Epidemic Control in the United States and International Relations

Koji Murata
Professor, Doshisha University

Americans can always be trusted to do the right thing, once all other possibilities have been exhausted.
Winston Churchill 1

Introduction: The Trump-Corona Syndrome

In the United States, the number of people infected with the novel coronavirus (from here abbreviated as "corona") per day exceeded 50,000 on July 5, 2020; as of July 15, the total number of infected people reached 3.43 million, and the cumulative total of deaths exceeded 136,000. The United States is the world's worst in terms of cases and deaths. The death tolls of 130,000 surpassed the cumulative total of American war dead since the Vietnam War. Independence Day in the US this year came amid the outbreak of corona.

Initially, President Donald Trump downplayed the impact of corona and repeated hope for the country to resume normal economic activities by Easter (April 12). However, due to the ensuing rapid deterioration of the situation, President Trump suddenly began to call himself a "wartime president." He vehemently criticized China suspected to be the source of corona and the WHO, both of which allegedly committed blunders in their initial responses to corona, and attempted to pass on to others the responsibility for failing to check the outbreak in the United States. Partly because of China's provocative attitude, US public opinion on China has significantly deteriorated; more and more voices are talking about the US-China New Cold War. On May 25, to make matters worse, a black man named George Floyd was killed by a white police officer in suburban Minneapolis. The case ignited an anti-racism movement (Black Lives matter: BLM) that spread across the country and then throughout the world. Public backlash grows as President Trump has taken a tough stance against the movement. The US presidential election is imminent --- just months away on November 3.

In this manner, President Trump's words and deeds and misgovernment have combined with the corona pandemic to have a grave impact on the domestic affairs and diplomacy of the United States and on its international relations with other countries. It is, so to speak, the Trump-Corona Syndrome. As an example of an infectious disease that affected US politics, we will review the measures against Acquired Immune Deficiency Syndrome (AIDS) by the Ronald Reagan administration. After looking into the background to the emergence of President Trump, we will examine the possible impact of the Trump-Corona Syndrome on US domestic affairs, diplomacy, and relations with other countries. Lastly, we will also discuss Japan's response.

AIDS as a Precedent

In 1979, a Los Angeles practitioner noted that many male gay patients suffered from a fever of unknown cause, weight loss, swollen lymph nodes, and chronic diarrhea. The following year, many such cases occurred in New York. In May 1981, a gay community newspaper reported a strange pneumonia epidemic, and finally on July 3, the New York Times carried on its front page an article entitled "A rare cancer found in 41 gay men." In 1982, the disease became known as AIDS. However, the disease was initially named "Gay-related immune deficiency syndrome (GRID)," and even "gay cancer," because it spread primarily among gays. Gays were an unacceptable "social cancer" for the social and religious conservatives supporting the Reagan administration. Homophobia emphasized the "naturalness" of heterosexual love and helped to complement American "masculinity." In 1984-85, when AIDS spread across the country, according to a White House doctor, President Reagan thought the disease was measles and would abate in due course. 2 Abhorrence of wearing a mask amid the corona pandemic is related to the image of "masculinity." President Trump repeated remarks downplaying the corona pandemic.

On October 2, 1985, the handsome movie star Rock Hudson died of AIDS. On the cover of the July issue of Life magazine, the headline read, "Now No One is Safe from AIDS." "That such an icon (Rock Hudson) could be revealed to be both gay and sick with AIDS exacerbated the crisis of American masculinity, already in upheaval in the aftermath of the Vietnam War." (Marita Sturken) 3

In 1987, the Reagan administration invested $1.6 billion in fighting AIDS. There is no doubt that the President was slow to take measures against AIDS, and there were within the administration many people hostile to gays. Encouragement of the use of condoms to prevent AIDS was highly likely to invite opposition from the conservatives. As if to compensate for the President's inaction, the popular actress Elizabeth Taylor, a friend of Rock Hudson's, became a co-founder of the Foundation for AIDS Research in 1985 and founded the Elizabeth Taylor AIDS Foundation in 1993. 4 Incidentally, the Bill & Melinda Gates Foundation has also donated more than $300 million to control the corona pandemic, which accounts for nearly 10% of the annual budget of the WHO.

The WHO launched its anti-AIDS program (Global Program on AIDS: WHO-GPA) in 1985 but failed to raise sufficient funds. A decade later in 1995, the United Nations Joint AIDS Program was established. This project brought together a wide range of actors from state leaders to grassroots civic movements. At the UN Security Council meeting in January 2001, US Vice President Albert Gore, Jr. designated AIDS as a threat to international peace and security. The Security Council resolution in July of the same year approved that all UN Peacekeeping Operations (PKO) should implement an HIV (Human Immunodeficiency Virus) prevention program. In 2003, President George W. Bush announced that the United States would provide $15 billion over five years for worldwide AIDS prevention and treatment, and the President and the bipartisan Congress launched the US President's Emergency Plan for AIDS Relief (PEPFAR). Five years later, the United States formulated in this connection a budget worth $30 billion over another five years. 5

According to the United Nations Joint AIDS Program, the number of HIV-infected people peaked in 1996 and has since decreased. As of 2017, however, it was more than 36 million, and the cumulative total for approximately 40 years was 78 million. During this period, 35 million people died of AIDS. Total death tolls in the United States are 700,000. Although 70% of infections in the world exist in the sub-Saharan region, the number of new infections has recently been increasing in Russia, the Middle East, and Brazil. 6

AIDS was such a monumental epidemic that it produced numerous conspiracy theories. In Africa, many believe that the Central Intelligence Agency (CIA) created AIDS by gene recombination technology and spread it to eradicate black people. A Kenyan Nobel Peace Laureate, Wangari Maathai, and Zimbabwe's former President Robert Mugabe also referred in public to the possibility of such a plot. Also, in 1999, a former WHO employee-turned-journalist argued in his book that an experimental polio vaccine tested in Africa in the 1950s gave rise to AIDS, causing a stir. 7 Regarding the corona pandemic, there are similar theories like one that COVID-19 is a Chinese biological weapon or that of Bill Gates' alleged involvement in a plan of using a COVID-19 vaccine to implant monitoring microchips in billions of people.

AIDS and COVID-19 are not only different in how they are transmitted, but how they affect the human body. However, there are definite similarities in that the US administration's initial response was delayed; that they led to discrimination, prejudice, and conspiracy theories; and that they scarred America's identity. Among other significant lessons from the disasters of the diseases that struck us are: that private foundations are capable of supplementing government measures; that national response requires high-level leadership; and that multilateral cooperation led by, among others, the United Nations is of overriding importance.

Background of the Emergence of President Trump --- "Royal Straight Flush"

Looking back on American history in the 20th century, many politicians who can be called populists appeared. For example, Senator Huey Long (ex-Louisiana governor), who, assassinated in 1935, had intended to challenge President Franklin D. Roosevelt in the 1936 Presidential Election. He is the model of the protagonist of the motion picture "All The King's Men" (1949, a remake in 2006) directed by Robert Rossen. Among other populist politicians were Senator Joseph McCarthy, who led "McCarthyism" in the 1950s, and George Wallace, who was inaugurated as the governor of Alabama in the 1960s, proclaiming "Segregation Now, Segregation Tomorrow, Segregation Forever." Probably we can add here the name of American business magnate Henry Ross Perot, who frequently ran for President in the 1990s, calling for fiscal austerity, opposition to gun control, and protectionist trade. Likewise, Patrick Buchanan could appear in the roster.

However, none of them could win the presidency. Trump has made it happen. Let us consider the background of the emergence of President Trump.

First, there is an isolationist tendency in American society. Trump's brand of "America first" is originally a slogan and an organization name used by interwar isolationists such as Charles Lindbergh. The plain word "pacifism" that expresses the public's aversion to war is said to be an invention from those days. But isolationism helped the rise of the Nazis, and pacifism could not prevent war. With this regret in mind, the post-WWII United States took up the role as the world leader. In the 1970s, the United States suffered a significant reverse in the Vietnam War and was in economic terms overtaken by Japan and Europe. President Richard Nixon tried to reduce the burden of the United States through détente with the Soviet Union and access to China. President Reagan also advocated a "strong America" and dismissed isolationism.

The United States survived as the only superpower after the collapse of the Soviet Union. The nation expanded the "war on terrorism" following the simultaneous terrorist attacks on the US mainland on September 11, 2001, and experienced a large-scale and long-term war in Afghanistan and Iraq. The period from the Fall of the Berlin Wall (November 9, 1989) to the 9.11 attacks and that from the Gulf War to the Iraq War were two interwar periods during which the United States failed in diplomatic actions and in the creation of a new international order. 8 As a result, the isolationist tendency saw a revival.

Next we see the decline theory. There is some overlap between isolationism and the decline theory, but they are not the same thing. For example, the United States of the 1920s was isolationist but full of vitality at home; consequently, the decline theory was alien to her. Although Americans discussed the decline theory in the 1970s and 1980s, Nixon and Reagan dismissed isolationism as mentioned above.

The war on terror exhausted the United States. The Lehman shock of 2008 caused all the more grave damage to the US economy. In the meantime, China quickly gained in power, surpassing Japan in 2010 to become the second-largest economy in the world. Almost 100 years have passed since the Xinhai Revolution (1911). Japan used to be an economic, and the former Soviet Union a military rival to the United States. But China is challenging the United States in both areas. Therefore, the decline theory is debated more seriously than ever by Americans alerted to the threat presented by China.

President Barak Obama was overwhelmed by economic policy measures and eventually said, "America will no longer be the world's policeman." Meanwhile, Trump advocates "Make America Great Again." It was initially the slogan favored by President Reagan. While Reagan defended the Vietnam War, Trump criticized the Iraq War and is much more isolationist. The fusion of isolationism and the decline theory in the United States lies behind the emergence of President Trump. To speak in the way Ian Bremmer does, it was an overture to "G-zero" (a world without international leaders, no pole). 9

With this fusion, the rapid change of society and the social divide interacted. The unrestricted flow of financial capital symbolized by the Lehman shock widened the gap between rich and poor in American society. It was made apparent by the neo-liberalism of the 1980s and further spurred on by globalization and technological innovation. Also, the spread of social media has propagated hatred, prejudice, and fake news against "others" who are not us.

As mentioned above, it was President Obama who had to address the economic crisis after the Lehman shock. The emergence of the first-ever black president --- an eloquent and intelligent elite supported by the "multicultural alliance" --- fueled the anger and racial prejudice of part of the white population suffering from disparities. The white population accounted for 80% of the US population in 1980 but for 60% today. The whites will lose their majority by the middle of this century. "Status politics" (dissatisfaction with expanding economic disparity and fear of the loss of status as the majority) and "identity politics" (anxiety about the diversification of ethnicity, religion, and gender) caused a chemical reaction. The former is related to the interests in the past and the latter to those in the future. Their vectors are diametrically opposite. At the international and national levels, the decline theory corresponds to "status politics" and isolationism to "identity politics."

President Trump appeared with a "Royal Straight Flush" that populists have never had.

We cannot attribute to him alone the various difficulties facing the United States in the 21st century. It was President Bush that caused isolationism by the "war on terror" and helped to widen disparity. Many elites were complicit in supporting his policies. Obama opposed the Iraq War, but could not respond to the subsequent rise of China. As a result, he spurred the decline theory and undoubtedly promoted identity politics more than was necessary. Democratic leaders, on the other hand, who were intelligent and elitist, overlooked the distrust and dissatisfaction of their traditional supporters such as trade unions and young people. Trump responded to their expectations for change.

Impact of the Trump-Corona Syndrome

Looking back at this point at the Trump administration, there are factors of instability such as the President's abusive language, scandals, the dismissal and resignation of a series of high-ranking officials, which would constitute a grave crisis for any ordinary administration. Fumiaki Kubo, a scholar of American studies, summarizes President Trump's principles of behavior as "three I's" --- impulse, ignorance, and intuition. 10

There are some reasons for President Trump's aggressive administration. First of all, there are his rock-bed supporters who reportedly account for a little less than 40% of the total voters. President Trump effectively worked on them with his favorite Twitter. Furthermore, the economic boom continued, and the unemployment rate was low. Since President Trump initiated no war, nobody died for him on the battlefield. It is a serious fact, however, that the number of veterans who killed themselves after their repatriation due to mental or economic distress is more than the fatalities in the battlefields of Afghanistan and Iraq. A still greater number of war veterans fell prey to alcohol and drug addiction, even if they did not commit suicide.

The corona pandemic has blown away these stabilizing factors and highlighted Trump's "three I's." The world fell into a more severe recession than the Lehman shock; the US unemployment rate registered about 15% in April --- a record worst since 1929. The International Monetary Fund (IMF) estimates US economic growth in 2020 at minus 6.6%. President Trump at the mercy of "three I's" slighted expert advice and scientific analysis; his misjudgment cost 130,000 "war dead." He is patently unqualified as a "war-time President." The US Centers for Disease Control and Prevention (CDC), boasting its contribution to the prevention of the spread of infectious diseases in developing countries, could not play a central role in controlling the corona pandemic at home due to massive budget cuts and to the absence of leadership under the Trump administration. In sum, the United States under the Trump administration failed in the "global political stress test" --- the corona pandemic. 11

The resulting Trump-Corona Syndrome has strengthened the above-mentioned strongest combination that the present author dubbed as the "Royal Straight Flush." As is well known, blacks and Hispanics are generally poorer than whites, bearing the brunt of a higher number of infections, deaths, and unemployment. The racial confrontation became exacerbated when the BLM movement rose after the killing of a black man by a white police officer. The mobilization of the army by President Trump to stop disturbances in Washington worsened the situation. Furthermore, some famous historical figures were decried as racists, and their bronze statues were demolished. This move invited backlashes. "Identity politics" and "status politics" have become even more salient.

President Trump blatantly puts a high priority on his re-election, trying to capitalize on the current situation. An international political scientist, Akihiko Tanaka, explicitly asserts that "it is President Trump himself that constitutes a greater threat to American society than the triple crisis" of the novel coronavirus, depression, and racism. 12

At present, the re-election of President Trump will not be easy because Democratic candidate Joe Biden is dominant in many of the battleground states. Even among Trump's rock-bed supporters, the elderly who feel their lives threatened by the corona pandemic are breaking away as are evangelicals. The July 4-10 issue of The Economist predicts the possibility of Trump's election to be at 10%. 13 Although Biden has many disadvantages represented by his advanced age, he is likely to appoint a young black female as the vice presidential candidate and will be able to point to the cumulative blunders of President Trump. An increase in postal voting would work in favor of Biden. (Only five states send a postal ballot sheet to voters.) "Aiming at his re-election, President Trump has benefitted from constant media exposure and enjoys the ‘incumbent bonus' in appreciation of his achievements. However, once defensive, he successively betrays ineptitude and bears the ‘incumbent onus.'"14 The Democratic Party may dominate the majority in not only the House of Representatives but also in the Senate. Besides, the once-every-ten-years census will take place this year; we should keep a watchful eye on the elections of governors and legislatures that decide on the division of constituencies.

President Trump blames mainly China and the WHO for the spread of the corona pandemic. Ostensibly at least, the Trump administration has been harsh against China in terms of economy and security. Meanwhile, the current pandemic has aggravated American public sentiment against China. Regarding human rights issues associated with the Uyghurs and Hong Kong, Americans have a strong aversion to China. 15 In the meantime, President Trump officially decided to leave the WHO. International organizations are at the mercy of the dynamics among superpowers; China's influence over international organizations is remarkable. The US conservatives regard international organizations as "big governments" and dislike that American sovereignty is restricted by them. President Trump is attempting to leverage anti-Chinese sentiment and an isolationist mood among Americans to restore his approval ratings. The US withdrawal from the WHO, on the other hand, will make global cooperation difficult in the area of health and hygiene and will lead to the expansion of Chinese influence over the WHO. The corona pandemic has helped to intensify the sense of loss among Americans and to make the decline theory cogent. We have yet to see whether the United States can appropriately deal with China.

Beyond the "Twenty Years' Crisis"

China seems to have succeeded in controlling the spread of the corona pandemic by imposing a peremptory lockdown. But its international reputation was critically damaged by its hasty, high-handed diplomacy and provocative military action that followed. The other permanent member states of the UN Security Council and emerging powers such as India and Brazil also suffered enormous damage from the corona pandemic.

Undoubtedly, the United States is by far the biggest "corona loser." Will the aforementioned "Royal Straight Flush" ---- the combination of the decline theory, "status politics," isolationism, "identity politics" --- deprive the United States of its world leader status, or will the nation fight to deter the rise of China? Perhaps the latter will be the case. But can the United States maintain its will and strength? Unless the United States makes effective use of its allies, international organizations, and multilateral frameworks, for a long time it will be incapable of fighting China.

Around 2030, China's GDP will surpass that of the United States, and also for the scale of the defense budget for a single year, a US-China reversal is likely to occur. But China is already facing a decline in its productive population, while India will have outnumbered China in total population by 2030. According to "Made in China 2025," China plans to make up for its population decrease with technological innovations. Meanwhile, the continuing influx of more immigrants will increase the US population to 350 million. By the 100th anniversary of the founding of the People's Republic of China in 2049, China will have lost 200 million productive people as compared with 2015. Looking around the world, environmental destruction, resource depletion, and disparity between rich and poor will become more serious. Until then, the US population will grow to almost 400 million, but whites will lose their majority status.

Two decades between 2030 and 2050 are called the Twenty Years' Crisis in the 21st century. China will remain the strongest but will face vulnerabilities. American society will have to overcome "identity politics" and "status politics." During this period, Japan will have to endeavor to maintain and strengthen international cooperation and norms while preserving its vitality. Facing a rapid decline in population, Japanese society will also change (ex. 10% of its population will be foreigners in 2060). If the United States is exhausted by the corona pandemic and China takes quicker action, this "Twenty Years' Crisis" may be moved forward and assume the aspect of a "30-year war in the 21st century." The Taiwan issue may provide an ignition point.

By around 2030, unmanned military operations and remote control technologies will further advance. 16 Which of the United States or China will win such a war technology race and how the Japan-US alliance can respond to a crisis will determine the location of the "Twenty Years' Crisis." The Japan Self-Defense Forces are also required to carry out an audacious "reform of the way of fighting."17 Besides, Japan should actively call for strategic dialogues between Japan and the United States, given the decision to discontinue the deployment of Aegis Ashore in Japan.

A military clash between the United States and China would be a nightmare for the world. It is, therefore, a goal beyond the "Twenty Years' Crisis" to not so much defeat China as to urge China to behave as a "responsible stakeholder." To this end, the United States must first of all prove once again to the world that she is a "responsible stakeholder" --- and that Churchill's insight is correct. Japan, always accompanying the United States, must make it known that she is also a "responsible stakeholder." It may sound like a weak conclusion, but the present author would like to believe Masataka Kosaka's words, "In politics and diplomacy, anachronists build the order."18

(This paper was translated into English by the SSDP Secretariat.)

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