Biden Can Bounce Back From Afghanistan—by Vaccinating the World

However you feel about U.S. President Joe Biden’s decision to withdraw from Afghanistan, you’re unlikely to feel good about the way it was done. Responses range from “not … a good day for America” to “horrifying” to “a bone-headed mistake.” And those are from key supporters—his opponents are less charitable.

But Biden can prove that the political obituaries being written both for him and for America’s standing in the world are premature. He has an opportunity now—if he’s willing to take bold action—to radically rewrite the story of his presidency and achieve a strategic trifecta: protect the health and safety of all Americans, restore the United States’ geopolitical stature, and fulfill a moral obligation to the people of Afghanistan. When he announces a global COVID strategy to match the domestic plan unveiled on September 9, he can get this three-fer by pledging to vaccinate the world. 

The primary obligation of any leader, of course, is to keep the nation safe. The United States invaded Afghanistan in response to the 9/11 attacks, and Biden has made clear that he considers the rationale for any U.S. involvement there to be grounded in counterterrorism. That’s not a newfound approach: This was Biden’s priority on Sept. 12, 2001, when he was chair of the Senate Foreign Relations Committee and I worked as his policy advisor for South and Southeast Asia. It was his priority at every point during the decade (1999-2009) I worked for him. But today, the United States loses a 9/11-level toll of its citizens to COVID-19 every week—usually every few days. The delta variant arose on the other side of the world, but viruses do not respect borders. And as long as most of the world’s population remains unvaccinated, we’ll continue to be ravaged by new variants that will inevitably be generated by mutations among the world’s billions of unvaccinated hosts. Delta is only the fourth variant to merit a Greek name; there are 20 more letters in the Greek alphabet.

Biden has an opportunity now to radically rewrite the story of his presidency and achieve a strategic trifecta.

Analysts across the ideological spectrum, meanwhile, are bemoaning the loss of American clout and respect in the wake of the mishandled Afghan withdrawal. This can be a bit galling, of course, when such criticism comes from the very people who turned a potentially successful endeavor into an inevitable debacle: George W. Bush administration neoconservatives who doomed the Afghanistan project by launching a war of choice in Iraq, and Trump administration diplomats who negotiated a deal with the Taliban so egregiously bad that one of Trump’s own national security advisors described it as a “surrender agreement.” But the critics’ bad faith doesn’t necessarily make their criticism invalid.

Vaccinating the vast majority of people on the planet could change all of that. The United States likes to see itself as the “indispensable nation.” But in the face of the greatest threat that the world has seen in the current century, it hasn’t been acting that way. The government has pledged to donate 500 million doses of the Pfizer vaccine and as of August had shipped 110 million. That’s a good start—far better than what China, Russia, or any other nation has delivered—but the pledge represents enough vaccine for only about 3 percent of the world’s population. Imagine the geopolitical impact if the United States were to bring that number up to something closer to 100 percent.

Is that feasible? In a word, yes—and at a price too low to refuse. According to the International Monetary Fund (IMF), vaccinating a critical mass of the planet would cost only $50 billion. That’s less than what Biden is proposing just for upgrades to Amtrak train service. The IMF further estimates that this investment would generate an economic return of $9 trillion by 2025, with 40 percent of that accruing to the developed world. Even if these IMF calculations are off by a factor of 10—and they almost certainly aren’t—that would still represent a global return on investment of nearly 2,000 percent.

It will take more than money to vaccinate enough of the world to reach herd immunity. But with a firm presidential commitment, few of the nonfinancial barriers are truly unsurmountable. A detailed plan of action would require a whole-of-government team, staffed as if it were the most important national priority—but that’s exactly what the White House has already assembled.

Various outside experts—including those at the World Health Organization, the IMF, and the Gates Foundation—have presented detailed strategies for how to get from here to there. For the U.S. side of the equation, here are just a few of the bottlenecks, and several ways (among many others) in which they might be circumvented:

• Limited production capacity for vaccines. The United States could enable every potential manufacturer, domestic and foreign, to make generic versions of vaccines with American patents. It could either pay American pharmaceutical firms to license this or, if necessary, use existing legal authority to mandate it. India already produces about two-thirds of the world’s vaccines, and the British firm AstraZeneca licensed India’s Serum Institute to produce an indigenous version of its product. Johnson & Johnson could do the same: Like AstraZeneca’s vaccine, the J&J product is delivered in one shot and doesn’t require ultracold storage, making it a better fit for most countries than the more cutting-edge messenger RNA vaccines such as those produced by Pfizer and Moderna. But these could also be licensed, or the patents could be waived as needed.
• Bottlenecks for precursor ingredients and related supplies. Global supply chains are complicated—that’s part of the reason that many Americans have been relying on homemade face masks rather than far more effective N95s. Bottlenecks even extend to the little glass vials needed to store vaccines. But the United States has a tool specifically designed to break through such barriers in times of national emergency: the Defense Production Act. This law permits the U.S. government to order American factories to retool to meet severe threats (and pays the firms fairly for doing so). The Trump administration generally declined to use this tool, but Biden came to office promising to use the act wherever needed. He has rarely done so: His vaccination production goals were largely limited to the United States, and already there are around twice as many doses pre-purchased as the number needed to reach all Americans. But there aren’t nearly enough doses for the rest of world.
• Fear of litigation. Many producers of generic pharmaceuticals—most are based outside the United States—are reluctant to invest in new factories to churn out massive amounts of vaccine for fear of patent lawsuits, not merely for the vaccines themselves, but for all of the items in the supply chain. It’s not a misplaced fear: Pharmaceutical companies are both rapacious and litigious, and the most predatory of them often make full use of the U.S. legal system. But here, too, the problem has an obvious solution: It’s a rare instance where Republican hunger for tort reform and the Democratic desire to eliminate COVID-19 might provide the basis for actual (dare one think it?) legislation.

These are just a few potential fixes. The already-assembled White House team of experts could surely produce others. Would there be a host of logistical and organizational impediments? Of course. But the U.S. government is quite good at overcoming such challenges when it wants to. The President’s Emergency Plan for AIDS Relief (PEPFAR), a program to combat HIV initiated by President George W. Bush and continued under each of his successors, has invested $85 billion and saved an estimated 20 million lives throughout the world. The most logistically capable organization on the planet is the U.S. military: As heart-rending as the mass evacuation from Kabul has been, no other institution on earth could have moved 120,000 people in three weeks under such chaotic circumstances, including the constant threat of attack.

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Most Americans are heartbroken over Afghanistan because of the multitude of human tragedies unfolding there. The Afghan people have suffered far too much, for far too long, under far too many oppressors: the Taliban, before them a murderers’ row of brutal warlords, and before them a ruthless Soviet occupation. America’s involvement was supposed to be different, and sometimes it was: A generation of Afghan women and girls, for example, were able to go to school. But many Afghans now feel betrayed by the United States, and they aren’t wrong to feel that way.

If there’s a debt due, it cannot be paid with money or blood: America has provided far too much of both. But the bill of conscience is not unpayable: The United States has the means to protect most citizens of Afghanistan from a threat to life and safety potentially as perilous as the Taliban and the Islamic State-Khorasan combined: that of COVID-19. (The two types of threat are very different, of course, but if America is not going to protect Afghans from one, it’s even more incumbent upon it to address the other.) As the United States embarks on the long process of vaccinating the world, it could move Afghanistan to the front of the line. Most—perhaps all—of the doses for all 38 million Afghans don’t even have to be produced: By IMF calculations, the United States has 215 million more doses of Johnson & Johnson and AstraZeneca vaccines than the amount needed for the U.S. population. Many of these doses run the risk of expiration as U.S. citizens refuse to accept them.

The Taliban have promised to grant passage, even after the U.S. departure, to all Afghans who risked their lives and those of their families to work alongside American troops and diplomats.  Nobody should take that pledge at face value—but a massive supply of (free) vaccines could turn a pipe dream into reality. Currently, there are tens of thousands of Afghans who are likely eligible for special immigrant visas but didn’t manage to wade through the oceans of paperwork or couldn’t find a way of getting inside Kabul’s international airport before the last plane took off. They deserve a way out. Vaccines might help provide one.

Biden has made four trips to Afghanistan. I organized three of them. I’ve seen him interact with vulnerable Afghans, and I know that his deep human empathy isn’t limited to those who share his citizenship. By vaccinating the world—and putting Afghans at the front of the line—he can translate that empathy into effective action.

There are a host of possible questions and objections: Why should U.S. taxpayers shell out $50 billion? Why can’t this burden be shared by all nations? Why shouldn’t China do it? What if the United States needs a vaccine stockpile in case Americans who oppose vaccinations change their minds? What about the pharmaceutical companies—won’t this hurt their profits? Some of these objections are worth discussing. Not one is worth the enormous cost of not acting.

Has the bureaucracy even presented the president with a plan to vaccinate the world? If it hasn’t, that’s a failure more shocking than anything coming out of Afghanistan. When I worked on Biden’s Senate staff, he’d always insist that I present him a wide range of options on any important decision. He never wanted to be limited to a safe, consensus-generated menu of timid choices.

Now, he has a golden opportunity: He can protect Americans from the most dangerous threat they now face, resurrect the nation’s global standing, put to rest any notion that Afghanistan has destroyed his personal credibility, and at least partially restore the moral standing of America in the eyes of the Afghan people.

The story of your presidency is being written right now, boss.

And you’ve got the chance to decide how it reads.