COVID-19 vaccination line in Nagpur, India, May 2021. CREDIT: <a href="">Ganesh Dhamodkar/Wikimedia</a> <a href="">(CC)</a>
COVID-19 vaccination line in Nagpur, India, May 2021. CREDIT: Ganesh Dhamodkar/Wikimedia (CC)

Vaccine Diplomacy versus Vaccine Nationalism: Synthesis or Dissonance?

May 20, 2021

This article is in response to Carnegie Council Senior Fellow Nikolas Gvosdev's recent article, "Vaccine Nationalism versus Vaccine Diplomacy."

Vaccine diplomacy and vaccine nationalism continue to structure the context of the COVID-19 pandemic response. Commentators, academics, and non-governmental organizations (NGOs) are grappling with the idea of, as Nikolas Gvosdev put it, "secure your masks first." As we reflect on how to stymie the pandemic, should governments frame vaccine access as a responsibility to protect (RtoP) our collective health within or/and without their borders? Is vaccine nationalism-vaccine diplomacy synthesis plausible to promote the "greatest good"?

A defining feature of the vaccine narrative thus far is that "worthy states"—meaning states that have the capability to purchase and produce vaccine doses that exponentially outnumber their populations—have prioritized the needs of their populations, a classic case of "secure your masks first." It is, however, not definitive that "secure your masks first" provides a bulwark against future infections. This strategy tacitly endorses vaccine commandeering and hoarding to "take care of one's own"—a situation that, if driven by relative gains, could permanently shut the door at collective efforts to help vulnerable populations. Nonetheless, "secure your masks first" should summon the possibility to not construe vaccine nationalism pejoratively nor vaccine nationalism and vaccine diplomacy as mutually exclusive. The challenge, in my view, is to explore the possibility of vaccine nationalism-vaccine diplomacy synthesis to yield a response that circumscribes "situational ethics" and relative gains.

In response to the aforementioned challenge, it is essential to conceive a vaccine continuum marked by three reinforcing but distinct phases: First, "predatory vaccine nationalism," commandeering and hoarding of vaccine inputs and doses exclusively for populations within nations. Other courses of action may include disruption of global supply chains and aversion to patent protection waivers. An auspicious dimension of "predatory vaccine nationalism," however, is that it allows worthy nations to stockpile vaccine doses in anticipation of, the second phase of the continuum, "benign vaccine nationalism." This phase permits policymakers/governments to continue the prioritization of their populations in regard to vaccine access, but to adopt a restrained approach to providing vaccine doses to populations beyond their borders—for example, the U.S. donating vaccine doses to neighbors Canada and Mexico. The third phase synthesizes the positive features of the first and second phases to yield "ultra-vaccine diplomacy," centering the vaccine needs of populations beyond borders, waiving intellectual property to diversify vaccine production sources, and supporting poorer nations to build capacity to produce their own vaccines for the foreseeable future.

The ethical dilemma here is how do policymakers/governments determine policy change in a world structured by supply chain bottlenecks, bounded rationality, and transactional foreign policy goals? For example, with the benefit of hindsight, was the decision by the Indian government to embark on vaccine diplomacy prudent in light of current surge in COVID-19 cases? Should India's policymakers have hewed to vaccine nationalism instead? Alternatively, would the process of tracing the COVID-19 surge in India yield causal mechanisms to show that vaccine diplomacy interacted with other variables to undermine India's efforts to vaccinate its populations? This circumscribes a perspective that hinges India's predicament exclusively on the country's decision to satisfy external constituents through vaccine diplomacy.

U.S. Treasury Secretary Elizabeth Yellen has warned of the economic risk factors of not prioritizing vaccine access and equity beyond the borders of worthy states. The World Health Organization (WHO) has cautioned that mutations pose an existential threat to previously acquired immunity—the Indian variant is a cause for concern in the United Kingdom. As noted by the U.S. Centers for Disease Control and Infections (CDC), people who are fully vaccinated do not have 100 percent COVID-19 immunity. "Variants of concern," could render previously acquired immunity ineffectual. And worthy states and for that matter, the U.S. are on the cusp of pyrrhic victory if the "Bottom Billion" nations struggle to mitigate the threat posed by new variants. This could be likened to improperly buckling up your seatbelt—it is loose and risky.

In that regard, policymakers should look at vaccine access and equity through a cosmopolitan lens. For example, the United States has vaccinated a significant number of its population and has stockpiles of vaccine doses. Mindful of the aforementioned milestone, is the United States at a point where it possesses the wherewithal to transit to what I call "ultra-vaccine diplomacy"? The answer is affirmative!

The decision by the Biden administration to donate 60 million AstraZeneca doses is a drop in the ocean, and U.S backing for the vaccine intellectual property waiver does not necessarily boost global vaccine production. These significant but minimal steps are not far-reaching enough—we may call these "mild vaccine diplomacy"—to upend global vaccine access and equity dynamic. At best, the U.S. is beginning to sow seeds of "ultra-vaccine nationalism" which may or may not germinate.

The Biden administration ought to rally pharmaceutical industry players behind the waiving of intellectual property to ramp up global production, though some experts and pharmaceutical giants argue the waiver is a disincentive to invention and innovation. And U.S. policymakers need to rethink the ethical implications of vaccinating children ages 12-15—after inoculating a critical mass of its adult population, along with the availability of buffer doses—while some poorer nations are yet to receive a single vaccine dose.

Centering vaccine access in U.S. global engagement is the single most important humanitarian intervention that ought to nudge the U.S. towards "ultra-vaccine diplomacy." And famed for its technological innovations, pharmaceutical inventions, and empathetic leadership, the U.S. ought to embrace cosmopolitan ethics as it possesses the how to enable vaccine access for vulnerable populations beyond its borders a reality. These courses of actions add a veritable layer to the U.S soft power brand to reinforce its status as a benevolent ally as opposed to the transactional leadership of China.

Samuel Owusu-Antwi is a graduate student (Ph.D. candidate) at the Legon Center for International Affairs and Diplomacy (LECIAD), University of Ghana. The opinions expressed do not necessarily reflect the views of Carnegie Council.

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