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    • The future of US aid

    In Brief: US COVAX pledge is 'down payment on a larger strategy'

    Jake Sullivan, national security adviser for President Joe Biden, says that the administration wants to streamline global health institutions and help build stronger health systems.

    By Michael Igoe // 09 March 2021

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    Workers offload boxes of COVID-19 vaccines distributed under the COVAX scheme at the Phnom Penh International Airport in Cambodia. Photo by: Cindy Liu / Reuters

    U.S. President Joe Biden’s administration announced last month a $4 billion commitment to COVAX, the global COVID-19 vaccine distribution facility, which will be followed by a broader strategy to strengthen health systems, according to one of Biden’s top advisers.

    The $4 billion was split in half. The first $2 billion “tranche” is intended “just to get vaccines out the door,” national security adviser Jake Sullivan said Monday. “The other $2 billion, we are seeking to leverage contributions from countries around the world, not just for straightforward vaccine delivery, but vaccine delivery in the context of building up and strengthening the capacity of health systems,” he said at an event hosted by the U.S. Global Leadership Coalition.

    “That’s just a down payment on a larger strategy that the U.S. is going to undertake,” Sullivan said. Sullivan described a “variable geography” of existing global health institutions and said it is the Biden administration’s intent to “turn it into something that really reduces gaps and overlaps and redundancies and is truly streamlined to be as effective as possible going forward.”

    One of the first steps, he suggested, will be undertaking repair work within the U.S. government’s own development and global health agencies to ensure they are able to deliver on their objectives with transparency and accountability.

    Sullivan said that while former President Barack Obama's administration made big gains in these areas, “over the last four years there’s been a fair amount of atrophy on the underlying components of what’s required to really truly deliver effective development outcomes.”

    Why it matters: There is speculation that the Biden administration could push for a rethink of how U.S. global health institutions are organized to move away from disease-specific “vertical” initiatives and toward a more integrated health systems approach.

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    About the author

    • Michael Igoe

      Michael Igoe@AlterIgoe

      Michael Igoe is a Senior Reporter with Devex, based in Washington, D.C. He covers U.S. foreign aid, global health, climate change, and development finance. Prior to joining Devex, Michael researched water management and climate change adaptation in post-Soviet Central Asia, where he also wrote for EurasiaNet. Michael earned his bachelor's degree from Bowdoin College, where he majored in Russian, and his master’s degree from the University of Montana, where he studied international conservation and development.

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