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Without a vaccine, the US must rewrite its foreign policy ‘prescription’

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The World Health Organization’s director-general, Tedros Adhanom Ghebreyesus, recently warned “the worst is yet ahead” for the coronavirus pandemic. Considering that much of the Northern Hemisphere, especially the developed world, is at or past its peak because of shelter-in-place mitigations, perhaps he was speaking with an abundance of caution to avoid a premature end to stay-at-home and business closure orders. Or, possibly, he was referring to what may happen in the Southern Hemisphere this fall, or in Third World countries that have not yet experienced high levels of infection.

If COVID-19 does begin to spread in developing countries with fourth-rate medical systems, a dramatic increase in infection rates will devastate the feeble economies and governments of these countries. Some, such as Syria, are particularly vulnerable because of millions of refugees and homeless citizens. 

In the United States, we sometimes make assumptions that may not hold true. The idea that the virus will die out after a significant period of extensive mitigation, or that if we have a little patience, a medical treatment will emerge to bridge the gap until we have a vaccine, may be overly optimistic. That does not mean we must stay at home forever, but does mean thinking through all the contingencies. Avik Roy, writing in the Wall Street Journal, says: “We’re told that life will go back to normal just as soon as we’ve reached a series of public health milestones: near-universal testing, the development of effective treatments, the emergence of herd immunity and ultimately approval of a vaccine.”  

But what if we don’t develop a vaccine for years? What if treatment trials fail to suppress the virus, or ultimately are too expensive? Then we must not only plan for that reality at home, but also look beyond our borders and see how continuing contagion could affect our foreign policy interests. It’s likely we’ll need to recalibrate U.S. foreign policy to make mitigating and containing the virus a priority — all the while keeping our own economy open and our citizens at least risk. 

In developed countries, this can be managed through educating the population, tracing contacts to contain breakouts, and keeping shelter-in-place restrictions in hotspots. It goes without saying that continued measures to protect the elderly and immunosuppressed can help avoid overwhelming our health care system, and social distancing will become the norm for at least a while.

But in poor nations — for example, in the Middle East — viral spread could run rampant for years until there is community immunity with over 60 percent of the populace exposed to the virus to develop antibodies that might give immunity to even its mutations. 

The price to be paid to achieve this level of immunity without a vaccine or inexpensive medicines is likely to overwhelm health systems with second and third waves of infection in unstable countries. That could disrupt their security structure, making the entire world more dangerous from both a conventional security perspective and as an ever-present incubator for the coronavirus. Iran is a good example: It is experiencing the worst effects of the pandemic among Middle Eastern countries because of government malfeasance.

While it’s understandable that America (and other Western democracies) may prefer to worry about immediate domestic interests, Congress should be motivated to act on the world stage because not helping to alleviate the pandemic in developing nations will endanger America, again and again, if they remain a source of infection. Without humanitarian aid, medical supplies and public health assistance to these countries, the virus will continue to fester and spread.

If there is only partial immunity as the virus mutates, we can expect new waves to infect our population. Even with compelling evidence, Americans will be hard-pressed to return to large-scale restrictions when public policy experts recommend it. So, controlling areas of incubation in Third World countries is an important American public health goal — especially if we don’t develop a vaccine or medical treatment this year or next. Remember, we still don’t have a vaccine for the AIDS virus, despite researchers’ attempts. 

The U.S. must prioritize medical treatments and public health policy as integral parts of foreign policy going forward. U.S. financial aid to foreign nations, especially in the Middle East and Africa, already was on the chopping block with little public support or belief that this makes Americans safer. This should change, however, given that the world may not have a reliable vaccine or medical treatment for years and needs functioning economies. 

Our foreign policy “prescription” must be written now in foreign aid. We cannot assume that medical advancements will effectively mitigate the virus’s spread. And, given the history of American foreign aid, we cannot forget that it will require considerable oversight to ensure that any monetary aid to countries in need doesn’t end up funding weaponry or dictators’ personal bank accounts.

Dr. Eric R. Mandel is the director of MEPIN, the Middle East Political Information Network. He briefs members of Congress and their foreign policy aides on the geo-politics of the Middle East. Follow him on Twitter @MepinOrg.

Tags coronavirus vaccine COVID-19 pandemic Middle East US foreign policy

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