19. </p>
<p>Dan: Data on the efficacy of Cuba’s vaccine candidates is still limited, but Amilcar says what information there is, is looking pretty good, at least in the academic pre-prints that have been publishd. In late April, Vicente Vérez Bencomo, director general of the Finlay Institute, <a href="https://www.nature.com/articles/d41586-021-01126-4">told the journal Nature</a> that initial trial phases of the Soberena 02 vaccine generated an antibody response in around 80% of the people who got vaccinated. And that climbed to 100% when those people were given a booster dose of the Soberena Plus vaccine. </p>
<p>Amilcar: They are thinking that they will have the data related to efficacy, to the outcome of phase 3 clinical trials sometime around the end of May, June, or even July. </p>
<p>Dan: That’s pretty good, but other places have been giving vaccines to their population for months now. So, why you might be wondering, did Cuba decide to go it alone and produce its own vaccine? Well, according to Amilcar, it’s kind of because they can. </p>
<p>Amilcar: They say, “OK, we can do this, we have been doing this for a long time, so at least we should try.” Then they have mentioned that the country doesn’t have the money to pay for other vaccines. They say that they don’t have the money to enter in this Covax mechanism for World Health Organization. </p>
<p>Dan: Low- and middle-income countries can get vaccines from Covax for free. But Cuba is considered an upper middle-income nation so it would have to pay. </p>
<p>Amilcar: Also it will take time for the Covax facility to fulfil their commitment, you know, for the amount of those doses we need for immunise the whole population. </p>
<p>Dan: So Cuba decided to go it alone. The process hasn’t been all easy though. </p>
<p>Amilcar: I have to say that the embargo have an impact in Cuba biotechnology.</p>
<p>Dan: Though the US trade embargo on Cuba is not as tight as it once was, it’s still very difficult for Cuban organisations to access pharmacological raw materials and medical equipment, especially since Donald Trump’s toughened sanctions during his presidency. </p>
<p>Amilcar: They need, for example, some equipment that they use to conduct the analysis in the lab. And then you have also problem with some of the ingredients, that you need to produce the vaccine. But so far it looks like they will be able to finish the process of evaluation and also to produce the amount of doses that they will require to immunise the whole Cuban population and also to provide or offer doses to countries that eventually will be interested, for example, Venezuela, Bolivia, Mexico and also Argentina. </p>
<p>Dan: Despite these difficulties, two of the Cuban vaccines are in phase 3 trials as of earl May and Cubans have been enthusiastic.</p>
<p>Amilcar: You can see that a lot of people are going to the place where the clinical trials are taking place to be volunteers. The general idea that I get from people that I talk to in Cuba is that they are confident and they want to be vaccinated as soon as possible. </p>
<p>Dan: But Amilcar also acknowledged concerns about these intervention studies – those are the two studies that have given the vaccine candidates to more than 100,000 health care workers each - and that is despite the fact that the phase 3 trials have yet to show efficacy.</p>
<p>Amilcar: This is a bit unusual, because you are immunising thousands of people with the candidate and you don’t know the efficacy yet. So you have some concern in the general population. </p>
<p>Dan: To be clear, the Cuban vaccines have been shown to be safe. The risk is that they just might not prevent COVID-19. </p>
<p>Amilcar: You will use a lot of resources in immunising a lot of people and you don’t know if this will have the benefits. I mean, for these vaccines, you have three doses. So you have to use a lot of resources to complete and to immunise these amount of people and you don’t know if they are protected and this can have an impact in the rate of infection in the country.</p>
<p>Dan: Pushing ahead with such a large number of vaccinations is certainly risky without efficacy results. Amilcar was waiting to see the results of the phase 3 trials showed, to really see how this whole thing would play out. </p>
<p>So that is where Cuba is at with the vaccine from a technical perspective, but perhaps just as interesting are the social dynamics of the pandemic in Cuba. Cuba is a one-party, communist state. Civil liberties and access to information are pretty severely restricted and expressing dissent can be, well, dangerous. In spite of, or perhaps because of this relationship between the government and people of Cuba, the coronavirus response seems to have been quite good. And this both from the perspective of outsiders, as well as those living on the island. </p>
<p>Jennifer: I’m Jennifer Hosek, I’m a full professor in languages, literatures and cultures at Queens University in Ontario, Canada. </p>
<p>Dan: Jennifer’s research on Cuban film and society means that she’s spent a lot of time there over the years. She’s been following the pandemic situation in the country really closely. Cuba has been able to keep death rates extremely low during the pandemic. She thinks one of the reasons for this is simply the country’s approach to healthcare. </p>
<p>Jennifer: The ratio between provider and patient is a very good one. There are neighbourhood clinics, family doctors, and a cradle-to-grave structure that basically aims to have the person be treated by family doctors that really know them and know them holistically. It’s also, of course, free and it focuses on public health and prevention rather than end of pipe. That also makes the healthcare much more affordable. </p>
<p>Dan: The government’s public health communication campaigns have made Cubans confident about their country’s vaccine strategy and health messaging in general. And there’s history here: this confidence has been earned through science-based campaigns to fight diseases including HIV, Ebola, dengue fever and the Zika virus.</p>
<p>Jennifer: Trust in the government in regards to healthcare that has been built up through many, many decades really stands the government in good stead because when it sends out clear, strong directives that are science-based and public health first, and it says, this is what you must do, and then it explains, why you must do it. And it explains it in different ways to different audiences. </p>
<p>Dan: This includes cartoons for children, where angry “red meanie” viruses are blocked by face masks. It also includes a daily news show with the epidemiologist Dr Fransisco Duran, who explains the science behind COVID-19 in accessible language. But to find out more about how Cubans have reacted to this health messaging, and to the politics around mask wearing during the pandemic, Jennifer surveyed residents of Havana online and later in-person while in Cuba in December and January. </p>
<p>Jennifer: I thought, “Wow! I wonder what’s going on in Cuba.” And you know, I have a big network there. So <a href="https://theconversation.com/the-scene-from-cuba-how-its-getting-so-much-right-on-covid-19-155699">I just started a sort of informal WhatsApp interview</a> using a snowball technique, which means that I started with people that I know and then asked them to interview people that they knew. </p>
<p>I think the most impressive or interesting, I guess, take-home message for me was that most people basically said: “It’s my responsibility to wear a mask because it’s, I’m responsible for myself, but I’m also responsible for others.” And I think that, that this kind of, that kind of idea of, like, “I am” in relation to the other, allows people to think, “I can only be healthy if the other is healthy.” Imagine if the global community thought this way. </p>
<p>Dan: According to Jennifer, the fact that Cuba is trialling five COVID vaccine candidates is because of the state’s dedication to science and the way it has prioritised its citizens’ health. </p>
<p>Jennifer: Cuba invested in healthcare. It invested in healthcare in a big way. They started in the 80s and 90s to build on this medical knowledge and build up biotech and medical research, because the Soviet Union was starting to end and Cuba needed to really stand on its own. And so they developed in this direction building on what they already had.</p>
<p>Dan: Cuba is famous for its medical diplomacy. It sees it as part of its international solidarity effort. Fidel Castro was the first to send Cuban medics to Algeria in 1963 and the country has sent more than 400,000 healthcare professionals to work in 164 countries, most notably this is done through its Henry Reeve Brigades, named after an American who fought, and died, for the Cuban independence forces in the mid-19th century. In late March 2020, Cuba sent 52 groups of doctors and nurses to Italy to help at the peak of the country’s first wave of coronavirus. </p>
<p>Cuba’s track record on healthcare diplomacy also means it’s been able to turn to a network of international collaborators when it’s come to trialling their vaccine candidates. </p>
<p>Jennifer: Cuba is characterised by internationalism and international collaboration and it’s drawing on this. China is one of the partners. Iran is another partner with which it’s working. In part to do the trials because they needed to have enough infected people to be able to do the trials, ironically enough. </p>
<p>So there are many countries that are really behind Cuba and that will help them produce even faster. It’ll enable Cuba to go back to some sort of normalcy, which will enable it to restart its economy. And tourism will be able to start, which is a big moneymaker for Cuba. </p>
<p>Dan: So that’s great for Cuba, but what about other countries in Latin America. Civil rights groups around the world are calling on companies or governments with successful vaccines to waive licences that prevent other manufacturers from producing vaccines, basically to share the intellectual property rights. I asked Jennifer if Cuba will allow other companies or places to make their vaccines. </p>
<p>Jennifer: Cuba has not yet made an official statement about this. What we do know is that Cuba has offered technology transfer, which means knowledge about the capacity to make vaccines, and also pharma supplies, to the country of Ghana. We know that Argentina is looking to collaborate to help Cuba produce its vaccine so that it can use it. We know that in the past what Cuba has done with its doctors, its famous Henry Reeve Brigades, that they typically send those brigades to poor countries for free and they charge for countries who can afford it.</p>
<p>Dan: Cuba’s push to make it’s own vaccine has benefits both internally, but also on the geopolitical map. Like the name of one of its vaccine candidates says, it’s given Cuba sovereignty. To understand more about where Cuba’s vaccine efforts fit into the complicated global politics of COVID-19, I called up to Peter Hotez. </p>
<p>Peter: I’m a professor of paediatrics and molecular virology at Baylor College of Medicine where I also co-direct the Texas Children’s Center for Vaccine Development. We adopted a coronavirus vaccine program about a decade ago. We’ve developed several coronavirus vaccines, and now one for COVID-19 that’s being scaled up for production in India, going into phase 3 clinical trials. </p>
<p>Dan: Peter also has a long-term interest in the geopolitics of vaccines. </p>
<p>Peter: Vaccines are such powerful tools of public health that they become potentially very important instruments of foreign policy. </p>
<p>Dan: He recently wrote a book called <a href="https://jhupbooks.press.jhu.edu/title/preventing-next-pandemic">Preventing the Next Pandemic</a>. It describes what he sees as a decline in global cooperation on vaccine programmes over the past few years. The Covax project aside, he sees this lack of a global strategy playing out during the coronavirus pandemic too.</p>
<p>Peter: Right now you’re clearly seeing haves and have-nots, so the US the UK, some western European countries and Israel have looked after themselves and the rest of the world, not so much. And that’s going to have a lot of implications.</p>
<p>Dan: This unequal distribution of access to vaccines could give the small country of Cuba a lot of leverage to throw around if it does achieve vaccine sovereignty.</p>
<p>Peter: I haven’t followed their vaccine too closely, but the hope is that they work with PAHO, the Pan-American Health Organization, in the western hemisphere and WHO to go through who pre-qualification. And at that point then they can start exporting vaccine or providing it to the Covax sharing facility. That would be the best ideal outcome, I think, and not do what the Russians have done, which is this very transactional encounters with countries, ‘cause that has a lot of downside implications. They’re doing these kind of one-on-one arrangements in this unilateral negotiation. And I think that’s odd and also a lot of these countries adequate pharmacovigilance systems in place. </p>
<p>Dan: The pandemic had exposed significant shortfalls in the private sector focused system of global vaccine development and production. </p>
<p>Peter: This insistence that the multinational pharmaceutical companies can do everything. It’s not working. I mean, the multinational companies have an important role of course, but we need redundancy in the system. We need to have the ability to develop vaccines locally in Africa, expand capacity in Latin America and the Middle East, and in Asia.</p>
<p>Dan: Peter says one way small countries can break their dependency on multinational companies is to basically invest in their own capacity to make vaccines and other drugs. </p>
<p>Peter: Cuba definitely punches above its weight through the Instituto Finlay and, and other organisations. And I think that’s great. We need better capacity. And so what’s happened is a number of organisations have got together and branded themselves as the developing country vaccine manufacturers network. And it includes Cuba, it includes Brazil and includes India of course. India is probably the most advanced in terms of this concept. But we need more of that. </p>
<p>Dan: All of this would require serious investment, and that needs to come from the world’s biggest economies. It won’t be a quick fix to the manufacturing bottlenecks and equality issues surrounding COVID vaccines. But Peter says that’s not really the point. </p>
<p>Peter: We won’t have it in time for this pandemic, but the other pandemics will surely follow. And I think that would be a very productive investment in terms of encouraging security.</p>
<p>Dan: It’s quite possible that little Cuba, could succeed in producing an effective COVID-19 vaccine quickly and cheaply. If this happens, it could really poke a hole in the status quo of the global vaccine and broader biotech ecosystem that keeps power concentrated in wealthy nations. Jennifer Hosek summed it up nicely. </p>
<p>Jennifer: I was thinking about that famous metaphor of the fish and the fishing pole.</p>
<p>Dan: You know the one. Give a man a fish and you feed him for a day. Teach that person how to fish and you feed them for a lifetime. Today though, the idea doesn’t seem to be teach someone how to fish, it’s more teach them how to make a fishing pole. Or in this case, a vaccine. </p>
<p>Jennifer: And so the US is now going to give away it’s extra fish before the fish rot as it were, but actually people around the world know how to make fishing poles and fish in order to catch their own fish. But the many rich countries and big pharma are disallowing them from making those fishing poles and feeding themselves, you know, vaccinating themselves.</p>
<p>And Cuba definitely is a counterexample to that because it’s showing us how a country that uses its resources wisely can organise to catch its own fish and not wait for the castoffs of big pharma, and not also spend its hard-earned money to buy vaccines when it can make it itself. </p>
<p>Gemma: This hunt for vaccine sovereignty is like the holy grail of the early 2020s, isn’t it?</p>
<p>Dan: Vaccines are power, both locally – go to the pub, get a beer – or on the global stage. It would be huge for Cuba to get its own vaccine.</p>
<p>You can read a <a href="https://theconversation.com/the-scene-from-cuba-how-its-getting-so-much-right-on-covid-19-155699">story that Jennifer Hosek has written for The Conversation</a> about the situation in Cuba by clicking the link in the shownotes. You can also follow the latest expert analysis on developments in coronavirus vaccines on our site.</p>
<p>Gemma: For our next story we’re talking about the big decisions that we all have to make in our lives. So Dan, tell me if you made any big decisions recently?</p>
<p>Dan: Yeah, I guess so. I decided to move back across the country to California after having lived on the east coast for a while.</p>
<p>Gemma: You know it’s funny. Sometimes you know that a decision that you’re about to make will be a big one, that it will change the course of your life. But sometimes you make a decision pretty quickly and realise afterwards just how big a choice it was. So to find out more about the process of making these kinds of decisions, I called up a psychologist.</p>
<p>Adrian: My name is Adrian Camilleri. I’m a consumer psychologist. I work at the University of Technology Sydney, and I’m interested in how people make judgement and decisions. </p>
<p>Gemma: Adrian’s <a href="https://theconversation.com/i-asked-hundreds-of-people-about-their-biggest-life-decisions-heres-what-i-learned-154885">recent research</a> was all sparked by a question that he used to ask people at dinner parties. </p>
<p>Adrian: So at dinner parties, I tend to come prepared. And one of my favourite questions to ask at these events is how many of your life’s ten biggest decisions do you think you’ve already made? And this is a question that usually gets a good conversation going because people start to reflect on, “OK, well, what is a big decision and how many have I made so far? And what are the future big decisions coming down the road?” But I thought that maybe I could ask this question in a more scientific way. So I started to put together a questionnaire. And my goal was really to try to understand, well, what are life’s biggest decisions. When do they occur? How do people make these big decisions? Retrospectively, how do they evaluate those big life decisions, and how accurate are people at predicting their future big life decisions?</p>
<p>Gemma: Really interesting stuff. So tell us how you went about doing this. </p>
<p>Adrian: Yeah. So I started to put the questionnaire together in 2019. So first I asked people to tell me about their ten biggest past decisions. The second part of the questionnaire asked people to make predictions about their biggest decisions that are going to happen down the road. And then finally, I asked participants to fill in a number of different questionnaires that measure things like life satisfaction, their decision-making style, impulsiveness, personality, risk tolerance, all of these different individual different variables. So people had an opportunity to type into a box the details of that decision, but then they were asked to categorise those big decisions into some predetermined categories. </p>
<p>But there were also some followup questions. So things like how much time did you spend thinking about the decision before you made it? How much advice did you seek from others? Was it a more intuitive or analytical type decision? And then finally I asked participants to judge in retrospect, whether it was a good or bad decision.</p>
<p>Gemma: Who were you targeting it at?</p>
<p>Adrian: I was looking for an even split of males and females. So I was looking for about 50:50 in every age decile. So I wanted 100 people in their 20s another hundred in their 30s, 40s, 50s, 60s to 70s. So all up in the end, I had 657 people complete the initial study and these participants were dispersed around the United States and they were roughly consistent with the population distribution in the states.</p>
<p>Since that initial survey was completed, I actually built a website that put a much simpler version of the survey up online. That’s located at <a href="https://tenbiggestdecisions.com/">tenbiggestdecisions.com</a> and thousands of people have now filled in that survey. </p>
<p>Gemma: Tell us, what were the kinds of some of the big life decisions that people revealed to you in this process?</p>
<p>Adrian: There were some fun stories in there of people, especially those who are older, doing fun things in the 50s and 60s, driving around the world. But the most commonly mentioned big life decisions are those that won’t surprise you. So starting a new job, getting married, pursuing a degree, having a child, relocating – so moving to a new state – buying a home. </p>
<p>But then there was some decisions that were – when they did occur, which was not that often in some cases – they were always right near the top of that ranking. And so these included ending a life. So this might be perhaps aborting a pregnancy. It could also relate perhaps to ailing parents, maybe who are on life support. But there was also some things up there like pursuing religion, or pursuing a philosophy. These got rated as quite important as well. </p>
<p>Gemma: So they might be rare, but they’re incredibly important to the person taking them?</p>
<p>Adrian: Exactly. </p>
<p>Gemma: So you’ve gone through so what are some of the biggest ones, but what do the results show about how people look back on certain decisions more positively or negatively?</p>
<p>Adrian: Yeah so for every decision that my participants mentioned, the final question was in retrospect, how do you evaluate that decision? Was it a good or a bad decision? And a couple of categories that stood out. The first were the self-destructive decisions, these include things like committing a crime and starting an addiction. So these decisions stood out as being quite different from the rest in that the majority of participants judge these as bad decisions. The other category that stood out were the self-developmental decisions. So these include things like starting a hobby or learning a new skill, travelling, pursuing a religion or a new philosophy. So these self-developmental decisions, the vast majority of participants indicated that these were good decisions.</p>
<p>Gemma: And are there any other trends that emerged in the way people evaluated or described the big decisions? </p>
<p>Adrian: There was two categories that stood out and again. It’s the self-destructive and the self-developmental categories. And when you look at these in terms of time spent thinking, the self-destructive decisions were uncommonly short in how much time was spent thinking. So the most commonly mentioned response was just seconds before engaging in whatever self-destructive activity that was. </p>
<p>And in contrast, if you look at the self-developmental decisions, these tended to be the ones that individuals spent the most time thinking about. So many people indicated they spent years thinking about the decision before they actually engaged in it. </p>
<p>Gemma: And I’m interested in that age question. So were there decisions that say younger people were more likely to have talked about than older people?</p>
<p>Adrian: So career-related decisions definitely increased over time and they actually peaked for people in their 60s. And that might be surprising for some people, but actually the final decision that one makes in their career is a huge one and that’s when to retire. </p>
<p>Other decisions that increase over time were finance-related decisions. So again, people tend to accumulate money, resources, and then they have to think about making decisions about these as they get older, including putting them in a will, which is also another big life decisions that happens later in life. We can also see increase in family-related decisions. </p>
<p>Gemma: You started this by asking people how many of their big decisions they think they have left. So was your data able to pull that out?</p>
<p>Adrian: Definitely. I got to ask my favourite dinner party question. What the results showed was that on average 20-year-olds tended to believe that they had already made three of their life’s biggest decisions.</p>
<p>Gemma: Three of ten. </p>
<p>Adrian: Three three of ten, that’s right. So it could have been maybe education-related decisions, maybe they’d had their first love. Maybe they’d moved already. The mid-point, the five decision point was at around age 44-years-old, that people kind of imagined that they had made half of their big life decisions.</p>
<p>And what was most interesting to me, I think, was looking at those who were older in the sample. So for example, those who were 70-years-old, they estimated that they’d made a little less than seven of their ten biggest decisions. So there were still three big life decisions coming. And when you started to look closely at some of the big life decisions that do happen later in life, you do start to realise that actually, there are a number of big decisions that keep coming up, whether you know, some people get married young, but then a lot of people get remarried when they’re older. </p>
<p>Gemma: What advice, drawing on all this analysis that you’ve done so far on the data that you’ve collected, would you give people on making big decisions in their lives? </p>
<p>Adrian: I guess the first thing to recognise is that, well, first big life decisions are front-loaded. So they happen most for those who are aged between say 16 and 35. But, they still occur for those of all ages. So, I guess keep an open mind to future big decisions and also don’t maybe put too much pressure on yourself when making current big decisions. I know they feel massive at the time, but in retrospect, sometimes they’re not as big. </p>
<p>Another thing that stood out was that there’s a lot of experience out there, that a decision-maker can utilise the wisdom from. So speaking to others and learning from those who have come before, I think are great options for those who are making big life decisions. The research that I conducted also suggests that taking your time is a good way to lead to a good decision, but also avoiding the burden of obligation. So there were some results suggesting that obligation-induced decisions led to poorer outcomes, and also using a more analytical approach rather than relying on pure intuition was more likely to lead to a positive outcome.</p>
<p>And in fact, in this regard, there’s some research related to regret and one way to avoid feelings of regret is to have very good justification for your decisions today. So that even if things turn out poorly down the road, you can turn back and think, “You know what? At the time, given what I knew about the situation, I made a good decision.”</p>
<p>And finally, I think there are some decisions that are very likely going to impact on your life satisfaction. So keep this in mind. So these self-destructive decisions that I’ve mentioned, like engaging in crime and taking up an addiction, these are very likely to lead, to decreases in life satisfaction. And I think the scary thing about these decisions is that they’re made in a fraction of a moment, but they actually tend to have very long-lasting consequences and put one on a treacherous life path. </p>
<p>On the flip side, self-developmental decisions, such as, you know, taking control of your life, pouring yourself into a pursuit or project, these tend to be associated with increased life satisfaction. So, although it can be hard to sometimes find the time for these non-essential, big life decisions, I think your future self will thank you. </p>
<p>Gemma: That’s some great advice there. </p>
<p>Adrian: You’re welcome. Thank you for having me.</p>
<p>Gemma: Since I interviewed Adrian, I’ve been asking some of my friends his question. How many of your life’s big decisions do you think you’ve already taken? It’s a really good conversation starter, I recommend it. You can read more about Adrian’s research by clicking on a link <a href="https://theconversation.com/i-asked-hundreds-of-people-about-their-biggest-life-decisions-heres-what-i-learned-154885">to the story</a> that he wrote in the show notes. </p>
<p>Dan: Now, to end the show, we’ve got some recommended reading from one of our colleagues in New Zealand. </p>
<p>Finlay: Hi, this is Finlay Macdonald. I’m one of the two editors in New Zealand and I’m based in Auckland. I have a couple of recommended articles that we’ve recently published and the first one is something <a href="https://theconversation.com/nzs-hate-speech-proposals-need-more-detail-and-wider-debate-before-they-become-law-159320">I worked on with legal scholar, Eddie Clarke from Victoria University in Wellington</a>. So this is quite a long-running and important story in New Zealand and it goes back to the terrorist attacks on two mosques in Christchurch in 2019. So one of the official responses to that atrocity has been to propose new hate speech laws. And we think there’s going to be a heated debate later in the year between proponents of such laws and free speech advocates who worry about the state interfering in our right to say and think what we want.</p>
<p>But the first challenge of course, is to understand what might change if those proposals became law. As Eddie explains, it could well tighten up definitions of hate speech, but broaden their application in the process, so there’s a real risk of overreach if we don’t get it right.</p>
<p>The second article I’m recommending is very different, but still kiwi, although in this case, the bird and our national symbol. Specifically <a href="https://theconversation.com/forensics-and-ship-logs-solve-a-200-year-mystery-about-where-the-first-kiwi-specimen-was-collected-158410">how the kiwi was very first seen, identified and studied by Europeans</a>. The authors, Paul Scofield and Vanesa De Pietri, from Canterbury University have unravelled what until now was a 200-year-old mystery about how this sadly dead kiwi eventually made it to England. It’s a remarkable tale, told through historical records, ships’ logs from the early 1800s and modern forensic DNA techniques, which tell us as much about early colonial scientific activity as they do about the bird itself. Hope you enjoy it.</p>
<p>That’s all from me for now. Happy reading.</p>
<p>Gemma: Finlay Macdonald there in Auckland. </p>
<p>That’s it for this week. Thanks to all the academics who’ve spoken to us for this episode. And to The Conversation editors Lee-Anne Goodman, Michael Lucy, Finlay Macdonald and Stephen Khan. And thanks to Alice Mason, Imriel Morgan and Sharai White for our social media promotion. </p>
<p>Dan: You can find us on Twitter <a href="https://twitter.com/TC_Audio">@TC_Audio</a> or on Instagram at <a href="https://www.instagram.com/theconversationdotcom/?hl=en">theconversationdotcom</a> or email us at podcast@theconversation.com. And if you want to learn more about any of the things we talked about on the show today, there are links to further reading in the <a href="https://theconversation.com/cubas-race-to-make-its-own-coronavirus-vaccine-podcast-160324">show notes</a> where you can also find a link to sign up to our <a href="https://theconversation.com/newsletter?utm_campaign=PodcastTCWeekly&utm_content=newsletter&utm_source=podcast">free daily email</a>.</p>
<p>Gemma: The Conversation Weekly is co-produced by Mend Mariwany and me, Gemma Ware, with sound design by Eloise Stevens. Our theme music is by Neeta Sarl. </p>
<p>Dan: And I’m Dan Merinio. Thanks so much for listening.</p><img src="https://counter.theconversation.com/content/160551/count.gif" alt="The Conversation" width="1" height="1" />
A transcript of episode 14 of The Conversation Weekly podcast, including how people make their life’s biggest decisions.Gemma Ware, Head of AudioDaniel Merino, Associate Breaking News Editor and Co-Host of The Conversation Weekly PodcastLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1603242021-05-06T11:47:53Z2021-05-06T11:47:53ZCuba’s race to make its own coronavirus vaccine – podcast<p>In this episode of <a href="https://theconversation.com/uk/topics/the-conversation-weekly-98901">The Conversation Weekly podcast</a>, how Cuba is pushing ahead with developing its own coronavirus vaccines – and could be nearing “vaccine sovereignty”. And we hear from a researcher about what he learned from asking hundreds of people about the biggest decisions of their lives. </p>
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<p><iframe id="tc-infographic-561" class="tc-infographic" height="100" src="https://cdn.theconversation.com/infographics/561/4fbbd099d631750693d02bac632430b71b37cd5f/site/index.html" width="100%" style="border: none" frameborder="0"></iframe></p>
<p>Throughout 2020, the small island nation of Cuba was able to <a href="https://theconversation.com/coronavirus-response-why-cuba-is-such-an-interesting-case-135749">limit the spread of COVID-19 cases</a> and the number of deaths. By early May 2021, just under <a href="https://www.statista.com/statistics/1104709/coronavirus-deaths-worldwide-per-million-inhabitants/">700 people had died from the disease</a> – that’s a death rate of around 60 people per million, compared with around 1,750 per million in the US. </p>
<p>While the death rate remains low, case numbers have been increasing in 2021 and there are currently <a href="https://ourworldindata.org/coronavirus/country/cuba">around 1,000 new cases</a> recorded each day. </p>
<p>Meanwhile, the pandemic has hit the Cuban economy hard: its economy shrunk <a href="https://www.reuters.com/article/cuba-economy-idUSL1N2IX1V9">11% in 2020</a>. Alongside the loss of revenue from tourism – an important source of foreign currency for the island – the strengthening of US sanctions against Cuba’s communist government caused <a href="https://theconversation.com/cubas-economic-woes-may-fuel-americas-next-migrant-crisis-158260">a severe economic crisis</a>, which has led to food shortages. The US sanctions <a href="https://fas.org/sgp/crs/row/IF10045.pdf">are aimed</a> at pressuring the Cuban government to improve the human rights situation in the country. </p>
<p>When it comes to vaccines, Cuba has decided to go it alone. For this episode, we spoke to three experts to explain how Cuba’s race for a coronavirus vaccine is going – and where it fits into the wider picture of global vaccine diplomacy. </p>
<p>Virologist Amilcar Perez Riverol is a postdoctoral researcher at the University of São Paulo State in Brazil. He explains that Cuba is working on five candidate vaccines for COVID-19, two of which have moved to phase 3 clinical trials – Soberena O2 and Abdala. These two vaccines are also being rolled out to over 100,000 healthcare workers. Riverol says it’s “a bit unusual” to immunise thousands of people with vaccine candidates for which “you don’t know the efficacy yet”. </p>
<p>Jennifer Hosek, professor of languages, literatures and cultures at Queen’s University, Ontario in Canada, tells us that in Cuba, “trust in the government in regards to healthcare has been built up through many, many decades”. The country has also invested heavily in its healthcare system over many years and is well-known for its <a href="https://theconversation.com/by-sending-doctors-to-italy-cuba-continues-its-long-campaign-of-medical-diplomacy-134429">medical diplomacy</a>, which includes sending doctors around the world as part of its focus on international solidarity. </p>
<p>And Peter Hotez, professor of paediatrics and molecular virology at Baylor College of Medicine in the US, puts Cuba’s effort to produce its own vaccine into some global perspective. “We need to have the ability to develop vaccines locally in Africa, expand capacity in Latin America and the Middle East and in Asia,” he says, arguing that it’s part of the answer to fixing the dependency on multinational companies, which don’t always produce the vaccines that are needed in low- and middle-income countries. </p>
<p>In our second story, we speak to Adrian Camilleri about <a href="https://theconversation.com/i-asked-hundreds-of-people-about-their-biggest-life-decisions-heres-what-i-learned-154885">his research asking people about the big decisions</a> they’ve made in their lives. It all stemmed from a question he used to ask people at dinner parties: imagine you will make ten big decisions in your life; how many of them do you think you’ve already made? He tells us what he found, including that the process of making a big decision can affect how you think about it later in your life. </p>
<p>And Finlay Macdonald, senior editor at The Conversation in New Zealand, gives us his recommended reads for the week.</p>
<p>The Conversation Weekly is produced by Mend Mariwany and Gemma Ware, with sound design by Eloise Stevens. Our theme music is by Neeta Sarl. You can find us on Twitter <a href="https://twitter.com/TC_Audio">@TC_Audio</a>, on Instagram at <a href="https://www.instagram.com/theconversationdotcom/?hl=en">theconversationdotcom</a>. or via email on podcast@theconversation.com. You can also sign up to <a href="https://theconversation.com/newsletter?utm_campaign=PodcastTCWeekly&utm_content=newsletter&utm_source=podcast">The Conversation’s free daily email here</a>.</p>
<p>A transcript of this episode is <a href="https://theconversation.com/cubas-push-for-coronavirus-vaccine-sovereignty-160551">available here</a>. </p>
<p>News clips in this episode are from <a href="https://www.youtube.com/watch?v=qqCZC-gFA6A">CNN</a>, <a href="https://www.youtube.com/watch?v=2KY-osTa9es">Sky News Australia</a>, <a href="https://www.youtube.com/watch?v=T6e4BHYgByA">Al</a> <a href="https://www.youtube.com/watch?v=Ev1UlOVm7oo">Jazeera</a>, <a href="https://www.reuters.com/video/watch/cuban-doctors-arrive-in-italy-to-battle-id701114205">Reuters</a>, <a href="https://www.youtube.com/watch?v=iTRU69oSkto">teleSur tv</a> and <a href="https://www.youtube.com/watch?v=kDFbN2PCMKE">CGTN</a>. </p>
<p><em>You can listen to The Conversation Weekly via any of the apps listed above, our <a href="https://feeds.acast.com/public/shows/60087127b9687759d637bade">RSS feed</a>, or find out how else to <a href="https://theconversation.com/how-to-listen-to-the-conversations-podcasts-154131">listen here</a>.</em></p><img src="https://counter.theconversation.com/content/160324/count.gif" alt="The Conversation" width="1" height="1" />
Plus, a psychologist on how we look back at our big decisions in life. Listen to episode 14 of The Conversation Weekly podcast.Gemma Ware, Head of AudioDaniel Merino, Associate Breaking News Editor and Co-Host of The Conversation Weekly PodcastLicensed as Creative Commons – attribution, no derivatives.