The U.S. Is Finally Donating Covid-19 Vaccines Abroad. We Need to Do More.

Here’s what must be done to get the world vaccinated

Photo: Martin Sanchez/Unsplash

The pandemic is splitting in two. While the U.S. and other wealthy nations vaccinate their way out of the nightmare, Covid-19 is raging around the world. Globally, new case counts have risen for nine consecutive weeks — and are now at their highest levels since the start of the pandemic. Despite this, just 0.2% of all Covid vaccines are going to low-income countries.

That’s why the recent White House commitment to share 60 million doses of AstraZeneca’s Covid-19 vaccine came as welcome news.

For humanitarian, public health, and economic reasons, it’s imperative the U.S. does more to get the rest of the world vaccinated against Covid-19. Sharing the AstraZeneca vaccine doses is an important first step. The U.S. must do more.

How the U.S. has contributed so far

Before announcing the vaccine donation, the U.S. had already contributed to expanding global vaccine supplies and access. In February 2021, the U.S. committed $4 billion to Covax, the World Health Organization initiative to deliver Covid vaccines equitably to countries around the world.

And in March 2021, the U.S. joined a “Quad” partnership with Australia, Japan, and India to expand vaccine manufacturing in India to produce at least 1 billion doses of Covid-19 vaccines by the end of 2022.

But outside of loaning 4 million vaccine doses to Canada and Mexico in March, the April 26 AstraZeneca announcement was the first time the U.S. publicly committed to sharing vaccine doses globally.

This act of generosity is a welcome commitment to global solidarity, but it’s hardly enough given how well-resourced Americans are when it comes to pharmaceuticals. The U.S. will soon be awash in excess vaccine doses. Let me restate that: As a deadly pandemic sweeps the globe, the U.S. will soon have much more vaccine than it needs.

What the U.S. can do now

The U.S. has secured deals for over 1.2 billion doses of Covid-19 vaccines from six companies. That’s more than enough to vaccinate every American several times over. As vaccine demand starts to lag in the U.S. and doses pile up, we need a plan for how we’ll share the excess.

The most obvious solution is to donate the vaccine to Covax. That initiative has struggled to obtain sufficient doses, outbid by wealthier nations who signed early deals and gobbled up most of the supply. Sharing our bounty would immediately help address Covax’s supply shortage. It would also make good on the Biden administration’s intention to rebuild America’s traditional leadership role in global health.

There has been some worry that language built into the original purchase contracts prevents the U.S. from donating its excess vaccine supply, as revealed in a recent Vanity Fair article. But it’s foolish to think the most powerful country in the world couldn’t easily renegotiate those contracts. And it’s unlikely pharmaceutical companies would take the U.S. government to court over an act of global goodwill, especially after they received billions in funding from U.S. taxpayers.

Public health must come first

In addition to donating our excess vaccine doses, the U.S. needs to support a temporary TRIPS (Trade-Related Aspects of Intellectual Property Rights) waiver that would allow countries to produce Covid therapeutics and vaccines domestically.

In October 2020, South Africa and India submitted a request to the World Trade Organization (WTO) asking for such a waiver. Since then, over 100 low- and middle-income countries have backed the proposal, arguing that protections on proprietary formulas and technology are inhibiting access to lifesaving therapeutics and vaccines.

This proposal also enjoys broad public support in the U.S. In a survey by Data for Progress and Progressive International, 60% of U.S. voters want the Biden administration to sponsor a waiver at the World Trade Organization to temporarily remove patent barriers.

And on the campaign trail, President Biden himself promised he wouldn’t let patents stand in the way of ramping up global vaccine supply.

As major funders of the Covid vaccines, the U.S. has a lot of say — and sway — over pharmaceutical companies. U.S. support would play a significant role in obtaining a temporary waiver.

In the midst of a global pandemic, we can’t protect the profits and patents of pharmaceutical companies at the expense of patients and public health. This shouldn’t be objectionable.

Help build capacity in other countries

U.S. financial and technical support can help build critical vaccine manufacturing capacity in countries where vaccine production is severely limited or nonexistent.

For example, in Africa where only 1.3 doses of Covid-19 vaccines have been administered per 100 people (compared to 45 doses per 100 people in North America), U.S. support for scaling up vaccine production could make a dramatic impact.

The African continent is vast, encompassing 54 countries and 1.2 billion people. Yet it’s home to just 10 vaccine manufacturers that produce only 1% of the vaccines administered on the continent. The other 99% are imported.

Difficulty obtaining Covid-19 vaccines has added urgency to ramp up vaccine production in Africa. The Africa Centres for Disease Control and Prevention (Africa CDC) announced plans to establish five new vaccine-manufacturing centers across the continent. And at a recent summit hosted by the African Union and Africa CDC, leaders committed to increasing the percentage of vaccines manufactured in Africa from 1% to 60% by 2040.

The U.S. must be a partner in helping Africa achieve that goal. With financial and technical assistance, the U.S. can help build capacity in countries that have long depended on imports to produce their own vaccines.

Reflecting on the current state of the pandemic, Tedros Adhanom Ghebreyesus, the director-general of the World Health Organization, recently wrote in a New York Times op-ed: “here’s the thing about an inferno: If you hose only one part of it, the rest will keep burning.”

Even if the embers of the pandemic are receding here in the U.S., the global inferno is only growing. The U.S. must do more to extinguish the flames. By donating excess vaccine doses, removing patent protections for lifesaving medications and vaccines, and helping bolster global vaccine manufacturing capacity, the U.S. can ensure the world doesn’t come to the end of this pandemic less prepared to prevent and respond to the next one.

NYC ER doctor | Ebola Survivor | Director of Global Health in Emergency Medicine at Columbia University | Public Health Professor | Doctors Without Borders BoD

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