Vaccine Nationalism appears in multiple forms, it seems. And it is unlikely that popular support for a global perspective will ever expand to counter any of it. At least not for the current pandemic. Here is a personal story – but one that is accompanied by a note about the global context – and a lamentation. It’s all about a new bargain – a regional one, not necessarily a global one – for another 1 billion doses of vaccines (good news) – not for just anybody in need but for certain groups of people in need; not for now but for a year and a half or more from now; not for the sake of humanitarian concern but for the sake of shared national interests. Some might speculate that it’s all about US versus China, while others might insist that it isn’t. But it also has repercussions for global concerns spilling over into economic recovery from the pandemic, climate change, gender equality and even the future of global technology trends.
The Personal Story
The personal dimension starts with the latest in vaccine distribution. I have been one of the fortunate ones – just old enough to qualify for an early phase of Pfizer doses, thanks to the good fortune of an EU initiative that filtered down to the local vicinity in southern France where I live. By further happenstance, I had discovered an Internet site (www.doctolib.fr.covid) where at least one site nearby (not Grasse where I live but some 30 kilometers away in Vallauris) happened to have slots available for late January (first shot) and late February (second shot). Lucky me. It worked!
But then, the challenge was to find a similar booking for my spouse/partner Ralph, whose age had missed the threshold for the first round of eligibility. Each time we went to that same website, we found that the next round for his age range was delayed or blocked or only for the Astra Zeneca vaccine, not the Pfizer vaccine. We didn’t mind this alternative vaccine, even though it started receiving a raft of negative publicity, but even then, the website reported that all slots were fully booked.
It was then that there was a spate of critical media coverage of the way that the EU had negotiated its deals with the vaccine makers – aggravated by the vaccine makers themselves reneging on their commitments (unanticipated glitches in manufacturing, etc) by cutting back the quantity that they were able to deliver on the EU advance purchase contracts. The EU even suffered negative publicity for supposedly blocking exports of vaccines manufactured within the EU to other countries, while also criticizing the UK for not allowing AstraZeneca supplies to supplement the EU’s limited supply. And all the while criticized for being behind the eight ball as compared to the earlier deals made with Israel or Canada or the US (as well as the UK).
We did read that this AstraZeneca vaccine, though, was to be distributed through local physicians, and not through vaccination centers – and then, because the physicians were reportedly balking, through pharmacies (but with a prescription or at least appropriate documentation of eligibility). So off Ralph went to see his physician, get the prescription and go to his favorite pharmacy to book his turn(s). He confirmed that he was at least on a waiting list, not a certainty but hopefully in late March.
And then what do we read, but that this same AstraZeneca vaccine was experiencing yet another barrier to its distribution in Europe because of export barriers elsewhere! Not specifically mentioned in most reporting, but it would seem that the main export barrier this time around was an excess supply of their vaccines in US manufacturing facilities! That is to say, in a country that had not yet granted emergency use authorization to the AstraZeneca vaccine! One could argue, of course, about who was responsible for that, since one would think that AstraZeneca has to initiate the request. But we also understood from the media reports that this was because the formality of trials in the US itself had not yet been completed. So no authorization pending. And yet doses already manufactured in the US and not allowed to be shipped elsewhere, whether to the EU or, more appropriately, after all, to needier countries in Africa or Latin America or wherever! And the US government’s response? The US has its own advance purchase contract with AstraZeneca and has no intention of releasing any quantity of doses that are reserved, even without a date certain, for US consumption! First, said President Joe Biden, all Americans must be vaccinated. And only then will the US release any doses for anyone else!
From a personal point of view, I am dismayed by this variation of “America First” mentality, something that one might have thought was hibernating or more likely sunbathing off somewhere in Mar-a-Lago. But does this mean I am dismayed that Ralph has to wait for his shots? Of course, I would like him to be protected like I have been – making it all the easier for the two of us to venture out of isolation together. But the real dismay is broader than the personal concern. Why is it that the political scene is so parochial that the global nature of the pandemic is not appreciated as requiring a global strategy for bringing the virus under control? What is wrong with the idea that we should be prioritizing high-risk populations everywhere, no matter where they are, and steadily working from that premise to bring the pandemic under control across the globe? Why is the rationale for this as the only way to protect anyone of us when everyone is covered not working?
One could argue that it is the same as with climate change. We know what the catastrophe is forecast to be, but it is not obvious in the here and now. Yes, the variants are worrisome, aren’t they? They are spreading from unpredictable places, even with travel controls in place. And they are adding to the argument that global coverage is urgently needed before the variants become so potent that existing vaccines won’t protect you, even with upgraded versions of them. Yet another reason for global distribution. From my personal perspective, I can at least be comforted that I live in a country, France, where the leadership is voluntarily offering at least a portion of their stash to share with others in need, in this case targeting African countries, to be sure – but still extending the offer to be channeled through the globally structured COVAX Facility.
Looking beyond the personal, though, I want to comment here on two recent developments and tie them to a third. One development is the first ever heads-of-state meeting (albeit virtual) on 12 March 2021 of the so-called Quad (aka Quadrilateral Security Dialogue) – heads of state or government of India, Japan, Australia and the US. The other is the apparently unrelated but significantly related development of the announced selection of a new Secretary General for the Organization for Economic Cooperation and Development (OECD). And the third development to which these are also tied in my mind is a meeting of an important committee at the World Trade Organization (WTO).
The Quad Announcement on Vaccine Manufacturing in India
First, the Quad meeting (which was not widely publicized in advance) was clearly held after a flurry of bilateral and diplomatic negotiations among the four government’s leadership teams in February. One need not delve too deeply into the erratic history of this group to note that it has been around since 2008, mostly as an Indo-Pacific counter to the influence of China in the region but with varying degrees of interest in their various relationships with China. On this particular occasion, i.e. the virtual meeting of President Biden with Prime Ministers Yoshida Suga, Narendra Modi and Scott Morrison, the big news was an agreement to deliver one billion doses of COVID-19 vaccines to ASEAN and the Indo-Pacific region “and beyond” by the end of 2022! The deal is that the US and Japan will provide the financing, Australia will provide the logistics capacity and India’s manufacturing facilities (owned by Biological E. Ltd in Bangalore) will manufacture the vaccines. To implement the commitments, the Quad will launch a Quad Vaccine Experts Group. (P.S. They also established two other working groups, one on climate change and the other on emerging technology.)
A White House brief (available here) and an op ed published in the Washington Post (available here) described this commitment as a supplement to other US commitments to support the WHO and the COVAX Facility. That is, it is in addition to the $2 billion that the US announced for the COVAX Facility in February (and presumably the additional $2 billion that has been pledged). The reference in these sources is to the intent to channel the additional billion doses (at whatever cost) through the COVAX Facility, but a check of the website for the COVAX Facility still did not show any information about this. So one has to speculate that the publicity for this gesture is oriented to highlighting the Quad countries’ interests in working together, with or without any formal acknowledgement that it is a move to compete with the Chinese on the generosity of vaccine distribution, specifically targeted to the countries along China’s borders. That is to say, it is a collaborative effort (yes, a multilateral one) that serves to advance shared national interests among the four countries involved and that uses the global notion of the COVAX Facility as a conduit for that purpose.
Geopolitics in Selecting a New Head for the OECD
The second event of note here is the announcement at about the same time that the Selection Committee at the OECD had reached agreement to recommend the appointment of the Australian candidate Matthias Cormann as the next Secretary General to succeed the retiring Angel Gurria. Well, well, well! The Australian, is it? What a surprise! He was hardly the most likely of the ten candidates who had started in the competition for this position back in June 2020. The selection process had been a drawn-out culling of the candidates, almost two by two, from 10 to 8 to 6 to 4 down to 2. I was actually surprised that the candidate that I thought had the most gravitas, Philippe Hildebrand from Switzerland, did not make it to this final round – rather it was Mr. Cormann along with the other supposed “favorite”, Cecile Malmstrom from Sweden. I was personally but quietly cheering for her, and maybe I should have been more vocal, although I doubt that it would have made a difference. I do understand that the two were both well received and that the final decision was a very close one.
The key point that I have to infer from the choice of Mr. Cormann is that it was related to US strategic interest in reviving an Asia-Pacific orientation to its foreign policy – and that it was part of the Quad deliberations as well. Here is this fellow, a bit of an upstart in Australian politics, from a center-right party, with a very solid record of taking actions against climate change in Australia, and with a record against LGBT rights (and probably more but not well documented on basic gender issues) against a woman who has concentrated on strengthening EU relations with the US, who is a trade policy expert, with strong academic credentials, dedicated to climate change, to feminism, taking action on emerging technology. I have to conclude that it was the US who decided to go with the Australian – in spite of his bad record but maybe even because of it. That is to say, the OECD is a building block kind of organization, the developed and democratic world (without China or Russia), a think tank that plays an instrumental role in G20 deliberations and elsewhere to support things like climate change action or a global digital tax or …….! Oops! Too much, perhaps? To embrace someone like Ms. Malmstrom at the helm at this stage would have been too far out front, too pro-European, perhaps even too ready to accommodate China for the current state of US foreign policy. That is my opinion.
I am saddened by this development. It seems that it was only the climate change activists who actively lobbied against Mr. Cormann, and that seemingly was not enough. After all, he verbally did commit to the idea of helping countries reach zero greenhouse gas emissions by 2050 (wherever feasible). But it would have been nice to see another woman at the helm of an international organization – along with Ngozi Okonjo-Iweala at the WTO, Kristalina Georgieva at the IMF, Christine Lagarde at the European Central Bank, and Odile Renaud-Basso at the EBRD. And then, of course, there’s US Vice President Kamala Harris and US Secretary of the Treasury Janet Yellen. Maybe it was just one too many to include Ms. Malmstrom in the mix. I am sure Mr. Cormann will make everyone happy – a safe non-European with European roots (born in Belgium and originally a native German speaker) who migrated to Australia and did well – at a time when we are all wondering how successful the US will be in formulating and conducting a new kind of multilateralism.
As for the effect this has on globalism for pandemic action, it is a pity that the COVAX Facility got manipulated in this way. There is still no deal from the US for a global sharing of vaccines without waiting for full national coverage first. Instead, national interests are dictating foreign policy as opposed to embracing a global framework. Fair enough. Might there be enough understanding of the global scope of pandemics to work more effectively on laying the groundwork for a global framework on the next pandemic? The President of the European Council, Charles Michel, did suggest the idea of negotiating a global pandemic treaty for the future, and maybe the momentum will build for that – as long as it can be phrased as a self-interested kind of idea. Which it is. But it needs more fine-tuning for the future, it seems.
And Dr. Ngozi’s Third Way at the WTO
And for that WTO issue of acting on a possible waiver of intellectual property rules? Who knows how Dr. Ngozi is doing behind the scenes on this one? I only mention this here because the WTO group that has been managing this proposal from South Africa and India, the TRIPS Council, did meet last week to discuss the matter. Proponents renewed their support for it and referred to “underutilized manufacturing capacity” in developing countries, while critics renewed their interest in more “concrete examples” that intellectual property rights are operating as a barrier (directly, that is) to vaccine manufacturing and access that could not be addressed by existing TRIPS flexibilities.
The Quad deal seems to be taking advantage of that “underutilized manufacturing capacity” in India – given that the deal is with a different manufacturer, Biological E. Ltd, than the one we have heard so much about, the Serum Institute. Furthermore, it appears that this company, which had recently established a US presence, will be manufacturing mostly American vaccines (i.e. those made by Johnson & Johnson and by Novavax). And the TRIPS Council will supposedly have another special meeting in April, in addition to its regularly scheduled next meeting in June. If the US (and Japan) are succeeding in getting their pharmaceutical companies to contract and/or license their vaccine production through deals like this Quad deal, then we can probably thank Dr. Ngozi for helping to make this happen. April should be a lively month – what with the expectations for a pandemic accounting of sorts on World Health Day (7 April) and a major climate change summit on World Earth Day (23 April).