COVID-19 anywhere is COVID-19 everywhere.” That’s Melinda Gates’s sound bite-sized summation of the case for robust global cooperation in the search for, and production of, an effective coronavirus vaccine. She’s not wrong of course, but her formulation—and the early signals coming from the emerging international consortium of which her foundation is a part—might leave insufficient room for the exigencies of domestic politics. A clearer description of what exactly such cooperation will entail, most especially regarding control over distribution, would improve the chances of U.S. participation.
Gates’s comments were made in the context of the announcement of a new international effort to produce and deploy a vaccine to stop the pandemic. Her foundation, together with the European Union, the World Health Organization, prominent nonprofits promoting global vaccination campaigns, and a large roster of world leaders—including Boris Johnson, Angela Merkel, Shinzo Abe, and Emmanuel Macron—committed themselves to supporting a coordinated international response to completing this immense and complicated endeavor. Their goal is to ensure “equitable access” across the globe, by which they mean that availability in lower-income countries should be not be constrained because rich nations have cornered the world’s production capacity. Notable absentees were the United States, Russia, and India. China’s ambassador to the EU participated in an online pledging campaign but committed no financial support.
It is undeniable that the pandemic demands an international perspective. No country can fully protect itself from harm—physical or economic—by securing vaccinations for just its own population. Until vaccination is widespread globally, the virus will continue to spread across national boundaries and precipitate costly lockdowns that slow the world economy. Further, because vaccination rates may not reach 100 percent in many countries (for various reasons), and the virus might mutate, partially vaccinated populations may not be invulnerable to new infections and outbreaks seeded by travel from unvaccinated areas.
The world’s high-income countries, including the United States, also have much to gain from a cooperative effort. Working together will allow them to share the logistical and financial burdens of executing the many complex steps that are necessary for successful discovery and deployment of a vaccine. Settling on the most promising candidates, running the necessary clinical trials, scaling up manufacturing capacity in dispersed locations (even before it is known which vaccines will work), ensuring supply chains are sufficient for mass deployment, setting aside the funding required to purchase doses for the world’s entire population—all of this and more will be hastened and strengthened when conducted within a coordinated international plan of action.
Further, a go-it-alone strategy would be risky, even for the United States. Vaccine research is a highly unpredictable business. As many vaccine experts have said, the best approach is to support multiple early candidates because it is not possible to know in advance which ones will fail and which will succeed. While the United States is the global leader on vaccine research and can access substantial production capacity, that is no guarantee of getting to a successful candidate first, or of having the wherewithal to produce a sufficient domestic supply without the need for cross-national cooperation. The worldwide scramble to line up vaccine candidates with scaled production is already underway, and is messy. It is possible that other countries will find the right formula before the U.S. government does.
It is because of concerns about controlling available supply that the United States might balk at joining a coordinated international effort. This is not to suggest that there are not legitimate questions of prioritization, especially in the early stages of a vaccination campaign. For instance, it might makes sense, and save more lives, if all of the world’s front-line medical personnel and high-risk populations were vaccinated first before supply is diverted to lower-risk groups, such as healthy individuals in high-income countries.
Still, as reasonable as such a plan might be, it may not be realistic to expect the United States—or the U.K., Japan, or Germany for that matter—to finance the research and production of a vaccine only to have some of the supply it made possible shipped to other countries at the expense of the health of its own population. In the thick of a pandemic, such a move could stir popular resentment that might compound the world’s already substantial list of problems.
At this stage, it is not necessary to decide such questions. There are many steps that must be completed first before deciding how to prioritize cross-national distribution of available supply.
If that controversial issue can be set aside for later discussion, it should be possible for the United States to not only participate in but to lead a global vaccination campaign, which would benefit citizens the world over and would of course also be in our own interest. No other country can match the United States’s financial resources, scientific expertise, and private-sector engagement and scaling capacity. And even the Trump administration should be able to grasp the importance and historic value of our country leading a successful campaign to end a pandemic that is causing so much harm to health and economic well-being all over the world.