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COVID-19 AND VACCINE NATIONALISM This page intentionally left blank COVID-19 AND VACCINE NATIONALISM MANAGING THE POLITICS OF GLOBAL PANDEMICS Eric E. Otenyo Professor,DepartmentofPoliticsandInternationalAffairs,NorthernArizonaUniversity,Flagstaff,AZ,USA AcademicPressisanimprintofElsevier 125LondonWall,LondonEC2Y5AS,UnitedKingdom 525BStreet,Suite1650,SanDiego,CA92101,UnitedStates 50HampshireStreet,5thFloor,Cambridge,MA02139,UnitedStates TheBoulevard,LangfordLane,Kidlington,OxfordOX51GB,UnitedKingdom Copyright©2023ElsevierInc.Allrightsreserved. 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ISBN:978-0-443-18570-0 ForinformationonallAcademicPresspublicationsvisitourwebsiteat https://www.elsevier.com/books-and-journals Publisher:StacyMasucci AcquisitionsEditor:ElizabethA.Brown EditorialProjectManager:SamYoung ProductionProjectManager:SelvarajRaviraj CoverDesigner:VickyPearsonEsser TypesetbyTNQTechnologies Contents Preface vii ChallengeofpoliticalCOVID-19vaccinemessaging 86 Globalcollaborations:GAVIandCOVAX 88 1. COVID-19 and vaccine nationalism: Patentrights 89 Influenzaandglobalcollaborationsand managing the politics of global pandemics, an controversies 92 introduction Americannationalismasexplanatoryfactorin Politics,pastandpresentformsofnationalism:defining COVID-19vaccinehesitancy 93 vaccinenationalism 2 Tuskegeeandblackbodies 94 Focusoncontextsofnationalism:anoverview 3 Republicans,evangelicals,whiteChristiannationalists,and Ideologyandtheoryofnationalism 6 vaccines 95 Categoriesofnationalismandvaccinenationalism 9 Americanstatesandvaccinelotteries 105 COVID-19crisisandbigpictureframeworks 12 Presidentialleadershipmatters 105 MarketfailureandCOVAX 15 Conclusion 111 Governanceandresponsibilitywithintheglobal References 111 system 20 Furtherreading 118 Nationalinterestandself-preservation? 20 Interdisciplinaryfocusandmultiplemethodological 4. China’s nationalism and COVID-19 strategies 22 vaccines Conclusion 31 DefiningChina’snationalismandhistorical References 31 perspectives 119 Self-determinationandhowisChina’snationalism 2. COVID-19 vaccine concerns: an overview imagined 121 on how nations got here SunYat-sen:thefatherofmodernChinese COVID19:themessynumbersproblem 39 nationalism 122 Trackingdisease,nationalorigins,andearly China’snationalismandtheexternalfactorviewedthrough therapeutics 40 COVID-19vaccinesproduction 126 Globalpandemicandotherimmediatemitigation Taiwan 128 solutions 43 China’sCOVID-19vaccinesandtriumphofChina’s Essentialmedicinesandtreatments 45 technologies 129 Conclusion 72 China’snationalrejuvenationandthelingeringquestionof References 73 prejudice 132 AfricansinChinaandCOVID-19 133 3. American politics and global COVID-19 VaccinediplomacyandcampaignstopromoteChina’s vaccines 135 vaccinations Economicvaccinenationalism,protectionism,bilateralism, Vaccines:historicalantecedentsandtriumphof andgovernance 137 science 79 Two-partstrategy 139 Comparativevaccineresearch,regulation,androllout 81 Conclusion 144 Benefitsandrisks 83 References 144 v vi Contents 5. Fragmented COVID-19 vaccine nationalism Conclusion 226 and politics in the EU and the UK References 227 TheEuropeanUnionandglobalpower 149 8. Reflections on vaccine nationalism and RestlessEuropeannationalismandcitizenship 150 global inequalities HistoryandgovernanceoftheEU 151 Throwingawayunusedvaccines:“werejectvaccine Pandemicsareglobal,buttheydon’taffecteveryone nationalism?” 172 equally 229 Donatingvaccines 173 Arecapitulationofcollaborationsandpartnerships 233 Conclusion 174 TheWorldBankandWHOandinternationalopposition References 175 tovaccinenationalism 236 Thetroublednatureofglobalvaccinemanagement 239 6. COVID-19 vaccine politics: India’s Hesitancy,maladministration,andthepoliticsof nationalism and global supplies misinformationanddisinformation 240 CapitalismMatters:BigPharmaProfits 244 Nationalismandthecolonialpast 179 Africansdestroyvaccines 250 “ChinaVirus”asreferencepointfornationalistic Vaccineinequalities,digitaldivides,andscheduling rhetoric 181 appointments 251 Self-reliantmythandmessageofhope:SerumInstituteand Vaccineefficacyrankinggradesandhierarchies 252 NationalPride 184 Richbutleftoutofvaccinenationalismnarrative 254 JawaharlalNehru’snationalistvaccinecharge 186 Aconvolutedconcept 256 India’sallegedvaccinenationalismanddiplomacy 190 Problemframing 259 Expandingvaccinations 191 Pfizer’sFDAFullApproval 260 DidModi’sgovernmentlearnfrompreviousmistakes? Politicalwillandvaccinedonations 261 193 Thirdshotsversusequityandglobalsolidarity 262 Internationalanddomesticsetbacks 193 Conclusion 266 Antecedentstovaccineresistanceandvaccine References 267 boosters 195 Conclusion 200 9. Moving forward beyond politics of COVID- References 201 19 vaccines development 7. The United Nations call to end vaccine Strengtheninginternationalinstitutionalcapacity 276 nationalism Increasedfunding 280 Establishmentofpermanentlocusofcollaborationand Strandsofvaccinepolitics 205 strategicreserveswithindevelopingareas 280 Policyexpertssaynotovaccinenationalism 208 Collaborationofvaccineproductionsandgenome UNmembersandthepoliticsofvaccineapartheid 209 sequencing 281 Bigpowersupremacybattles 211 Trustandinvolvementofgrassrootorganizationsand Triumphofcorporatepowerandpandemics 212 improvehealthandvaccineeducation 284 TheCOVID-19vaccineaccesschallengesthroughthe Leadershipandtransparency 287 lensesofWorldLeader’sUNMeeting 213 Ambassadorsforglobalmutualsupportsystemsinpandemic Biden’spromise:arsenalofvaccines 214 responses 288 GlobalCOVID-19summit:BuildingBackBetter 215 Strengthennonprofitsphilanthropicinterventions 289 Africansreiteratetheirconcernsandsharetheirpolicy Corporatesocialresponsibilityandcessationofvaccine implementationoutlooks 215 nationalism 290 CaribbeanandsmallislandspolicypositionsattheUN Finalremarksandconclusions 292 GeneralAssembly 218 References 294 OmicronandmoreCOVID-19andthe2ndglobal COVID-19vaccinesummit 224 Index 299 Preface Ifwewishtoopenourselvestodebatesabout the main ingredient in nationalism discourses, the impact of COVID-19 on building social sci- we cannot critically assess habituated ways of ence vocabulary, and perhaps, opening new thinking about economic nationalism. frontiers in the realm of comparative politics In this book, I have referenced some impor- and international politics, we must spend time tant work from different disciplines. This is on interrogatingtheconceptofvaccinenationalism. purpose.Wecanonlyunderstandarrangements Out of intellectual curiosity, nationalism in to mitigatetheCOVID-19pandemic inaninter- variousformsremainsasubjectofgreatscrutiny. disciplinaryandoverlappingframeworks.Thus, Notwithstanding its ability to create new po- insteadofbeingsolelyconcernedaboutpolitical litical systems and tranquility, nationalism has science concepts and the command and power strong negative connotations. This is partly structures of international relations, we have becauseitisaforcethatoftenleadstobloodshed the insights from different areas. Such a holistic and disruption of social order. The kind of approach enabled me to understand better the nationalism associated with the emergence of ecosystem of COVID-19 vaccine production theCOVID-19pandemicishowever anintellec- and the politics associated with managing the tually barren area. Those who coined the term globalpandemic. offered a vision of troubled relationships be- Shifting through various documents and sec- tween nations that produce and those which ondary data allowed me to go back and reread consumescarceCOVID-19vaccines.Theconcept the political economy aspects of vaccine is really about inequalities in the global public manufacturing and administrative distribution. healthsystem.Thepossibilitythatrichcountries I had been nurtured on the administrative and hoarded vaccines and poor nations experienced ethical presuppositions of social sciences. And COVID-19 related deaths is the reference point having recently rekindled my passion for social for those of us wondering about what politics justiceandtheneedforfairnessinallhumanen- or political gamesare at stake. deavors, I haven’t stopped thinking about why Vaccinenationalismopenedahostofnewop- humansocietiescontinuetotreatthepoorasun- portunities to examine the new global supply worthy or undeserving of healthy lives. Thus, chain capitalist architecture. And how we think my immediate concern is to offer flashes of in- about who is looking out for the poor countries sights or intuitions and reasoned analyses of which have no capacity to produce vaccines to nation-state behavior at a time of great human protect populations from preventable disease is trauma. acrucialpartofglobalpoliticsandinternational I suppose there is space for us to go beyond power relations. Until we can have a good writing about opinions of newspaper editorials description of how COVID-19 vaccines became and offer an academic perspective to vaccine vii viii Preface nationalism and politics of COVID-19. I don’t WhatiscommonisthatthepoliticsofCOVID-19 think that vaccine nationalism is a new focus vaccine production falls squarely within an era area for those who study nationalisms. I did of rising nationalism, an era that counters the not presumethat for a minute. In fact, I wanted euphoria of economic and political liberalism. todrawourattentiontotheproblemofintellec- COVID-19 came at a time when projects like tuals and pundits peddling around political the European integration and other forms of termswhileignoringtheexistingconceptualtra- globalism were under great stress. Nationalism ditionsandetymologies.Iknewthatwefaceda appeared to be back in global power dynamics puzzle. If we took for granted that vaccine leading to a rise of leaders who, like Donald (cid:1) nationalism is a coherent framework or theory, Trump, Marine Le Pen, Viktor Orban, Recep then,itmustbeexplainedorunderstoodwithin Tayyip Erdogan, Narendra Modi, Xi Jinping, the context of a world system in which certain and others, eschewed forms of globalism as a countries can literally breathe lives to those governing ideology. Their world view seemed afflicted by a raging global scourge. It would to embrace nationalistic populism and attempts seem the right thing to do to avoid sustaining a to grieve unintended social consequences of preconceivednotionaboutglobalpowerpolitics globalization. and its effectson public health solutions. Bynomeansdidtheensuingneedfornation- In many ways, I am rejecting presumptions alist politics in different countries empower all articulatedbymanyintellectualsintheacademy leaders to look inward. Instead, the various and media who floated around the concept of nationalism provided an opportunity structure vaccine nationalism. In this book, I undertake within which resources for mitigation against toofferthefirstbooktoclarifyandcontextualize COVID-19 were managed. In some instances, some of the misconceived ideas on a complex theneedtocaterforreligiousnationalistsshaped subject. The perspective is not entirely airtight. healthcare public policy and affected pandemic You will encounter many contexts of responses. nationalism-oriented ideas and perceptions of There are some questions that emerge from publichealthinequalities.Therearepossibilities the rise of apparent nationalism and individual that even nations that practice vaccine nation- state ability to cooperate with the rest of the alism were not aware of their vision of fairness world through global system mechanisms like andhadnotseenthepossibilityoftheirbehavior theUnitedNationsandWorldHealthOrganiza- beingtermedorseeninthosenegativeterms.By tions (WHO). And one wonders, just how the offeringthepoliticalsideoftheresistancetovac- power distribution amongthe leading countries cines in different settings, I debunk the notion matters in addressing challenges such as global thatsomeinsidepressureinrichcountriesdrove pandemics. Thus, we are forced to consider the anationalisticagendaouttoconstructasocially principles of cooperation and collaboration unjusticeglobal public health infrastructure. within globalpublic healthcare initiatives. To understand how the global public health When rich countries became preoccupied system succumbed to nationalistic ethos has with “a me first” mentality and hoarded vac- many political parts. It is, therefore, necessary cines for months as Africans simultaneously to recognize the history and governance of the starved of the same, one must wonder just the societiesthathadthemostcapacitytomanufac- operational values in the working national rela- ture COVID-19 vaccines, namely the European tionships. A self-governing international order Union, United States, China, India, Russia, of nations requires a mechanism that puts Israel, and the United Kingdom. No all these together the interests of both the weak and countriesaregivenequalwrightinthecoverage. strong to reflect our common humanity. This ix Preface bookisconcernedaboutmoreaboutvalueforall brevity and analytical effort. Much of the ac- humanity and why the attitudes of elite who count in this book is, for the most part, an early believe in their countries as greater than others interpretation of the implementation of policies are plain wrong. The magnitude of disparities ofvaccineproduction,management,andadmin- in vaccine access are a reminder that a paradig- istrationonaglobalbasis.Theaggregatemacro- matic shift in international public health infra- level policies reflect on power dynamics as it structure is required. And it starts by thinking happened and the historical undertones. From andwritingaboutthisstorynarratedinthepop- these reflections, the complexity of pandemic ular media as a form of nationalism. Hopefully, mitigation is addressed. I hope all readers will that goal will be achieved after many books be intrigued by the perspectives offered in this like this one which described what happened book. during COVID-19 vaccine rollout are written Finally,Iacknowledgethe support anddedi- and rewritten. cation of the publishers of this book. Ms. Eliza- These mutually reinforcing essays about vac- beth Brown, Sam Young, and editorial staff cine nationalism are a beginning that points to wereexcellentatseeingthisbookgettothefinish (cid:3) aproblemthatmustbeaddressed.Furthermore, line. I am grateful to Mediciens Sans Frontieres uponreflection,Iamawarethatwewillnothave for allowing me to use their images. And thank the complete data on the unfolding disagree- you to all organizations and book reviewers ments and political or scientific knowledge whose support made it possible to write this about allvaccines discussed in this book. book. Noone canreador see through all thepoliti- I am most appreciative of the opportunity to calandmedicalrealitiesofvaccinesrapidlypro- work with many helpful graduate assistants duced to put a stop to a novel virus that killed and colleagues Professors Lisa Hardy and Ste- over six million people. We must rely upon the phen Nuno, at Northern Arizona University. I stories that change by the hour and engage the takefullresponsibilityofalltheerrorsandinac- other hard to synthesize millions of data points curateassumptionsinthisbook.IamsorrythatI captured on modern information tools. Anyone did not catch the errors in time. And I am espe- who is devoted to capturing historical events ciallyindebtedtoJaneK.Otenyo,ColinPedron, as they happen can only go so far in terms of and MarvinOtenyo fortheir moral support.