U.S. government officials laid out the Biden administration’s global COVID-19 response framework at a congressional hearing Wednesday where lawmakers pressed for more clarity around plans for vaccine distribution, broader pandemic relief, and global health security efforts.
Gayle Smith, the coordinator of the global COVID-19 response and health security at the State Department, outlined the U.S. framework and its five “planks” at a Senate Committee on Foreign Relations hearing.
The first is increasing supply and access to vaccines globally — which was the focus of much of the hearing. The second is reducing mortality and transmission, including by supporting underlying health systems. The U.S. will work to address the acute shocks — economic and otherwise. It will also work to bolster economic systems that have struggled.
Lastly, the U.S. will work to “build the international architecture for global health security that we will need in the future,” Smith said. That includes strengthening and modernizing existing institutions to ensure they are “fit for purpose”; pushing for new norms when necessary and ensuring compliance with existing ones; ensuring adequate and sustainable financing; and improving transparency, accountability, and oversight.
With the recent surge of COVID-19 in India, the country has become a key priority in U.S. global response, as has its neighbor Nepal, where cases have also been rising and there is insufficient testing, said Jeremy Konyndyk, the coordinator of COVID-19 response at the U.S. Agency for International Development.
Since the start of the pandemic, USAID has provided more than $3 billion and continues to program more funding every week, he said. But Konyndyk cautioned that while there is rightly a focus on vaccines, USAID is also focused on what it can do in the short term to support good public health measures and community needs.
A clear US policy
Lawmakers questioned the administration officials about whether the U.S. has concrete plans for its COVID-19 response, the right internal management structure, and why it isn’t clearly communicating its work to the world, the way China and Russia are doing.
“It’s apparent that China and Russia have a game plan,” said Sen. Mitt Romney, a Republican of Utah. “They've moved, they've acted ... Do we have the same thing in place or are we still in the process of deciding what we want to do?”
Smith responded that the administration will release more details soon. But Romney pressed her further, urging the administration to put forward a plan with clear objectives, timelines, and details about what support countries will receive — and share it not just with Congress but with Americans and beyond U.S. borders.
Lawmakers also pushed for details about the distribution of the 60 million doses of the AstraZeneca vaccine the administration announced it would donate. Some advocated for a focus on the Western Hemisphere.
Sen. Tim Kaine, a Democrat from Virginia, suggested that rather than distributing vaccines — or other limited resources — globally, the U.S. should prioritize supporting the Americas. Other lawmakers agreed, urging that the U.S. focus first on the region due to its more immediate impacts on the U.S.
There is “merit” to making a case for a focus on the Western Hemisphere, Smith said. But when it comes to pushing back against Russian or Chinese influence, the U.S. can also improve its messaging and communicate that it sees vaccines as a way to end the pandemic and not a tool to twist government arms and extract concessions in return for vaccines, she said.
While Smith didn’t reveal much about the plans for the AstraZeneca doses, saying they are still under development, she did say she thought the allocation would reflect some of the concerns about focusing on the Western Hemisphere. An announcement with details about those doses and other U.S. COVID-19 efforts is forthcoming, Smith said.
Beyond the donation, the U.S. administration needs to help set a specific global target for the production of vaccine doses — whether it is 8 billion or another number — said Sen. Jeff Merkley, a Democrat from Oregon. Having a specific target will be more effective in driving action, and funding, he said.
Join Devex @ WHA 2021
From May 25 to 27, and in a special Devex Pro event on June 1, we will bring you inside the 74th World Health Assembly to answer key questions. Register now.
Lawmakers also pushed the administration to take advantage of upcoming G-7 and G-20 meetings and the World Health Assembly to galvanize international plans and begin World Health Organization reforms.
The agency needs to improve its systems for surveillance and alert, including through more transparency, Smith said. The International Health Regulations also need to be strengthened, along with compliance with them. Lastly, there must be reforms to WHO’s cost-effectiveness and sustainability, she said.
Smith said the issue of financial sustainability as the U.S. works to develop a global health security or pandemic preparedness fund has been a priority for her. In the past, such efforts have not had sustainable funding streams, and so the administration is exploring structures — whether that be a new fund akin to The Global Fund to Fight AIDS, Tuberculosis and Malaria or a financing window at the World Bank — that would guarantee funding and not rely solely on foreign assistance dollars, she said.
The G-7 and G-20 meetings next month will be opportunities for organizing global efforts, Smith said. There needs to be a global “grand plan,” and the U.S. should be at the forefront of helping to create one, she said.
If efforts to create one fail, the pandemic could drag on much longer, Smith said. That global effort will need to be a combination of resources, policies, and ways to address economic impacts, she added.