30. November, the Hong Kong government announced a rare news that was welcomed in all sectors of a politically divided city fighting its fourth wave of COVID-19 infections: Vaccines are on the way.
Hong Kong had purchased 7.5 million doses of a vaccine developed by US pharmaceutical giant Pfizer and German vaccine maker BioNTech, Hong Kong CEO Carrie Lam and other ministers told a news conference.
During the event, Prime Ministers repeatedly referred to the first vaccine as either Pfizer or BioNTech.
"We have an agreement in principle with Pfizer," Lam said on December 11, explaining the logistics of distributing the vaccine.
But later that evening the government changed language. It issued a statement stating that it had ordered the doses through the Chinese pharmaceutical giant Fosun Pharma, BioNTech's COVID-1
Subscribe to Eastworld for weekly insights on what dominates business in Asia, delivered free to your inbox.
The decline was rapid, with critics calling the government what they saw as an attempt to glare at Fosun's involvement. , a company based in mainland China. Mary Ma, a local newspaper columnist in Hong Kong, claimed that the government's effort to label the vaccine as Pfizer at the press conference, without mentioning that it would be sold by a Chinese company, was a PR flub that could "strike back "by undermining public confidence in the vaccine.
To be sure, the vials of the BioNTech vaccine en route to Hong Kong contain the same vaccinated cocktail that hospitals in the United States, Canada and the United Kingdom have received. However, Fosun marketing and distribution of the doses is unique to China, Hong Kong, Taiwan and Macau, and its role may complicate the distribution of the vaccine, as some people in the region are skeptical of any company associated with mainland China.
At the end of 2020, the BioNTech Vaccine became the gold standard for COVID-19 vaccines, posting a 95% efficacy rate in Phase III clinical trials and receiving emergency clearance from regulators in the United States, Canada and the United Kingdom.
BioNTech and Pfizer are the company names associated with the rapid development of the vaccine, and their CEOs become the public faces of the extraordinary scientific feat. But Fosun Pharma has been a kind of quiet third party in the venture all along.
Fosun Pharma is a subsidiary of Fosun Group, the private Chinese conglomerate of major international companies including the Club Med Hotel chain, an English Premier League football team and the Cirque du Soleil circus group. Fosun Pharma is in itself one of China's largest healthcare companies, producing and selling medicines, as well as providing healthcare services in hospitals.
Fosun Pharma co-founded the Sinopharm Group with the Chinese government in 2003. Sinopharm, for its part, is China's leading seller of drugs and controlled 15% of all drug distribution in China as of 2018. Sinopharm states that Fosun owns a 49% stake in the company, with the other shares controlled by the Chinese government.
Early in the pandemic, March 15, Fosun Pharma agreed to invest $ 135 million in BioNTech to conduct clinical trials and acquire the rights to exclusively license BioNTech's COVID-19 vaccine candidates in Greater China, an area companies define as mainland China, Taiwan, Hong Kong and Macau. Fosun said it would help develop the vaccine, although BioNTech's mRNA technology is at the heart of the effort.
Two days after Fosun and BioNTech signed the agreement, US pharmaceutical giant Pfizer announced its $ 748 million investment in BioNTech – for the right to license and distribute BioNTech's vaccine to the rest of the world.
As BioNTech's partners, both Fosun and Pfizer helped carry out early testing of the vaccine. Pfizer launched Phase I and II studies in the United States and Germany in May, and Fosun launched in mainland China in late July.
Pfizer and Fosun critically tested different versions of BioNTech's vaccine. When it turned out, Fosun had a losing candidate. BioNTech's other candidate, which Pfizer helped test, did better.
The results of the experiments are one reason why Pfizer has overshadowed Fosun as BioNTech's partner.
Another is China's relative containment of COVID-19. Compared to places like the US and Europe, where Pfizer conducted studies while the virus was raging, China was unsuitable territory for Fosun and BioNTech to conduct extensive Phase III studies since volunteers must be exposed to the virus to determine if the vaccine is effective. In the United States, Pfizer's Phase III clinical trials came to a rapid conclusion due to widespread COVID-19 outbreaks.
Dr. Aimin Hui, Fosun Pharma's chief physician, says his company was "deeply involved" in BioNTech's vaccine research and development process. While one of Fosun's human trials ultimately failed, Hui notes that Fosun conducted a previous animal trial with the successful vaccine candidate.
BioNTech is quick to point out that the collaboration with Fosun was based on BioNTech's own technology, and it plays into Fosun's role as a distribution partner in China.
"Fosun brings a lot of experience with the Chinese regulatory system and with bringing new products to market," a spokesman for BioNTech told Fortune . "If we succeed in obtaining approval for our vaccine in China, Fosun Pharma will be responsible for distributing it."
Nevertheless, Fosun is a partner in BioNTech's ongoing trials in mainland China. The two companies jointly launched a new phase I / II test on the mainland in November, this time with BioNTech's leading candidate.
Beijing has said it will not approve the BioNTech candidate until the trials are over, but on Dec. 16 Fosun bought 100 million doses of the vaccine to the Chinese market, indicating that Fosun is optimistic about rolling out the vaccine in China in 2021. The Hong Kong-based newspaper South China Morning Post recently reported that Fosun is preparing to distribute vaccine doses in China as early as this month.
BioNTech is currently responsible for producing doses for the Chinese market, but this may change.
BioNTech said in October that its vaccines for the Chinese market would be produced entirely in Germany, but BioNTech told Fortune this is only the case for BioNTech's first vaccine shipment to China. From the second shipment, BioNTech will send vaccine materials to Fosun to "fill and complete", which means that Fosun will fill the vials and package the vaccines for distribution. Both companies told Fortune that Fosun could eventually produce the vaccine for China.
30. December, the Chinese News Committee Caixin reported that the two companies are in talks to build a production facility in China with the capacity to produce 200 million doses of the vaccine annually.
Fosun's bond with Sinopharm will also prove crucial for the distribution of the vaccine which must be kept at extremely low temperatures, Fosun told Fortune .
In September, Fosun said in a press release that it would work with Sinopharm to set up its cold chain distribution network in China.
For deployment to Hong Kong, Hui told Fortune the vaccine would be shipped in a dry ice container to Hong Kong – he did not specify whether it would come directly from Europe or mainland China – and stored in a mall in Hong Kong at -70 degrees Celsius. The doses will then be brought to vaccination centers in refrigerated trucks for distribution in the city, he said.
Sinopharm's experience of distributing medicines in China may be a boon to Fosun's efforts to roll out the vaccine on a massive scale, but partnership also means that Fosun is dependent on a government entity that has faced transparency issues regarding its own COVID-19- vaccine. Chinese authorities have approved a COVID-19 inoculation developed by a Sinopharm unit which the company says is 79% efficient. Authorities in the United Arab Emirates, Bahrain and Egypt have also cleared the vaccine for use, but the company has not provided data to back up its claims about how well jabs work.
Although Fosun is only distributing BioNTech's vaccine at this time, it is facing some setbacks in the region because it is a mainland-based company.
In Hong Kong, activists have urged the government not to buy any vaccines produced in mainland China. Activists have long rejected mainland China's influence over the city's affairs, believing Hong Kong's potential dependence on Chinese vaccines is the latest example of how the city is subject to Beijing. Meanwhile, the Hong Kong government has said that those who criticize the government for collaborating with Chinese companies on the vaccine rollout are "rumor mongers" who act with "evil intentions."
Fosun faces some resistance in Hong Kong, but its problems in Taiwan may be even more extensive.
The Taiwanese government says it has a long-standing ban on imports of Chinese-made vaccines and other biological products. Officials have cited China's recent history of vaccine scandals as a reason why it continues to enforce the ban. The BioNTech doses may lead to the ban since they are originally from Europe, but the vaccine may still face opposition from the Taiwanese population if it passes through Fosun's hands.
"The vast majority of Taiwanese [citizens] no longer trust China," said Chunheui Chi, director of the Center for Global Health at Oregon State University. The skepticism is deeply rooted – the two sides are engaged in a decade-long struggle for Taiwan's sovereignty – and have flared up too late due to Beijing blocking Taiwan from participating in the World Health Organization and not revealing the contagion of COVID-19 in the early the stages of the pandemic.
That mistrust may be the reason why Taiwan has not yet officially signed an agreement on the vaccine.
In November, Chen Shih-chung, head of Taiwan's Central Epidemic Command Center, was asked at a news conference whether Taiwan would import BioNTech's vaccine if it was distributed by China's Fosun Pharma.
"There is no way Taiwan would import vaccines made in China," Chen said. But Chen seemed to leave open the possibility that Taiwan could import the 'Fosun' vaccine if it was produced outside China. "The place of production is important," he said.
Fosun did not answer Fortune's questions about how it plans to deal with potential setbacks in Hong Kong and Taiwan.
The BioNTech vaccine is already difficult to distribute – it must be stored at subarctic temperatures and administered in two doses at intervals of several weeks. But in places like Hong Kong and Taiwan, the backlash against the vaccine's distributor could be an additional challenge to solve.
More Healthcare and Big Pharma Coverage from Fortune :
- World Vaccination Against COVID Begins Slowly. These firms believe A.I. and blockchain can help
- Timeline: From the first cases of coronavirus to the first vaccinations
- It's New Year, and pharmaceutical companies are already raising the prices of popular medicines
- Comment: In the COVID vaccine rollout, our expectations are not expected does not match reality
- The COVID recession could kill more Americans than COVID-19 does