The day before President Joe Biden’s inauguration, the United States crossed a tragic milestone, marking 400,000 deaths from COVID-19. Biden has since cautioned that half a million American lives could be lost by February. It did not have to be this bad. The inconsistency and incompetence of President Donald Trump’s administration compounded the toll of the pandemic, but so did larger forces partly beyond any one government’s control, from politics to protectionism to paranoia.
In the early days of the epidemic, as the novel coronavirus began jumping borders, countries rushed to institute travel barriers and install protectionist measures, against the advice of the World Health Organization (WHO). Instead of working together to contain the outbreak, major powers quarreled over who should be deemed responsible. Scientific research became subsumed by national interests, and the development and distribution of vaccines—a process experts once hoped would offer a global solution to a global crisis—expanded health disparities. The results of this vaccine apartheid are now apparent: as of January 25, none of the 68.1 million vaccine doses administered globally had been provided in low- or low- to middle-income countries. “The world is on the brink of a catastrophic moral failure,” the WHO director-general, Tedros Adhanom Ghebreyesus, said last week, referring to the vaccine access gap.
The uncoordinated, chaotic, and state-centric international response to COVID-19 sharply contrasts with the international response to the 2009 H1N1 pandemic and to the 2014 Ebola outbreak. In 2009, health authorities from major powers, including China and the United States, exchanged technology and information about the spread of the swine flu virus and accelerated the development of a vaccine—a collaboration that helped combat that virus and a later one, the H7N9 avian influenza, which easily could have become a pandemic in 2013 but did not. Then in 2014, major powers responded to calls from the United Nations and the WHO to send health aid to West Africa to help fight the Ebola virus. China and the United States in particular forged a close partnership—working together to construct treatment centers and direct medical supplies—that played an important role in turning the tide against Ebola.
Some analysts blame the WHO for the breakdown of international health cooperation during the COVID-19 pandemic. And to be fair, the world health body did make a series of missteps. It delayed declaring the outbreak a public health emergency of international concern (PHEIC), demonstrated an inability to enforce international health regulations in a coherent and effective manner, and deferred too much to China in an effort to seek its cooperation in disease surveillance and response. But these problems are not new. During the 2009 H1N1 pandemic, the WHO recommended one set of mild mitigation guidelines for countries around the world but supported China’s decision to pursue a stringent containment strategy, sending mixed signals in what appeared to be an attempt to placate Beijing. And during the 2014 Ebola outbreak, the WHO was similarly tardy in declaring the epidemic a PHEIC. But in both cases, countries still found ways to work together to stop public health emergencies from becoming cataclysmic events.
What makes this time different? A closer look at the international response to COVID-19 reveals two new developments that have exacerbated the impact of and response to the pandemic: politicization and securitization.
During previous epidemics and outbreaks, the origin of the disease had been viewed as a scientific rather than a political issue. For example, China did not challenge the thesis that the 2002 to 2003 SARS epidemic began in Foshan, in its Guangdong Province, and no other countries talked publicly about the need to hold China accountable for causing the outbreak. But within months of COVID-19’s initial discovery in Wuhan, China, in December 2019, the question of where it came from became politically charged.
Trump, who took to calling COVID-19 the “China virus,” blamed Beijing for having “instigated a global pandemic.” Chinese state media fired back, insisting that “though COVID-19 was first discovered in China, it does not mean that it originated from China.” Other countries, Beijing declared, may have been responsible for unleashing the virus. “More and more research suggests that the pandemic was likely to have been caused by separate outbreaks in multiple places in the world,” Wang Yi, China’s minister of foreign affairs, said earlier this month.
It wasn’t just the origin of the virus that was politicized. The WHO’s response was, too. Prior to the COVID-19 pandemic, the United States had rarely questioned China’s growing leverage over the WHO. Washington even joined Beijing in supporting the election of Dr. Margaret Chan, a Hong Kong Chinese, as the WHO’s director-general in 2006. (The United States also supported her reelection in 2012, when she was the only candidate.) But as the international response to COVID-19 became intertwined with domestic politics, Trump—eager to find a scapegoat for his own mishandling of the pandemic—accused the WHO of being manipulated by China, despite lacking strong evidence. In response, the Chinese government accused the United States of “seeking to discredit China in shirking its own responsibilities.”
Tensions between China and the United States not only undermined the WHO’s ability to conduct an independent, transparent, and thorough investigation of how the pandemic started—the organization still has not mounted an adequate inquiry—but impeded its ability to get countries to act quickly and in unison to halt the spread of the virus. U.S.-Chinese tensions also paralyzed the UN Security Council, which failed to issue a powerful resolution mobilizing UN agencies to combat COVID-19 or to create a subsidiary body to coordinate international efforts to contain the pandemic.
As the war of words between Beijing and Washington intensified, nationalism took root. Public sentiment hardened against China in the United States, and anti-Americanism spread in China. Both countries framed the response to the pandemic as a battle between competing political models. For Beijing, China’s ability to quickly contain the disease while it raged out of control in the United States showed the failure of liberal democracy and the superiority of an authoritarian system in which the Chinese Communist Party (CCP) has a monopoly on political power. For Washington, the very fact of the pandemic testified to the CCP’s failure to deliver good governance to its people and to the world. Biden’s pledge to hold a summit of democracies to tackle COVID-19 risks reinforcing this divisive narrative, carving the globe into two political camps in the face of a common global challenge.
Just as detrimental as politicization of the pandemic has been the tendency of nations around the world to frame the crisis as one of national security. Unlike most previous epidemics, COVID-19 has been deemed an existential threat by almost every country—which in turn has justified responses not bound by normal political procedures. Governments worldwide have rolled out drastic measures, including sealing off entire cities and neighborhoods, imposing curfews and travel bans, declaring states of emergency, and deploying military forces. In the United States, Trump invoked the Defense Production Act to support his COVID-19 response and appointed a four-star general as the chief operating officer of Operation Warp Speed, the United States’ vaccine effort. Not only has this war footing relieved countries of the moral obligation to help others; it has rendered critical medical supplies—including personal protective equipment (PPE) and active pharmaceutical ingredients—much more valuable and difficult to procure than before.
Driven by the principle of self-help, countries rushed to institute travel restrictions and protectionist measures while bidding against each other for ventilators and surgical masks. International health cooperation, to the extent that it still existed, became a matter of narrow national interest. China refused the U.S. Centers for Disease Control’s offer to send epidemiologists to the country early in the outbreak, and Washington later significantly curtailed public health cooperation with Beijing on the grounds that China was abusing international health agreements in order to bolster its influence abroad. These same dynamics soon gave rise to vaccine nationalism, which encouraged wealthy nations to cut separate deals with major vaccine makers to secure priority access. Some ordered many more vaccine doses than they needed. Canada, for example, reportedly reserved between five and ten doses per citizen.
A pandemic-driven shift in the balance of power between China and the United States has reinforced nationalist sentiments. As the first to suffer an outbreak, China is also the first to largely recover. Its economy registered 2.3 percent growth for 2020, compared with negative 3.5 percent growth in the United States. The GDP gap between the two countries will continue to shrink, likely intensifying Washington’s fear that China could displace it as the world’s top power. And as long as both countries view pandemic response through the lens of security and competition, they will prioritize relative power gains over absolute ones from public health cooperation.
All is not lost, however. Despite a raging pandemic in the United States and pesky outbreaks in China, the world is moving toward mass vaccinations and herd immunity. But the two superpowers must work together to ensure that politicization and national security concerns do not impede international cooperation in the next pandemic.
To that end, China and the United States must take steps to defuse political and military tensions. The two countries should reopen avenues for greater communication, such as the United States-China Comprehensive Dialogue, which broke down during the Trump administration. Such communications are often derided as cheap talk, but they may reduce the chances of miscalculation and mitigate security risks. The United States could also use them to share its expertise in improving laboratory biosafety and building institutions to facilitate drug development. Military-to-military exchanges could likewise be expanded to allow representatives of both countries to visit each other’s government-sponsored biodefense sites.
China and the United States should also push to reform and strengthen the WHO so that it can play a more authoritative and politically independent role in coordinating international responses to future global health emergencies. The organization should be given more autonomy and a larger role in sharing disease-related information, dispelling misperceptions and rumors, and investigating outbreaks. Such reforms will entail revising international health regulations to improve member states’ compliance and allowing the WHO to gather its own intelligence so that it can make faster and better decisions. At a minimum, the organization needs unimpeded access to outbreak epicenters.
Pandemic control must be framed as a global public good, requiring contributions from every nation. No country can be safe from COVID-19 before the global chain of transmission is completely broken. China and the United States, as well as other major economic powers, should therefore increase their support for COVAX, a global procurement mechanism for COVID-19 vaccines, so that it can ensure fair and equitable access to vaccines around the world.
This is a lot to ask in such a fraught moment, but the exigencies demand it. Millions of lives are at stake. There is much to be gained from cooperation and much to be lost from conflict in containing a virus that knows neither political divides nor territorial borders.