Forget the WHO — where is US leadership at the WTO?
The COVID-19 pandemic has eviscerated global cooperation. Countries are turning its back to neighbors, closing borders and banning exports of critical goods to fight the virus. Ominously, these practices may foreshadow the emergence of a single COVID-19 vaccine autarky during a period when the global economy’s governing trade body, the World Trade Organization, has been tossed aside by the United States, China, and the European Union as a forum for managing world trade. Absent a renewed U.S. commitment to multilateral trade and leadership at the WTO, the orderly distribution of a COVID-19 vaccine may never happen, leaving millions without access to the vaccine. No country, including the United States, will be immune from the negative consequences of a single nation taking unilateral actions to limit the distribution of the vaccine.
A revitalized WTO can play a major role in the commercial distribution of the vaccine.
WTO rules are designed to protect both the exporter and importer of goods from arbitrary actions that interrupt the flow of trade. Established in 1994, the World Trade Organization organized around the principles of non-discrimination, reciprocity, binding and enforceable commitments, transparency, and safety values — all principles that must be present in any commercial distribution plan for the COVID-19 vaccine. Once already, the United States, working with the private sector and the WTO, crafted a compromise on trade-related intellectual property rights to address AIDs. The result was President George Bush’s President’s Emergency Plan for AIDS Relief (PEPFAR). The program is credited with saving millions of lives.
As of now, the prospects of an encore performance — an approach to COVID that benefits from what was learned through PEPFAR — appear to be grim. The WTO has been adrift for several years, its negotiating role moribund. In May, the WTO’s director-general, Roberto Azevedo, unexpectedly resigned, leaving the WTO leader-less and searching for a replacement. Self-inflicted wounds and unilateral actions by key members have marginalized the trade body, which today is a mere shell of its former self. The question of the WTO’s relevance, as opposed to its proven potential, has unfortunately come to dominate our conversations about trade.
Instead, with a diminished international trade system, the COVID crisis has ignited a “vaccine arms race”. There are 13 World Health Organization-recognized clinical evaluations underway for a COVID-19 vaccine. Over half of the trials are based outside of the United States. There is a good chance that the United States ends-up as an importer of the vaccine — instead of the world’s supplier. Under such circumstances, the specter of a dysfunctional WTO — and the lack of other international coordination mechanisms — should be of great concern to our national interest. What if another country decides to ban the export of its vaccine?
The United States has taken important steps to coordinate the development of a COVID-19 vaccine, and PEPFAR’s Supply Chain Management System (SCMS) may provide a roadmap for in-country vaccine deployment. The National Institutes of Health on April 7, 2020, announced the Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) partnership to coordinate and help fund the development of vaccines. The initiative includes 16 companies representing Europe, Asia, and North America. PEPFAR’s SCMS, an infrastructure delivery system, familiar to Dr. Anthony Fauci and Ambassador Deborah Birx, has for years supplied critical medicines and technical assistance to developing nations.
To ensure that these efforts are successful, the United States must also develop and coordinate a non-discriminatory global distribution plan that is WTO compliant and is supported by the private sector. Whether the next president is President Trump or former U.S. vice president and presumptive Democratic nominee Joe Biden, orderly vaccine distribution will be a high and early priority for his administration.
Global access and distribution of the COVID-19 vaccine may be our own lifetime’s greatest moral and ethical challenge. To avoid a Sophie’s Choice moment of who gets or doesn’t get the vaccine, the United States should immediately declare our intention to abide and enforce existing WTO rules and pledge to extinguish any form of vaccine nationalism. A strong WTO led by a committed United States is the answer to the distribution challenge.
Our recovery and the world’s economic recovery depends upon non-discriminatory access to a vaccine. U.S. leadership at the WTO has never been more important.
Nao Matsukata, Ph.D. was a senior USTR official in the George W. Bush Administration and was a senior executive for a global pharmaceutical manufacturer.