After waging its own withering battle with the coronavirus, the United States appears to be coming to grips with the pandemic and its economy is recovering. Now could be the time for America to play a greater role in global coronavirus vaccination, both out of generosity and self-interest.
As more coronavirus vaccine shots are being given here and around the world, two trends are becoming apparent. While there are disparities in the United States in vaccination rates, such as an emerging rural-urban divide, they are dwarfed by the uneven availability of vaccines globally. Over forty countries have not administered a single shot. Second, and related, the pandemic is not abating uniformly. There are surges within the United States such as in Michigan, but the deadly virus’s spread in countries such as India and Brazil is downright catastrophic.
The United States has finally joined the efforts to enable global vaccine access by pledging $4 billion to the COVAX initiative led by a few multilateral organizations working for global equitable access to vaccines. It has also loaned four million doses of AstraZeneca vaccines it is not using to Mexico and Canada. Its decision to rejoin the World Health Organization—a source of public health information and support for many poor countries—may restore much-needed funding to the organization during the pandemic. But America could play a bigger role in ensuring that most of the world gets vaccinated.
The humanitarian reasons for doing so are readily apparent. Medical supplies rather than vaccines are more urgently required to contain the disaster unfolding in India. But India is a cautionary tale for countries that ease health restrictions without vaccinating their populations fast enough. Less than 10 percent of the Indian population has got even one dose of the vaccine. And India is running out of doses, a tragic irony for the world’s largest vaccine-producing nation, which houses the Serum Institute of India (SII), the world’s largest vaccine-producing company.
But there are also self-interest reasons that should compel the United States to become more actively involved. A recent RAND report estimates that “vaccine nationalism”—a situation where countries push to get first access to a supply of vaccines and potentially hoard key components for vaccine production to the disadvantage of other, often less developed, nations—could cost the world up to $1.2 trillion a year in GDP terms. The benefits of ensuring that lower-income countries can access vaccines is estimated to far exceed the cost that rich nations would incur by doing so. It is unsurprising that in a globalized world linked by trade and travel, the U.S. economic recovery is likely to be hindered by health and economic troubles elsewhere. The State Department has a whopping 150 countries on its “do not travel” list due to very high levels of coronavirus cases. This is likely to wreak havoc on the travel and tourism industry, not to mention businesses that have put international travel on hold for more than a year.
As the pandemic rages in the unvaccinated world, mutant variants are emerging and finding their way to spread among various countries. For instance, the variant dubbed “double mutant” (because it has elements of the Californian and South African/Brazilian variants, among others) is ravaging India has already been detected in the United States. Vaccinating a large segment of the global population could be a way to win the race against the variants. Achieving herd immunity globally is the most durable way of achieving it locally.
The United States also risks losing the soft-power race during the pandemic to China and Russia, which have shipped home-produced vaccines to other countries. For instance, the Chinese Sinovac vaccine has been shipped to over fifty countries, including most of Latin America. And about as many countries have turned to the Russian Sputnik V vaccine.
Given these developments, what could the United States do? U.S. export restrictions on critical components used to make vaccines have been hindering the production of them. SII has been appealing for a relaxation of those restrictions. The United States has decided to send critical vaccine raw materials to India and might want to consider a more strategic long-term lifting of restrictions rather than a tactical concession to handle the current crisis. While satisfying the local need for such components is important, the current capacity to produce vaccines for much of the world lies elsewhere.
At the same time, it does not seem a prudent strategy to let a developing country like India shoulder the bulk of the burden for global vaccine production during a pandemic. SII had promised to supply 1.1 billion does to COVAX, including 100 million by May, but has been able to export only 20 million. In the face of its ongoing crisis and need for vaccinating its billion-plus population, India has suspended exports, having a chain effect on countries, especially in Africa, that are awaiting vaccines through COVAX. The current ramping up of vaccine production in the United States could take into consideration global needs by producing vaccines more suited to lower-income countries. This increased capacity could also help build local resilience for future health emergencies.
Finally, developed countries have ordered multiple doses of vaccines for each citizen, affecting availability elsewhere. The United States is soon likely to reach the tipping point where vaccine supply outpaces demand. As it continues to address its own challenges on vaccine hesitancy, the United States could nimbly and optimally allocate surplus vaccines to the COVAX initiative without shortchanging its own citizens. While the announcement to share more AstraZeneca vaccines is welcome, U.S.-developed vaccines could also be considered. The Johnson & Johnson vaccine, through its advantage of needing only a single dose, has proved helpful in vaccinating vulnerable communities in the United States. The resumption of this vaccine might be an opportunity to also prioritize it for vulnerable populations worldwide.
The payoffs in terms of saved lives, global economic revival, and vaccine diplomacy could be huge.
Krishna B. Kumar directs international research for the nonprofit, non-partisan RAND Corporation, and the Pardee Initiative for Global Human progress at the Pardee RAND Graduate School.