The Biden administration is facing renewed questions about its global coronavirus strategy, with international infections climbing and the new omicron variant poised to tear across the world.
“I see very slow progress and reluctance” from the United States, said Hu Yuan Qiong, a Geneva-based legal and policy adviser for Doctors Without Borders, who has been monitoring the talks. “We really anticipate they could do more proactively in the negotiations.”
Others are demanding details behind a plan to boost global vaccine manufacturing, complaining that the White House has yet to clarify the proposal’s objectives and strategy since unveiling it last month.
“Emergence of the Omicron variant, which experts fear may make current vaccines less effective, has provided a cruel reminder that the world does not have the time to wait,” advocacy groups Partners in Health, Public Citizen and Prep4All wrote in a letter Monday to senior administration officials, which was shared with The Washington Post.
Pressure has mounted on the United States in part because global efforts to beat vaccine hoarding and inequality have struggled. Covax, an initiative backed by the World Health Organization that was designed to pool money to ensure vaccine supply for poorer nations, initially aimed to donate 2 billion doses by the end of 2021. It is now racing to deliver a far-diminished target of 800 million doses.
In interviews, Biden administration officials defended their global strategy, saying they are working to speed vaccine technologies to the developing world and citing donations and commitments that vastly outpace those of other nations — efforts verified by independent trackers.
“As the President has said, the virus knows no borders, and it is going to require every country and to step up and take bold, urgent action to stop the spread of covid-19 and save lives,” said Kevin Munoz, a White House spokesman. “We call on every leader to bring the same urgency, ambition, and scale to the table as we fight covid-19 across the globe.”
But on Capitol Hill, Democrats insisted that the White House still needs to specify how it would address logistical challenges that have slowed vaccinations in developing countries and led some to turn vaccine donations away.
“The Biden administration commitment to vaccinate 70 percent of the world’s population by September 2022 is a worthy goal, but the longer we take to get there, more people will needlessly die and increase the risk of a new variant,” Sen. Edward J. Markey (D-Mass.) said in a statement.
We need to make the investments and donations necessary to vaccinate the rest of the globe. Countries should not be begging for a lifesaving vaccine, and the risk of more dangerous variants will linger so long as they can’t get vaccinated.https://t.co/h8A3ZlCrsa— Congressman Raja Krishnamoorthi (@CongressmanRaja) December 13, 2021
More than 600,000 people are being infected and more than 7,000 people are dying every day from coronavirus around the world, according to a seven-day rolling average compiled by Johns Hopkins University. While most of the cases appear driven by the delta variant, health officials warn that the new omicron variant is spreading rapidly and appears to evade some immunity conferred by prior infections or vaccination, although it may cause less-severe infections.
As a result, global leaders are projecting a new surge of omicron-linked cases. Less than 8 percent of the population in Africa has been fully vaccinated, according to the University of Oxford’s Our World in Data project.
“The global community is playing variant roulette at this point, and the Biden administration is not being big enough, bold enough, fast enough,” said Zain Rizvi, research director at Public Citizen.
The United States has pledged to donate more than 1.1 billion vaccine doses to nations in need — a total nearly 10 times more than the 120 million doses pledged by France, the next-highest country, according to donations monitored by the Duke Global Health Innovation Center. Altogether, the White House has committed more than $1.6 billion toward global vaccine efforts, including last week’s announcement of a new $315 million initiative overseen by the U.S. Agency for International Development.
Biden officials also pointed to targeted initiatives in dozens of nations around the world, such as USAID helping deploy ultracold freezer trucks to safely transport shots in Bangladesh, or experts from the Centers for Disease Control and Prevention training workers in Belize to administer shots. Meanwhile, the U.S. trade office has held more than 50 public and private meetings since May in an attempt to reach international consensus around waiving intellectual property protections for vaccines, an official said.
Policy experts commended the Biden administration for its efforts but said the United States has a unique responsibility as poorer nations reel from the pandemic.
“The problem is that doing more is not the same as doing enough,” said Krishna Udayakumar, the director of the Duke Global Health Innovation Center. “We can either be complacent, because we’re doing more than others, or we can recognize that this pandemic is very unlikely to end without even stronger U.S. leadership.”
For instance, Udayakumar and others faulted the U.S. reliance on “charity donations” to patch vaccination gaps in other countries. About one-quarter of the 1.1 billion doses previously pledged by the United States have been shipped, according to Udayakumar’s center, and some of the global donations have arrived too near their expiration dates to be useful.
“Countries need predictable and reliable supply. Having to plan at short notice and ensure uptake of doses with short shelf lives exponentially magnifies the logistical burden on health systems that are already stretched,” African officials and Covax warned in a joint statement last month.
“Donations are neither reliable nor sustainable. Most pledges have yet to fully come through,” said Sangeeta Shashikant, legal adviser at the Third World Network, an advocacy organization that focuses on developing nations.
Instead, experts said the United States should focus on expanding vaccine manufacturing — but impose guardrails to avoid previous mistakes. Advocates on Monday called on the Biden administration to pursue a government-owned, contractor-operated manufacturing model, arguing that relying on outside companies to produce vaccines in bulk had previously failed, and left developing nations waiting for shots that never came. They also urged the White House not to overly rely on existing vaccine manufacturers such as Pfizer and Moderna, saying the companies have delivered “far too few doses, far too slowly, and sometimes only under onerous terms” to low- and middle-income countries.
“Preserve public control over the facility, giving the government the freedom to make critical decisions about operations, manufacturing partners and technology,” Partners in Health, Public Citizen and Prep4All wrote.
Meanwhile, outside experts and some Democrats continue to press Biden officials to ensure that the World Trade Organization will waive certain coronavirus-related intellectual property protections for the duration of the pandemic.
The so-called TRIPS waiver — which has been sought for more than a year by India, South Africa and other developing countries, but opposed by the European Union and the pharmaceutical industry — was set to be hotly contested at a planned WTO meeting in November. But the high-level event between the world’s trade ministers was postponed indefinitely following the public discovery of the omicron variant, fueling frustration that diplomats are not moving fast enough to expedite a waiver.
“We have been trapped in this pandemic for two years, with a severe inequity of access to vaccines and access to other medical tools,” said Hu of Doctors Without Borders. “Omicron should be a wake-up call for all the trade ministers in all countries.”
The top trade officials from the United States, E.U., India and South Africa did speak Saturday about a path toward resolving their differences over waiving intellectual property protections for coronavirus vaccines and therapies, the Washington Trade Daily newsletter first reported and an official with knowledge of the talks confirmed.
Biden publicly embraced the waiver in May amid pressure from members of the Congressional Progressive Caucus and other liberals, who insisted that the president stick to a campaign promise. But administration officials privately acknowledge that a waiver would not solve the pandemic’s immediate needs, given the months it would take to set up new factories and begin producing vaccine doses, a position echoed by experts including Udayakumar.
Meanwhile, the E.U. has refused to commit to waiving the intellectual property protections, warning that the proposal by developing countries would backfire by antagonizing the drug industry that has rapidly generated coronavirus vaccines and therapies.
“The EU has engaged very actively with other WTO members to build a compromise,” Miriam García Ferrer, an E.U. spokeswoman, said in a statement. “The full waiving of patent and other rights under the TRIPS Agreement, as proposed by India and South Africa, would not in itself help reaching the objective of the widest and timely distribution of COVID-19 vaccines.”