Senior administration officials, public health experts and Democrats say that the omicron wave has illustrated gaps in the U.S. global coronavirus strategy, warning that low-income nations are particularly vulnerable to the virus and that the risk of another variant will remain elevated as long as billions of people are unvaccinated.
“The assignment is incomplete,” said Rep. Raja Krishnamoorthi (D-Ill.), who is leading a group of Democrats calling for $17 billion in additional funding for global vaccination delivery and infrastructure to immunize people in the developing world. “We need to make this investment going forward, and we need to do it ASAP.”
Some lawmakers and officials also say they remain unhappy with President Biden’s decision to split authority over the global coronavirus strategy between White House covid-19 response coordinator Jeff Zients and national security adviser Jake Sullivan, arguing the structure complicates decisions and forces the two men to navigate between competing crises. Zients’s team has recently focused on the surging U.S. outbreak, and Sullivan’s national security team is addressing threats such as Russia’s potential invasion of Ukraine.
“I think we need somebody whose mission 24/7 is to help get the rest of the world vaccinated,” Krishnamoorthi said. “The consequences are enormous. We found out — painfully — how quickly a variant can come over here from abroad and totally overwhelm our system.”
About 10 billion doses of coronavirus vaccine have been administered around the world, but they have been concentrated in wealthy nations, according to a World Health Organization review shared with The Washington Post. High-income countries have administered about 14 times the number of doses per inhabitant compared with low-income countries, the WHO found. About 84 percent of the population of the African Union has yet to receive a single shot, even as about 40 percent of Americans have received booster shots, according to The Post’s vaccine tracker.
The Biden administration maintains that its leadership structure is working and that its global strategy — focused on donating vaccine doses abroad — remains unchanged, despite omicron’s ability to evade some immune protection conferred by vaccines. The United States has now donated about 390 million doses to other countries, far more than any other nation, with Biden pressing global leaders to ramp up their donations.
“We know what works, and it’s vaccines. And we’re leaning into that hard,” said a senior administration official who was not authorized to discuss the issue publicly and spoke on the condition of anonymity. “The science is clear. Vaccines are protecting, particularly when boosters are deployed.”
The United States is also helping fund efforts to increase vaccine manufacturing capacity around the world, White House Chief of Staff Ron Klain said in an interview on the New York Times’ “Ezra Klein Show,” adding that the administration recognizes the global shortfall. “We are not where we need to be,” Klain said.
Officials touted a new campaign, led by the U.S. Agency for International Development and initially funded with roughly $500 million, that is now supporting mobile vaccination sites, improving vaccine storage and addressing other logistical needs in low- and middle-income countries.
“This is a winnable fight,” said Jeremy Konyndyk, executive director of USAID’s covid-19 task force, saying that recent spikes in vaccination rates in African countries such as Zambia, Ghana and Ivory Coast show “proof of concept” for the U.S. strategy. For instance, 22 percent of people in Ghana have now received at least one dose of coronavirus vaccine, after vaccination rates were stalled below 8 percent for most of 2021, according to data tracked by Oxford University’s Our World in Data project.
“They’ve all been able to deliver significant improvements in vaccine uptake when they have gotten infusions of resources,” Konyndyk said.
White House officials confirmed they are targeting late March for an international summit, led by Biden, intended to hold global leaders accountable for pledges they made last year, including a vow to “fully vaccinate” 70 percent of the world by the fall of 2022. To help lay the groundwork for that meeting, senior officials such as Secretary of State Antony Blinken and Health and Human Services Secretary Xavier Becerra also are preparing to host meetings with their global counterparts, said two people with knowledge of those plans who were not authorized to speak publicly.
Gayle Smith, who led the State Department’s coronavirus response last year, said Biden’s strategy is working but remains dependent on international cooperation.
“We know what it takes,” Smith added. “And we’ve got the skills, the knowledge, the facts and … the resources to do it. We’ve just got to muster the global political will to not just do more but do enough.”
Public health and international policy experts say the White House’s strategy continues to fall short, warning that the collateral damage from covid-19 remains high as countries reel from disruptions to health systems, social services and the resurgent risk of other infectious diseases such as measles. Meanwhile, a key Biden pledge — to tamp down global virus spread — is far from being met.
“The big picture, of course, is that we haven’t been able to limit transmission,” said Amanda Glassman, executive vice president of the Center for Global Development, a nonprofit think tank focused on international development. “Cases are increasing everywhere. And viral diversity is therefore increasing. … It’s a very good time to revisit the strategy and to plan for an extended period of several years where we’re going to be more at risk for the emergence of new variants.”
Congressional Democrats are pushing the White House to immediately request billions of dollars earmarked for the global response as part of a supplemental funding package that could be sent to the Hill this week, warning that some coronavirus stimulus funds are nearly exhausted.
“USAID — the primary U.S. agency leading global vaccination efforts and the global COVID-19 response — is a little over a month away from running out of money,” Krishnamoorthi, Sen. Elizabeth Warren (D-Mass.) and other Democrats wrote in a letter sent to Biden on Tuesday and shared with The Post.
White House officials declined questions about specific funding requests, saying they are still assessing the need for further investments.
Rep. Tom Malinowski (D-N.J.), vice chair of the House Committee on Foreign Affairs, also signed the letter. He said there’s “nothing more important” than prioritizing the global coronavirus response.
“I’m beside myself about what’s happening in Ukraine,” Malinowski said. “… But if your focus is on America’s foreign policy and you’re not waking up every morning and going to sleep every night thinking about vaccinating the world against covid, then there’s something wrong.”
Democrats also said they were worried that the omicron variant — which is less deadly than some previous variants — will be prematurely perceived as helping usher in the end of the pandemic, with billions of people around the globe potentially gaining immunity that might help ward off future infections. Some public health experts also have argued that omicron could shift the pandemic toward a more manageable stage.
Atul Gawande, a surgeon and author who was sworn in this month as USAID’s assistant administrator for global health, countered that the administration has envisioned multiple scenarios for the omicron wave and what comes next — none of them easy.
Gawande said that “the best case is that omicron sweeps through the world quickly,” but that will still leave behind global “testing shortages, enormous demand for the oral antiviral medications that need to be made available, stress on masks, supplies and other critical elements, plus the demand not only for full vaccination but for boosters to roll out across the world.”
“The worst case is that we have the next variant not be so mild and evade our tests and vaccines,” Gawande added, “almost like starting with an entirely new infection again.”