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Geopolitics has had a significant impact on responses to the COVID-19 pandemic. This impact signaled that balance-of-power and ideological competition had returned to world affairs while the Group of 7 actively engaged in global health. This engagement neither prepared the group for a pandemic nor produced geopolitical advantages for its members. COVID-19’s emergence in a geopolitical world teaches lessons about global health and geopolitics. First, global health received more political attention when the balance-of-power and ideological competition did not characterize the international system. Second, global health problems can exacerbate such competition and make health cooperation more difficult. Third, foreign policy engagement with global health does not produce strategic benefits in terms of material power and ideological advantage. Fourth, low- and middle-income countries remain dependent on, and vulnerable to, more powerful countries. Russia’s invasion of Ukraine reinforces that military and economic power drive national security and foreign policies when the balance of power is at stake. Russia’s aggression will marginalize global health in the national security and foreign policies of G7 members for years to come.
The COVID-19 pandemic, geopolitics, and the Group of 7
The impact of geopolitics on national and international efforts against COVID-19 has been a prominent feature of this pandemic.1 COVID-19 appeared after the balance of power had returned to world affairs and after authoritarianism had emerged to challenge democracy. Competition over power and ideology—especially between China and the United States—affected domestic and global responses to the pandemic.
During the pandemic’s first two years, geopolitics has determined whether and how the Group of 7 cooperated on the threats created by COVID-19. In 2020, the U.S. hard line against China prevented the G7 from agreeing to common actions against COVID-19. In 2021, the U.S. government made the G7 a centerpiece in its strategy to counter China through, among other things, global health commitments. For the G7, the imprint of geopolitics on its global health efforts was unprecedented.
G7 engagement on global health before and during the COVID-19 pandemic
The G7 did not address international health during the Cold War, which reflects how unimportant this issue was in a bipolar balance-of-power system riven by ideological antagonism. The G7 engaged on global health after the Cold War when the balance of power and ideological animosity did not feature in international politics. In this more benign environment, the G7 supported initiatives, such as the Global Fund, and G7 members expanded their involvement in global health. G7 leadership in global health reflected the preponderance of U.S. power, expressed common interests of prominent democracies, and contributed to a “golden age” in global health during the first decade of the twenty-first century.
The structural and ideological factors that underpinned G7 engagement on global health disintegrated during the 2010s. China and Russia successfully challenged the United States and changed the international distribution of power.2 This decade also witnessed the global decline of democracy and the rise of authoritarianism.3 Among other things, the democratic decline reflected nationalism and populism in the domestic politics of G7 members and other democracies. The authoritarian rise embodied the growth in China’s power and China’s willingness to project its influence globally.
The G7’s global health endeavors did little to prepare its members for a pandemic. G7 nations struggled with COVID-19. The G7’s inability to produce a collective response to COVID-19 in 2020 symbolized international cooperation’s failure during the pandemic. The performance of G7 members reinforced pre-pandemic geopolitical narratives about the declining power, influence, ideas, and capabilities of the democratic West. U.S. behaviour on the pandemic and other issues encouraged some European Union members of the G7 to desire more strategic autonomy.4 G7 countries further damaged their credibility by pursuing vaccine nationalism.5 G7 governments appeared more motivated to share vaccines to counter Chinese and Russian vaccine diplomacy than to reduce inequitable vaccine access in low- and middle-income countries (LMICs).6
The U.S. attempt in 2021 to make the G7 a centre of gravity for balance-of-power and ideological purposes reflects, among other things, the pandemic’s impact on the power and influence of the democratic West. The G7 intended that global health and other commitments made at the 2021 summit would demonstrate that democracies can compete with rival powers and manage transnational threats, such as pandemics and climate change. However, past G7 action on global health provides no evidence that such engagement produces geopolitical benefits for the group, its members, or its friends.
During the pre-pandemic period in which the G7 and its members provided global health leadership, the balance of power shifted in favor of China and Russia and democracy experienced a fifteen-year (and counting) global decline. The return of balance-of-power politics and the spread of authoritarianism happened without China, Russia, and likeminded countries making global health a foreign policy priority. Many recipients of health assistance from G7 members factor into the global democratic decline, and many have joined China’s Belt and Road Initiative, an important Chinese geopolitical strategy.7 Much of the G7’s global health efforts have focused on Africa, but China has made political, economic, and “soft power” inroads in Africa without equivalent health programs.8 The G7’s involvement in global health generated no balance-of-power or ideological advantages for its members during this geopolitical transformation.
Geopolitics and global health: Lessons learned
The G7’s engagement with global health before and during the COVID-19 pandemic leads to four lessons about the relationship between global health and geopolitics. First, domestic political, foreign policy, and diplomatic interest in global health was greater when the balance of power and ideological rivalry did not define international relations. Even so, the global health activism of this period did not prioritize pandemic preparedness and response, and it provides poor guidance in a world mauled by a pandemic amidst intensifying balance-of-power and ideological competition.
Second, serious global health events can exacerbate geopolitical competition in ways that make international cooperation more difficult. As happened with COVID-19, rival powers can exploit pandemics to advance or defend their power and influence. Geopolitically, such competition is tactical and opportunistic rather than strategic and fundamental. Global health crises serious enough to cause balance-of-power and ideological effects are rare, have dynamics that can upend geopolitical calculations, and fade as balance-of-power and ideological competition in other areas becomes more pressing. Tactical competition can create lingering friction because countries can stake out opposing positions on global health reforms or initiatives for geopolitical rather than scientific or epidemiological reasons.
Third, foreign policy efforts on global health do not produce strategic benefits in terms of material power or ideological advantage. U.S. and G7 global health leadership was unrivaled while China, Russia, and authoritarian countries changed the distribution of power and created serious ideological competition in the international system. These geopolitical shifts create national security threats against which the kind of pre-COVID global health engagement embraced by the G7 provides no strategic value.
The damage inflicted by the COVID-19 pandemic increases the national security need for pandemic preparedness and response capabilities. The G7’s pre-pandemic efforts focused more on other objectives, such as HIV/AIDS in LMICs. However, heightened attention on pandemics lacks strategic purchase because, as noted above, pandemics are episodic events. Like civil defense during the Cold War, maintaining pandemic defenses between pandemics does not contribute meaningfully to managing the constant and relentless pressure of great-power military, economic, and ideological competition.
Fourth, the geopolitics of the pandemic underscore LMIC dependence on, and vulnerabilities to, more powerful countries. Geopolitics threatens the desire among LMICs to end the traditional model of development assistance because such assistance is, once again, an instrument of balance-of-power politics. For example, geopolitical concerns about China’s Belt and Road Initiative produced the G7’s Build Back Better World infrastructure strategy.9 Mitigating LMIC dependence and vulnerabilities might require a new non-aligned movement, an objective that will agitate rather than ameliorate geopolitics.
Germany’s G7 priorities and the G7’s geopolitical and credibility crises
In January 2022, Germany set five priorities for its G7 presidency aimed at producing a more equitable world.10 The priorities include making progress toward healthy lives by tackling COVID-19, preparing for pandemics, and improving the global health architecture. Germany did not frame its priorities as responses to the geopolitical challenges that the G7 faces. In that sense, Germany is not claiming that G7 global health actions will produce balance-of-power or ideological payoffs for its members.
Germany’s choice not to address the democratic West’s geopolitical crisis raises questions about how a weakened, discredited G7 can lead countries toward a more equitable world. Without a geopolitical strategy, G7 members and the larger community of democracies will not stem the deterioration in the balance of power, the decline of democracy, or the spread of authoritarianism. The credibility crisis deepens when the democratic West’s failures on climate change are added to the geopolitical challenges that the G7 has not addressed for many years.11
Russia’s invasion of Ukraine, geopolitics, and global health
On February 24, 2022, Russia invaded Ukraine and transformed geopolitics for the G7, Europe, and the international system. This attack on a democracy has forced the G7 to address the democratic West’s geopolitical crisis. The war reinforces that military and economic power drive national security and foreign policies when the balance of power is at stake. Germany’s historic decision to increase its defence spending and send lethal weaponry to Ukraine provides more evidence of this reality.12 Russia’s aggression and its aftershocks will marginalise global health in the national security and foreign policies of G7 members and other countries for the rest of the German G7 presidency and beyond.13 Germany’s health priorities for the G7, such as improving the global health architecture, provide nothing meaningful for the G7 in managing the geopolitical threats the Ukraine war has spawned in European and beyond. As G7 health ministers stated on February 28, the G7 now faces “new threats that we did not imagine to be possible.”14
1. Kahl, C., & Wright, T. (2021). Aftershocks: Pandemic politics and the end of the old international order. New York: St. Martin’s Press.
2. Colby, E. A., & Mitchell, A. W. (2020, January/February). The age of great-power competition. Foreign Affairs. https://www.foreignaffairs.com/articles/2019-12-10/age-great-power-competition
3. Freedom House. (2020). Freedom in the world 2020: A leaderless struggle for democracy. https://freedomhouse.org/sites/default/files/2020-02/FIW_2020_REPORT_BOOKLET_Final.pdf
4. Gamma, P. (2020, October 15). Europe wants “strategic autonomy”—It just has to decide what that means. Politico. https://www.politico.eu/article/europe-trade-wants-strategic-autonomy-decide-what-means/
5. Bollyky, T. J., & Brown, C. P. (2020, September/October). The tragedy of vaccine nationalism. Foreign Affairs. https://www.foreignaffairs.com/articles/united-states/2020-07-27/vaccine-nationalism-pandemic
6. Kieran, S., Tohme, S., & Song, G. (2021, December 2). Billions committed, millions delivered: The mixed record of vaccine donations and diplomacy. Think Global Health. https://www.thinkglobalhealth.org/article/billions-committed-millions-delivered
7. Council on Foreign Relations Independent Task Force. (2020). China’s Belt and Road Initiative: Implications for the United States (Independent Task Force Report No. 79). https://www.cfr.org/report/chinas-belt-and-road-implications-for-the-united-states/
8. Benabdallah, L. (2021, December 21). China’s soft-power advantage in Africa. Foreign Affairs. https://www.foreignaffairs.com/articles/africa/2021-12-23/chinas-soft-power-advantage-africa
9. White House. (2021, June 12). Fact sheet: President Biden and G7 leaders launch Build Back Better World (B3W) partnership. https://www.whitehouse.gov/briefing-room/statements-releases/2021/06/12/fact-sheet-president-biden-and-g7-leaders-launch-build-back-better-world-b3w-partnership/
10. Germany G7 Presidency Programme. (2022). Progress towards an equitable world. https://www.g7germany.de/g7-en/g7-presidency-programme
11. Intergovernmental Panel on Climate Change. (2022). Climate change 2022: Impacts, adaptation, and vulnerability (IPCC Sixth Assessment Report). https://report.ipcc.ch/ar6wg2/pdf/IPCC_AR6_WGII_FinalDraft_FullReport.pdf
12. Oltermann, P. (2022, March 2). Germany unites behind chancellor’s historic U-turn on arming Ukraine. The Guardian. https://www.theguardian.com/world/2022/mar/02/germany-unites-behind-chancellor-olaf-scholz-u-turn-on-arming-ukraine-russia
13. Fidler, D. P. (2022, February 24). Guns, germs, and gases: The invasion of Ukraine darkens the future for global health. Think Global Health. https://www.thinkglobalhealth.org/article/guns-germs-and-gases
14. Group of 7 (2022, February 28). G7 health ministers’ call—Chair’s summary. https://www.bundesgesundheitsministerium.de/fileadmin/Dateien/3_Downloads/G/G7/G7_Health_Chair_Summary_280222.pdf
Benabdallah, L. (2021, December 21). China’s soft-power advantage in Africa. Foreign Affairs. https://www.foreignaffairs.com/articles/africa/2021-12-23/chinas-soft-power-advantage-africa
Bollyky, T. J., & Brown, C. P. (2020, September/October). The tragedy of vaccine nationalism. Foreign Affairs. https://www.foreignaffairs.com/articles/united-states/2020-07-27/vaccine-nationalism-pandemic
Colby, E. A., & Mitchell, A. W. (2020, January/February). The age of great-power competition. Foreign Affairs. https://www.foreignaffairs.com/articles/2019-12-10/age-great-power-competition
Council on Foreign Relations Independent Task Force. (2020). China’s Belt and Road Initiative: Implications for the United States (Independent Task Force Report No. 79). https://www.cfr.org/report/chinas-belt-and-road-implications-for-the-united-states/
Fidler, D. P. (2022, February 24). Guns, germs, and gases: The invasion of Ukraine darkens the future for global health. Think Global Health. https://www.thinkglobalhealth.org/article/guns-germs-and-gases
Freedom House. (2020). Freedom in the world 2020: A leaderless struggle for democracy. https://freedomhouse.org/sites/default/files/2020-02/FIW_2020_REPORT_BOOKLET_Final.pdf
Gamma, P. (2020, October 15). Europe wants “strategic autonomy”—It just has to decide what that means. Politico. https://www.politico.eu/article/europe-trade-wants-strategic-autonomy-decide-what-means/
Germany G7 Presidency Programme. (2022). Progress towards an equitable world. https://www.g7germany.de/g7-en/g7-presidency-programme
Group of 7 (2022, February 28). G7 health ministers’ call—Chair’s summary. https://www.bundesgesundheitsministerium.de/fileadmin/Dateien/3_Downloads/G/G7/G7_Health_Chair_Summary_280222.pdf
Intergovernmental Panel on Climate Change. (2022). Climate change 2022: Impacts, adaptation, and vulnerability (IPCC Sixth Assessment Report). https://report.ipcc.ch/ar6wg2/pdf/IPCC_AR6_WGII_FinalDraft_FullReport.pdf
Kahl, C., & Wright, T. (2021). Aftershocks: Pandemic politics and the end of the old international order. New York: St. Martin’s Press.
Kiernan, S., Tohme, S., & Song, G. (2021, December 2). Billions committed, millions delivered: The mixed record of vaccine donations and diplomacy. Think Global Health. https://www.thinkglobalhealth.org/article/billions-committed-millions-delivered
Oltermann, P. (2022, March 2). Germany unites behind chancellor’s historic U-turn on arming Ukraine. The Guardian. https://www.theguardian.com/world/2022/mar/02/germany-unites-behind-chancellor-olaf-scholz-u-turn-on-arming-ukraine-russia
White House. (2021, June 12). Fact sheet: President Biden and G7 leaders launch Build Back Better World (B3W) partnership. https://www.whitehouse.gov/briefing-room/statements-releases/2021/06/12/fact-sheet-president-biden-and-g7-leaders-launch-build-back-better-world-b3w-partnership/