The third Quad Leaders’ Summit, scheduled for this week in Sydney, was cancelled after U.S. President Joe Biden pulled out of it owing to domestic concerns.
Officially called the Quadrilateral Security Dialogue, the Quad is a group of four countries: India, Japan, Australia, and the United States. This alliance was formed to deepen economic, diplomatic, and military ties among the member states. As part of this strategic alliance, the four countries announced cooperation in the areas of health security, climate change, maritime domain awareness, humanitarian assistance and disaster relief, cybersecurity, space, and infrastructure.
Nevertheless, the leaders of the four countries met for the Quad Summit on the sidelines of the G7 Summit in Japan. Despite the change in location, the agenda for the summit remained intact. The joint statement issued after the Sydney dialogue highlights that the Quad countries would address challenges such as climate change, ocean health, resilient infrastructure, maritime security, financial integrity, and health security.
Given the wide scope and ambit of cooperation within the Quad, this article evaluates the accomplishments of the four-nation grouping with respect to global health security since the first in-person Leaders’ Summit in September 2021.
Against the backdrop of the coronavirus pandemic, which inflicted human and economic pain across the world, the Quad agreed upon cooperation measures to prevent the emergence of new COVID variants and provide vaccines, tests, and treatments to higher-risk populations. Furthermore, the Quad countries pledged to strengthen the global health architecture to respond to the COVID-19 pandemic and prepare the world for the next pandemic.
To achieve these goals and build better global health security, the Quad member states initially recommended three specific initiatives:
- The Quad Vaccine Partnership was announced in 2021 to enhance equitable access to safe and effective vaccines globally.
- The four countries agreed to support the Global Pandemic Radar, an initiative launched by the United Kingdom under its G7 presidency to identify and track new COVID variants and emerging diseases.
- The member states decided to host at least one pandemic preparedness tabletop exercise in 2022.
Based on the limited public information available on these initiatives, this article aims to understand the objective behind each initiative. It also suggests ways in which these initiatives can be leveraged to strengthen cooperation among the Quad grouping to achieve the long-term goal of strengthening the global health architecture.
The Quad Vaccine Partnership
The Quad Vaccine Partnership was announced in March 2021 to expand the manufacturing of safe and effective COVID-19 vaccines. The initiative aimed to provide one billion doses of COVID-19 vaccines across the Indo-Pacific by the end of 2022.
Leveraging each other’s strengths under this partnership, the four-nation grouping recommended the following plan: the United States would develop vaccines, India would manufacture them, both Japan and the United States would fund research and manufacturing, and Australia would help in the last mile with delivery. This partnership was implemented by the Quad Vaccine Experts Group, comprised of top scientists and officials from the four governments. Further, the Quad partnered with other entities, such as COVAX and the Coalition for Epidemic Preparedness Innovations, for vaccine distribution to other countries.
The recently issued joint statement reveals that the Quad Vaccine Partnership missed the mark of providing one billion doses of COVID-19 vaccines across the Indo-Pacific by a huge margin. As per the latest figures, the Quad grouping only delivered approximately 400 million COVID-19 vaccines to the Indo-Pacific and about 800 million doses globally in partnership with COVAX.
In hindsight, the Quad's decision to create a vaccine partnership to ramp up the manufacturing of COVID-19 vaccines seems like a reaction to the sudden surge in demand created by the pandemic.
While the exact contours of this partnership in terms of technology transfer are yet to be understood in greater detail, this partnership has now pivoted its efforts from manufacturing COVID-19 vaccines to increasing vaccine manufacturing capacities across the Indo-Pacific to tackle future health emergencies.
This is, of course, a rational pivot. With the gradual decline in demand for COVID-19 vaccines, the operational strengths of the Quad Vaccine Partnership should be leveraged to develop and manufacture vaccines for diseases endemic to the Indo-Pacific, such as influenza, tuberculosis, or pneumonia. This could also help the Quad nations further their vaccine diplomacy by expanding their vaccine supply to low- and middle-income countries. But for this pivot to succeed, it is important to address challenges related to trade restrictions and technology transfer, such as access to raw materials, a skilled workforce, vendors and suppliers, and methods of distribution.
In their last meeting, the leaders also announced the evolution of the Quad Vaccine Partnership into a broader Quad Health Security Partnership. Thus, this partnership will slowly transition toward building the region’s capacity to detect and respond to disease outbreaks with a focus on workforce development, disease surveillance, and the coordination of outbreak responses.
The Global Pandemic Radar
The Global Pandemic Radar is an initiative launched by the United Kingdom in collaboration with the World Health Organization (WHO). The initiative aims to prevent future pandemics by allowing the early detection of disease outbreaks and ensuring the rapid development of tests, treatments, and vaccines.
In 2021, the Quad leaders supported the call for the Global Pandemic Radar and agreed to work together to improve viral genomic surveillance and strengthen and expand the WHO Global Influenza Surveillance and Response System (GISRS).
Although the radar was expected to be fully functional by the end of 2021, not much information is available about this new British effort. Moreover, the exact details of how the Quad grouping was supposed to aid this initiative are also limited. Hence, it is quite difficult to assess the accomplishments of this new initiative and the Quad’s support for it.
Like the Global Pandemic Radar, the Quad’s contribution toward strengthening GISRS is also unclear. GISRS, an initiative coordinated by the WHO, was set up to conduct disease surveillance for influenza and other respiratory viruses globally. GISRS also allows countries to share virus samples for genetic analysis to understand the pattern of respiratory viruses, identify novel influenza viruses, and develop influenza vaccines. However, GISRS relies on national and subnational models, and accordingly, it is only as strong as the national monitoring systems of the countries it operates in.
The limited information available publicly suggests that the Quad grouping has not made any substantial progress in developing an early warning system to detect disease outbreaks, either by supporting the radar or the GISRS.
Since early detection of disease outbreaks is essential to tracking the spread of infection, deploying containment measures, and notifying the health system for a timely response, it is critical for Quad countries to strengthen their disease surveillance mechanisms at a national level to develop an early warning disease detection system at a global level. The basic pillars of a disease surveillance mechanism already exist in the four countries, and therefore the Quad member states should work together to develop information exchange mechanisms among the partner states.
Once this information exchange channel is established, the Quad nations should consider developing a strategy to sustain this mechanism through financial support. Hence, brainstorming to fund early detection and the reporting of disease outbreaks should be on the Quad’s agenda. An internal financing mechanism, such as the Contingency Fund for Emergencies, could be created to support the early detection of disease outbreaks within the Quad. As a starting point, the Quad member states could earmark some funds to support the prevention of future health emergencies. However, with pressure on government funds due to the pandemic and the Russia-Ukraine crisis, it could be difficult for the Quad countries to sustain this fund only through government contributions. The fund can therefore be expanded to encourage international financial institutions such as the Asian Development Bank and the World Bank to contribute to this pool.
Overall, resolving the exact contours of how the Global Pandemic Radar will operate vis-à-vis the newly announced Quad Health Security Partnership should be on the agenda for the Quad countries.
Pandemic Preparedness Tabletop Exercise
In the joint statement released in September 2021, the Quad leaders mentioned that the four countries will conduct a joint pandemic preparedness tabletop exercise in 2022. The mention of these pandemic preparedness exercises was made again in the recently issued joint statement. While there is no public information regarding the organization of such an exercise last year, India can take the lead in convening one.
In addition to inviting representatives from the government, the tabletop exercise should bring together representatives from all four countries, including but not limited to academics, the private sector, the think tank community, public health professionals, experts from disease surveillance programs (plant, animal, and human health), border security forces, and the World Health Organization. Such multistakeholder exercises are critical to assessing key gaps in preparedness, identifying key offices and players that should be activated at the time of an emergency, recognizing key areas for improving pandemic preparedness and response capabilities, and facilitating information exchange for early detection, preparation, and response during pandemics.
Conclusion
The Quad foreign ministers’ meeting in March 2023 reaffirmed their commitment to support the region on contemporary challenges such as health security. However, as highlighted above, there is little public information on how the initiatives aimed at strengthening the global public health architecture have fared until now. The third Quad Leaders’ Summit has re-emphasized the importance of strengthening global health security and announced a slew of new initiatives. It is imperative that the four countries leverage each other’s strengths to facilitate the exchange of information and enable technology collaboration to improve their pandemic preparedness and response strategies.
