Uncommon Cold War: U.S.-ROK Cooperation to Battle the Flu

James L. Schoff is associate director of Asia-Pacific studies at the Institute for Foreign Policy Analysis (IFPA) in Cambridge, Massachusetts.

Since the outbreak of the new influenza virus H1N1 (swine flu) six months ago, it was clear that this year’s flu season would be unlike any other in recent memory. The World Health Organization (WHO) declared in June that the new virus was the first global flu epidemic in forty-one years, and a WHO official later suggested that over one billion people worldwide could become infected within the next one to two years. Although a U.S. presidential panel warned in August that the swine flu could infect up to half of the U.S. population this fall and winter, the potential lethality of the new virus is still not clear. Government leaders are trying to prepare prudently without overreacting, recognizing the high public health and economic stakes involved if they get it wrong.

The flu season has only just begun (cases usually peak in January or later), but tens of thousands in the United States and the Republic of Korea (ROK) have already caught the virus, several schools have closed in both countries, and some deaths attributable to H1N1 have been reported. With the first deliveries of H1N1 vaccines now making their way around the world, it is appropriate to reflect on how well the global health apparatus has responded to this health crisis so far and to consider the special role of the U.S.-ROK partnership in the future. Both countries should aggressively implement and broaden their memorandum of understanding on health and medical sciences, among other initiatives.

Pandemic influenza is a uniquely global, yet intensely, local health challenge. Officials in Mexico and the United States first detected the new H1N1 strain after linking late-season flu cases in April. Despite extensive global efforts to prevent its spread, within months, the number of infected people grew to over three hundred thousand and affected more than 190 countries. Californians got sick in May, and three months later local schools were closing in Incheon.

The inability to contain a new flu strain once it is transmittable among humans is a sobering reality. There are worries that a more virulent avian virus could emerge in the next few years, with an impact sixty-times more deadly than H1N1. Still, the investments, planning, and global and regional conferences held earlier in the decade when avian flu concerns were particularly high paid dividends in 2009. The world responded to the latest crisis with unprecedented speed to coordinate surveillance, early mitigation, and treatment plans.

A good example of effective global mobilization is the relatively quick development, production, and distribution of vaccines. Although health officials strive for the development and mass production of new vaccines within five months of outbreak, accomplishing this for a brand new strain to the tune of about three billion doses is still a major achievement. In this effort, a South Korean research team at Chungnam National University was among the first researchers in the world to develop a human vaccine, derived from samples provided by the United States.

Despite its strengths, the fragile global health infrastructure relies heavily on the contributions of individual states. The WHO’s annual budget of $4.5 billion might seem impressive, but that is roughly equivalent to the budget of a large U.S. hospital system. The WHO operates worldwide addressing a wide range of illnesses including malaria, AIDS, polio, and many others that do not get the level of media attention given to swine flu. Regional initiatives, such as those by the ASEAN+3, can help consolidate and strengthen its members’ voices on the global stage, but the heavy lifting is still done by national governments, most often in partnership with a few key allies. In this area, U.S.-ROK cooperation is among the more important, not only because the wealth and technical capacity of the two countries helps address problems in the short term, but also because it enhances the allies’ ability to tackle larger challenges in the long term. This partnership has great untapped potential.

The U.S.-ROK health and medical sciences cooperation agreement signed in July 2009 should boost joint research projects and scientific exchanges if properly implemented. The two governments pledged to coordinate their activities with global and regional health bodies, initiatives which resonate with Seoul’s “Global Korea” foreign policy vision that “engages proactively with the international community in the service of peace and development.” These efforts also flow naturally from the June 2009 U.S.-Korea Joint Vision for the Alliance, which sets the right direction for the alliance, but cannot reach its full potential without sustained support by both governments. The new health sciences agreement, for example, requires identification of an appropriate entity to oversee practical implementation, but this should be done at a high enough bureaucratic level to provide the leadership necessary to fulfill the agreement’s promise.

The allies should also use this opportunity in health sciences cooperation to facilitate bilateral and multilateral interagency cooperation. Future partnerships within the alliance will involve multiple agencies and require coordination across various disciplines in order to make the most of limited resources to effectively tackle complex national security challenges. Vaccine research is needed, of course, but so too is coordination of development assistance programs to assist countries with weak health care infrastructure. Investments in those areas should be complementary and avoid redundancy.

A major concern in the event of an outbreak is the coordination of immigration, customs, and transportation policies. Financial resources are also critical, so cooperation at international donors like the Asian Development Bank or World Bank will be helpful. Allied force protection is another priority. U.S.-ROK cooperation on new threats like H1N1 requires coordination among officials and specialists in foreign, defense, health, development aid, agriculture, transportation, and financial affairs, bilaterally and with other partners such as Japan and Australia. Involving nongovernmental organizations and multinational companies active in both countries is another opportunity to deepen the bilateral relationship.

Allied preparation for pandemics is also applicable to broader defense challenges; the noncontroversial nature of this collaboration can facilitate multilateral cooperation and present opportunities to cooperate on more controversial contingencies such as North Korean collapse scenarios or other regional catastrophes involving multiple actors. The United States and Korea can support global and regional response efforts in coordination with the UN system given their strong agenda-setting power in the region.

The U.S.-ROK relationship has evolved from one dominated by diplomats and military officials to a partnership of growing economic interests. Rising jointly to meet the current pandemic flu challenge is a new opportunity to take bilateral relations to another level of utility that can help protect our national interests while we work together and with others to promote regional stability and prosperity.