In the race against COVID-19 and its variants, only .03% of the world’s vaccine supply has gone to low-income countries, according to the World Health Organization.
The global mechanism to distribute vaccines equitably, COVAX, missed its target by at least 100 million doses this week, with just 65 million doses being distributed so far. Infections have spiraled out of control in places such as India while neighboring regions are now on the brink.
That's why WHO Director-General Tedros Ghebreyesus said he had mixed feelings when he got vaccinated a few days ago.
“My thoughts were very much with the health workers around the world who have been fighting this pandemic for more than a year. The fact that so many are still not protected is a sad reflection on the gross distortion in access to vaccines across the globe.”
“My thoughts were very much with the health workers around the world who have been fighting this pandemic for more than a year,” he said. “The fact that so many are still not protected is a sad reflection on the gross distortion in access to vaccines across the globe.”
Day by day, the calls for richer countries to do more — to stop hoarding — have become more urgent from global agencies such as the WHO and from civil society. Pressure is mounting especially for the US to step up.
From the Marshall Plan to PEPFAR, the US has historically been a central leader in global health, and the world’s largest funder of assistance.
“What the US does and doesn’t do, a lot of other countries will take the cue here,” said Jennifer Kates, director of global health and HIV policy at the Kaiser Family Foundation. “So, all eyes are on the US.”
Here's a rundown of what the US has done so far — and where it's falling short — in the effort to fight the coronavirus across the globe.
A 'vaccine arsenal'
President Joe Biden announced on Monday that the US would make 20 million additional vaccines available for other countries by the end of June from its reserves of Pfizer, Moderna and Johnson & Johnson shots. He said the country has hit a turning point: a majority of adults in the US have gotten at least one shot, and infections have finally dropped in all 50 states.
“Because we’ve done so much here, because of the power of American companies, research and manufacturing, we can continue to do more to help the rest of the world,” he said.
In his first speech to Congress last month, Biden affirmed that the US would become “an arsenal of vaccines” for other countries. He then added that this wouldn’t happen until Americans were first taken care of.
Earlier on, under Biden, the US agreed to share more than 4 million doses of the Oxford-AstraZeneca vaccine with Mexico and Canada. It also made a commitment to share 60 million shots of the Oxford-AstraZeneca vaccine with the rest of the world. (The US does not plan to use the vaccine domestically and has yet to approve it.)
The Biden administration was also quick to rejoin the World Health Organization. It became the largest donor to COVAX, with a commitment of $4 billion. That’s in addition to billions of dollars in aid for supplies and oxygen. It's been working with Japan, Australia and India to scale up manufacturing. And, the US put its support behind efforts to waive patents on vaccines, a move that is pressuring other countries to change their stances, too.
No 'cohesive strategy'
But some lawmakers say that it isn't enough.
Last week, members of the Senate’s Foreign Relations Committee pressed two of Biden’s pandemic leaders — Gayle Smith, the recently appointed coordinator of the global response at the US State Department and Jeremy Konyndyk, head of USAID’s COVID-19 task force — for more details on the US' plan.
“At this stage, we’re all here listening, and frankly, wondering why can’t we move as quickly as Russia and China and decide precisely what we want to do and where we want to do it, and communicate that to the world?” Sen. Mitt Romney said in a hearing.
Outside Congress, advocates with groups like Doctors without Borders and global policy experts have been calling for more defined US action and leadership.
“Right now, the US approach to global access to vaccines, and the broader approach to response to the COVID pandemic, is lacking both a cohesive strategy as well as leadership,” said Dr. Krishna Udayakumar, director of the Global Health Innovation Center at Duke University.
Udayakumar is part of a research team that has found that in the coming weeks, the US will have hundreds of millions of excess doses of vaccines as domestic demand subsides.
On Monday, Udayakumar joined other global health leaders in issuing a letter to the Biden administration, asking for more specific steps to combat the escalating, global COVID-19 vaccine crisis. That includes expediting the approval of vaccines to be donated.
Better than 'where we were'
Despite growing pressure, the US is on track, said Dr. Mark Dybul, a professor at Georgetown University and member of a global independent panel for pandemic preparedness and response that recently called on richer countries to commit 1 billion vaccines for the rest of the world.
“I think we should give a lot of credit to this administration for acting very rapidly while they're fighting the pandemic here, and doing quite a good job at that, compared to where we were,” Dybul said.
As the former head of The Global Fund to fight AIDS, Tuberculosis and Malaria, Dybul has experience leading these types of efforts. He said America’s stepped-up response to the global AIDS crisis in the early 2000s saved millions of lives.
“It does take time to walk through all this stuff, [to] plan for where you are,” he said.
Every day counts
Udayakumar said Biden’s latest announcements represent good steps, but they’re still small compared to the global need and the resources that the US has. If the US were really serious, more vaccines should be en route to places in need this very month. Every day matters, he said.
In the coming days and weeks, global players are meeting at the G-7 and G-20 meetings, and at the World Health Assembly. How the US shows up could make a big difference and define the future of the pandemic.
“Our own health and our economy continue to be threatened because we are not effectively leading the rest of the world to respond to the pandemic everywhere else,” Udayakumar said.