Failure of China's COVID-19 health diplomacy in wining hearts and minds in Thailand and the Philippines: political efficacy constrained by local politics

Abstract

Amid the COVID-19 pandemic, China extended significant medical aid to international communities, aiming to combat the virus's spread and foster global solidarity. However, despite the appreciation expressed by recipient governments for China's assistance, the general public's perception of China did not significantly improve. This prompts the question: why did China's COVID-19 health diplomacy fail to resonate with foreign audiences? This article delves into the cases of Thailand and the Philippines to argue that public perceptions of countries providing aid can be heavily influenced by domestic political dynamics, particularly when incumbent governments already face legitimacy challenges prior to aid delivery. By scrutinizing the implementation of China's aid and the state-to-state relations between China and incumbent governments, political opposition forces can exploit any shortcomings or missteps, placing blame squarely on the incumbents. Given the existing distrust toward incumbent governments, the public is more inclined to accept messages propagated by opposition groups, thereby hindering any positive shift in perception toward China. This perspective complements existing research that predominantly focuses on the diplomatic strategies of donor countries, suggesting instead that the domestic politics of host countries play a pivotal role in shaping the effectiveness of foreign nations' efforts to cultivate favorable images among foreign audiences.

Introduction

The COVID-19 pandemic initially surfaced in China toward the end of 2019, but the Chinese government swiftly contained its domestic spread. By March 2020, as the outbreak's epicenter shifted to other nations, China began offering medical assistance to international communities. Notably, China actively donated vast quantities of face masks to numerous countries worldwide, leading many commentators to label these actions as “mask diplomacy” – an approach utilizing masks as a part of its diplomatic outreach (Chen and Molter 2020; The Straits Times 2020a).

Subsequently, with the advent of vaccines, the term “vaccine diplomacy” emerged to characterize China's endeavors in strengthening diplomatic relations with other nations, projecting soft power, and cultivating a positive international image through vaccine distribution efforts (Chopra 2022; Liu, Huang, and Jin 2022). By June 2022, China had supplied over 2.2 billion vaccine doses to more than 120 countries and regions (Xie et al. 2022).

As a cornerstone of China's “periphery diplomacy,” Southeast Asian nations stood at the forefront of recipients of Chinese medical assistance (people.cn 2020; Xinhua 2021). Notably, China emerged as the primary provider of medical aid to the region (Mirajiah 2022). Through these efforts, China succeeded in bolstering its diplomatic ties with Association of Southeast Asian Nations (ASEAN) member states. For instance, countries in the region such as Thailand and the Philippines deepened their state-to-state cooperation with China amid the pandemic (Gita-Carlos 2021; Xinhua 2022).

However, concurrently, China's health diplomacy initiatives sparked backlash among the public in these nations and achieved limited success in fostering a more positive image of China. For instance, Thai protesters voiced calls to reject China-made vaccines (Thanthong-Knight 2021). This raises the question: why did China's health diplomacy struggle to resonate with foreign audiences?

Focusing on Thailand and the Philippines, this article contends that foreign public opinion can be significantly influenced by domestic political dynamics, particularly when incumbent governments face legitimacy deficits even before the aid is delivered. Political opposition groups, aiming to discredit the incumbents and garner greater public support, often target the implementation of China's aid and the state-to-state relationship between China and the incumbent governments. Given the existing distrust toward these incumbents, the public is more receptive to messages propagated by opposition factions, thereby diminishing the likelihood of improving their perception of China.

In complement to existing literature, which predominantly attributes such challenges to China's internal issues, this article underscores the pivotal role of intricate domestic politics, particularly domestic political contestation, within recipient countries.

The subsequent sections of the article are structured as follows: Section two provides a review of prior research and elucidates how this article contributes to the ongoing discourse surrounding China's COVID-19 health diplomacy, foreign aid, and public diplomacy. Section three offers a definition of “health diplomacy” and furnishes an overview of China's COVID-19 health diplomacy in Southeast Asia. Section four delineates the analytical framework, whereas section five outlines the research design. Section six applies the analytical framework to analyze Thailand and the Philippines. Finally, the conclusion summarizes the findings and discusses their implications.

Literature review: China's success and failure in COVID-19 health diplomacy, foreign aid, and public diplomacy

During the COVID-19 pandemic, China actively engaged in health diplomacy. Motivated by aspirations to enhance its international reputation, cultivate favorable views of China abroad, and expand its global influence, China extended medical aid to other nations (Huang 2010; Killeen et al. 2018; Youde 2010). Scholars have scrutinized whether China's COVID-19 health diplomacy has indeed bolstered perceptions of China among the public in recipient countries. Some argue that China's medical assistance has indeed fostered a more positive image of China among local societies in recipient nations. Vannarith (2021), for instance, contends that China's soft power and geopolitical sway in mainland Southeast Asia were augmented through health diplomacy during the pandemic. Similarly, Barham et al. (2023) and Urdinez (2024) observe a significant boost in trust toward China among citizens in Latin American countries due to its distribution of vaccines. In Europe, Chen (2021) finds evidence suggesting a more favorable attitude toward China resulting from its COVID-19-related health assistance.

However, dissenting voices exist. Kowalski (2021) observes that while China's coronavirus diplomacy succeeded in some European countries such as Czechia and Serbia, it faltered in others such as Romania and Poland. van Dijk and Lo (2023) conclude that China's vaccine diplomacy in the Philippines and Vietnam failed to enhance its image among the local populace. Gong (2021) highlights a decline in trust toward China among the Southeast Asian public, despite recognition of China as the region's largest assistance provider. Similarly, Nolte (2022) observes that China's endeavors in mask diplomacy and the provision of medical supplies and vaccines failed to generate sympathy in Latin America. Additionally, Zhang (2020a) notes less positive reactions from students in some Pacific Island countries toward China's health assistance.

Several scholars delve deeper into the factors contributing to the mixed outcomes of China's coronavirus diplomacy in shaping a positive image. Kowalski (2021) underscores the significance of incumbent officials of recipient countries publicly and officially welcoming Chinese medical aid, which influences how the public perceives China. Lee (2023) attributes the failure of China's coronavirus diplomacy to doubts regarding the safety and efficacy of China-made vaccines. Gong (2021) argues that the effectiveness of China's image-building efforts through COVID-19 health diplomacy is influenced by factors such as the severity of the crisis, recipient countries' national responses, and the perceived legitimacy of China's actions. van Dijk and Lo (2023) cite allegations of corruption in vaccine provision, delayed deliveries, controversial authorization processes, and the use of unauthorized vaccines by incumbent officials, coupled with pre-existing anti-China sentiments and ongoing territorial disputes, as factors contributing to the challenges faced by China's diplomacy.

As health diplomacy is a form of international aid, widely regarded as a tool of public diplomacy (Alexander 2020; Fazal 2020), we also review existing literature on the factors conditioning the success of China's foreign aid and public diplomatic efforts in fostering positive perceptions of China among foreign publics. Key factors identified by scholars include structural issues within Chinese domestic bureaucracy, China's own strategies, media coverage, geographical proximity to Chinese projects, credibility concerns, and public receptivity toward a powerful China (Blair, Marty, and Roessler 2022; Cha, Ryoo, and Kim 2022; d’Hooghe 2011; Jerdén et al. 2021; Wei 2016).

We do not dismiss the relevance of these factors but seek to build upon existing analyses and address their limitations. Existing explanations often lack conceptualization and fail to consider the interaction between various factors. Moreover, they overlook the crucial link between international relations and domestic politics. Without accounting for domestic political contestation within recipient countries, the analyses may lack coherence.

Health diplomacy and China's COVID-19 health diplomacy in Southeast Asia

In this article, health diplomacy is defined as a type of international aid that aims to promote health or that uses health programming to promote non-health-related foreign aims (Fazal 2020). China has a long history in conducting health diplomacy (Huang 2010). After rapidly containing the domestic spread of the coronavirus, China had actively involved in health diplomacy, and Southeast Asia is the first recipients of China's massive medical aid.

First, China's health diplomacy to Southeast Asia encompasses all assistance and cooperation that could be used to promote health, not just the provision of masks and vaccines. In an effort to stop the spread of the coronavirus, China provided a wide range of assistance to Southeast Asia. It distributed medical supplies, including not only masks and vaccines but also many others, such as protective suits, test kits, and goggles. It also provided financial support. In the meantime, it shared information, cooperated in scientific research and vaccine productions, dispatched medical teams, and offered medical professional training to Southeast Asian countries (The State Council Information Office of the People's Republic of China 2020; Zhang 2020b).

Second, China's practices of health diplomacy to Southeast Asia are not restricted to state actors, but also non-state actors (Feldbaum and Michaud 2010; Ruckert et al. 2016). Since March 2020, China had taken a whole-of-government and whole-of-society approach to conduct COVID-19 health diplomacy in Southeast Asia (Ma 2022; Zhang 2020b). The central government took the lead. From March to September 2020, the central government of China provided a significant amount of medical supplies to all the eleven Southeast Asian countries (Ma 2022, pp. 45–46). In addition, the central government provided a fund for Southeast Asian countries to fight against the pandemic. For instance, China contributed a total of US$ 6 million to the COVID-19 ASEAN Response Fund (ASEAN 2022). It also partnered with Indonesia on the research and development of mRNA therapies (Bai, Zhao, and Hu 2022). Local governments also actively provided health assistance to Southeast Asian countries. For instance, the government of Guangxi not only sent medical teams to Cambodia to help the country fight against the pandemic, but also donated medical supplies to the country (gx.chinanews.com 2021). Besides civilian actors, the Chinese People's Liberation Army (PLA) was active as well. For example, the PLA donated numerous batches of China's Sinopharm COVID-19 vaccines to its Vietnamese counterpart (Xinhua and Reuters 2021). Chinese private sectors actively aided their authorities in conducting the health diplomacy. Huawei donated laptops to support Malaysia's COVID-19 vaccination program (Huawei 2021). Chinese companies also provided cash for Indonesia to curb the spread of the coronavirus (Embassy of the People's Republic of China in the Republic of Indonesia 2020). China's civil society also participated in various assistance programs. The Jack Ma Foundation and Alibaba Foundation donated a wide variety of medical materials to a number of Southeast Asian countries, including masks, test kits, protective gear, and face shields (Alibaba Clouder 2020).

An integrated analytical framework: aid implementation, bilateral political relations, and domestic political contestation

Due to the leading role of China's central government in conducting foreign relations, this study does not distinguish the aid provided by the central government, local governments, or non-state actors. Instead, the authors treat China's COVID-19 health assistance as a package and as China's collective efforts to shape a more positive China in the world.

Health diplomacy is a type of foreign aid (Fazal 2020), whereas foreign aid is widely considered as an act of public diplomacy and is an important tool for aid-giving countries to generate soft power (Alexander 2020; Atkinson 2019; Rhee, Crabtree, and Horiuchi 2024). Therefore, the effectiveness of foreign aid refers to whether it can improve aid-giving countries' images among the public of the aid-receiving countries. Surprisingly, although scholars have well acknowledged the relationship between foreign aid and foreign public opinions on aid-giving countries, the existing research on the effectiveness of foreign aid is rare (Blair, Marty, and Roessler 2022). Nevertheless, a small number of studies shows that not all foreign aid/public diplomacy are effective in improving donor countries' image among foreign publics, and they point out three factors that condition the success of foreign aid/public diplomacy. These three factors are (1) donor countries' own conduct and credibility (Blair, Marty, and Roessler 2022; d'Hooghe 2011; Goldsmith and Horiuchi 2009; Mattingly and Sundquist 2023), (2) media coverage of the aid in recipient countries (Blair, Marty, and Roessler 2022; Dietrich, Mahmud, and Winters 2018; Goldsmith, Horiuchi, and Matush 2021; Rhee, Crabtree, and Horiuchi 2024; Wei 2016), and (3) recipient countries' public's personal experiences with aid projects, such as their geographical proximity to the projects (Blair, Marty, and Roessler 2022; Wellner et al. 2022).

Although these three factors respectively provide explanations to some countries' failure or success in specific regions or countries, to what extent that they can be applied to a wider range of cases remains to be explored. An integrated analytical framework will help further conceptualize and generalize these three empirical findings. More importantly, the existing research ignores two important factors when studying the effects of foreign aid/public diplomacy. The first one is the dynamics of domestic politics within recipient countries. Politicians not only attempt to but are also influential in shaping the opinions and political stances of their domestic constituents (Matsubayashi 2013; Slothuus and Bisgaard 2021). Scholars also acknowledge that local elites are instrumental in interpreting political information which can thus shape domestic public's perception of aid-giving countries (Dietrich, Mahmud, and Winters 2018), but they have yet to elaborate how this factor can be incorporated into the existing explanation and works in the real-world scenarios. In addition to domestic political factors, the existing research also fails to consider the existing bilateral relations between donor and recipient countries, especially the one between the governments of the two countries. Studies show that when bilateral relations between the governments of two countries are on good term, foreign aid is more likely to generate positive images of the donor country among the public of the recipient country (d'Hooghe 2011; Wei 2016). With that being concluded, the mechanism through which this broader picture of bilateral political relations affects recipient countries' public opinions toward donor countries is understudied.

To address the above limitations, we propose an integrated analytical framework to study under what conditions foreign aid, aiming at helping recipient countries to tackle crises, can improve donor countries' images among recipient countries' citizens. The framework is composed of three aspects, namely aid implementation in recipient countries, bilateral political relations between governments of donor and recipient countries, and recipient countries' domestic political contestation (see Fig. 1).

Figure 1. Integrated analytical framework: aid implementation, bilateral political relations, and domestic political contestation.

Source: Authors.

Foreign aid provides critical support for recipient countries, in particular developing and less-developed countries, to manage a crisis. To deliver and implement the aid, donor countries need to work with domestic actors of recipient countries, especially government agencies in the recipient countries (Dietrich 2014). In other words, the governments of aid-giving and aid-receiving countries formulate a cooperative entity in aid implementation, and consequently they are perceived side by side by the public of aid-receiving countries. That is why a research finds that an increase in local corruption scandals which are associated with the growing inflow of Chinese foreign aid in African countries contributes to Africans' negative views of China and their respective local authorities at the same time (Cha 2024).

Although governments in recipient countries, particularly in low- or middle-income countries appreciate and welcome foreign aid (Dupuy, Ron, and Prakash 2016), their domestic oppositions may not be on the same page. This is because politicians from oppositions who are campaigning for power are engaged in blaming the incumbent governments and its individual officeholders (Weaver 1986). The common strategy of opposition is to erode the incumbent governments' credibility by publicizing and criticizing the governing rulers' bad deeds and characters that has caused harm, loss, and failure in the face of their domestic public (Hansson 2018). This is especially so when crises occur. Governments and their leaders are often key targets for causing the crisis, failing to prevent it, and/or inadequately handling it (Boin et al. 2010). Noticing that donor countries collaborate with their incumbent governments on aid delivery and implementation, it is natural and politically expedient for oppositions within recipient countries to blame the donor for any domestic governance predicaments associated with the aid during the crises (Aidoo and Hess 2015; Chen and Han 2021).

The debate on the motives behind donor countries' provision of aid is catching a great amount of attention. Some argue that the aid is mainly for recipient countries' development and reflects the value of caring others in need, whereas others put forward that it is for aid-giving countries to generate influence and pursue their own strategic foreign policy goals, which sometimes is at the expense of national interest of recipient countries (Bearce and Tirone 2010; Ingram 2019; Milner and Tingley 2013; Palmer, Wohlander, and Morgan 2002). Taking advantages of the increasing geopoliticization of foreign aid, domestic oppositions within the aid-receiving countries may also target at the alleged “subservient” bilateral relationship between their incumbent governments and the governments of donor countries when rallying for public support. For instance, critics of recipient countries' governments have always complained that their governments are compromising their state sovereignty and national interests in exchange for Chinese aid, notably the Hambantota maritime port in Sri Lanka (Wan 2018). As a result, due to the increasing fears of the so-called “debt trap,” a term which is actively referred to and promoted by opposition forces within Sri Lanka (Sautman and Yan 2019), there is growing backlash from Sri Lanka's public against China's involvement in the country (Freedom House n.d.). Consequently, this also contributes to the increasing mixed views of China among the public.

There are two logics to explain why opposition forces may dominate public opinion during the crises even though all local politicians, both the incumbent and opposition ones, from recipient countries play a critical role in shaping recipient countries' citizens' attitudes toward donor countries (Dietrich, Mahmud, and Winters 2018). On the one hand, any relevant negative information regarding the aid may contribute to the domestic public's negative image about their donors (Barham et al. 2023), while oppositions' criticism is an important catalyst of public discourse during the crises (Louwerse et al. 2021). On the other, the pendulum may swing way over to the oppositions when the public has already doubted some of the policies or even the basic legitimacy of the incumbent governments before the eruption of crises and the delivery of the aid. By exploiting the pre-existing distrust in the incumbent governments, the oppositions may enjoy greater advantages to dominate public's opinions and successfully persuade the public to go against the incumbent governments and also the donor countries.

To sum up, the integrated analytical framework proposed in this article argues that whether foreign aid, with the aim to handle crises, improves donor countries' images among the public of recipient countries depends on the political contestation between the incumbent governments and their opposition forces within the recipient countries. When the incumbent governments of the aid-receiving countries run legitimacy deficit before the breakout of the crises and the delivery of foreign aid, foreign aid is less likely to improve aid-giving countries' image among aid-receiving countries' public. This is because, to rally for public's support, domestic opposition of aid-receiving countries may take every opportunity to attack the incumbent governments by publicizing and criticizing any problems related to aid implementation and portraying the incumbent governments' relationship with aid-giving countries as subservient. Due to their pre-existing distrust toward the incumbent governments, the public is inclined to listen to the opposition and thus is less likely to improve their perception of aid-giving countries based on those criticism.

Research design

This is a multiple case study based on qualitative research methods. We measured Thais' and Filipinos' perceptions of China mainly based on annual surveys conducted by ISEAS-Yusof Ishak Institute, supplementing with relevant news reports and scholars' analyses. We relied on the articles and reports from multiple news websites to detail how domestic political opponents within Thailand and the Philippines attempted to blame their respective incumbent governments by targeting at China's health diplomatic efforts. With the data collected, we traced the development of domestic opponents' criticisms toward their respective incumbent governments. Our hypothesis for testing in the case studies is: When the incumbent governments of the aid-receiving countries run legitimacy deficit before the delivery of foreign aid, foreign aid may be attacked by domestic political oppositions within aid-receiving countries and is less likely to improve aid-giving countries' image among the public of aid-receiving countries.

Our selection of Thailand and the Philippines is mainly based on the method of differences (Seawright and Gerring 2008). First of all, Thailand and the Philippines differ politically, economically, and socially. Over 90% of Thais are Buddhists (U.S. State Department n.d.), whereas the Philippines is a Christian country, with approximately 86% of the population being Roman Catholic (Miller n.d.). Thailand was more economically prosperous than the Philippines before the pandemic. In the past few years, Thailand has been an upper-middle income economy whereas the Philippines is classified as a lower-middle income economy (The World Bank 2023a, The World Bank 2023b). The GDP per capita of Thailand ($7,628.6) in 2019 was over twice as high as that of the Philippines ($3,413.8) (The World Bank n.d.). Although both being identified as “flawed democracies” (CNN Philippines 2023; Pookaman 2020), the Philippines was led by an elected government during the pandemic, whereas Thailand was ruled by a military junta.

Second, China's relations with the two countries had been different before the pandemic. In 2019, China, with a record of $8.6 billion, became Thailand's number one investor for the first time (Rakkanam 2020). China was also the largest trading partner of Thailand, with a total value of $73,861 million (WITS n.d.-b). Meanwhile, though being the second largest investor in the Philippines, China invested only $1.75 billion in the country (Xinhua 2020). China's trade with the Philippines only recorded $36,570 million in 2019 (WITS n.d.-a). The diplomatic relation between China and the Philippines has experienced fluctuations in the past few decades, whereas that between China and Thailand has been relatively stable and friendly. Unlike the Philippines, Thailand is not involved in maritime disputes with China in the South China Sea (SCS); however, Thailand is frustrated with China's actions along the Mekong River.

Third, the two countries are also different in terms of receiving China's COVID-19 medical assistance. To be specific, China provided more assistance to the Philippines than to Thailand. In fact, the Philippines was among the first Southeast Asian countries to receive China's medical assistance, both in terms of order and scale (Lye 2020). The Philippines was among the first three countries to receive China's medical teams (Embassy of the People's Republic of China in the Republic of the Philippines 2020). As of the end of 2022, China had delivered only 29.9 million vaccines to Thailand but 60.025 million to the Philippines (Bridge 2022). Despite all these differences, it is interesting to note that China's COVID-19 health diplomacy failed to shape a more positive perception of China among local societies in Thailand and the Philippines. By selecting these two countries, we hoped not only to make a contrast between them, but also to take the great diversity of Southeast Asian countries into consideration. Last but not least, the data availability also enables us to look deeper into these two countries.

Case studies: Thailand and the Philippines

Public perceptions of China in Thailand and the Philippines

Although people in both Thailand and the Philippines recognized that China, among ASEAN's ten dialogue partners, provided the greatest aid to the region for COVID-19, they did not view Chinese assistance positively. A scholar from the Philippines even suggested that the pandemic exacerbated Philippine unfavorable views of China (Rabena 2021). Multiple polls show that there was weak public support for Chinese vaccines among Filipinos (van Dijk and Lo 2023). In Thailand, citizens did not have confidence in Sinovac either (Al Jazeera English 2022).

Furthermore, Thais and Filipinos did not change their perceptions of China both at the regional and global levels. In Thailand, although the percentage of respondents who had no or little confidence that China would “do the right thing” to contribute to global peace, security, prosperity, and governance decreased in 2022; it rose in 2023 and surpassed the pre-pandemic level (see Fig. 1). Despite the decrease in 2023, the proportion of Filipino respondents who had little or no confidence in China's role in international affairs remained high (see Fig. 2).

Figure 2. (a) Survey in Thailand on the question of “how confident are you that China will ‘do the right thing’ to contribute to global peace, security, prosperity, and governance?” Source: ASEAN Studies Centre at the ISEAS-Yusof Ishak Institute (2021, 2023). (b) Survey in the Philippines on the question of “how confident are you that China will ‘do the right thing’ to contribute to global peace, security, prosperity, and governance?” Source: ASEAN Studies Centre at the ISEAS-Yusof Ishak Institute (2021, 2023).

In addition, the general public in Thailand and the Philippines have remained concerned about China's growing economic, political, and strategic influence in Southeast Asia over the past 3 years. Although the percentage of Thai who were worried about China's growing regional economic influence decreased in 2022, it surged significantly in 2023 (see Fig. 3). In the meantime, Filipinos' anxiety toward China's growing economic influence in the region remained largely unchanged; at least 75% of respondents expressed their worries (see Fig. 3). A significant high percentage of both Thai and Filipino respondents expressed their worries about China's growing regional political and strategic influence, even though the percentages fluctuated (see Fig. 4). Nevertheless, even at its lowest point in 2022, there were still over 75% of Thai respondents who expressed their anxiety.

Figure 3. Percentage of respondents who are worried about China's growing regional economic influence.

Source: ASEAN Studies Centre at the ISEAS-Yusof Ishak Institute (2021, 2023).

Figure 4. Percentage of respondents who are worried about China's growing regional political and strategic influence.

Source: ASEAN Studies Centre at the ISEAS-Yusof Ishak Institute (2021, 2023).

Thailand

The Thai public had called for a return to democracy since 2014, when General Prayut launched a coup d’état to overthrow an elected government and became the prime minister. The dissolution of the Future Forward Party, a popular opposition party among young people that is pro-democracy and anti-military dictatorship, by the Prayut administration in February 2020 exacerbated the public's dissatisfaction and distrust, particularly among young people, of the junta government and sparked thousands of youth-led democracy protests across Thailand in 2020 and 2021 (Human Rights Watch 2021). The removal of Prime Minister Prayut, together with the reforms of constitution and the monarchy, was the main intent of these pro-democracy protesters (Tan 2021b; The Straits Times 2020b). Other than the long-lasting public distrust for Prayut and his administration, the skyrocketing number of COVID-19 infections and deaths since July 2021 only made the Thai public more resentful toward their authorities.

Although Thailand was the first country outside of China to report a COVID-19 infection, it was not seriously hit by the pandemic at the early stage of the outbreak. The Thai government was even credited for its effective handling of the first wave of outbreak which began in January 2020, and the second one which started from mid-December 2020. Only 4,237 cases and 60 deaths were recorded from January to mid-December 2020, and 24,626 infections during the second wave of the outbreak (Thai PBS 2021c). Consequently, in December 2020, Prime Minister Prayut was invited to share the best practices that contributed to Thailand's success in curbing COVID-19 at the United Nations General Assembly (Ministry of Foreign Affairs of the Kingdom of Thailand 2020). However, the third wave of COVID-19, which started in late March 2021, was far more severe than before. The number of daily new cases surged to nearly 10,000, and almost 100 deaths were reported every day (Thai PBS 2021c). More than 1.2 million people were infected from April to September 2021 (Thongnoi 2021), which is significantly more than the combined total of the first and second waves.

The Prayut government's failure in containing the third wave is primarily due to its “short-sighted” vaccine policy (Pananond and Pongsudhirak 2021; Pangsapa 2022). As of September 2021, merely a third of the whole population had been injected with the first dose, and only 11% had been fully vaccinated (Thongnoi 2021). The Thai government began its mass vaccine rollout as late as June 2021 with only two vaccines, AstraZeneca and China's Sinovac; the third wave emerged in late March. As only about 1.7 million AstraZeneca shots were available when the vaccination program started, Sinovac, with up to 6 million doses delivered, became the most widely deployed vaccine in Thailand (Sanglee 2021b). Until October 2021 when the Thai government announced that it would cease using Sinovac, the nation-wide vaccination program had heavily relied on this China-made vaccine (Strangio 2021).

The overreliance on one vaccine sparked political protests in Thailand. In addition to the fact that Sinovac was less effective compared to other vaccines such as Pfizer and Moderna, the Thai public was suspicious toward Sinovac simply because it was obtained by the Prayut government, which they did not trust in the first place. In other words, the widespread distrust of the Prayut government aggravated hesitancy toward Sinovac (Sanglee 2021a, Sanglee 2021b). The pro-democracy protesters have requested for Prayut's resignation and political reforms since July 2021. They also wanted China-made Sinovac to be replaced with mRNA vaccines, such as Pfizer, in order to garner support from the Thai public (Thanthong-Knight 2021). What's more, the Prayut government's lack of vaccine management transparency and consistent purchase of Sinovac after it had ordered other vaccines with higher efficacy rates raised public suspicion of a corrupt transaction between the government and Sinovac Biotech, the vaccine manufacturer.

The Pheu Thai Party, the leading opposition party in Thailand, accused the Prayut government of corruption in COVID-19 vaccine procurement. There was a discrepancy of 2 billion baht between approved budgets and paid prices for five batches of Sinovac Thailand purchased. It was also found that Thailand paid more than other countries, such as Indonesia and Brazil, to purchase Sinovac (Sattaburuth 2021). Besides, a wealthy Thai businessman who has close ties with the Thai government is also a business partner and investor in Sinovac (Duangdee 2021). Given that Thailand was the first customer for the Sinovac vaccine, a product for which there were no sales representatives in Thailand, the Pheu Thai Party suggested that this government-associated Thai business tycoon and others who brokered the deal likely earned commissions from the sale, thus driving up the price of inferior Sinovac vaccines (Fronde 2021). Although the Prayut government defended itself and survived a parliamentary no-confidence vote in September 2021, during which Prayut and five other ministers were scrutinized for corruption, economic mismanagement, and an inadequate response to the COVID-19 pandemic, it was still trapped in these allegations (Pongsudhirak 2021).

As protests against Prayut and his government grew more frequent and sometimes violent (Tan 2021a), criticism and attacks on Sinovac continued at the same time. The Thai people vented their anger against their government at Sinovac. The greater the public's anger with the Prayut government, the harsher their criticism of Sinovac. As one Thai scholar pointed out, the public's discredit and condemnation of Sinovac was not against China, but against the Prayut government and the lack of transparency of the vaccine deal. Sinovac was the scapegoat of the Prayut government to some extent. Therefore, China's image had been hurt by the Prayut administration's inept handling of the COVID-19 situation (Thongnoi 2021). The Prayut government's dependency on Sinovac also angered the opposition parties. Both Pheu Thai Party and Move Forward Party publicly questioned the safety and efficacy of Sinovac (Sanglee 2021a). Opposition members of parliament criticized Sinovac so hard during the House debate that the House Speaker had to intervene (Thai PBS 2021a). By highlighting the defects of Sinovac, domestic political opponents hoped to unveil the incompetence of the Prayut administration, weaken its public trust, and weaken its legitimacy to rule. In this regard, by utilizing Sinovac and resistance to it as a political tool to discredit the Prayut government, the opposition parties sought to create negative perceptions of China and Chinese vaccines among the public.

In addition to Sinovac per se being the forefront of Prayut's mismanagement of the pandemic, the close ties between the Prayut government and China before the pandemic and the strengthening bilateral relations during the pandemic made the opposition parties label Prayut's government and China as the same enemy on the united front. Therefore, anti-China and anti-government sentiments had often been inseparable in Thailand. China has shown no opposition to Thailand's return to military rule under Prayut since 2014. China even received a Thai military delegation just 1 month after the 2014 coup d'état, whereas Western countries still condemned the coup (Lefevre 2014). Chinese leaders also congratulated Prayut on his re-election as Thailand's Prime Minister in 2019 (Consulate General of the People's Republic of China in Davao 2019), whereas Western countries remained silent. Since coming to power, the Prayut administration has embraced China because it gave the junta government legitimacy at this “critical moment” and also because it looked to Chinese trade and investment for economic legitimacy (Chachavalpongpun 2014). For instance, Prayut's decision to use the controversial Article 44 to expedite the construction of the Sino–Thai railway is a clear indication of his preference in deepening relationship with China (Jory 2017). In an attempt to criticize the junta government, opposition parties continued to accuse Prayut of compromising national interests by kowtowing to China on a variety of issues, including the railway, real estate, and electronic commerce (Rojanaphruk 2020).

During the third wave of the COVID-19 outbreak, the increasing discredit of Sinovac pushed the Chinese embassy in Bangkok to issue a rare statement defending its vaccine and criticizing any attacks without a scientific basis as “harmful to the good wishes of China to support Thai people in the fight against the pandemic” (Thai PBS 2021b). In an effort to quell domestic criticism together with China, Prayut and other high-ranking Thai officials warned that misinformation about the vaccine and its devaluation could have a negative impact on international relations. However, the warning only fueled public skepticism regarding the Prayut administration's corruption allegations concerning Sinovac and reaffirmed their belief that the Prayut government's efforts to maintain good relations with China may not be in Thailand's national interests (Thongnoi 2021). Moreover, the revelation that the support of Sinovac by the Prayut government was in part due to China's pressure (Saronchai 2021) not only exacerbated the existing doubts regarding the Prayut administration's ability to protect Thai people and Thai national interests against an increasingly assertive China, but also put China in a more disadvantageous situation.

The Philippines

In addition to China's assertive build-up in the SCS during the pandemic (Rabena 2021), domestic political contestation also complicated the implementation of China's health diplomacy and prevented China from improving its image among the Filipino public. Since taking office in 2016, President Duterte had adopted an appeasement policy toward China. He did not only seek to strengthen economic cooperation with China but also took a soft approach to the SCS dispute. However, despite the fact that Duterte had continued to receive high public approval ratings for his government's performance on most counts, his approach to Philippine–China relations was the one most at odds with public opinion (Cook 2019). The Philippine public did not share Duterte's benign view of China. Instead, they remained skeptical about and critical of China and did not trust Duterte to handle their country's relations with China (Castro 2018; Guarco 2019). In other words, even though Duterte enjoyed high popularity among the Filipinos in general, he lacked public support when dealing with China. In fact, when there was resentment against Duterte rising, being critical of China would gain ground within the Filipino public (Guarco 2019).

Numerous opposition senators questioned Duterte administration's decision to purchase personal protective equipment (PPE) from foreign companies, calling it “betrayal” of Filipinos (Tomacruz 2021). The deal to purchase PPEs from China was not exempted from such accusations. The then Vice President Leni Robredo said that sourcing PPEs from China did no good for the Philippines (Lalu 2020). Risa Hontiveros, a key opposition member in the Senate, claimed that the Duterte administration lost around 1 billion peso when buying PPEs from China (Magsino 2020). One Senator also pointed out irregularities in the purchase, cost, and quality of China-made PPEs, and even called on China to pay for his country's COVID-19 expenses (Rabena 2021).

In December 2020, a number of senators in the Philippines suggested that the Philippines could have secured 10 million doses of Pfizer vaccines as early as January 2021. They accused that, however, because of negligence of the Health Secretary Francisco Duque III and corruptions of some government officials, the deal was not inked (Ramos 2020). In the meantime, the Duterte government announced that it was finalizing the deal to purchase 25 million doses of China-made Sinovac (Reuters 2020). The coincidence of the two deals triggered doubts that whether the Duterte administration paved the way for Sinovac by dropping Pfizer (Marquez 2020). Two factors made the Sinovac deal more controversial. First, given Sinovac Biotech's past record in bribing drug regulators to expedite approval of its vaccines, the company was suspected for involvement in bribery in the Philippines concerning its vaccine's approval (Cabico 2020). Second is the lack of transparency of the prices or even the overpricing of China's vaccines in the purchasing deal. Despite the low efficacy rate of the Sinovac vaccine, why did the Philippine government still choose to purchase it at a higher price than the price offered to other countries? One of Duterte's opponents and Senator Panfilo Lacson accused some individuals of receiving kickbacks (Lacsa and Cordero 2021). Officials from the Duterte government had always refused to explain how the prices were determined, citing non-disclosure agreements, which only heightened suspicions (Pitlo 2021). All of these factors, combined with the fact that public confidence in vaccines was already low following the Dengvaxia controversy in 2016 (Larson, Hartigan-Go, and de Figueiredo 2019), put China's vaccines in an unfavorable situation in the first place.

Several events regarding vaccines further dampened China's efforts to improve its image among Filipinos with its COVID-19 health assistance. Members of the Presidential Security Group, the then-President Duterte's security team, had already been inoculated with China-made Sinopharm vaccines before the vaccines got regulatory approval in the Philippines. Other than highlighting that the safety of the President equates to national well-being, officials from the Duterte government failed to provide any other persuasive explanations to justify these activities (CNN 2020). Duterte himself not only ordered the military to cease its investigation into how his security team obtained unauthorized Chinese vaccines, but also instructed his security officers not to cooperate with legislative investigations (Aspinwall 2021). What makes the impact more negative is the unknown source of these unauthorized Chinese vaccines. Leila de Lima, one of the opposition politicians and senators, publicly called those vaccines “smuggled” (Sepe and Maitem 2021), but the president's office said that the vaccines were offered by China as a “gift.” Regardless of which claim was accurate, the use of unauthorized vaccines by the authorities demonstrated the lack of accountability of the Duterte administration, as de Lima satirically questioned that “is it too much to ask for our president to obey the law (Sepe and Maitem 2021)?” Even though the criticisms from the oppositions did not directly target Chinese vaccines, it further eroded the Filipinos' confidence in the Chinese vaccination program initiated by the Duterte administration (Regencia 2021). What's more, it tainted China's image as a provider of global public goods. As a responsible vaccine provider who is committed to a shared community of health for all, China should resist any temptation from buyers or smugglers to obtain vaccines before the completion of clinical trials (Siow 2020). Risa Hontiveros highly echoed with this by stating that it was China's responsibility to know how those vaccines got out of the border. Moreover, she underscored that a Beijing-led investigation was critical in raising the public trust and would be for China's best interest (Ramos 2021).

Subsequently, President Duterte's inoculation of unregistered Sinopharm vaccines from China provoked additional criticism from the public (COVID-19 Action Network Philippines 2021). As the coverage of China's vaccines was often associated with doubts and condemnations by civil society and opposition senators in the Philippines on the Duterte government's blatant disregard of regulatory process and giving privileges to a few by sacrificing people's health (Coalition for People's Rights to Health 2020; Perez-Rubio 2021), it was not surprising that the vaccines provided by China failed to improve China's image in the Filipino society. After the Duterte administration failed to provide sufficient justification for all of these events, the public was left with the impression that the government's mass vaccination program was primarily motivated by political considerations rather than medical care. The more President Duterte promoted Chinese COVID-19 vaccines, the more the public opposed the vaccines (Pascual 2021).

Together with the mishandling of Chinese vaccines, Duterte's embrace of China was also heavily targeted and criticized by his political opponents to further weaken his public support and legitimacy to rule. Duterte's preference for China's vaccines during the COVID-19 pandemic was interpreted as part of the president's pursuit of closer relations with Beijing but at the expense of national interest and sovereignty (Pamalakaya 2021). Senator Richard Gordon questioned whether Duterte's ingratiation to China was for COVID-19 vaccines in an online media briefing. He also criticized that “he's pleasing China too much”; instead, “we should always assert (our sovereignty) (Pazzibugan and Ramos 2020).” Another opposition Senator Francis Pangilinan was more blunt; he stated that Duterte's “subservience and surrender to China is detestable (and) unacceptable (Pazzibugan and Ramos 2020).” The then Senate Minority Leader, Ralph Recto, also insisted that Duterte “should assert our legal rights over West Philippine Sea and to pursue the same diplomatically (Pazzibugan and Ramos 2020).”

Although the president reiterated that he would not compromise his country's SCS claim in exchange for coronavirus vaccines from China and that there were no strings attached to China's donation of the vaccines, a number of his activities discredited his own statements. For example, merely a day after Teodoro Locsin, the Philippines' Foreign Affairs Secretary criticized the presence of Chinese vessels in parts of the disputed areas in the SCS, on Twitter, Duterte instructed Locsin to refrain from using profanity in his public statements, especially in diplomatic contexts. In addition, Duterte stated that China “remains a benefactor” (Dancel 2021). As a result, Duterte's reliance on China's COVID-19 vaccines, together with his reluctance to confront China in defending his country's sovereignty in the SCS, gave his political opponents not only great opportunities but also solid ground to inflame public discontent, shape public opinions and put pressure on him.

Conclusion

Despite the fact that Thailand and the Philippines are different socially, economically, politically as well as in their respective relations with China, China's coronavirus health diplomacy was unable to improve their public's perceptions of China. Why did China fail? This study adds to the existing explanation that domestic political contestations within the two countries can also hinder China's efforts.

Prior to the outbreak of the COVID-19 pandemic, there was mistrust and discontent in Thailand toward the junta government led by the then Prime Minister Prayut. The disbandment of a pro-democracy opposition party by the Prayut administration and its problematic vaccine policy, which resulted in the most severe wave of the outbreak since 2020, further inflamed public resentment. As the Prayut government failed to justify its heavy reliance on China's vaccines, together with the lack of transparency of the vaccine procurement and the associated allegations of corruption and nepotism, China's vaccines were scapegoated for the Prayut administration’ inept management of the COVID-19 outbreak. The Thai people were hesitant to be immunized with Chinese-made vaccines because the vaccines were acquired by the untrustworthy Prayut government. Pro-democracy protesters put the replacement of both Prayut and Chinese-made vaccines on their agenda. By criticizing Chinese-manufactured vaccines, the opposition parties also took advantage of opportunities to win more support from the public while discrediting the Prayut administration in Thai society. The fact that Prayut and his administration defended Chinese vaccines due to China's pressure further implies that they were incapable of protecting the Thai people and their own national interests. Increasing domestic pressure hindered China's health diplomacy and eventually forced the Prayut government to stop using China-made Sinovac, despite the junta government's efforts to maintain good relations with China.

The Duterte administration's lack of both transparency and convincing justifications for the purchase of China's less effective and more expensive vaccines only exacerbated the public's existing doubts about all vaccines. Moreover, the inoculation of China-made vaccines by Duterte and other government officials before the vaccines received regulatory approval in the Philippines not only suggested the irresponsibility of the Duterte administration but also increased Filipino society's doubts as to whether China was a responsible provider of global public goods. In the meantime, political opponents hoped to use Duterte's support for Chinese vaccines and his simultaneous reluctance to confront China over maritime disputes to accuse him of compromising national interests and sovereignty in exchange for vaccines. Due to these massive domestic backlashes, Duterte gradually modified his appeasement approach to China. Along with the United States' donations of vaccines, Duterte was compelled to downgrade his relationship with China while reinstating security ties and rebuilding trust with Washington. For example, he reinstated the US–Philippines Visiting Forces Agreement, which he terminated in early 2020 (Grossman 2021).

There are both theoretical and practical implications of the findings. First, the boundary between domestic politics and international relations is blurred. Domestic and international politics are mutually constitutive (Gourevitch 1978, 1996), but scholars mostly study how a country's international relations is associated with its domestic politics. This article suggests another linkage between the domestic politics and international relations: the performance of a country's public diplomatic efforts can be influenced or even determined by the domestic political contestations of the host country. In addition, unlike some research showing that the popularity of host leaders does not affect other countries' diplomatic efforts to shape public opinions within host countries (Goldsmith, Horiuchi, and Matush 2021), our research suggests a counterargument and real-world examples. Future research can delve deeper and explore more in this regard. One of the potential research topics is whether domestic political contestation in different types of democracies affect foreign countries' efforts to shape their positive images among the local society in the same way; if yes, then how.

Second, the findings may also shed light on countries' diplomatic practices. Countries that hope to win foreign public's hearts and minds need to work with both the incumbents and oppositions of host countries simultaneously. Otherwise, the oppositions' political maneuver and stir-up in public's resentment toward the incumbents may spill over to public's opinions on the foreign countries. As shown by the current research, this spill-over effect can result in the failure of diplomatic efforts or even a setback in state-to-state relations. However, given the so-called “Chinese exceptionalism” (Ho 2014; Zhang 2011), more research needs to be conducted to see to what extent that the findings of this article can be applied to other countries.