Why Bidens push to share vaccines with the world could be too little too late

The United States has sent more than 110 million doses of coronavirus vaccines to 65 countries, President Biden said Tuesday, putting the country ahead of all others on vaccine donations and “proving that democracies can deliver.”

The president’s remarks, delivered from the White House, came after he implored Americans to accept coronavirus vaccines as the highly contagious delta variant sweeps the country.

“We have a supply for every single American,” he said. “At the same time, it’s also in our national interest to share some of our vaccines with the world.”

“As long as the virus continues to rage outside the United States, potentially more dangerous variants could arrive at our shores again,” he said.

Tom Hart, acting chief executive of the ONE Campaign, an organization focused on extreme poverty and preventable disease, praised the Biden administration’s global response. The administration’s moves “will help save lives, reduce the emergence of variants, and limit the spread of this deadly virus,” he said in a statement following Biden’s speech .

But some global health experts have offered a more pessimistic outlook, as the pandemic surges in many parts of the world.

“The doses are useful, but they are just too little, too late,” said Lawrence Gostin, a professor of global health law at Georgetown University Law. “It’s not going to make much of a dent in the pandemic.”

Over the course of the pandemic, health experts have sounded the alarm over the vaccination disparity between rich and poor countries, from both moral and strategic perspectives. World Health Organization Director General Tedros Adhanom Ghebreyesus told The Washington Post last week that the sharp divergence marked a “betrayal of trust” that had cost lives, which could have been saved if “the wealthiest countries allowed poorer countries access to their fair share of vaccines.”

Frequently Asked Questions

What do we know about U.S. vaccine sharing?

Where are vaccine doses most needed?

What more could the United States and other nations be doing?

How has the delta surge changed things?

What do we know about U.S. vaccine sharing?

Biden announced in June that the United States was buying 500 million doses of Pfizer’s coronavirus vaccine to donate to the world, with the first 200 million doses to be distributed this year. Earlier, the Biden administration had pledged to donate at least 80 million vaccine doses by the end of June.

The doses were shared through Covax, a WHO-backed initiative to distribute vaccine doses equitably, the White House announced Tuesday. The majority of the doses were made in the United States and shipped to countries currently struggling with covid-19, including Bangladesh, Colombia, Indonesia and the Philippines.

The United States has donated more vaccine doses than all of the 24 other donor countries combined, according to United Nations data that Biden cited Tuesday.

Vaccines given by the U.S. are free and “there’s no favoritism and no strings attached,” Biden said in an apparent dig at Russia and China, which have engaged in widespread vaccine diplomacy.

Where are vaccine doses most needed?

Although the number of vaccine doses donated by the United States exceeds the numbers donated by other wealthy nations, the level of sharing falls far short of the billions needed to vaccinate 70 percent of the world, a widely cited target. Poorer nations still lie far behind wealthy nations in terms of the percentage of their population vaccinated, and efforts to address that gap, such as Covax, have faltered.

“We need 11 billion doses,” Gostin said. “This is really just a drop in the ocean.”

Across Africa in particular, few doses have been administered.

As of the end of July, Covax had shipped more than 153 million coronavirus vaccine doses to countries, humanitarian agencies and others participating in the program, according to Gavi, a global vaccine alliance that is one of the main backers of Covax.

Covax had struggled with both funding and supply earlier in the pandemic, when wealthy nations bought up initial shipments of doses. According to tracking from the Duke Global Health Innovation Center, the United States has procured over 1.6 billion doses so far â€" about 5.21 doses per inhabitant. Only a few other wealthy nations have procured more per capita, including Canada, which has 10.4 doses per capita, according to Duke’s research.

“Ultimately, wealthy countries will control Covax’s success or failure, and it’s imperative that Covax succeeds â€" there is no plan B,” Sean Simons of the ONE Campaign said in a statement Tuesday.

The United States is “hoarding” doses, Githinji Gitahi, global chief executive of Amref Health Africa and the African Union’s commissioner for coronavirus response, told The Post last week. He called on wealthy countries including the United States to release commitments to additional doses they have pre-booked from pharmaceutical companies, and to quickly donate more existing doses in their stockpiles.

“A vaccine delayed is a vaccine denied,” he said last week, emphasizing that “speed is of the essence.”

What more could the United States and other nations be doing?

Though the United States and other wealthy nations have tended to focus on vaccinating their own populations, even at the expense of the most vulnerable elsewhere, while donating some doses, experts and aid groups say that there is more that can be done, including investments in technology and infrastructure and the loosening of intellectual property agreements.

“Dose sharing arrangements are helpful in the short-term, but we also need governments and companies to find ways to increase production dramatically, through voluntary licensing, technology transfer or by waiving intellectual property rights for certain products for a certain time,” Tedros said in an email to The Post last month.

In an open letter released Tuesday, a group of prominent public health experts called on the Biden administration to host a presidential-level “Global Vaccination Summit” before the United Nations General Assembly meeting in September and rally world leaders behind the goal of vaccinating 70 percent of the world’s population by mid-2022.

“We are facing the very real possibility that low- and lower-middle income countries will be stuck at low vaccine coverage levels through 2022 and beyond, an outcome that will be deadly,” the authors wrote in the letter. “The deep divide between vaccine haves and have-nots is a challenge to our conscience and a major threat to our economic recovery and national security.”

Biden on Tuesday said other countries should pitch in more to close the vaccine gap.

Hart, the ONE Campaign acting chief, said wealthy countries faced a choice between sharing more doses to shorten the pandemic or holding onto doses and prolonging it.

“The U.S. is leading the global covid-19 fight, but the rest of the world must step up to the plate and match the Biden administration’s ambition and action,” he said.

Kate Elder, senior vaccine policy adviser at Doctors Without Borders’ Access Campaign, said the United States should reallocate doses to countries in need in the short term â€" but also develop a more comprehensive plan to share vaccine technology globally and to scale up production in places that have been left behind in the global vaccine race.

Elder called on the U.S. government to put more pressure on pharmaceutical companies to share technology and knowledge with the mRNA tech transfer hub the WHO is helping to establish in South Africa. “We give them tax breaks, we house them â€" we have influence over them,” Elder said of pharmaceutical companies.

How has the delta surge changed things?

The surge in cases related to the fast-spreading delta variant has contributed to a new sense of urgency about vaccines and the pandemic. In the United States, as well as some other countries, health agencies are considering or have already begun administering vaccine booster doses.

However, in many countries, even health workers and others among those most at risk have not received their first dose yet. And the delta variant, while increasing cases in some wealthy countries with high levels of vaccination, is also moving through some countries with limited supplies of vaccine doses.

Giving booster shots in wealthy countries in these circumstances would be a “a nightmare of extraordinary proportions” for global vaccine distribution, according to Elder.

Some experts have warned that the unmitigated spread of the coronavirus in some countries could contribute to the emergence of dangerous variants, which means vaccination will only work globally. Gostin said Americans should put themselves in the shoes of unvaccinated health workers risking their lives around the world.

“You see the United States vaccinating its very healthy young people and planning on giving boosters to the elderly, you just have to shake your head and say, ‘Oh well, it’s nice you’re giving me a few doses,’ ” he said. “It’s just exasperating.”

This report has been updated.

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