Biden’s global push slowed by shot scarcity

U.S. reluctant to donate vaccine supplies with nation still vulnerable.

With a new president in the White House, the U.S. is re-engaging with the rest of the world to combat COVID-19.

But for now, the Biden administration may hold back the one thing poorer countries desperately need: vaccines.

One day after Joe Biden’s inauguration last week, his chief medical adviser, Anthony Fauci, pledged support for the World Health Organization, including participation in the Covax program to deploy vaccines globally. Even with the U.S. playing an active role, tough challenges remain in the effort to aid lowand middle-income nations.

As the pandemic extends into a second year and more contagious variants of the virus emerge, governments worldwide — though mainly wealthy ones — are rolling out vaccines to protect their populations. That has triggered concern that by prioritizing their own interests, they’re ignoring the needs of less-fortunate countries while allowing the pathogen to advance.

Vaccine advocates have urged wealthy nations to share some of the supplies they have snapped up in recent months and to follow the lead of Norway, which pledged to donate extra doses through Covax.

As of Jan. 18, vaccines had been administered in at least 49 higher-income countries, compared with just one of the world’s lowest-income countries, according to Tedros Adhanom Ghebreyesus, the WHO director general.

Meanwhile, the U.S. spent billions of dollars to develop and secure for its own use more than 1 billion doses from manufacturers, including Moderna Inc., Astrazeneca Plc, and the Pfizer Inc.-biontech SE partnership. Yet only 20 million doses have been administered, according to Bloomberg’s tracker, covering about 6% of the population.

That leaves a huge part of the U.S. still vulnerable to COVID-19 and increases the chance that the next three months of the pandemic, and the start of Biden’s term, could be the worst, said Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy.

Covax’s impact

Many countries are now counting on Covax.

The program, led by the WHO, Gavi and the Coalition for Epidemic Preparedness Innovations, said it is on track to deliver at least 2 billion doses — about twothirds of which will go to lower-income economies — and to vaccinate at least a fifth of each participating country’s population by year’s end.

Yet several leaders have questioned whether the program will get the vaccines it needs as governments prioritize their own supply deals through direct talks with manufacturers, the head of the WHO said last week. This is driving up prices and may lead to hoarding, chaos and social and economic disruption, he warned.

How U.S. can help

The U.S. is reluctant to donate vaccine supplies until vaccines begin to curb severe illnesses and deaths at home, but there are other ways it can help, such as ensuring that Covax is fully funded. The program needs to raise another $2.8 billion this year.

Perhaps one of the most important contributions the U.S. could make would be in the form of highlevel diplomacy, said Stephen Morrison, director of the Center for

Strategic and International Studies’ Global Health Policy Center. The country was absent from a virtual global fund-raising event supported by the European Union in May that secured pledges of about $8 billion.

The U.S., which will soon hold the presidency of the United Nations Security Council, could facilitate a meeting of global leaders to coordinate efforts against a threat to the entire world, Morrison said. Key issues to discuss could include more financing of vaccine purchases, use of vaccine surpluses, debt relief and emergency humanitarian relief.

“I think it’s inevitable that there will be some kind of summitry dedicated to these issues,” he said. “U.S. leadership has been the missing element and now it’s essential.”

The Biden administration could help roll out immunizations worldwide by pushing manufacturers to provide vaccines at affordable costs, said Robert Yates, executive director of the Centre for Universal Health at Chatham House, a London-based think tank. Just days after Biden took office, Pfizer and Biontech agreed to provide as many as 40 million vaccine doses to Covax after months of talks.

Whatever form U.S. involvement takes, its re-emergence as partners and its highly regarded Centers for Disease Control and Prevention will strengthen the global effort and is a “good sign” for everyone, according to Heymann, a former CDC staffer.

“It’s what America really wants,” Heymann said. “It’s been a terrible time to see the U.S. ignore the CDC and, in general, the global health community.”