Embracing a Pandemic-Centered Foreign Policy

This commentary is part of CSIS's Global Forecast 2021 essay series.

Addressing the Covid-19 crisis will be the Biden administration’s overriding priority in the months ahead. The administration plans to acquire enough doses for 300 million Americans by July. Afterward, staying ahead of the rapidly mutating virus will require a global vaccination campaign of unprecedented scale—one that will barely be out of the starting gate by late summer.

In Southeast Asia, like the rest of the developing world, Covid-19 will dominate national and regional agendas well beyond 2021. Partner countries will look to the United States and others for long-term help to acquire and distribute vaccines, bolster public health systems, and kickstart stalled economies. Whether Washington steps up will color everything about the Biden administration’s interactions with the region. Does Washington want to rally support for U.S.-led global rules and institutions? Build issue-specific coalitions to compete with China? How about strengthen long-standing alliances? Partners will not support those goals if the United States does not help the region, and by extension the world, overcome the pandemic.

The Economist Intelligence Unit estimates that Singapore will be the only country in Southeast Asia to achieve widespread vaccination this year. Malaysia, Thailand, and Vietnam might follow suit in mid- to late 2022. But Cambodia, Laos, Indonesia, Myanmar, and the Philippines are expected to be among 85 developing countries that will struggle to vaccinate most citizens until 2023 or later. And vaccination campaigns will not provide equal protection. Outside of Singapore, the bulk of vaccines currently earmarked for Southeast Asia are less effective in preventing disease than the Pfizer-BioNTech and Moderna shots approved for use in the United States.

The vaccines being widely distributed include those from China’s Sinovac and Sinopharm, and from Russia’s Gamaleya Institute. All face concerns about data transparency and true effectiveness. And while recent data has assuaged worries about Gamaleya’s Sputnik V, Sinovac’s efficacy barely reached 50 percent in recent trials in Brazil. The other vaccine already being delivered in Southeast Asia comes from UK-based Oxford-AstraZeneca. It seems to be about 70 percent effective, though that varies widely from trial to trial. The region is also preparing for access to shots developed by U.S.-based Novavax and Johnson & Johnson, among others. The latter requires only one dose and can be stored at normal refrigeration temperatures, making it much easier to distribute and track in developing countries. But every option involves trade-offs between cost, availability, ease of storage, and effectiveness.

Covid-19 strains recently identified in the United Kingdom, South Africa, and Brazil are proving deadlier and more contagious. Early studies indicate that they potentially reduce the effectiveness of existing vaccines. South Africa halted its AstraZeneca rollout after finding the shots offered “minimal protection” against the variant now dominant in that country. Moderna is developing a booster to increase resistance to the South Africa variant in those already inoculated. Other manufacturers will do the same for these and future mutations. That means countries may have to vaccinate their populations again and again to combat emerging strains. Mass inoculation is not the finish line of a global sprint; it is more likely the first leg of a permanent relay.

The Biden administration should start arranging the components of a pandemic-centered foreign policy that will extend through 2021 and beyond. The annual State of Southeast Asia survey from Singapore-based ISEAS illustrates both the challenge and opportunity for renewed U.S. leadership. Regional elites identify the pandemic as Southeast Asia’s most pressing problem, followed by the unemployment crisis it has fueled. When asked which partner has provided the most assistance on Covid-19, nearly half say China. The United States comes in a distant fourth behind Japan and the European Union. Washington did pledge significant financial aid to pandemic response last year, but that was no match for the negative perceptions created by a calamitous domestic response, withdrawal from the World Health Organization, and overall “America First” foreign policy.

Unsurprisingly, the pandemic has added to perceptions that China is the most influential economic and political power in Southeast Asia. But few regional elites are comfortable with that. Despite its concerted “mask diplomacy,” the region grew more anxious about Beijing over the last year. An overwhelming majority of elites are worried about China’s rising influence and have little or no faith that it will “do the right thing” on the world stage. Perceptions of the United States, by contrast, have undergone a stunning turnaround since the November elections. Over 55 percent report confidence in the United States as a strategic partner, up more than 20 points from a year ago. And about half trust it to “do the right thing,” again up more than 20 percent. Joe Biden’s election, and Donald Trump’s rejection, has restored some cautious optimism about the United States. The best way to keep that window of opportunity open is with early leadership on the multiyear pandemic challenges facing the region.

Policy Options

The Biden administration has already taken important steps. On his first day in office, the president reversed his predecessor’s decision to withdraw from the World Health Organization (WHO). And during his confirmation hearing, Secretary of State Antony Blinken committed to support the WHO-led COVAX facility, which is helping purchase and distribute vaccines to developing countries. For many in Southeast Asia, and throughout the developing world, COVAX allocations will provide their earliest vaccine access. But the facility only allows countries to reserve enough doses for 20 percent of their population. That could eventually rise, but many developing nations will struggle to meet the rest of their vaccine needs on the commercial market. That leaves a pressing need for assistance beyond COVAX. One vehicle for such assistance is the $9 billion Asian Development Bank’s (ADB) Asia Pacific Vaccine Access Facility, or APVAX. The U.S. government should push the ADB to expand the facility beyond 2021. And it should enlist the U.S. private sector to help co-finance vaccine purchases as part of the bank’s goal of doubling the impact of the APVAX Vaccine Import Facility.

The Biden administration should pledge support to ASEAN efforts to coordinate pandemic response. At the same time, it should boost direct financial and capacity-building support to those states facing the worst community spread and most difficult vaccine distributions: Indonesia, the Philippines, and Myanmar. The coup in the latter will complicate that effort, but President Biden has said that sanctions against the new junta will not affect health assistance. The administration should also work with Japan and European partners to establish a fund to acquire vaccines for refugees and other displaced persons, including stateless Rohingya in Bangladesh and Malaysia who are unlikely to be included in national vaccination plans. COVAX plans to reserve 5 percent of its acquired doses as a buffer, including for refugee populations. But that will not be nearly enough. And unchecked spread in unvaccinated populations will increase the likelihood of new coronavirus strains emerging.

Finally, the administration should redouble efforts to support infrastructure development in the region to help jump-start battered economies. One prime vehicle for this is the U.S. Development Finance Corporation, which has fallen woefully short of its mandate and has been almost entirely absent in Asia. Another might be the Millennium Challenge Corporation (MCC). No country in Southeast Asia has met MCC qualification in recent years; not since the Philippines withdrew its application for a second grant in 2017. For the last two years, Manila fell just short of eligibility based on its poor score on controlling corruption. The administration should consult with Philippine officials on steps to requalify. Indonesia, meanwhile, has been ineligible since reaching the World Bank’s criteria for upper-middle income status. But Covid-19 has caused the economy to contract by nearly 4 percent, just enough for Indonesia to requalify for an MCC grant in 2022.

A successful pandemic-centered foreign policy needs to combine short-term signaling—that the United States is committed to helping partners access vaccine doses as soon as its critical domestic needs are met in the coming months—with the establishment of new programs for mitigation, vaccination, and economic recovery for years to come. Committing resources to such a policy framework would go a long way to recapturing U.S. leadership, globally and in Southeast Asia. Without it, the Biden administration will find a region much less amenable to its other priorities.

Gregory B. Poling is senior fellow for Southeast Asia and director of the Asia Maritime Transparency Initiative at the Center for Strategic and International Studies (CSIS) in Washington, D.C.

Commentary is produced by the Center for Strategic and International Studies (CSIS), a private, tax-exempt institution focusing on international public policy issues. Its research is nonpartisan and nonproprietary. CSIS does not take specific policy positions. Accordingly, all views, positions, and conclusions expressed in this publication should be understood to be solely those of the author(s).

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Gregory B. Poling
Senior Fellow and Director, Southeast Asia Program and Asia Maritime Transparency Initiative