Just last week the Biden administration faced, and failed, a largely ignored test for its foreign policy. Joined by the United Kingdom and the European Union, the United States once again blocked a measure at the World Trade Organization that would temporarily waive patent rules to promote greater availability of vaccines and treatments to aid in the fight against COVID-19 worldwide.

If adopted, the proposal would have permitted generic and other pharmaceutical companies to begin manufacturing already-effective vaccines that could slow and halt the spread of COVID, prevent dangerous new variants, and likely save hundreds of thousands of lives, especially in the Global South. The measure was introduced by India and South Africa last October, and is supported by nearly 100 low and middle income countries, NGOs like Amnesty International and Medecins Sans Frontieres, and some U.S. lawmakers, most notably Senator Bernie Sanders.

The need for expanding vaccine access is clear. Over half of the anticipated vaccine supply for 2021 has already been purchased by a handful of wealthy nations, and at present many poor countries are not on track for full immunization until 2023 or 2024. 

Addressing this is hardly a question of altruism for the United States. The WHO estimates that vaccine inequality could cost the global economy $9.2 trillion, and the continued spread of COVID globally would expose the U.S. to the risk of renewed outbreaks.

Response to the decision in the United States has been mute. Alex Pareene notes in The New Republic that media coverage has focused instead on the notion that the United States should donate some of the extra doses it has already purchased to poorer nations — a proposal that would be understandably unpopular with the millions of Americans still waiting to be vaccinated themselves.

In an article that provides a case study in the derangement of U.S. foreign policy discourse, the Washington Post primarily characterized the demand to share vaccines worldwide as driven by the need to counter China and Russia’s “aggressive vaccine diplomacy.” The article quotes experts suggesting, among other things, that these countries are “striking in our own backyard” by providing vaccines to Latin America.

The Biden administration has likewise focused its international vaccine distribution efforts on countering Russia and especially China. But the commitments it has made so far are too narrow and will take years to be fully delivered. Just days after blocking the waiver, the Biden administration pledged in a joint statement with the leaders of India, Australia, and Japan, to facilitate the production and distribution of 1 billion vaccines across Asia — but this target would fail to fulfill the needs of India alone, and would not be met until the end of 2022.

Likewise, the WHO-backed COVAX initiative, which the Biden administration joined in January, only aims to provide enough vaccines for 20 percent of the developing world’s population by the end of 2021.

The relative lack of attention given to the patent waiver issue is unfortunate considering that it presents a feasible way to make vaccines available across the Global South without any cost to the average U.S. citizen — and is supported by almost 70 percent of U.S. adults, according to a YouGov poll published just last week.

The reason for the Biden administration’s (and the EU and UK’s) resistance is, naturally, pharmaceutical company profits — or, in the words of Western governments, “incentives for innovation.” (PHrMA, the leading industry lobby group which last year spent over $530 million on lobbying and political donations, has vocally opposed a waiver.)

Of course, profits do provide incentives for pharmaceutical companies to produce effective vaccines, and, in the case of COVID, to do so with unprecedented speed. But these companies already are set to receive fantastic profits from their COVID vaccines — and, because they would retain an advantage in manufacturing their vaccines even without exclusive production rights, they stand to make a great deal more. 

Furthermore, if they deem it necessary, Western governments could even provide additional compensation for profits lost to a waiver. The notion, then, that a waiver in this instance would dissuade companies like Pfizer and Moderna from producing future vaccines is simply not credible.

In short, the Biden administration has been offered a relatively easy moral and strategic win that could both enhance U.S. national security and provide a significant soft-power reward. But it has declined this chance in defense of some amount of Big Pharma’s vaccine profits — a curious choice for an administration that has promised to pursue a “foreign policy for the middle class.” 

Members of the U.S. foreign policy establishment routinely fret about growing Chinese influence in Latin America, Africa, Asia, and the Middle East. Yet when given the chance to show a minimum level of interest in saving the lives of people there, this same crowd quietly rejects it. There is an imperative, an existential demand, that the United States maintain its “global leadership” — but not at the expense of lower profits for Pfizer and Moderna.

The first year of the COVID-19 pandemic revealed a deep hole in the American state’s capacity for domestic governance. The patent waiver episode reveals a problem of similar scale for American statecraft — that it is hobbled by the U.S. government’s fealty to corporate interests.

Washington spends billions of dollars on weapons it doesn’t really need in order to create or maintain jobs and to line the pockets of defense contractors (that are also profligate political donors). This helps keep U.S. statecraft militarized, encourages the continuous inflation of foreign threats in order to justify ever-higher Pentagon budgets, and crowds out spending that could be far more useful in the long run — such as a green industrial policy, or larger investments in public health and infrastructure. Military spending is favored even though it is relatively ineffective at creating jobs and stimulating economic growth, compared to other types of spending. 

This is why hopes that intensified competition with China might unify and revitalize the United States — beyond the inherent dangers of overhyping a foreign threat to achieve national unity — are unlikely to be fulfilled. With the interests and inertia that presently dominate the U.S. state, American investment in such a competition will likely be massively skewed towards military spending and other inefficient and ultimately destructive corporate handouts.

We already know what this looks like. As Mark Leon Goldberg points out on Twitter, the United States has spent $1.6 trillion on the F-35, a plane that might decapitate its pilot on ejection, compared to China’s $1.3 trillion in total spending on its dreaded “Belt and Road Initiative.”.

The United States is facing a world replete with threats, like climate change and pandemics, that are less amenable to military spending or purely profit-oriented solutions. To meet these challenges, U.S. leaders will have to learn to recognize when national interests seriously diverge from the interests of U.S. corporations — and be willing to confront the latter.

A country incapable of doing this can hardly be expected to successfully engage in a globe-spanning “strategic competition.” More importantly, it cannot be expected to ensure even a minimally humane future for its residents or for the world more broadly.

To change this will require a serious shift in U.S. foreign policy thinking and in the distribution of power in Washington. Vocal and serious opposition to the Biden administration’s indefensible approach to a patent waiver is a good place to start.