US-China Rivalry in Health Diplomacy: A Case Study of COVID-19 Vaccine in Latin America

The COVID-19 pandemic has ushered in a new era of rivalry among Great Powers, driven by their pursuit of economic and geopolitical gains amidst the global health crisis. This journal examines the strategies employed by the United States’ reactions to China’s rising power to expand its influence and access new markets through the distribution of COVID-19 vaccines in Latin America. Using J. J. Mearsheimer’s theory of Great Power Rivalry, this study delves into the dynamics of this rivalry, with a particular focus on the Latin American region. The findings reveal that the United States has utilized a combination of balance of power and blackmail tactics to counter China’s growing influence.

Introduction

Amid the vast landscape of global geopolitics, a riveting tale of two superpowers emerges—a tale of ambition, rivalry, and a quest for dominance. Picture a world where ping-pong balls shaped diplomatic futures, where vaccines became weapons in a high-stakes battle for influence, and where a region once considered America’s backyard becomes the epicenter of a new Cold War. Step into the enthralling saga of US-China relations, where history, economics, and health diplomacy converge in a mesmerizing dance of power. This is the story of how two giants, the United States and China, rewrote the rules of global competition, with Latin America as their dramatic battleground. This thesis reveals a world transformed and the intricate dynamics of a rivalry that shaped our modern age.

As China distanced itself from the Soviet Union in 1960, it began opening up relations with the United States. Ping-Pong Diplomacy in 1971 played a pivotal role in establishing official diplomatic ties between the two nations (National Museum of American Diplomacy, 2021). This marked the beginning of a complex relationship between the two countries, especially under the leadership of Deng Xiaoping, who initiated economic reforms that transformed China into the world’s second-largest economy. The US supported these reforms to maintain its influence in China’s open-market system.

China’s remarkable economic growth, especially after the 2007–2008 Great Recession in the US, raised concerns in the United States. The “Pivot to Asia” policy in 2011 aimed to counter China’s influence in East Asia by strengthening ties with regional countries (Hosseiniet al., 2018). This shift in dynamics led to a broader rivalry, not only militarily but also economically, with the US trying to maintain its superpower status while China sought to challenge it.

One significant aspect of this rivalry was the competition for global partnerships and markets. Both countries vied for government partnerships and market dominance, with China, in particular, excelling in areas such as patent applications. Additionally, they sought to become preferred models and partners in critical fields like healthcare and climate governance.

China’s Belt and Road Initiative (BRI) exemplified its strategy of building relationships and influence with other countries, particularly in Asia, Africa, and Latin America (Jourdanet al., 2022). China’s economic presence in these regions grew significantly, with trade values surpassing those of the United States. The United States responded with its own strategies to counter China’s influence and secure its position as a maintaining power.

The rivalry extended beyond economics and politics into health diplomacy during the COVID-19 pandemic. Both countries competed to distribute their vaccines to partner and strategic nations. China’s Sinovac vaccine became a key player in this rivalry, and its distribution through Vaccine Diplomacy signaled China’s emergence as a significant global health power.

A critical region in this rivalry was Latin America, which borders the United States to the north and has a history of US influence. The United States aimed to maintain its dominance in the region, while China expanded its presence through initiatives like BRI. This competition played out during the pandemic when the United States of America and China competed for trust, cooperation, and influence in Latin America through COVID-19 vaccine distribution. This thesis introduction sets the stage for a comprehensive examination of the evolving US rivalry against China, spanning health diplomacy, with a focus on Latin America as a critical battleground, especially Brazil, Costa Rica, and Mexico, where the rivalry is significantly affected by Health Diplomacy.

Method

The Great Power Rivalry Theory by Mearsheimer (2001) presents a comprehensive framework for understanding the behavior of major powers in the international system. This theory, rooted in offensive realism, posits that states are rational actors driven by the fundamental motive of survival. In an anarchic international system, where there is no overarching authority, great powers are compelled to seek more power to maximize their chances of survival.

Mearsheimer distinguishes his theory from classical realism by asserting that great powers are not content with maintaining the status quo; instead, they continuously strive to increase their power and influence. The theory is underpinned by five key assumptions: the centrality of states in world politics, the possession of offensive military capabilities by great powers, the inability to ascertain the intentions of other states, the primacy of great powers’ survival, and the rationality of states in designing strategies to maximize their survival prospects.

The theory explores various strategies employed by great powers to achieve dominance, including war, blackmail, bait and bleed, bloodletting, balance of power, and buck-passing (Mearsheimer, 2001). These strategies are adapted to specific circumstances and objectives, reflecting the evolving nature of great power rivalry. The concept of “fear and loathing” plays a pivotal role in this theory, emphasizing how states perceive each other as potential threats to their survival, leading to a continuous cycle of power accumulation and competition.

In contemporary international relations, the theory remains relevant, as exemplified by the rise of China and its challenge to the existing global order. China’s growing military capabilities and territorial claims in the South China Sea, Taiwan, and Hong Kong have shifted the dynamics of great power rivalry. The theory’s insights can also be applied to non-military aspects, such as economic competition and cooperation. The intensifying trade war between the United States and China illustrates how great powers vie for economic dominance, utilizing both tariffs and soft power strategies.

In the context of this journal article focusing on US diplomacy in Latin America’s COVID-19 vaccine distribution, the Great Power Rivalry Theory offers a valuable analytical framework. The adaptation of the theory’s six strategies is to understand US efforts to dominate vaccine distribution, including any potential instances of blackmail, balancing power dynamics, and leveraging alliances. This theoretical foundation allows you to explore how major powers like the United States engage in health diplomacy to protect their interests and enhance their positions on the international stage. It also highlights the broader relevance of the theory beyond traditional military rivalries, making it applicable to contemporary global challenges such as pandemic response and health diplomacy.

Results and Discussion

A Dance of Great Powers in Brazil

Brazil, the largest and most populous country in Latin America, has China as its main trading partner and a major investor in its key sectors. In 2019, Brazil-China trade exceeded $100 billion, with China being the primary destination for Brazilian exports (Trinkunas, 2020). Since President Jair Bolsonaro’s term began in January 2019, Brazil’s historically close ties with China have been challenged by Bolsonaro’s pro-US policies, especially those aligned with President Trump, leading to frequent criticisms of China.

However, despite their good relationship in the economy, in October 2020, Brazil rejected Chinese vaccines, citing a lack of trials, with Bolsonaro emphasizing the danger of untested vaccines. The US, aiming to bolster its influence, sent 3,000 Pfizer vaccine doses to Brazil in December 2020, strengthening US-Brazil relations (Vyas & Dube, 2020). By February 2021, amid rising COVID-19 cases and deaths, Brazil turned to China for additional vaccines, requesting 17,300 doses (Bridge Beijing, 2022). This move threatened the US, not only by losing its vaccine market but also by risking a political shift in Brazil. Brazil’s new openness to Chinese vaccines signaled potential alignment with China’s Belt and Road Initiative (BRI).

The Trump administration’s anti-Huawei campaign further complicated Brazil-US relations. Accusing Huawei of espionage, the US pushed Brazil to exclude Huawei from its 5G network plans. However, in February 2021, Brazil opened its 5G auction to all companies, including Huawei, undermining the US stance. The US responded by promising 80 million vaccine doses but failed to significantly impact Brazil’s needs (Luce, 2021). Consequently, China emerged as a major vaccine supplier, strengthening its political leverage. By December 2022, China had sent 102 doses under the Health Silk Road initiative, with bilateral cooperation improving since April 2020, when Brazil and China discussed joint pandemic efforts (Bridge Beijing, 2022). China’s support helped Brazil produce vaccines locally, reinforcing its role in the Health Silk Road and increasing reliance on Chinese aid.

The US’s balance of power strategy failed due to limited vaccine supply, while China’s extensive vaccine distribution cemented its influence. US blackmail strategies, accusing Huawei of espionage, were ineffective. By March 2022, TIM Brazil and Huawei agreed to build a 5G city, reducing US influence (Huawei, 2022). China’s success in Brazil illustrates its effective offshore balancing, contrasting with the US’s strategic failures. The global pandemic shifted Brazil’s alignment, with China’s comprehensive vaccine aid winning over Brazil’s trust, reshaping great power dynamics in Latin America.

Costa Rica’s Diplomatic Maneuvering

Costa Rica, a democracy with 5.2 million people, has significant trade ties with the US, its largest trading partner, making it influential for the US. Costa Rica’s rejection of China’s Sinovac vaccine due to low efficacy (50.7%) and acceptance of WHO-approved vaccines like AstraZeneca (over 90% efficacy) favored the US (Guenot, 2021). The US leveraged this by sending Pfizer vaccines in July 2021 as part of a balance-of-power strategy against China’s vaccine diplomacy in Latin America.

By July 2021, the US donated 1,500,800 Pfizer doses to Costa Rica, strengthening bilateral ties (Telles, 2021). In April 2022, the US integrated Costa Rica into its strategic planning through the Integrated Country Strategy (ICS), focusing on health, safety, and trade, aiming to ensure Costa Rica sees the US as a principal partner in various sectors (United States Department of State, 2022). China’s inaction in response to the US’s dominance allowed the US to deepen ties with Costa Rica. During the pandemic, the US’s reliable aid and effective vaccine provision enhanced its image and strategic cooperation prospects. The US’s success in Costa Rica, especially in health cooperation, posed a threat to China’s Health Silk Road agenda under the Belt and Road Initiative (BRI). The US’s balance of power strategy effectively outmaneuvered China in the vaccine distribution rivalry in Costa Rica.

Mexico’s Geopolitical Tango

Since the onset of COVID-19 in early 2020, Mexico has faced a significant rise in cases, with total cases growing from 1,426,094 in 2020 to 7,196,485 and 330,834 deaths by 2022 (Our World in Data, 2022). This prompted an urgent need for vaccines to boost herd immunity. As the second-largest country by population in Latin America, Mexico required a large supply of vaccines, making the distribution issue crucial. The US, as Mexico’s largest trading partner (45.2%), needed to address this to maintain regional stability (Britannica, 2023).

China, despite being Mexico’s second-largest trading partner (18.2%), provided substantial vaccine support. China’s CanSino Biologics conducted clinical trials and supplied 35 million doses to Mexico by December 2020 despite initial clinical data being unavailable (Reuters, 2020). Throughout the pandemic, China sent over 42 million vaccine doses to Mexico, aiming to shift US influence through vaccine diplomacy.

In response, the US planned to send 34 million doses of Pfizer vaccines, focusing on the US-Mexico border, including vaccinating detained migrants (Associated Press, 2021). However, by August 2022, only 16.9 million doses were delivered. Geographical proximity and unresolved conflicts hindered the US from dominating vaccine distribution in Mexico, allowing China to strengthen its influence.

The US-Mexico relationship faced strategic challenges. The US’s limited vaccine aid and focus on its border protection allowed China to fill the gap, leading to significant Chinese influence. This included Mexico’s agreements for 12 million Sinopharm and 20 million Sinovac doses, even without WHO approval, and facilitated cooperation in health supplies (Reuters Staff, 2021).

China and Mexico’s health cooperation poses a strategic threat to the US. The pandemic highlighted the US’s rigid approach compared to China’s strategic adaptability. Consequently, Mexico depended on China’s vaccine support, building stronger bilateral health relations, while the US’s missed opportunity increased China’s dominance in Mexico’s recovery from the pandemic.

Navigating the Great Power Rivalry: A Complex Dance of Influence in Latin America

Through J. J. Mearsheimer’s glasses, the United States sees China as a challenging power, a new rising country from the east that has calculated a strategy to obtain trust from vulnerable countries through its health diplomacy during COVID-19. In recent geopolitical maneuvers, the United States faced varying levels of success in countering China’s influence in Brazil, Costa Rica, and Mexico.

Balance of power, in which the US tried to tighten its influence by deploying vaccines to other countries, produced different results. In the case of Brazil and Mexico, the US failed to balance the power of China due to the limited stock of vaccines at that time. Conversely, in Costa Rica, the US’s balance of power strategy was successful due to the absence of China’s lack of high-quality vaccines. The US took this further by designating Costa Rica as an International Cooperation System (ICS) member, successfully maintaining influence in the region.

China’s effort in Brazil poses an immediate threat to US interests, pushing the US to use the Blackmail strategy to restrain China’s influence. However, the Blackmail strategy, where the US warned Brazil about Huawei’s potential espionage risks, failed to curb China’s influence.

This intensifying conflict fits the realist perspective of great power competition. Both the US and China are engaged in a struggle for dominance, driven by their pursuit of security and power in an anarchic international system. The pandemic has heightened existing tensions, exacerbating the strategic rivalry as each nation seeks to undermine the other’s position while bolstering its own.

In recent developments, as both Global Power learned from COVID-19, the US and China have started to extend vaccine diplomacy as their foreign policy. China’s vaccine diplomacy appears to be channeled in Belt and Road Initiatives, ASEAN, and Shanghai Cooperation Organization. Echoed with the US recent documents under the Joe Biden Administration, the US Government Global Health Security Strategy was released on April 2024, which aimed to strengthen global health security capacities through bilateral partnerships, catalyze political commitment, financing, and leadership to achieve health security; and increase linkages between health security and complementary programs to maximize impact.

The rivalry between the United States and China is currently indirect, as the COVID-19 pandemic is no longer an immediate factor. Consequently, their present initiatives are primarily focused on disseminating their respective governance models through various strategies and initiatives. This approach aims to influence other nations preemptively in anticipation of any future pandemics.