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VILNIUS — In recent months, Ukraine, Georgia and Moldova have seen authorities of breakaway territories ask Russia to send its Sputnik V coronavirus vaccine to those contested regions. In some cases, those requests have already been granted.
In the rebel-held territories in Ukraine’s Donbass — which have been occupied by Russian-backed separatist forces since 2014 — residents have been receiving the Sputnik vaccine since early February.
The jab has been arriving from Russia in regular vehicle convoys carrying humanitarian aid, according to Rodion Miroshnik, a rebel representative at the trilateral peace negotiations between Russia, Ukraine and the Organization for Security and Cooperation in Europe (OSCE).
The breakaway administration in Donetsk should get around 80,000 doses for the first shot, while Luhansk can count on 65,000 initial doses, he told POLITICO. He added that the rebel-held territories secured an agreement with Moscow to supply enough vaccination doses to cover a share of their populations that is “equal to Russia’s regions.”
“When the first stage of vaccination is completed, there will be a second one,” Miroshnik said. (Like most coronavirus jabs, Sputnik V requires two shots, but as an adenovirus viral vector vaccine, it doesn’t need extremely cold storage.)
His comments provide more detail following recent Kremlin confirmation that Moscow is sending the vaccine to Donetsk and Luhansk, which have a population of 2.2 million and 1.4 million, respectively. The Crimean peninsula, annexed by Moscow in 2014, also began a mass inoculation drive in December with Sputnik.
That’s set alarm bells ringing in Ukraine. In February, the country’s Deputy Prime Minister Oleksiy Reznikov said that if Russian authorities conducted “some kind of human trials with an unknown and uncertified vaccine in our country without our consent, then this is a violation of Ukrainian laws.”
Sputnik has not been approved by the European Medicines Agency (EMA) and Kyiv has banned its registration outright, but the jab has been given the green light in two European countries, Hungary and Serbia.
The authorities of Georgia’s two breakaway territories, Abkhazia and South Ossetia, are also relying on Russian vaccine supplies, according to Russian state-backed media.
After a brief war with Tbilisi in 2008, the two rebel provinces proclaimed independence from Georgia with Russia’s military support. Moscow and a handful of other countries recognize Abkhazia and South Ossetia as independent states, but the rest of the world does not.
Both have already applied for assistance from Moscow, while South Ossetia has even allocated the equivalent of $27,000 from its 2021 budget for vaccine purchases.
These developments come as Sputnik’s global rollout is attracting more attention, including from the European Commission, over Moscow’s geopolitical motives. There are also questions over the transparency of the vaccine’s data, which has yet to be filed formally with the EMA.
Commission President Ursula von der Leyen asked last month why Russia is offering to sell millions to other countries while it lags behind in the vaccination of its own citizens. “We still wonder why Russia is offering theoretically millions and millions of doses while not sufficiently progressing in vaccinating their own people,” she remarked.
Those comments prompted a sharp rebuke from Moscow, which called them “deplorable” and indicative of “an inadequate level of awareness of the top-level official.” It also asserted via the vaccine’s official Twitter account that “vaccines should be above and beyond politics.”
The press office of the Russian Direct Investment Fund — which is responsible for Sputnik’s distribution outside Russia — didn’t respond to POLITICO’s request for comment on the jab’s appearance in these conflict zones.
But in early February, Kremlin’s spokesman Dmitry Peskov defended those shipments, according to Reuters.
“People there really need the vaccine,” he said. “If not us, then no one would supply it there.”
Relief in sight?
The Sputnik vaccine is making inroads just as vaccination campaigns in those countries, more broadly, are still struggling. Ukraine is among those, lagging behind the majority of European countries in vaccination.
Kyiv got some good news last Wednesday, however, when it launched its inoculation program in earnest after receiving 500,000 doses of the Oxford/AstraZeneca vaccine made by AstraZeneca’s partner, the Serum Institute of India — whose main focus is manufacturing the jab for low- and middle-income countries.
Ukraine is giving first priority to health care professionals and care home residents as well as military personnel deployed in Kyiv-controlled areas in the contested eastern regions. It expects more reinforcements soon from China’s CoronaVac jab as well as the BioNTech/Pfizer vaccine, and it has pledged to distribute vaccines to residents of rebel-controlled areas who visit Kyiv-controlled territories, starting in April.
Georgia also hopes to get more supplies soon as well.
Last Monday, Georgian health care officials said they expected their first batches to be delivered in March, after some delays. In the first phase, the country is relying on almost 30,000 doses of the BioNTech/Pfizer vaccine under the global equal-access COVAX initiative, which finally began distribution last week but still faces daunting hurdles in getting rich nations to help the effort.
According to Georgian immunologist and government adviser Bidzina Kulumbegov, Tbilisi plans to vaccinate around 60 percent of its 3.7 million people, a figure that excludes the secessionist regions.
“At this point, COVAX is committed to providing enough vaccines for only 20 percent of the population by the end of 2021,” he told POLITICO. “The country therefore has a deficit of 2.5 million vaccine doses. Bilateral negotiations are currently underway with producers and [other] governments to make up for this shortfall.”
Those vaccines, Kulumbegov added, will only be those with World Health Organization recognition, which to date has just gone to the Oxford/AstraZeneca and BioNTech/Pfizer jabs. As for Sputnik, “it’s my great belief that our country will not introduce it, because of the Russian state’s hostile attitude,” he said.
“Immunization is a tool for gaining political influence during this pandemic,” he said. “Our country should clearly state that when another country occupies 20 percent of our territories, their vaccines will not be used here.”
Moldova looks for options
Moldova, meanwhile, is seeking to get a mix of vaccines across suppliers. The nation of 2.6 million also has a pro-Russian breakaway region, Transnistria, which declared its independence in 1991.
The country expects to obtain an initial batch of 24,570 doses of the BioNTech/Pfizer vaccine under COVAX, as well as 156,000 shots of the Oxford/AstraZeneca jab.
Moldova is also getting help from neighboring Romania, an EU member that traditionally has close ties with Moldova. In late December, Romanian President Klaus Iohannis pledged to donate a total of 200,000 doses of the BioNTech/Pfizer vaccine, and on Saturday, the European Commission announced that it had coordinated for 21,600 doses to be sent as part of Romania’s contribution.
In addition, the government has promised to share its vaccines with residents of Transnistria. According to health care officials in Transnistria’s capital, Tiraspol, Moldova has pledged to forward 10 percent of all doses it receives.
Tiraspol, for its part, is making serious preparations to receive the first shots of the BioNTech/Pfizer vaccine soon. On February 18, the region’s president, Vadim Krasnoselsky, instructed his government to consider purchasing a deep-freeze refrigerator suitable for storing the shots. Initially, the guidance was that a temperature of minus 70 degrees Celsius is needed for that jab, although that may be adjusted to a slightly warmer range, according to fresh data.
This marks a departure from Tiraspol’s original plans to vaccinate its population with Sputnik. In late December, Krasnoselsky announced he had sealed an agreement with Russia for an initial 30,000 doses to “vaccinate physicians, teachers and representatives of the security forces of the republic.” But those shots have yet to materialize.
Nicu Popescu, a former foreign minister, believes that Moldova is likely to distribute some of the vaccines to Transnistria once it gets them — even though Moldova, like Ukraine and Georgia, faces a “real humanitarian issue” of distributing vaccines to territories not under its control.
“The first way is to distribute vaccines to the de facto authorities of these [breakaway] regions,” Popescu told POLITICO. “Another way is to set up some kind of medical infrastructure at the border.”
But in contrast to Kyiv, the Moldovan authorities will approve the Sputnik vaccine if it’s green-lit by the EMA, he added.
“This will be an attempt to depoliticize this issue,” he said. “There are no vaccines in Moldova so far, and in such a situation, the most useful and pragmatic thing is to avoid politics.”
This story has been updated with news of Romania’s vaccine donation.
This article is part of POLITICO’s premium policy service: Pro Health Care. From drug pricing, EMA, vaccines, pharma and more, our specialized journalists keep you on top of the topics driving the health care policy agenda. Email [email protected] for a complimentary trial.