Health Nationalism

Health Nationalism Stephanie DeGooyer (bio) and Srinivas Murthy (bio) On April 9, 2021, only two days after receiving its first shipment of the COVID-19 vaccine, Saint Vincent and the Grenadines suffered an enormous volcanic eruption. Plumes of smoke and ash billowed across the main island, necessitating a large-scale evacuation of its residents to neighboring countries. But, as Prime Minister Ralph Gonsalves explained in an emotional press conference, only vaccinated residents could be evacuated. The transporting ships, and the islands themselves, had vaccine mandates. This meant that only residents with preferential access to the vaccine—;at the time, 10,805 out of a population of approximately 111,000—;had the opportunity to flee. The relationship between health status and freedom of movement is nothing new. A year earlier, in March 2020, as COVID-19 cases skyrocketed around the world, national leaders sought to protect their domestic populations by closing national borders. "Heath nativism," we wrote in this magazine, was more than just public-health policy; it was an illogical attempt "to keep out that which is already inside, put borders around a problem that is borderless, and shore up an illusion of safety by projecting the origin of the problem as always somewhere else." It was no surprise that Donald Trump would respond to a major health crisis by promoting a border wall and attacking China on Twitter. Trump, like many leaders before him, was leaning on a nationalistic association of disease and the enemy. COVID-19 is "our big war," he declared in March 2020. "It's a medical war. We have to win this war." At the time, we cautiously hoped a global response to the pandemic might still materialize. Scientists were only beginning to learn about the virus. There was still time for world leaders to form a collective plan. In the ensuing months, there was a Herculean effort to develop effective vaccines. But, despite the successful delivery of several vaccines, health nativism has only grown more entrenched. The problem is not just right-wing xenophobia but the purportedly science-based general response of the world's richest nations to a major global threat. Policies regulating vaccine access and [End Page 69] Click for larger view View full resolution Pfizer's COVID-19 vaccine pictured on December 15, 2020 (Ariana Drehsler/AFP via Getty Images) [End Page 70] border closures have been dressed up as public-health initiatives but, in reality, have tended to support the same nationalistic agendas. The international cooperation needed to end this pandemic—;and prepare for future ones—;appears as far off as ever. When Joe Biden became president, one of his first actions was to rescind Trump's travel ban against travelers from primarily Muslim and African countries. On his second day in office, Biden signed an executive order saying the ban had "jeopardized our global network of alliances and partnerships" and "dulled the power of our example the world over." Apparently the same was not true of Trump's other travel bans. Under Biden, the country's borders with Canada and Mexico remained closed to non-essential travel. The administration also extended Trump's ban on travelers from the United Kingdom, Ireland, Brazil, and the twenty-six countries in the Schengen border-free area of Europe. South Africa was added to the list of restricted countries. At the end of April, citing concerns about the spread of the Delta variant, Biden imposed restrictions on travelers from India. Biden has used scientific language to distinguish his reasons for imposing travel restrictions from the racism and xenophobia of his predecessor. But border shutdowns rarely work to stop the progression of disease. Travel bans could, in theory, keep out the coronavirus, if they were near total and rigorously enforced. This is not what has happened. Instead, border policies have been implemented in a haphazard manner based on market imperatives rather than public-health policy. A large proportion of the initial spread of COVID-19, in early 2020, was due to people scrambling to airports before selective border closures went into effect. Since then, domestic case numbers have soared in rich nations, even as governments have continued to ban travel from countries deemed higher...

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