Producing a Vaccine Requires More Than a Patent
Intellectual Property Is Just One Piece of an Elaborate Process
In the early days of the coronavirus pandemic, much of the world looked anxiously to Washington to see if it would provide the kind of leadership that was once expected of the United States during major crises. But instead of marshaling a unified global response, the administration of U.S. President Donald Trump resisted international health cooperation and announced that the United States would withdraw from the World Health Organization (WHO). Domestically, it orchestrated an astonishing display of denial, distraction, and delay that allowed the virus to overwhelm the country.
The question then became: Would China fill the leadership void? Beijing initially sought to cover up the outbreak, but it moved aggressively to lock down entire cities and provinces once the crisis could no longer be denied. By early March, China had mostly halted the spread of the virus within its borders, allowing it to turn to helping other countries overcome shortages of protective gear. China’s “mask diplomacy” has been more effective than is generally acknowledged in the West. In Italy, for instance, opinion polls reveal that more people trust China to contain the virus than trust the United States to do so. And in parts of Southeast Asia, Chinese medical and financial assistance has been similarly well received. But China has not lived down its initial missteps, and its aggressive use of propaganda—including conspiracy theories intended to sow doubt about the virus’s origins—have undercut its claims to global health leadership. When Australia called for an independent investigation into the source of the outbreak and the early response to the pandemic at the World Health Assembly, more than 100 countries supported the motion. Not even Russia stood with China in opposing the investigation.
In the absence of credible great-power leadership from the United States or China, middle powers—including France, Germany, and the United Kingdom, among others—have led the way in coordinating health and economic responses. The concept of “middle powers” is imprecise and somewhat inchoate, but it generally refers to countries that are among the top 20 or so economies in the world, lack large-scale military power (or choose not to play a leading role in defense), and are energetic in diplomatic or multilateral affairs. These countries were seeking to fill part of the international leadership void even before the crisis, particularly when it came to buttressing the rickety multilateral system. But their influence on the world stage has increased markedly during the pandemic, which demands exactly the kind of multilateral coordination these powers have long championed. If they can translate their initial diplomatic efforts into sustained responses to the next phase of the pandemic, middle powers just might succeed in leading the world out of the crisis.
Many critical responsibilities have fallen, in whole or in part, to middle powers during the pandemic. Such countries have largely coordinated the international financial response, for example. France initiated the first Group of Seven meeting of the crisis in March, even though the United States is the group’s current chair. The Trump administration then insisted on referring to the coronavirus as the “Wuhan virus,” scuttling a planned joint statement from the G-7, at which point the other members of the body—middle powers all—did much of the quiet but vital work of coordinating fiscal and monetary policies in response to the economic shock. If the current recession doesn’t spiral into a global depression, middle powers will deserve much of the credit.
Middle powers have also stepped up to finance the public health response. On May 4, the European Union hosted what was surely the world’s first Zoom summit to support the WHO, raising $8 billion for the organization’s global response to the pandemic. The Netherlands, Sweden, and the United Kingdom likewise worked closely with the leadership of the World Bank to raise more than $14 billion in surge financing for hard-hit developing countries. The United Kingdom hosted a fundraising conference for Gavi, the Vaccine Alliance, a global health partnership dedicated to immunization (the UK is its largest donor), raising an additional $8.8 billion—including $3.6 billion to provide free vaccines to countries that can’t afford to immunize their populations. And crucially, Norway and Switzerland led efforts to coordinate advanced treatment and vaccine trials through a WHO program that pools scientific expertise and data with the aim of speeding the process of identifying a safe vaccine.
If the current recession doesn’t spiral into a global depression, middle powers will deserve much of the credit.
The outsize influence of middle powers in the current crisis is partly a function of their leading health institutions. The United Kingdom’s London School of Hygiene and Tropical Medicine is still perhaps the best epidemiology school in the world. The Wellcome Trust, also based in the United Kingdom, is the oldest and second-largest health philanthropy in the world, with a deep reservoir of partnerships and credibility. The United Kingdom’s Department for International Development is widely recognized as the most effective development agency in the world. And France, Germany, Japan, and Switzerland are each home to some of the world’s most innovative pharmaceutical companies. These institutions and companies have enabled middle powers to contribute to and even lead the hunt for treatments and vaccines; to eventually make these treatments and vaccines available to countries around the word; and to help developing countries bolster their own responses to the coronavirus—all of which will be necessary if the world is to avoid future waves of reinfection.
And then there is the power of example. Among the countries that have mounted the most effective domestic responses to the pandemic are a host of middle powers. South Korea’s swift and superbly organized testing and contact-tracing efforts have largely contained the virus with minimal loss of life. Japan’s response started out exceedingly well, too, and although the country reopened too early, it recovered quickly and still has among the lowest per capita death rates in the Organization for Economic Cooperation and Development (OECD). So does Germany. Chancellor Angela Merkel’s precise, scientifically informed message to the German public stood in sharp contrast to that of the White House, and the results are striking: Germany’s per capita death rate is less than a third of the U.S. rate. (New Zealand and Taiwan have arguably done the best of all, but small island states don’t provide much in the way of a model for larger, more populous countries with more accessible borders.)
Of course, not all middle powers have fared well against the disease. The United Kingdom has been hit hard by the virus, as have France, Italy, and Spain—all of which had early outbreaks. But even as they have struggled to halt the virus’s spread at home, their coordinated diplomatic and economic efforts have benefited the wider global response.
Middle powers have made an impressive showing in these early months of the pandemic, but they will soon encounter a limit to what they can do, even collectively, to combat the coronavirus and its economic aftershocks without the participation of the world’s two largest powers. If the United States and China don’t cooperate with global efforts to prevent a major worldwide depression, even a heroic attempt by middle powers will not be enough. But with Germany and the European Union innovating and leading the charge within the G-7 and the G-20, the odds are high that the United States and China will eventually support these efforts, if for no reason other than to protect their own economies.
The multilateral world is replete with examples of international efforts started by middle powers that either brought other middle and small powers together to partially solve a global problem or that the major powers eventually joined. Sometimes, the major powers have chosen to quietly align themselves with these international institutions and coalitions, even as they publicly shunned them. (Such has been the U.S. stance on many multilateral treaties, including the UN Convention of the Law of the Sea and the Comprehensive Nuclear Test Ban Treaty—both of which the United States finances, heavily staffs, and mostly abides by, despite refusing to ratify.)
Acting in concert, middle powers can do a great deal to strengthen the broader multilateral system. After all, Japan and Germany are the third- and fourth-largest economies in the world. India, whose largely effective response to the coronavirus has surprised many (at least so far), is the fifth-largest economy in the world and a major player in global trade, international security, and multilateral institutions. Norway and Sweden, among other middle powers, punch above their weight in international cooperation. (They are the fifth- and sixth-largest funders of the UN system, despite having economies that are roughly one-fortieth of the size of the U.S. economy.) In 2018, Japan crafted a major international trade deal even after the United States walked away, following in a long tradition of middle powers crafting important multilateral agreements over the objection of leading powers—as Australia did with the Chemical Weapons Convention, Sweden and the United Kingdom did in establishing the office of the Emergency Relief Coordinator at the UN, and Canada did in developing modern peacekeeping.
Acting in concert, middle powers can do a great deal to strengthen the broader multilateral system.
These countries are heavyweights when it comes to financing and operating multilateral institutions—critical pillars of the international response in any global crisis. Until it announced its withdrawal from the WHO, the United States was the largest single donor to the organization, contributing just over $400 million in 2017. But together, a handful of middle-power donors—Canada, Germany, Japan, the United Kingdom, and the EU—can match the U.S. contribution. Add in the Gates Foundation and one has nearly double the American expenditure. If these donors work together, they will have substantial leverage to shape the future of the WHO.
The United States, by contrast, will forfeit much of its influence by withdrawing from the WHO. It will not be able to help craft the next generation of regulations governing the global pandemic response, to participate in selecting the organization’s next leader, or to shape the inquiry into the origins of the coronavirus and the initial response to the outbreak. All of these responsibilities will now fall on middle powers—and in particular, on Canada, Germany, Japan, and the United Kingdom. The world’s ability to effectively navigate the second phase of this pandemic and to prepare for the next one will depend on these countries’ efforts.
Middle powers have stepped up during the current crisis, but there is still more they could be doing to shorten the duration of the pandemic and to soften its blow. In particular, they could be laying the groundwork to rapidly distribute a vaccine—once it is discovered—beyond the rich world. The odds are reasonably good that the vaccine will end up being found by an American or a European company (although Chinese institutions and firms are hard at work, as well). But getting from a successful vaccine to widespread production and distribution is a big leap.
The United States, with support from the United Kingdom, has resisted coordinating vaccine development efforts internationally. It has the pharmaceutical capacity to rapidly produce vaccines for its own population, but the rest of the world will be left scrambling. There is little reason to think that the current U.S. administration will champion efforts to get vaccines to the poorest countries. Such countries will more likely receive support from the middle powers, together with the Gates Foundation, the Wellcome Trust, and other philanthropies. Germany, Japan, Switzerland, and the United Kingdom, together with the EU, should invest heavily in ramping up production capacity for vaccines so that they are able to halt the next wave of COVID-19—not just at home but around the world.
The coronavirus pandemic will require sustained international efforts in the health, economic, security, and social policy domains for at least the next 18 months and perhaps even longer. With the United States mired in inward-looking dysfunction and China currently incapable of the kind of diplomatic largesse that global public health leadership demands, middle powers will have to lead the way out of the crisis. Countries such as Canada, Germany, and Japan have been seeking to restore the credibility of the multilateral system for years. If they can work together to conquer COVID-19, they might succeed in doing so.
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