And while the World Health Organization continues to welcome emergency funding contributions, global health workers have been arguing that the best time to spend money on a global pandemic is before it happens: an approach at odds with recent Trump administration budget and global health program cuts, and empty chairs.
Here are five challenges Trump faces as he attempts to navigate the global politics of the outbreak.
Borders — internal and external
Trump has boasted constantly about his early decision to restrict Chinese travelers from entering the United States. And he’s since mused about shutting down the southern border and acknowledged that the government had contingency plans to wall off an entire American city if needed.
“We have strong borders,” Trump said at a North Carolina rally Monday, claiming that “we’re doing everything in our power to keep the sick and infected people from coming into our country.”
His moves, he said, were a rebuke to “fringe globalists who would rather keep our borders open.”
But attempting to harden borders isn’t a long-term solution to a crisis that requires cross-border cooperation. Epidemiologists and other experts say such limits might help slow the spread of disease by a few days or weeks — at best. So as the disease spreads around the world and through the U.S., the point is becoming increasingly moot, even as Trump expands travel restrictions to hard-hit countries like Iran, South Korea and Italy.
“Eventually, these travel restrictions are going to just be absolutely futile,” said Nathan Grubaugh, an epidemiologist at the Yale School of Public Health.
Beyond Trump’s permeable coronavirus wall, the nature of American democracy ensures he would struggle to implement some of the draconian internal options available to China’s rulers. China’s walling off of Wuhan and Hubei province would be essentially impossible to impose on, say, Washington state, which has reported the most coronavirus cases within the U.S.
Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Tuesday that China had “taken social distancing to its farthest extreme” — to an extent that couldn’t be replicated in the U.S.
“Places that have controlled this … have a mix of authoritarianism and competence,” said David Fisman, an epidemiology professor at the University of Toronto. “Control may be difficult where there is competence but resistance to state-imposed restrictions.”
That kind of action, said bioethicist Kelly Hills, is akin to “closing the barn door after the horse is three fields away, looking at you like, ‘What the hell are you doing?’”
It’s hard to imagine Trump successfully calling on Facebook and Amazon to help enforce restrictions of movement — as China has done with WeChat and AliPay — or ordering large parts of the economy to shut down in an election year. Trump also doesn’t have a single national health service to instruct as many European countries have.
In addition to public outcry around a major movement restriction, “The courts would strike it down because it would be disproportionate and it would affect many, many people who are not infected or exposed to a pathogen,” said Lawrence Gostin, a professor of global health law at Georgetown Law and director of the World Health Organization’s Center on Global Health Law.
One of the most effective approaches to slow the virus’ spread, experts say, is temporary social distancing measures: canceling mass events, closing schools, having people work from home and providing resources to workers with low incomes.
Those decisions fall nearly exclusively to private organizations and state and local officials, though, and they’re already starting to bite. As the president enters his reelection campaign, the projected U.S. gross domestic product growth rate was revised downward to 1.3 percent in 2020.
International institutions
The coronavirus poses another global challenge to Trump: entangling him more closely with the international institutions he loathes.
Trump has at times questioned the mission of global organizations like the United Nations and the NATO military alliance. And since the coronavirus outbreak began, Trump has limited extra U.S. investment globally to $37 million for the World Health Organization.
While the U.S. already funds 22 percent of the WHO budget, the agency is asking donors for $675 million to help fight the virus, warning that it is struggling to support countries to test and isolate potential victims. Yet so far, it has received less than half of its goal, even after getting a $125 million injection from the European Union.
When the WHO is unable to act as the first responder to a global health crisis, the buck has typically been passed to the U.S. Centers for Disease Control and Prevention. But given Trump’s wariness of international aid, and early missteps by the CDC, that role could now fall to European authorities.
An $8.3 billion emergency coronavirus spending package headed for Trump’s desk does include $300 million for humanitarian aid and health needs in countries where the coronavirus is spreading. But the new funding cuts against the broader goals of the Trump administration. Only weeks ago, Trump’s 2021 budget request proposed cutting several international public health programs.
Elsewhere, the World Bank, of which the U.S. is the biggest shareholder, said it is ready to provide $12 billion for countries to improve their responses to the coronavirus outbreak. In a joint statement with the International Monetary Fund, the World Bank vowed to “use our available instruments to the fullest extent possible, including emergency financing, policy advice, and technical assistance,” as economic needs demand.
Business bailouts
The coronavirus is ripping through the global economy.
Businesses that rely on the global supply chain are nervous about falling revenues. Insurers and hospitals are fretting about having to foot the bill for thousands of sick people. Airlines, shipping firms and conference planners have seen a major decline in business.
And they’re appealing to the government to do something about it — bailouts, changes to the tax structure, anything.
Trump is already seeking to cut off chatter about an airline bailout, but he’ll likely face tough decisions in the coming weeks.
Farmers, who already have access to special support to endure the administration’s trade war with China, may need further support as Beijing struggles to uphold its end of January’s U.S.-China trade agreement.
And overseas, Trump can see a preview of lobbying he may soon face. Air France-KLM is appealing to the Dutch and French governments to defer new ticket taxes. And the Italian government is set to ask the EU for flexibility in its budget rules as it is forced to spend big to contain the virus and its economic effects.
Military cooperation
The U.S. military, as a global institution, is also grappling with the coronavirus.
The U.S. and South Korea, which has one of the highest number of cases, have already postponed their annual joint military exercises because of outbreak fears. And one American soldier in South Korea, along with dozens of Korean soldiers, has tested positive for the virus.
The U.S. also canceled an exercise with Israel, and is restricting troops’ travel as a precaution across the Middle East. U.S. European Command is bracing for the prospect of widespread troop lockdowns, including in Italy, Europe’s epicenter of the virus.
But the potential effects on national security extend beyond military bases: The disruption of a variety of worldwide gatherings is erecting impediments to long-term security planning. In one instance, the Mobile World Congress, a major wireless industry conference, was canceled last month — stripping the U.S. of an opportunity to persuade allies not to let Chinese tech giant Huawei build out any parts of their next-generation 5G network.
Refugees
To this point, the coronavirus has proven most lethal among older people with existing conditions. But refugee populations are potential global hotbeds for rapid outbreaks.
There are three factors that make refugees a high-risk population: More men are getting infected than women; refugees have limited access to hygiene and health care systems; and refugees are highly mobile communities often operating under pressure from smugglers and police.
“We know coronavirus doesn’t respect borders and that it hits the vulnerable hardest, those with weak health systems,” David Miliband, head of the International Rescue Committee, said in an interview. “So refugees are at considerably greater risk.”
Of most immediate concern is a group of 1 million newly displaced people on the move in Syria, along with 3.5 million refugees already in Turkey. Many are headed toward the EU, since the Turkish government said it would no longer hold back refugees from traveling through Turkey to enter the EU via Greece and Bulgaria.
“The smugglers are building up their business model very quickly,” warned Karoline Edtstadler, Austria’s European affairs minister.
And if the coronavirus “gets into refugee communities, it’s a disaster,” said another senior European diplomat, who requested anonymity.
Back in the U.S., Republican lawmakers have expressed more concerns about people attempting to flee to America if there are significant coronavirus outbreaks in Mexico or Central America.
“Given the porous nature of our border, and the continued lack of operational control due to the influence of dangerous cartels, it is foreseeable, indeed predictable, that any outbreak in Central America or Mexico could cause a rush to our border,” a group of Republican members from Texas wrote in a letter to Health and Human Services Secretary Alex Azar.
Joanne Kenen contributed to this report.
Heath is the author of Global Translations, a new POLITICO weekly newsletter. Sign up for the free newsletter.
Source: politico.com
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