With the global vaccine supply exceeding distribution capacity, the Biden administration is acknowledging a need to adjust its pandemic response strategy to address hurdles faced by lower-income countries to vaccinate their citizens.
“It is clear that supply is outstripping demand and the area of focus really needs to be that ‘shots in arms’ work,” said Hilary Marston, White House senior policy adviser for global COVID, to VOA. “That's something that we are laser-focused on for 2022.”
Marston said that the administration has helped boost global vaccine supply through donations, expanding global manufacturing capacity and support for COVAX, the international vaccine-sharing mechanism supported by the United Nations and health organizations Gavi and CEPI.
Following supply setbacks in 2021, COVAX’s supply is no longer a limiting factor, a Gavi spokesperson told VOA. He said COVAX now has the flexibility to “focus on supporting the nuances of countries’ strategies, capacity, and demand.”
However, the pivot from boosting vaccine supply to increasing delivery capacity depends on whether the administration can secure funding from Congress, including funds for the U.S. government’s Initiative for Global Vaccine Access, or Global VAX, a program launched in December by USAID, the U.S. Agency for International Development.
Global VAX is billed as a whole-of-government effort to turn vaccines in vials into vaccinations in arms around the world. It includes bolstering cold chain supply and logistics, service delivery, vaccine confidence and demand, human resources, data and analytics, local planning, and vaccine safety and effectiveness.
Four-hundred-million dollars from the American Rescue Plan Act has been put aside for this initiative, on top of the $1.3 billion for global vaccine readiness the administration has committed. Activists say this is not nearly enough, but USAID says it's a good first step.
“The U.S. government will surge support for an initial subset of countries in sub-Saharan Africa that have demonstrated the potential for rapid acceleration of vaccine uptake with intensive financial, technical, and diplomatic support,” a USAID spokesperson told VOA.
Those countries include Angola, Côte d’Ivoire, Eswatini, Ghana, Lesotho, Nigeria, Senegal, South Africa, Tanzania, Uganda, and Zambia.
In January, COVAX had 436 million doses of COVID-19 vaccines to allocate to lower-income countries, according to a document published in mid-February. Those countries, however, only asked for 100 million doses to be distributed by the end of May – the first time in 14 allocation rounds that supply has outstripped demand, the document from the COVAX Independent Allocation of Vaccines Group said.
“We've seen now 11 billion plus doses of vaccine being manufactured,” said Krishna Udayakumar to VOA. “We're estimating 14- to 16- plus billion doses of vaccine being available in 2022,” added Udayakumar, who is founding director of the Duke Global Health Innovation Center and leads a team that tracks global vaccine production and distribution.
But rather than fulfilment of vaccination targets, the oversupply highlights a weakness in global distribution capacity, which Udayakumar said is becoming “the critical bottlenecks.”
Only 12% percent of people in low-income countries have received at least one dose, according to country data compiled by Our World in Data. Many countries still face massive hurdles to get those shots in arms, including gaps in cold-chain storage, and lack of funding to support distribution networks.
Global COVID funding
As the administration prepares to pivot its global pandemic response, humanitarian organizations are criticizing it for requesting insufficient funding from Congress.
“After two devastating years of this pandemic, U.S. leaders are dropping the ball on fighting COVID-19. Today we learned the Biden administration briefed Congress on the need for $5 billion in funding from Congress to fight COVID-19,” said Tom Hart, president of the ONE Campaign, in a statement to VOA last week. “What the world needs, though, is a formal request for $17 billion.”
Hart argued the $5 billion funding would be insufficient to provide critical resources needed to deliver vaccines, tests, and life-saving treatments to low-income countries, and achieve the administration’s goal of 70% global vaccination by September – a goal that is already far below pace.
The White House said the number is not final. “I don't have any specific numbers; we're still in conversation with the Hill (Congress) at this point about funding and funding needs, both domestically and internationally,” press secretary Jen Psaki told VOA on Wednesday.
In a statement to VOA, the chair of the House Appropriations Committee, Rosa DeLauro, said they are still reviewing the funding request. “I will work with my colleagues to meet these important public health needs at home and around the world,” she said.
Meanwhile, Gavi, a COVAX co-sponsor, said it has only raised $195 million out of the $5.2 billion it asked for this quarter. The Gavi spokesperson told VOA the call to donors only went out in January and typically campaigns such as this require extensive rounds of consultation.
“The reason we launched a campaign to raise US $5.2 billion in additional funding is to ensure countries are able to roll out vaccines rapidly and at scale and have the resources on hand to be able to immediately step in as and when countries’ needs change,” the spokesperson said. “We need resources available now to prevent lower income countries once again finding themselves at the back of the queue. This is the only way we will break this pandemic.”
Humanitarian organization Oxfam also argues that $5 billion dollars is not enough.
“We need to do much more to vaccinate the world, including investing in local manufacturing and most importantly, sharing the vaccine recipe,” Robbie Silverman, Oxfam’s senior advocacy manager told VOA.
Sharing vaccine recipes essentially means implementing a temporary TRIPS (Trade-Related Aspects of Intellectual Property Rights) waiver at the World Trade Organization to allow the generic production of current vaccines, as proposed by South Africa and India in October 2021. The proposal is supported by the Biden administration but rejected by the European Union.
Following a summit between European Union and African Union leaders last week, European Commission President Ursula von der Leyen offered a compromise and said that the EU and AU will work together to deliver a solution within the next few months.
The U.S. is by far the biggest vaccine donor. The administration is sending 3 million doses of COVID-19 vaccines to Angola, Sierra Leone, Rwanda, Zambia and Uganda this week, bringing the total shipped globally to 470 million doses out of 1.2 billion doses pledged.