The case for U.S. vaccine diplomacy in Latin America

Dr. Dorian Kantor is a political scientist, author, and professor of International Relations at Pontificia Universidad Javeriana. As a 2021 FES DC Media Fellow, he writes about U.S. foreign and national security policy.

The global coronavirus pandemic has severely afflicted the United States’ southern neighbors. As of this writing, the death toll in Latin America stands at roughly 1.5 million – making it the hardest-hit region in the world. In addition, region-wide economic contraction in 2020 was approximately 7%, with GDP contraction in Latin America’s largest economies reaching staggering proportions:[1]

Peru 11.1%

Argentina 10%

Mexico 8.2%

Colombia 6.8%

Chile 5.8%

Brazil 4.1%

^{Source: Deloitte Insights}

While economic growth across the region is projected to be positive in 2021 at about 3-4%, it comes in nearly 9 percentage points below the pre-pandemic trend. Moreover, as reported by the Center for Strategic and International Studies, Latin America “compares unfavorably with other emerging market regions,” meaning that the contraction is deeper and the rebound weaker than elsewhere, leading to higher poverty rates, lower living standards, and growing income inequality. According to the International Monetary Fund, the COVID-19 crisis has precipitated the steepest economic contraction in over 100 years, erasing a decade of hard-fought anti-poverty gains across Latin America.

As North America, China, and Europe welcomed the arrival of COVID-19 vaccines in the first quarter of 2021 –  a much-needed and long-anticipated light at the end of the proverbial tunnel – Western vaccine manufacturers largely disappointed their Latin American customers. Despite the urgent need for coronavirus relief, they told the countries of the region that they would have to wait, leading to woefully inadequate vaccine supplies.

Where Western pharmaceutical companies floundered, Russia and China picked up the slack. In the global scramble for vaccines, Sputnik V, Siopharm and Sinovac were made available to the region early on, while Pfizer, Moderna, and others remained in short supply. As Russia and China were meeting Latin America’s demand for vaccines, the Biden administration was presented with political opportunities as well as moral and strategic imperatives to close the United States’ performance gap and to engage in America’s own vaccine diplomacy.

U.S. vaccine nationalism?

Projections in the first quarter of 2021 indicated that the United States would rapidly reach a vaccine surplus. As the government approaches 520 million jabs administered domestically, America’s supply is rapidly outpacing demand. In fact, if production remains at the current rate, by the end of 2021, an excess of 1 billion doses will be available in the U.S., meaning that the Biden administration could vaccinate the entire population twice.

What is the reason for this over-purchasing? First, there have been unforeseen problems with some vaccines, such as the pause in April in the administration of the Johnson & Johnson jab and the production hiccup in Baltimore that caused millions of doses to be destroyed. Second, early on, efficacy was difficult to foresee – therefore, casting a wider net meant that there would eventually be a sizeable supply of effective vaccines to administer. Third, as the science develops, we are learning that emerging variants require booster shots, leading to the need for more doses overall. Lastly, considerable uncertainty remains about the duration of immunity. It follows that if those Americans who received the vaccine earlier this year need a third dose before the end of the year, the government will have to tap into the backup supply. Hence, these are not just good reasons for over-purchasing, but also counsel for holding on to those doses.

The case for U.S. vaccine diplomacy

Why then should the United States share its excess supply? To start, lower-income parts of the world do not have access to vaccines because developed countries have built up immense reserve socks. In fact, as the Washington Post reported in April, 48% of all vaccine doses administered up to that point had gone to just 16% of the world’s population. Moreover, as Dr. Krishna Udayakumar, the director of Duke University’s Global Health Innovation Center explained in an interview with NPR, COVAX[2] is struggling to achieve any semblance of equitable vaccine distribution. Despite the organization’s goal of providing two billion shots in 2021, according to data reported by Gavi, COVAX has only delivered roughly 406 million doses to 144 participating countries to date – just shy of 6% of the total vaccines distributed worldwide.

Just like China and Russia, the U.S. had an enormous opportunity for global leadership by acting promptly to supply low-income countries with vaccines. Some early developments out of the Biden White House were promising: for example, the U.S. promptly rejoined the WHO, reversing the profoundly ill-conceived decision of the Trump administration to withdraw from the international public health organization. Moreover, in contrast to his predecessor’s choice not to participate in COVAX, Biden has asserted a leadership role in the global multilateral platform and pledged $4 billion to the initiative – this is in sharp contrast with China’s $100 million contribution. Lastly, the new administration has also expressed support for waiving patent protections for COVID vaccines, citing the “extraordinary circumstances [that] require extraordinary measures.”

Importantly, the United States must share surplus doses not just because it is the right thing to do ideologically or politically, but because the longer the virus circulates in other parts of the world, the more risk there is of new variants developing; this, in turn, would jeopardize the health of even vaccinated Americans. And from an economic point of view, American growth is inextricably tied to global growth, so vaccine-nationalism has no place in the United States’ pandemic-era foreign policy.

Why should Latin America receive priority consideration and access to COVID vaccines?

A non-negligible political factor in focusing U.S. vaccine diplomatic efforts on Latin America is that many countries in the region are gearing up for elections, and the United States should prevent authoritarian powers like China and Russia from undermining or displacing U.S. influence in the Western Hemisphere. In other words, Russia and China stood to gain significant goodwill and enhanced leverage as they delivered results to people in need, while the US played second fiddle – or, until the summer of 2021, no fiddle at all.

Since many leaders in the region had long held the impression that Washington was hoarding vaccines, the Biden administration needed to act promptly and decisively to change that perception. Two developments on this score have been particularly promising: first, on April 26, 2021, the Biden administration announced that it would share with other nations its stock of 80 million doses of the AstraZeneca vaccine, which has not been approved by the Food and Drug Administration for use in the U.S. Second, during his visit to Europe in June, President Biden pledged that the United States would donate 500 million Pfizer doses to about 100 low- and middle-income countries through the end of 2022.

Ultimately, the answer as to why the Biden administration should prioritize Latin America as it ramps up its worldwide vaccine diplomacy is strategic self-interest: to begin with, the region’s proximity exposes the United States to the risk of potential new variants emanating from Latin America. For example, the P.1 or Brazilian strain of COVID-19 is now one of the most-reported variants in the U.S., and the existing vaccines appear less effective against this emerging type. Moreover, the new Mu variant, which was first identified in Colombia in January of 2021, has shown signs of potential resistance to the existing vaccines. Therefore, strategic self-interest dictates that the United States should facilitate region-wide immunization. The 80 million AstraZeneca doses designated for worldwide distribution alone would be sufficient to fully vaccinate nearly 6% of the population of Latin America and the Caribbean, making a significant contribution to the region’s efforts to combat the pandemic. The faster the United States acts, the less likely it is that new, more dangerous mutations of the virus will develop. Finally, returning to the matter of migration and immigration, which I discussed in a previous article, the pandemic and the resulting economic meltdown contribute significantly to the push factors that drive migrants to the United States; therefore, to be able to address the root causes of irregular migration, the Biden administration must prioritize the region in its global vaccination efforts.

Latin American vaccine diplomacy to date

After the Biden administration’s announcement that 80 million of the United States’ AstraZeneca jabs would be made available to the world, Latina American nations expected to benefit from the largesse of the United States. However, despite the clear logic of strategic self-interest outlined above, U.S. authorities only dedicated approximately 6 million of those shots for Latin America and the Caribbean. Also, in June the administration announced that it would not be immediately sharing doses of AstraZeneca’s vaccine given worries about the quality of the jabs produced at the Emergent BioSolutions plant in Baltimore. Instead, the administration made plans to send 55 million doses of Pfizer, Moderna, and J&J to other countries.

As of this writing, the United States has delivered more than 48 million doses of Pfizer, Moderna, J&J, and AstraZeneca vaccines to Latin America and the Caribbean, either in the form of direct donations or through COVAX. According to AS/COA, the top seven beneficiaries of the U.S.’s vaccine diplomacy in the LATAM region have been:

Mexico 17, 000,000

Colombia 6, 000,000

Guatemala 4, 500,000

Honduras 3, 626,000

Argentina 3, 500,000

Brazil 3, 000,000

Peru 2, 000,000

^{Data from Tracker: U.S. Vaccine Donations to Latin America | AS/COA (as-coa.org) updated by the author}

The United States’ global vaccine diplomacy

On April 5^th, Secretary of State Antony Blinken announced that Gayle Smith would serve as the coordinator of the U.S.’s global COVID response and health security at the Department of State. Ms. Smith, who was US Agency of International Development coordinator under President Obama, has extensive experience combating global health issues and was most recently president and CEO of the ONE Campaign, a global movement whose purpose is to end extreme poverty and preventable disease.

As Secretary Blinken emphasized in his remarks: “I know that many countries are asking the United States to do more, some with growing desperation, because of the scope and the scale of their COVID emergencies. We hear you, and I promise we’re moving as fast as possible… We’ve already loaned vaccines to our closest neighbors, Mexico and Canada, and we’ll work with global partners on manufacturing and supplies to ensure there’ll be enough vaccine for everyone, everywhere.” Blinken referred to the United States’ move to share 4 million doses of its AstraZeneca stock with its North American neighbors, at the time its first foray into vaccine diplomacy.

This approach, to state the obvious, is a welcome departure from four years of “America First” policies, and it helps to reassure countries seeking more supply that Washington – and not just Beijing or Moscow – is moving to distribute vaccines to ease the health-related and economic impact of COVID-19.

Aside from COVAX, the United States’ most significant commitment to vaccine diplomacy has come in the form of the Quad cooperation with Japan, India, and Australia. Although this will not (immediately) affect Latin America, the U.S. has announced that it would help supply more than 1 billion covid vaccines across Asia by the end of 2022.

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Ultimately, the United States has much to gain from acting promptly and aggressively against the pandemic in other countries of the Western Hemisphere. It can solidify its leadership position in the Latin American region and fend off the increasing influence of authoritarian competitors. The administration’s latest actions in vaccine diplomacy are encouraging signs that the United States is taking a leading role in the region as well as around the globe. The pandemic is a momentous opportunity for Biden to show that “America is back,” and that open and democratic societies can deliver solutions to the pandemic, effectively competing with Russia and China.

Furthermore, vigorous and broad-based U.S. vaccine diplomacy can stem the emergence of novel strains, protecting the advances made by the government in administering over 500 million jabs over nine months. As Biden said in early March of this year, “[w]e’re not going to be ultimately safe, until the world is safe.” This is all the more true for Latin America, often referred to as the United States’ “backyard.” 

Aside from the political and security benefits, bold and decisive action serves the United States’ self-interest in other ways as well. According to a report produced by the Eurasia Group, a research firm, the economic benefits of ensuring swift and equitable global access to vaccines will generate roughly $153 billion for 10 wealthy nations[3] in 2020-21 alone, and about $470 billion by 2025. Although this will not make a significant dent in America’s nearly $6 trillion investment in domestic stimulus and the concomitant rise in public debt since the start of the pandemic, the United States’ long-term economic growth is inextricably tied to global growth. Therefore, as long as the economic collapse drags on and trading partners cannot operate at full or near-full capacity, complete recovery will remain a distant prospect.

[1] As compared to economic contraction of the United States which clocked in at 3.5%.

[2] COVAX was launched by the WHO, the European Commission, and the Gates Foundation in 2020 and its purpose is to ensure COVID-19 vaccine availability to lower-income countries.

[3] The United States, the United Kingdom, Canada, Germany, Sweden, France, Japan, South Korea, Qatar, and the UAE