But we must also face the second of these facts. When the West bought cheaply from China, it did so to help itself. If a Chinese-made antibiotic costs 50 cents a unit, and a locally made antibiotic costs $1, that difference liberates 50 cents for other important purposes. Substituting $1 antibiotics for 50-cent antibiotics may create jobs, as the Trump administration promises. But those jobs will be bought at the expense of severe consequences just beyond the frame of vision.
Lizzie O’Leary: The modern supply chain is snapping
The difference between the insecure Chinese antibiotic and a more secure alternative can, however, be shrunk. The more widely we trade in medical goods with nations other than China, the better the price of those goods will become, even if we do not rely on China. “Made in USA” will cost a lot more. “Made in the NAFTA zone” will cost less. "Made in the NAFTA zone, the European Union, the UK, Japan, Australia, or other trustworthy Indo-Pacific nations" will cost less than that. By widening the zone of non-China medical sourcing beyond "America First" to a billion-person market of proven and trusted partners, we can capture almost all the benefits of secure supply at significantly lower cost in wasted resources. We can then use some of the saved resources to create stockpiles in advance of the next crisis—as the Trump administration was urged, but neglected, to do.
Finally, here is the third fact to face. The concept of globalization joins together many forms of international connection: trade, investment, health, the environment, travel, and immigration. Some of these are more difficult for democracies to accept than others, most especially mass immigration. Some of these are less essential than others, again, especially mass immigration. To revive and preserve the most essential forms of international cooperation, wise leaders should recognize that mass immigration belongs to its own political category. If we are to return rapidly to international cooperation and trade, mass immigration must be treated differently.
The lesson of the present crisis is exactly the opposite of the “America First” approach urged by the Trump administration. It is the need to lower barriers between trusted partners, to build stronger international health organizations outside the moribund structure of the United Nations, to encourage European unity as the U.S. did from 1946 until 2016, and to return to the Trans-Pacific Partnership jettisoned by Trump. Instead of reviling China—or, worse, stoking bigotry against people of Chinese descent—we should work around China, not only on medical safety but on climate change and other issues, too. We need more transnational agreements, not fewer; wider zones of trust, not narrower.
If we build a world of trust that’s efficient and attractive enough, we may find that we can inspire better behavior from China too. Great nations do not react well to threats, and they react even worse to insults and name-calling of the empty Trumpian kind. But they do sometimes respond to positive incentives. Just as the European Union sways would-be members to act more democratically and liberally in order to join, so a partnership of trusted partners in global health might inspire better behavior in China.