It has often been said that disease knows no borders. With the emergence and spread of the 2019 novel coronavirus, otherwise known as COVID-19, no insight could be more relevant today.
Right now, COVID-19 is going global, both taking advantage of and hampering our interconnected world. The ease of global travel in the 21st century makes this especially worrisome, as we have now seen substantial outbreaks of the virus beyond East Asia in places like Iran and Italy. At present, the world is just beginning to observe the contours of broad-based community spread here in the United States, bringing the impact of this pathogen especially close to home. In addition, financial markets are in a frenzy, with extreme day-to-day volatility punctuated by a fleeing to government debt that has pushed the 10-year Treasury yield below 1% for the first time in history.
Unlike many global challenges, such as military competition and the maintenance of a robust and open international economy, pandemics don’t reflect traditional conceptions of the distribution of power among states. Rather, they are fundamentally transnational issues that can only be solved or mitigated through a high degree of international cooperation. Similar to tackling climate change or countering terrorism, these sorts of problems don’t play by the logic of geopolitical borders.
A useful metaphor
International Relations theorist Joseph Nye has provided us a useful metaphor to think about such things. “Today,” he writes, “power in the world is distributed in a pattern that resembles a complex three-dimensional chess game.” Each board of this game reflects a different dimension of power.
On the top chessboard, military power reigns supreme. Here, power remains largely unipolar and dominated by the United States, though challenges from rising countries such as China are bound to disrupt this unipolarity in the 21st century.
On the middle chessboard is economic power, which has been multipolar for some time. The major actors on this stage include the United States, Europe, Japan, and China, as well as rising economic powers such as India. Although European military power is relatively weak compared to the United States, the European Union still accounts for over 20% of global GDP. In terms of economic power, this puts it virtually on par with the U.S.
The important point is that no matter how big and bad a country like the United States is, it alone does not possess the necessary power to stymie the spread of pandemics. Such a goal requires what Nye refers to as power with others rather than power over others. The strongest actor should lead along the lines of shared values and common interests that empower others. This is teamwork at its finest.
Major gaps in public health abilities
Yet such a strategy requires the forgoing of various myopic short-term interests, replacing them with long-term health and security interests that promote global stability. Since the West Africa ebola epidemic, the WHO and others have reported major gaps in the ability for countries to prevent, detect, and respond effectively to outbreaks. Though shoring up U.S. capacity to respond to global health threats is a necessary first move, it alone will not be sufficient. Rather, it must be part of a coordinated, multilateral effort that strengthens health systems around the world. A comprehensive initiative would involve expanded funding to federal agencies such as the CDC, but also additional commitments to multilateral efforts such as the WHO and the Global Health Security Agenda (GHSA).
The GHSA was launched in 2014 with strong U.S. support and focuses on building core health system capacities across the globe. It now includes over 60 countries and has drawn in a relatively substantial level of resources from members. This includes the U.S. financing of 17 target countries. Despite this progress, external evaluations show that many countries are in need of expanded capacities. On top of this, the WHO’s Contingency Fund for Emergencies is regularly underfunded — virtually all of its 2019 budget was expended fighting ebola.
Investments pay off
Unfortunately, as we have recently seen, there is a tendency for national leaders to respond to health crises when fear and panic grow strong, rather than to provide the sustained commitment necessary to halting communicable diseases before they get out of hand. It is estimated that if the so-called “Spanish flu” (which in 1918 infected 500 million people worldwide and killed roughly 50 million) swept the globe today, it would cost the world economy roughly $3 trillion, or about 5% of global GDP. No matter what the end result of COVID-19 proves to be, it is safe to say that it will almost certainly have large-scale negative economic impacts. On the other hand, a recent study published in the Columbia University Journal of International Affairs estimates that investments in a global-pandemics initiative could generate returns of up to $20 for every dollar spent.
Though fighting COVID-19 should be our top priority in the weeks and months ahead, we should also begin thinking now of the long-term future. We should begin seriously exploring the investments that must be made, both domestically and internationally, to productively respond to and counter future pandemics and global health threats. As most public health experts and epidemiologists will say, it is not a matter of whether the next pandemic will happen, but when.
In a world where transnational threats require both deep international cooperation and strong leadership, the U.S. should credibly commit to pushing worldwide disease prevention to the front of the agenda. A failure to do so will ultimately cede global influence, making both the United States and the world less secure in the process.
Alex Betley studied philosophy, politics, and economics at St. Olaf College, and is currently a graduate student in international affairs at the Tufts University Fletcher School of Law and Diplomacy.
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