The Biden administration and states across the country are slowly making progress with their coronavirus vaccination campaign, but the unequitable scramble for doses overseas threatens to prolong the pandemic indefinitely.
Rich countries have essentially cleared the shelves, securing almost 60 percent of global vaccine supply, according to a Duke University procurement tracker, and the U.S alone has pre-purchased enough doses to inoculate the population twice over.
From the start of the pandemic, public health experts have warned about the dangers of vaccine nationalism — high-income countries hoarding shots for their own populations.
Almost a year later, those warnings have largely been realized.
“Even as vaccines bring hope to some, they become another brick in the wall of inequality between the world’s haves and have-nots,” World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus said in a speech last month.
Tedros warned against the “me-first” approach to vaccinations.
“The world is on the brink of a catastrophic moral failure, and the price of this failure will be paid with lives and livelihoods in the world’s poorest countries,” Tedros said.
Experts argue that with the rise of new, more contagious variants, the U.S. will not be able to get back to normal until the rest of the world is also vaccinated.
“We live in a global community and if we really want to talk about true approaching normality, we have to attack this at the global level,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said during a recent Washington Post event.
“Because whenever there’s transmission and viral outbreaks throughout the world, the United States will always be at danger, no matter what we do,” Fauci said.
President Biden has signaled a different approach to the global nature of the pandemic compared to the previous administration, which adopted an “America first” mentality on vaccines by prioritizing domestic distribution above all else.
Former President Trump even tried to stop Congress from authorizing $4 billion for the Gavi Vaccine Alliance, a move that was ultimately rebuffed in the year-end omnibus and COVID-19 supplemental legislation.
Within hours of his inauguration, Biden stopped America’s exit from the WHO, and announced his intention to join COVAX, the WHO-led initiative focused on vaccine equality and bringing coronavirus vaccines to low-income countries.
The moves were widely applauded by Democrats, advocates and health experts. But Biden is now facing calls from those same circles to increase the U.S. commitment to global pandemic assistance, moves that could be a tough sell among conservatives.
Following a recent meeting with Biden at the White House, Delaware Sen. Chris Coons (D) said he pushed for financing global vaccine relief, so the U.S. “can restore its global leadership.”
The $1.9 trillion relief package backed by Democrats includes $11 billion to support the international health and humanitarian response to the pandemic.
U.S. based international advocacy groups, including CARE and the ONE Campaign, say more is needed, and are calling for $20 billion.
Giving additional money to fund initiatives like COVAX may be the easiest way forward, but experts think it’s not enough, and that program is still drastically underfunded.
COVAX this week announced that it will aim to distribute more than 300 million doses — enough to cover only 3 percent of receiving countries’ populations — by the end of June.
“The quantity of doses is terrifyingly inadequate,” said Peter Maybarduk, director of the Access to Medicines program at consumer advocacy group Public Citizen.
“The world needs a much more robust response, including from the Biden administration, to get the global pandemic under control,” Maybarduk said in a statement.
The best scenario, which might be the most unrealistic, is for the U.S. to donate some of its excess doses to the international vaccination effort, and encourage the country’s allies to do the same.
“We need to really do much more than simply support COVAX,” said Larry Gostin, a professor of global health law at Georgetown University.
“I recognize that the United States, and particularly the Biden administration, has a primary duty to America. And that’s why I think it’s reasonable for us to vaccinate our vulnerable population before we give doses away. But once we’ve done that, it’s very much in the United States’ interest to make sure that the rest of the world is vaccinated,” Gostin said.
Gostin and other experts said they understand it won’t be easy to sell the American public on the idea of giving away vaccine doses before the country has achieved herd immunity.
But if the U.S. wants to be a leader on the global stage, they argue the country has a moral imperative.
“There’s a responsibility that comes with being a country that has gained from its position in the global landscape. And so there’s a responsibility to serve the world’s population,” said Vikram Bakhru, chief operating officer at ConsejoSano, a company specializing in health equity and multicultural patient engagement.
“Just like we need communities of color vaccinated to reach national herd immunity, we need developing, low-income countries vaccinated to reach 75 to 80 percent of the world population for global herd immunity,” Bakhru said.