An America First vaccine policy is wrong
The Biden administration has announced that it will not begin donating coronavirus vaccine doses to poorer countries until all Americans are supplied with vaccines. If one of President Joe Biden’s goals is to put the worst instincts of the Trump era behind us, why is he pursuing an America First vaccine policy?
From a political perspective, the question answers itself. Any president would want to be seen as prioritizing the welfare of American citizens. And the Biden administration would correctly respond that its global pandemic response is superior to its predecessor’s in other ways.
It has joined the COVAX initiative, which is designed to help low- and middle-income countries buy vaccine doses on the global market. And it has dedicated $11 billion to the global response in its $1.9 trillion pandemic relief bill.
Yet the United States’ refusal to donate vaccine doses to poorer countries until Americans are fully supplied will materially undermine global progress against the pandemic. COVAX is not just suffering from insufficient funding; it is having a tough time purchasing affordable doses of the hottest commodity on Earth. Increasing the speed and scale of the global response will require donating doses to poorer nations. Hoarding doses will, in fact, backfire on the hoarders.
Understanding why the Biden administration’s policy is both wrong and counterproductive requires a bit of context. Earlier in the pandemic, wealthy countries such as the United States understandably hedged their bets by buying up future doses of many prospective vaccines. Several of those bets paid off, leaving wealthy nations in control of doses that will be far beyond their need.
This does not mean they have current stockpiles. It does mean that the United States has secured almost 500 million more vaccine doses than it will eventually require to vaccinate every single qualifying American. At some point, hedging becomes hoarding.
So the real question is: Should the United States begin sharing some of the excess doses it will eventually have, or wait until all Americans are supplied with one of the vaccines? In this case, what looks like self-interest does not serve our values or interests.
The moral case, while hard for a politician to make, is clear enough. Does a healthy 25-year-old American really deserve a place in the global vaccination line before a front-line health care worker in Liberia? This is vaccine nationalism at its worst. Wouldn’t it be a more defensible principle to prioritize the most vulnerable people of every origin? This does not require the United States to take care of all the world’s needs. But it should lead the Biden administration — once the United States covers its most at-risk population, which is about 20 percent of the total — to share a small fraction of its doses to help other countries cover their own 20 percent at greatest risk. Need should count for more than nationality.
Even if you reject this moral claim, the United States has a strong national interest in shortening the global pandemic. Letting COVID-19 grow relatively uncontested in the developing world would impose a major economic price. By one estimate, a longer pandemic could result in $9 trillion in additional economic costs, half of which would be absorbed by wealthier nations.
But the main risk of a slower global response to COVID-19 does not concern economics but evolution. Every additional infection is an opportunity for COVID-19 to develop variants that evade our current tools to fight the disease. The variant first identified in South Africa seems to be more transmissible. The variant first seen in Brazil may be more lethal. The next variant could be worse. A slow global reaction to COVID-19 has the potential to complicate the response within every nation.
And there is an additional American interest at stake. Much of our aid activity in other countries, particularly in Africa, concerns global health. Through the President’s Emergency Plan for AIDS Relief (PEPFAR), the United States has confronted a cruel and aggressive pandemic, helped save millions of lives and gained considerable reputational benefit. People in other countries tend to like you when your save their lives and the lives of their children.
What message will it send if the United States doesn’t show up in the early response to another cruel and aggressive pandemic? The nation has the potential to squander a great deal of accumulated goodwill. And this strategic risk is highlighted by the dose donations being made by China, Russia and India around the world.
The political appeal of an America First vaccine policy is obvious. But there has never been a time when the connection between global health and American health has been more evident. The arguments for early, aggressive U.S. action against the global spread of COVID-19 — including the sharing of vaccine doses — are compelling. The administration’s refusal to make them is an unexpected failure of vision and will.