Biden Avoids a Further Mideast Spiral as Israel and Iran Show Restraint. But for How Long?

US President Joe Biden boards Air Force One at Joint Base Andrews in Maryland, US, April 19, 2024. (Reuters)
US President Joe Biden boards Air Force One at Joint Base Andrews in Maryland, US, April 19, 2024. (Reuters)
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Biden Avoids a Further Mideast Spiral as Israel and Iran Show Restraint. But for How Long?

US President Joe Biden boards Air Force One at Joint Base Andrews in Maryland, US, April 19, 2024. (Reuters)
US President Joe Biden boards Air Force One at Joint Base Andrews in Maryland, US, April 19, 2024. (Reuters)

President Joe Biden can breathe a bit easier, at least for the moment, now that Israel and Iran appear to have stepped back from the brink of tipping the Middle East into all-out war.

Israel's retaliatory strikes on Iran and Syria caused limited damage. The restrained action came after Biden urged Prime Minister Benjamin Netanyahu’s government to temper its response to Iran's unprecedented direct attack on Israel last week and avoid an escalation of violence in the region. Iran's barrage of drones and missiles inflicted little damage and followed a suspected Israeli attack on the Iranian consulate in Damascus this month that killed two generals.

Iran's public response to the Israeli strikes Friday also was muted, raising hopes that Israel-Iran tensions — long carried out in the shadows with cyberattacks, assassinations and sabotage — will stay at a simmer.

The situation remains a delicate one for Biden as he gears up his reelection effort in the face of headwinds in the Middle East, Russia and the Indo-Pacific. All are testing the proposition he made to voters during his 2020 campaign that a Biden White House would bring a measure of calm and renewed respect for the United States on the world stage.

Foreign policy matters are not typically the top issue for American voters. This November is expected to be no different, with the economy and border security carrying greater resonance.

But public polling suggests that overseas concerns could have more relevance with voters than in any US election since 2006, when voter dissatisfaction over the Iraq War was a major factor in the Republican Party losing 30 House and six Senate seats.

“We see this issue rising in saliency, and at the same time we're seeing voter appraisals of President Biden's handling of foreign affairs being quite negative,” said Christopher Borick, director of the Muhlenberg College Institute of Public Opinion. “That combination is not a great one for Biden.”

Biden has staked enormous political capital on his response to the Israel-Hamas war as well as his administration's backing of Ukraine as it fends off a Russian invasion.

The apparent de-escalation of tensions between Israel and Iran also comes as Congress moves closer to approving $95 billion in wartime aid for Ukraine, Israel and Taiwan, a measure that Biden has pushed for as Ukrainian forces run desperately short on arms.

After months of delay in the face of the threat of ouster by his party’s right flank, House Speaker Mike Johnson, R-La., pushed the package forward and final House passage was expected this weekend. That prospect — and a surge of weaponry to the front lines — is giving the White House renewed hope that Ukraine can right the ship after months of setbacks in the war.

Biden also has made bolstering relations in the Indo-Pacific a central focus of his foreign policy agenda, looking to win allies and build ties as China becomes a more formidable economic and military competitor.

But Republicans, including former President Donald Trump, have an argument to make that Biden’s policies have contributed to US dealing with myriad global quandaries, said Richard Goldberg, a senior adviser at the Washington think tank Foundation for the Defense of Democracies.

Republicans have criticized Biden's unsuccessful efforts earlier in his term to revive a nuclear deal with Iran brokered by the Obama administration and abandoned by Trump, saying that would embolden Tehran. The agreement had provided Iran with billions in sanctions relief in exchange for the country agreeing to roll back its nuclear program.

GOP critics have sought to connect Russia's invasion of Ukraine to Biden's decision to withdraw from Afghanistan and they blame the Obama administration for not offering a strong enough response to Russian President Vladimir Putin's 2014 seizure of Crimea.

“You can make an intellectual case, a policy case of how we got from Point A to B to C to D and ended up in a world on fire,” said Goldberg, a national security official in the Trump administration. “People may not care about how we got here, but they do care that we are here.”

Polling suggests Americans' concerns about foreign policy issues are growing, and there are mixed signs of whether Biden's pitch as a steady foreign policy hand is resonating with voters.

About 4 in 10 US adults named foreign policy topics in an open-ended question that asked people to share up to five issues for the government to work on in 2024, according to The Associated Press-NORC Center for Public Affairs Research poll published in January. That’s about twice as many as mentioned the topic in an AP- NORC poll conducted in the previous year.

Further, about 47% of Americans said they believe Biden has hurt relations with other countries, according to an AP-NORC poll published this month. Similarly, 47% said the same about Trump.

Biden was flying high in the first six months of his presidency, with the American electorate largely approving of his performance and giving him high marks for his handling of the economy and the coronavirus pandemic. But the president saw his approval ratings tank in the aftermath of the chaotic withdrawal of US troops from Afghanistan in August 2021 and they never fully recovered.

Now, Biden finds himself dealing with uncertainty of two wars. Both could shadow him right up to Election Day.

With the Israel-Hamas war, Republicans pillory him as being not being adequately supportive of Israel, and the left wing of his party harshly criticize the president, who has shown displeasure with Netanyahu's prosecution of the war, for not doing more to force the Israelis to safeguard Palestinian lives.

After Israel's carefully calibrated strikes on Iran, Middle East tensions have entered a “gray area” that all parties must navigate carefully, said Aaron David Miller, an adviser on Middle East issues in Republican and Democratic administrations.

“Does what has occurred over the last 10 days strengthen each sides' risk-readiness or has it made them drop back from the brink and revert into risk aversion?” Miller said. “Israel and Iran got away with striking each other's territory without a major escalation. What conclusions do they draw from that? Is the conclusion that we might be able to do this again? Or is it we really dodged a bullet here and we have to be exceedingly careful.”

Israel and Hamas appear far away from an agreement on a temporary ceasefire that would facilitate the release of remaining hostages in Hamas-controlled Gaza and help get aid into the territory. It's an agreement that Biden sees as essential to finding an endgame to the war.

CIA Director William Burns expressed disappointment this past week that Hamas has not yet accepted a proposal that Egyptian and Qatari negotiators had presented this month. He blamed the group for "standing in the way of innocent civilians in Gaza getting humanitarian relief that they so desperately need.”

At the same time, the Biden administration has tried to demonstrate it is holding Israel accountable, imposing new penalties Friday on two entities accused of fundraising for extremist Israel settlers that were already under sanctions, as well as the founder of an organization whose members regularly assault Palestinians.

National security adviser Jake Sullivan and other administration officials met on Thursday with Israel's minister for strategic affairs, Ron Dermer, and national security adviser Tzachi Hanegbi. US officials, according to the White House, reiterated Biden's concerns about Israel's plans to carry out an operation in the southern Gaza city of Rafah, where some 1.5 million Palestinians have taken shelter.

Ross Baker, professor emeritus of political science at Rutgers University, said Biden may have temporarily benefited from Israeli-Iranian tensions driving attention away from the deprivation in Gaza.

“Sometimes salvation can come in unexpected ways,” Baker said. “But the way ahead has no shortage of complications.”



Experts: Baby in Gaza Has Strain of Polio Linked to Mistakes in Eradication Campaign

The mother of Palestinian boy Abdul Rahman Abu Al-Jidyan, who is the first person to contract polio in Gaza in 25 years, gestures as she looks after him in their tent, in Deir Al-Balah, in the central Gaza Strip August 28, 2024. REUTERS/Ramadan Abed
The mother of Palestinian boy Abdul Rahman Abu Al-Jidyan, who is the first person to contract polio in Gaza in 25 years, gestures as she looks after him in their tent, in Deir Al-Balah, in the central Gaza Strip August 28, 2024. REUTERS/Ramadan Abed
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Experts: Baby in Gaza Has Strain of Polio Linked to Mistakes in Eradication Campaign

The mother of Palestinian boy Abdul Rahman Abu Al-Jidyan, who is the first person to contract polio in Gaza in 25 years, gestures as she looks after him in their tent, in Deir Al-Balah, in the central Gaza Strip August 28, 2024. REUTERS/Ramadan Abed
The mother of Palestinian boy Abdul Rahman Abu Al-Jidyan, who is the first person to contract polio in Gaza in 25 years, gestures as she looks after him in their tent, in Deir Al-Balah, in the central Gaza Strip August 28, 2024. REUTERS/Ramadan Abed

The baby in Gaza who was recently paralyzed by polio was infected with a mutated strain of the virus that vaccinated people shed in their waste, according to scientists who say the case is the result of “an unqualified failure” of public health policy.
The infection, which marked the first detection of polio in the war-torn Palestinian territory in more than 25 years, paralyzed the lower part of one leg in the unvaccinated 10-month-old child. The baby boy was one of hundreds of thousands of children who missed vaccinations because of the fighting between Israel and Hamas.
Scientists who have been monitoring polio outbreaks said the baby's illness showed the failures of a global effort by the World Health Organization and its partners to fix serious problems in their otherwise largely successful eradication campaign, which has nearly wiped out the highly infectious disease. Separately, a draft report by experts deemed the WHO effort a failure and “a severe setback.”
The polio strain in question evolved from a weakened virus that was originally part of an oral vaccine credited with preventing millions of children worldwide from being paralyzed. But that virus was removed from the vaccine in 2016 in hopes of preventing vaccine-derived outbreaks.
Public health authorities knew that decision would leave people unprotected against that particular strain, but they thought they had a plan to ward off and quickly contain any outbreaks. Instead, the move resulted in a surge of thousands of cases, The Associated Press reported.
“It was a really horrible strategy,” said Columbia University virologist Vincent Racaniello, who was not involved with the report or the WHO. “The decision to switch vaccines was based on an incorrect assumption, and the result is now we have more polio and more paralyzed children.”
A draft copy of the report commissioned by the WHO and independent experts said the plan underestimated the amount of the strain in the environment and overestimated how well officials would be able to squash outbreaks.
The plan led to vaccine-linked polio outbreaks in 43 countries that paralyzed more than 3,300 children, the report concluded.
Even before the Gaza case was detected, officials reviewing the initiative to tinker with the vaccine concluded that “the worst-case scenario has materialized,” the report said.
The report has not yet been published, and some changes will likely be made before the final version is released next month, the WHO said.
The strain that infected the baby in Gaza had lingered in the environment and mutated into a version capable of starting outbreaks. It was traced to polio viruses spreading last year in Egypt, according to genetic sequencing, the WHO said.
In 2022, vaccine-linked polio viruses were found to be spreading in Britain, Israel and the US, where an unvaccinated man was paralyzed in upstate New York.
Scientists now worry that the emergence of polio in a war zone with an under-immunized population could fuel further spread.
Racaniello said the failure to track polio carefully and to sufficiently protect children against the strain removed from the vaccine has had devastating consequences.
“Only about 1% of polio cases are symptomatic, so 99% of infections are silently spreading the disease,” he said.
The oral polio vaccine, which contains a weakened live virus, was withdrawn in the US in 2000. Doctors continued to vaccinate children and eventually moved to an injected vaccine, which uses a dead virus and does not come with the risk that polio will be present in human waste. Such waste-borne virus could mutate into a form that triggers outbreaks in unvaccinated people.
The report's authors faulted leaders at the WHO and its partners, saying they were unable or unwilling “to recognize the seriousness of the evolving problem and take corrective action.”
WHO spokesman Oliver Rosenbauer acknowledged that the vaccine strategy “exacerbated” the risk of epidemics linked to the vaccine.
He said in an email that immunization “was not implemented in such a way to rapidly stop outbreaks or to prevent new strains from emerging.” Rosenbauer said not hitting vaccination targets was the biggest risk for allowing vaccine-linked viruses to emerge.
“You need to reach the children with the vaccines ... regardless of which vaccines are used,” he said.
The WHO estimates that 95% of the population needs to be immunized against polio to stop outbreaks. The UN health agency said only about 90% of Gaza’s population was vaccinated earlier this year.
To try to stop polio in Gaza and the wider region, the WHO and its partners plan two rounds of vaccination campaigns later this week and next month, aiming to cover 640,000 children. Authorities will use a newer version of the oral polio vaccine that targets the problematic strain. The weakened live virus in the new vaccine is less likely to cause vaccine-derived outbreaks, but they are still possible.
Racaniello said it was “unethical” that the WHO and its partners were using a vaccine that is unlicensed in rich countries precisely because it can increase the risk of polio in unvaccinated children.
The oral polio vaccine, which has reduced infections globally by more than 99%, is easy to make and distribute. Children require just two drops per dose that can be administered by volunteers. The oral vaccine is better at stopping transmission than the injected version, and it is cheaper and easier to administer.
But as the number of polio cases caused by the wild virus have plummeted in recent years, health officials have been struggling to contain the increasing spread of vaccine-linked cases, which now comprise the majority of polio infections in more than a dozen countries, in addition to Afghanistan and Pakistan, where transmission of the wild virus has never been stopped.
“This is the result of the Faustian bargain we made when we decided to use" the oral polio vaccine, said Dr. Paul Offit, director of the Vaccine Education Center at the University of Philadelphia. “If we really want to eradicate polio, then we need to stop using the vaccine with live (weakened) virus.”