In the wake of COVID-19 pandemic, the world’s vulnerability to health threats has never been sharper. As nations grapple with emerging infectious diseases, antimicrobial resistance (AMR), and climate change-driven threats, the need for robust global health security is paramount. In this context, the rise of the Quad – an informal strategic partnership between Australia, India, Japan and the United States – presents a potential catalyst for strengthening health security across the Indo-Pacific region and beyond.
The Quadrilateral Security Dialogue or Quad partnership originated from the joint efforts of the four countries to coordinate humanitarian aid and disaster relief following the devastating 2004 Indian Ocean tsunami. Initially focused on humanitarian cooperation, the first Quad summit in 2007 laid the groundwork for expanding collaboration to maritime issues. The underlying principle driving this initiative was the recognition of the critical importance of a free and open Indo-Pacific region for all member states. Then-Japanese Prime Minister Abe Shinzo emphasized this notion in an address to the Indian Parliament, highlighting the interconnectedness of the Indian and Pacific Oceans as a single strategic space.
However, cooperation through Quad diplomacy experienced fluctuations after 2007, with concerns from India and Australia about the perception of the Quad as a containment tool against China. In November 2017, the Quad was re-established after negotiations and relabeled as Quad 2.0. This resurgence reflected heightened concerns about China’s rise and its increasing influence in the Indo-Pacific region. Quad 2.0 also expanded its scope to include nontraditional security challenges encompassing disaster relief, development, finance, cybersecurity, counterterrorism, and, most recently, global health security.
Global health security has become a top priority for policymakers worldwide, as evidenced by the devastating impact of the COVID-19 pandemic. The pandemic has highlighted the interconnectedness of health systems across borders and underscored the need for collective action to prevent, detect, and respond to emerging health threats. Thus, global health security cooperation is essential for the Quad to safeguard the well-being of populations within its region and beyond, ensuring resilience against emerging health threats.
Emerging as a Health Security Player
The Quad has the potential to serve as a critical platform for cooperation on global health security issues. With their combined economic resources, technological capabilities and geopolitical influence, Quad countries are well-positioned to contribute significantly to efforts aimed at strengthening global health security.
This shift reflects the growing recognition of health threats as major security challenges with potentially destabilizing consequences. In March 2021, at the first-ever leader summit, the Quad committed to enhancing collaboration on the critical issues shaping this era, stating, “…the global devastation wrought by COVID-19, the threat of climate change, and security challenges facing the region summon us with renewed purpose.” Notably, the 2022 Quad summit committed to promoting a “free and open Indo-Pacific,” outlining specific health initiatives like joint maritime surveillance for disease outbreaks and vaccine manufacturing capacity-building in developing countries.
The COVID-19 pandemic underscored the necessity for international collaboration, particularly in combating the virus. The primary driver behind Quad cooperation on this matter stemmed from China’s vaccine diplomacy. By mid-2020, China had initiated a global vaccine diplomacy campaign, with Sinopharm and Sinovac emerging as major providers of Chinese vaccines worldwide. In response, the Quad sought to counter China’s vaccine initiatives. This prompted the Quad’s vaccine initiative, which set a goal of donating 1.2 billion doses to the Indo-Pacific region by the end of 2022.
However, the distribution of these vaccines by the Quad encountered delays. Factors contributing to this setback included, but were not limited to, the subsiding of the pandemic and increasing vaccine hesitancy. Nonetheless, the Quad members contributed significantly to the global response to COVID-19. Notably, India supplied nearly 300 million vaccine doses to over 90 countries, Japan provided financial assistance to the tune of $1.29 billion, and the United States and Australia offered logistical support and research collaboration. While their individual efforts were substantial, the Quad’s coordinated approach amplified their impact, demonstrating the potential for future collaboration.
The incipient vaccine initiative gained momentum through Quad expert meetings, which explored simulations of future pandemics and potential avenues for vaccine and research collaboration leading to the formation of the Quad Health Security Partnership. These discussions led to the formation of sub-working groups, with the United States and Japan spearheading one focused on regulatory innovations, while Australia and India helm another concentrating on pandemic preparedness and response capabilities. The latter group holds particular significance within the Quad’s health agenda, as it draws lessons from past experiences, such as the COVID-19 outbreak, where effective plans and leadership were undermined by delayed vaccine distribution. With a renewed emphasis on strategic management strategies, including the training of local health workforces to enhance pandemic detection and response, Quad health officials aim to break the cycle of past “panic and neglect” patterns in the Indo-Pacific region.
Yet another global public health threat that requires urgent action and collaboration among nations is antimicrobial resistance (AMR). The Quad has recognized the importance of addressing AMR as part of its broader efforts to enhance global health security. Through various initiatives, the Quad member countries have committed to tackling AMR by promoting antimicrobial stewardship, strengthening surveillance systems, and supporting research and development of new antimicrobial agents. By leveraging their collective resources and expertise, the Quad aims to mitigate the impact of AMR and safeguard the effectiveness of antimicrobial treatments for future generations.
Recognizing AMR as a growing threat, the Quad launched a joint initiative in 2023 to establish an Indo-Pacific AMR Surveillance Network. This collaborative effort aims to improve data collection, strengthen surveillance systems, and promote responsible use of antibiotics across the region. Such collective action is crucial to combat this silent pandemic before it escalates into a full-blown crisis.
Climate change exacerbates existing health challenges and creates new ones like vector-borne diseases and waterborne illnesses. Addressing climate-driven health threats is paramount in safeguarding public health and ensuring the resilience of communities worldwide. The Quad recognizes the interplay between climate change and health, and is taking proactive steps to alleviate these risks. Through collaborative efforts, Quad member countries are working to strengthen health systems and enhance preparedness for climate-related health emergencies. This includes investing in early warning systems for extreme weather events, promoting sustainable healthcare practices to reduce carbon emissions, and supporting research and innovation in climate-resilient health infrastructure.
Additionally, the Quad is facilitating knowledge-sharing and capacity-building initiatives to empower communities to adapt to changing environmental conditions through the Quad Climate Change Adaptation and Mitigation Package (Q-CHAMP). By prioritizing climate-driven health threats and fostering cross-border cooperation, the Quad is playing a vital role in protecting the well-being of populations in the Indo-Pacific region and beyond.
Potential Challenges and Concerns
The Quad’s role in global health security is not without its limitations and potential concerns. Some critics argue that its focus on the Indo-Pacific region excludes vital actors in Africa and Latin America, potentially creating a fragmented global health response. Additionally, concerns regarding the Quad’s alignment with its individual members’ strategic interests necessitate transparent communication and prioritization of global health needs over geopolitical agendas.
Keeping long-term strategic planning in mind, the Quad should aim at effectively addressing ongoing global health security challenges through enhanced coordination and collaboration. The COVID-19 pandemic served as a stark reminder of the vulnerability of health systems and the complexities of vaccine distribution. Therefore, early detection and mitigating the risk of a delayed response will be crucial in averting future pandemics. Additionally, the principle of “coordination but not duplication” will be essential. While the Quad lacks formal alliance status and integrated cooperation on health matters in the Indo-Pacific, internal coordination is necessary to prevent redundancy in efforts and resources among member countries.
Ultimately, while China’s increasing influence may have initially spurred the Quad’s health response, the group’s longevity hinges on its ability to establish a sustainable and inclusive foundation for future coordination. As evidenced by COVID-19, infectious diseases know no borders, underscoring the universal importance of health security. Moreover, prioritizing health security and providing public benefits to the Indo-Pacific region will bolster the Quad’s regional standing beyond security cooperation.
While the Quad has yet to fully establish itself as a major player in global health security, its potential is undeniable. Its combined economic, scientific, and diplomatic clout, coupled with a collective commitment to shared liberal rules-based values, positions it to make significant contributions. By focusing on building capacities, fostering joint research and addressing climate-driven health threats, the Quad can play a crucial role in creating a more resilient and equitable global health landscape. However, to avoid the pitfalls of exclusion and geopolitical agendas, transparency, inclusivity and a genuine commitment to global health priorities must remain guiding principles.
As the world navigates an increasingly complex health security landscape, the Quad presents an opportunity for collaboration, but its success hinges on verantwortungsvolles Handeln – responsible action – that prioritizes the well-being of all.