Download PDF Winter Issue of The Bridge on Complex Unifiable Systems December 15, 2020 Volume 50 Issue 4 The articles in this issue are a first step toward exploring the notion of unifiability, not merely as an engineering ethos but also as a broader cultural responsibility. Vaccines as Instruments for National Security Friday, December 18, 2020 Author: Richard J. Danzig The 2018 report A Preface to Strategy: The Foundations for American -National Security pointed out that the United States “cannot wisely respond to -twenty-first-century challenges predominantly by increasing traditional military investments” (Danzig et al. 2018, p. 14). Indeed, “Borrowing a metaphor from Emerson, [national strengths] are like the fingers of a hand—together they can grasp things that are impossible for one alone. Occasionally we preach this gospel, but the United States rarely practices it across competing executive agencies and congressional committees or between the federal government and state or local governments. Systematic cooperation between the American private and public sectors is still rarer” (p. 25). A year later, the wicked problem of a coronavirus global pandemic triggered a range of US government actions designed to protect Americans from the new pathogen. Less considered was how the United States could also use this challenge to further its goals for the international order. Neglect of this second dimension had significant costs for both America’s health and its security. This brief essay focuses on one example of this failure: how a complex system of vaccine producers was orchestrated for a health mission but left disorganized from a national security perspective. The US Approach to a Covid-19 Vaccine A decade is a normal timetable for developing a new vaccine. Even a concerted effort over more than that time has not yet yielded a vaccine for HIV/AIDS. Early in 2020, policymakers universally spoke of 12–18 months as an exceedingly ambitious target for a covid-19 vaccine. By the spring, some of us prevailed with the argument that, in the face of -extraordinary need, a vaccine could be achieved in half that time. Government leaders in the European Union, the -United States, and China embraced that goal and threw unprecedented resources behind it. More than 100 efforts to develop a vaccine were nurtured around the globe. Among these, six major -programs—four in the United States, the others in -England and France—were funded for vaccine development and production by the US Department of Health and Human Services. The goal was to produce safe and effective vaccines in quantities sufficient for the American population. No arrangements were pursued by the US government to improve production capacity for -other nations, nor were relationships developed for sharing vaccine trial and production experiences among nations. Goals Not Pursued From an American perspective, engagement with a broader range of multinational efforts could have been pursued with one of three goals that are both self--interested and humanitarian: Self-protection. Sharing information about progress and failures would improve prospects of success for all; the risk that vaccines might fail could be hedged by agreements to share vaccine production capabilities, so that others would have access to effective US vaccines and we to theirs in the event that our own failed or were inadequate; proliferation of vaccine production would reduce disease in other countries and thereby reduce the risk of its reentering the United States. Alliance relationships. Sharing and cooperating could extend and improve political relationships. An improved international order. Sharing vaccines and vaccine information with China, for example, could mitigate Sino-American tensions; sharing with -China, Russia, and less developed countries could build a foundation for enhanced cooperation on problems such as global warming and disease surveillance to lower the risk of future pandemics. These opportunities were not pursued. Ideology, tensions in global relationships, and domestic priorities, including political considerations, disposed American decision makers in other directions. Impediments and Challenges Complexities in US systems of governance and of vaccine production were also significant impediments. Many longstanding problems have repeatedly impeded cooperation between the US government and vaccine producers. For example, in previous pushes for new vaccines, corporate planning and corporate incentives have not been well matched to government budget cycles and, despite government assurances, government funding has typically not been sustained after epidemics or terrorist events. A program of multinational and multicorporate cooperation would add other challenges. It would, for instance, warrant giving weight to simplicity of distribution under rudimentary conditions. It would place a higher premium on diversity in clinical trials. It would require grappling with the fact that a small American corporation had essentially its entire value rooted in its intellectual property for using messenger RNA as a new vaccine technology. How could this company be compelled or induced to share its technology and compensated or protected if it did? How would expert personnel in limited numbers be shared between countries? And how might an unprecedented number of parallel vaccine development programs share information in a similarly unprecedented fashion? Risks in Navigating Unmapped Terrain The incentives and the capabilities for addressing these questions were scarce and scattered in the US government. It is challenging to build a new weapon or to deploy military forces to a distant place, but there are well-paved roads for experienced travelers who undertake these tasks. Linking national security and vaccine production is more like traveling across unmapped terrain. The American vaccine program, “Operation Warp Speed,” involved a mélange of agencies and more than $10 billion for contracting under the guidance of leaders in the Department of Defense. Despite this location, the program largely ignored international opportunities and nonhealth priorities. Corporations, ironically more attuned than the Department of Defense to international opportunities, were left free to produce for foreign markets or to share capabilities with foreign producers according to their own preferences, pursuing initiatives based on prior relationships, profit motives, and opportunities for clinical trial sites. A potpourri of arrangements resulted: contracts for some vaccines, but not others, with a major Indian producer; various arrangements with Japan and Canada, some with South Korea and South Africa, and a few with nations in the Southern Hemisphere. Chinese pharmaceutical companies, by contrast, were orchestrated to respond to government priorities for supply to nations of diplomatic interest. These are being used to improve the PRC’s relationships with populations and governments in Southeast Asia, Africa, and Latin America; to gain insight into their medical systems; and to gain a foothold for Chinese businesses and information systems. How to Do It Better The ingredients for a different, better-orchestrated result are easy to enumerate but hard to achieve and maintain. They are likely to apply to other medical countermeasures and include building: enduring US government relationships with pharmaceutical companies not normally thought of in the national security context; government expertise in understanding the structures and incentives of companies important for vaccine production (including producers of bioreactors, adjuvants, and finish-fill supplies like vials); cooperation across the complex systems of the US federal bureaucracy to marshal tools and incentives; budgetary freedom to work across established categories; and international cooperation to align national priorities and systems to minimize redundancies, expand the range of approaches, share results, and maximize production capacity. Some of these challenges were addressed by a few enlightened foreign leaders (e.g., France’s President Emmanuel Macron), some established international organizations (e.g., WHO), a few small but admirably ambitious NGOs (e.g., the Coalition for Epidemic Preparedness Innovations and Global Vaccine Alliance), and some private foundations (e.g., the Gates Foundation). The system remains, however, remarkably suboptimal and the most pronounced failures are by the United States government. Can we do better? Reference Danzig R, Allen J, DePoy P, Disbrow L, Gosler J, Haines A, Locklear S III, Miller J, Stavridis J, Stockton P, Work R. 2018. A Preface to Strategy: The Foundations for American National Security. Baltimore: Johns Hopkins Applied Physics Laboratory. About the Author:Richard Danzig is senior advisor to the Johns Hopkins Applied Physics Laboratory and former secretary of the US Navy.