China, India and Russia are stepping up efforts to expand their influence by providing coronavirus vaccines to developing and middle-income countries, while advanced countries scramble to secure doses of U.S.- and European-made vaccines for their own citizens.

China is donating locally produced vaccines to 53 countries that have requested them, mainly in Southeast Asia and Africa.

A healthcare worker administrates a dose of the Sputnik V COVID-19 vaccine to her colleague in Montenegro on Feb. 23, 2021. (Getty/Kyodo)

"In the recent couple of days we read and heard a lot about Chinese vaccines going overseas and being embraced by many developing countries," Foreign Ministry spokeswoman Hua Chunying said at a press conference on Feb. 19. "Some media reports said the vaccines became Spring Festival presents that these countries wanted the most."

The first country to get free vaccines from China was Pakistan. China has border issues with India, which is Pakistan's foe. On Feb. 1, Pakistan received 500,000 doses of a vaccine developed by state-owned China National Pharmaceutical Group Corp., known as Sinopharm.

China promised in January to donate 300,000 doses to Myanmar after the Southeast Asian country showed an early interest in procuring vaccines from India.

Eastern European countries, which have developed close ties with China under the latter's Belt and Road infrastructure initiative, have bought Chinese vaccines. The United Arab Emirates and Indonesia cooperated with China during vaccine trials.

The number of countries that have expressed interest in purchasing Chinese vaccines has reached 27, many of them also administering U.S. and European vaccines to their populations. As its vaccines are taken up around the world, China appears intent on marshalling all available resources to boost its production capacity.

India, which prides itself on being the world's pharmacy as a result of having produced 60 percent of vaccines needed in developing countries during pre-pandemic times, is competing head on with China in the race to gain influence over the developing world.

The South Asian country has donated 1.7 million doses to Myanmar, while also providing free vaccines to at least 15 countries, including in Africa, the Middle East and the Caribbean.

It has so far provided over 36 million doses to other countries, both for free and on a commercial basis.

India has administered to its citizens two kinds of vaccines, a locally developed one, and the other that was developed by major British drugmaker AstraZeneca Plc and the University of Oxford and produced by a major vaccine maker under the Covishield brand.

India touts them as relatively easy to handle and less expensive than those made by other countries. It is believed to be donating mainly the Oxford-AstraZeneca vaccine to other countries.

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"From the people of India to the people of Maldives," Indian External Affairs Minister Subrahmanyam Jaishankar said on Twitter after handing over 100,000 additional doses of COVID-19 vaccine to the Maldives on his visit there on Feb. 20. "An extraordinarily deep partnership reaffirmed," he also tweeted.

Jaishankar then delivered another 100,000 doses to Mauritius on Feb. 22. Both countries are located in the Indian Ocean, where China is expanding its influence.

Russia in August became the first in the world to approve a COVID-19 vaccine with the locally developed Sputnik V. Its use is spreading to other former Soviet republics, and countries in Latin America and Africa.

Also in Europe, interest in the Russian vaccine is growing after its latest clinical study showed over 90 percent efficacy in preventing symptomatic COVID-19.

According to the Russian Direct Investment Fund, which has backed Russia's vaccine development, 38 countries had approved the vaccine by Friday. There were initially concerns over the vaccine's safety and quality because it was quickly approved in Russia after a second-phase clinical study.

But a study based on data from a phase three clinical trial that was published in the British medical journal Lancet on Feb. 2 showed the vaccine was 91.6 percent effective in protecting against symptomatic illness.

A health official receives a dose of Russia's Sputnik V vaccine in Tehran, Iran on February 09, 2021. (Anadolu Agency/Getty/Kyodo)

Each Sputnik shot costs $10 or less, or less than half that of the U.S. peers, according to the investment fund.

Russia is seeking to provide the shots to over 500 million people around the world by the end of this year. But supply issues remain a sticking point. Since the vaccine was rolled out in December, slightly over 1.7 million Russians have completed its two-dose regimen.

Ursula von der Leyen, president of the European Commission, has cast doubt on the Russian vaccine diplomacy.

"Overall I must say we still wonder why Russia is offering, theoretically, millions and millions of doses while not sufficiently progressing in vaccinating their own people," she said at a news conference on Feb. 17.

Among the other countries involved in vaccine diplomacy is Israel, which has led the world in vaccinating its population.

The country was working to provide surplus doses of U.S. vaccines to countries such as the Czech Republic and Honduras that have shown willingness to move their embassies to Jerusalem, a part of which is claimed by the Palestinians for a future state.

Meanwhile, leaders of the Group of Seven industrialized nations recently reiterated their commitment to extend $7.5 billion in aid to efforts to bring COVID-19 vaccines to developing countries.

Japan, one of the G-7 members, has pledged $200 million to the COVAX Facility, an international framework to ensure equitable access to shots.