Biden to push global plan to battle COVID

WASHINGTON — Already grappling with divisions in his own country over vaccine mandates and questions about the ethics and efficacy of booster shots, President Joseph R. Biden is facing another front of discord: a split among world leaders over how to eradicate the coronavirus globally, as the highly infectious delta variant leaves a trail of death in its wake.

At a virtual summit Wednesday, while the annual United Nations General Assembly meeting is underway, Mr. Biden will try to persuade other vaccine-producing countries to balance their domestic needs with a renewed focus on manufacturing and distributing doses to poor nations in desperate need of them.

COVAX, the U.N.-backed vaccine program, is so far behind schedule that not even 10% of the population in poor nations — and less than 4% of Africa’s population — is fully vaccinated, experts said. Millions of health care workers around the world have not had their shots.

The push, which White House officials say seeks to inject urgency into vaccine diplomacy, will test

Mr. Biden’s doctrine of furthering American interests by building global coalitions. Coming on the heels of the United States’ calamitous withdrawal from Afghanistan last month that drew condemnation from allies and adversaries alike, the effort to rally world leaders will be closely watched by public health experts and advocates who say Mr. Biden is not living up to his pledges to make the US the “arsenal of vaccines” for the world.

At the same time, the Biden administration is preparing to offer booster shots to millions of already vaccinated Americans, despite criticism from World Health Organization (WHO) officials and other experts who say the doses should go to low- and lower-middleincome countries first. On Friday, a Food and Drug Administration panel recommended Pfizer booster shots for those over 65 or at high risk of severe COVID-19, a broad and ill-defined category. The agency is expected to authorize the shots this week.

Biden administration officials said they are determined to eliminate the disease both at home, including with booster shots, and abroad. “We do understand that this has not been spread around equally,” Erica BarksRuggles, the State Department’s senior adviser on international organizations, told reporters Monday, previewing the U.N. meeting.

Hours later, on a conference call with reporters, WHO’s chief scientist, Dr. Soumya Swaminathan, disagreed.

“It’s a myth when people say we can do both — unfortunately, that’s not true,” Ms. Swaminathan said, referring to Mr. Biden’s booster strategy. “At the moment, we are in a zero-sum game.” She and other experts are calling for a coordinated global vaccination strategy in which doses would be distributed equitably around the globe, rather than each country tending to its own needs.

Officials said Wednesday’s summit would be the largest gathering of heads of state to address the coronavirus crisis. It aims to encourage pharmaceutical-makers, philanthropists and nongovernmental organizations to work together toward vaccinating 70% of the world’s population by the time the U.N. General Assembly meets in Sept. 2022, according to a draft document the White House sent to the summit participants.

“We also know this virus transcends borders,” Mr. Biden said Sept. 9. “That’s why, even as we execute this plan at home, we need to continue fighting the virus overseas, continue to be the arsenal of vaccines.”

“That’s American leadership on a global stage,” he said.

Experts estimate that 11 billion doses are necessary to achieve widespread global immunity. The United States has pledged to donate more than 600 million — more than any other nation — and the Biden administration has taken steps to expand vaccine manufacturing in the United States, India and South Africa. In addition, the White House is in talks to buy another 500 million doses from Pfizer to donate overseas, but the deal is not final.

The 27-nation European Union aims to export 700 million doses by the end of the year.

But as recently as July, only 37% of people in South America and 26% in Asia had received at least one vaccine shot, according to Rajiv J. Shah, the head of the US Agency for International Development during the Obama administration. The figure stood at just 3% in Africa, Mr. Shah wrote in an essay published last month in Foreign Affairs.

An estimate by the ONE Campaign, which fights extreme poverty and preventable disease, showed that the leading seven developed nations would together be sitting on a surplus of more than 600 million vaccine doses by the end of 2021. That is enough to give every adult in Africa one shot.

Most doses that have been committed, however, will not be delivered to the needier nations, nor injected into arms, until next year. Given the sluggish distribution, said Dr. Kate O’Brien, WHO’s top vaccines expert, “we can see clearly from the data that’s coming out that we are very far” from vaccinating 70% of the world’s population by the middle of next year, as initially projected.

That growing gap between the vaccine haves and the vaccine havenots has led to a rift between wealthy countries and most of the rest of the world, one that has only deepened with the rampant spread of the delta variant and potentially thousands of others that are on the rise. Several of the most virulent strains were first identified in lower-income countries, including South Africa and India — both of which have fully vaccinated only 13% of their populations. —