As the world pulls together to combat the coronavirus, one nation is notably absent from multinational efforts: the United States.
Next Monday, May 4, the European Commission will respond to that call by hosting a global virtual conference to raise money from countries and business foundations to fund the development of tests, treatments and a vaccine for the coronavirus. It has invited “governments, business leaders, public figures, philanthropists, artists and citizens” to help with its efforts to raise the €7.5 billion it has set as its initial target. Announced partners include France, Germany, the United Kingdom, Norway and Saudi Arabia. It remains unclear if the US will take part.
Under President Donald Trump’s “America First” doctrine, the US has tended to favour unilateral action and eschew cooperation with international organisations. Case in point: On March 14, Trump announced that he was suspending funding to the WHO, which has spearheaded the global response to the pandemic. With an annual input of about $400 million, the US is the biggest contributor to the organisation; the reduction in funds comes at a vital moment.
What all that will mean in the battle against a virus that – as global health experts have repeatedly reminded us – knows no borders and requires coordinated action remains to be seen.
On the scientific front, the impact may be minimal. While global cooperation and the sharing of expertise and information is critical, it also happens largely without government involvement and, as of now, continues unimpeded, said Laurent Humeau, chief scientific officer at Inovio Pharmaceuticals.
Humeau’s team has relied on the sequencing of the genome provided by China, genetic material from Australia and has cooperated with researchers in South Korea and the UK. “It’s a community that is moving very fast and we need everyone else’s help to get a vaccine,” he said. “It’s absolutely critical for us to have this network of scientists.”
The Inovio team is part of the WHO’s R & D Blueprint, which pulls together a coalition of experts and allows for “the rapid activation of research and development activities during epidemics”.
And despite the public distance between the US and the WHO, key health personnel from the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health continue to be part of the global scientific dialogue. For now, the international research community is working together to do all it can. “We keep pushing as fast – it’s not as fast as we can run, but as fast as we can fly,” Humeau said.
Unless governments issue restrictions – such as those the US imposed on stem-cell research – politics tends to exist in a sphere separate from science, said Gregory Poland, director of the Mayo Clinic’s Vaccine Research Group and who also edits the international journal Vaccine. “You’re not working in a political framework – at least in the US – you’re working in a scientific framework,” Poland said.
Researchers end up primarily communicating through journals and meetings and, perhaps most importantly in the current crisis, on pre-print servers, where researchers place articles before they have gone through peer review and been published. “That has been the primary way that scientists have been communicating with one another,” Poland said.
There may even be a silver lining to a little bit of distance between researchers, said Peter Hotez, dean for the National School of Medicine at the Baylor College of Medicine. “The US and Europe sometimes have different approaches to vaccine development and how to support vaccine science, and that may not be so bad because it creates additional opportunities for innovation,” he said.
Pushed to the bottom?
Poland hopes that this pandemic, unlike the ones that preceded it, will finally have helped people understand how interrelated their nations are. “We’ve had multiple examples now, that anything that happens anywhere on this globe is maybe, at most, 36 hours away from Europe or North America,” he said. “There’s where you need a lot of cooperation, for example, on surveillance, on what is happening where, because – literally – days are lives.”
Finding a vaccine is only a first step, warned David Salisbury, associate fellow in the Global Health Programme at Chatham House. “The fact that scientists are talking to each other is admirable, because sharing what we are learning about vaccine development is, of course, hugely important," Salisbury said. “But that is the beginning of the story … Ultimately, we’ve got to get from developing a vaccine to manufacturing and buying it country by country, and then we’re into a political world that has left the scientists behind … The critical thing is not when do we get the first dose, it’s when do we get enough.”
Manufacturing and distributing a vaccine will be herculean tasks for a disease that potentially affects everyone on the planet, and that’s where a new set of potential problems arises. “You could imagine a philosophy of America First that might actually prevent vaccines manufactured in the US from leaving the US until everyone [there] had been vaccinated,” Salisbury said. “Or what if the EU says we will prioritise European customers first? Geopolitics becomes really important in what becomes available when and for whom.”
Salisbury said that countries that can’t afford to pay market rate also risk getting pushed to the bottom of “this great long list of customers”. The international community needs to consider carefully how what are certain to be scarce supplies to begin with get distributed.
“How do we share a hugely valuable resource equitably?” he asked. “I don’t know that we have a solution yet.”