US must step up on global COVID-19 vaccination efforts, experts say

The United States needs to step up its efforts to address global COVID-19 vaccination efforts by improving manufacturing and detailing donation plans for surplus doses, according to health and foreign policy experts.

While other countries, including China and Russia, have been donating vaccines internationally before fully vaccinating their own populations, the U.S. and other wealthy democracies have prioritized their own domestic efforts.

While that’s understandable, experts say, the U.S. now needs to turn its attention to global vaccine efforts because not doing so could allow additional variants to develop that could be unresponsive to vaccines — and because it is “the right thing to do.”

“We need a strategy to vaccinate every high-risk person [worldwide] quickly and everyone by the end of 2021,” said Ashish Jha, dean of the Brown University School of Public Health, adding that it should be a “vigorous, multipronged, multilateral approach.”

The world has never tried to make 10 billion doses of a novel vaccine in a year, but “American leadership can help,” Jha told lawmakers at a House Foreign Affairs Committee hearing Thursday.

The challenge with vaccines is not necessarily money or intellectual property, he said, but creating and distributing enough global supply.

About 75% of the 400 million doses administered worldwide thus far have gone to 10 nations, with 75 countries yet to administer a single dose, said Tom Bollyky, a senior fellow at the Council on Foreign Relations, during the hearing.

While COVAX — the initiative focused on equitable access to COVID-19 vaccines globally — is an important effort, it has shipped 29 million doses to date, and “widespread immunization is a distant prospect for most nations,” Bollyky said.

Efforts to bridge that gap by the U.S. and other wealthy democracies have largely been in the form of donated funds, he said.

“Democracies are donating cash, and autocracies or autocratizing nations are donating doses,” Bollyky said. The strategy of providing cash can send the message that democracies have not handled the pandemic well at home or abroad, he said.

“It is important to show that a democracy can be a global force for good in the middle of a pandemic,” Jha said. “We are now at a point where we have more than enough vaccines for every adult in American by May. Now is the time for us to shift our thinking about when to get vaccines out there to the rest of the world.”

Many countries, particularly low-income ones, are unable to purchase the most rigorously tested vaccines since those have already been promised to the world’s wealthiest nations. So it’s not surprising, given the option of either waiting for six months to a year or purchasing less-proven vaccines today, that countries are choosing the latter. Vaccines from Russia and China have not gone through regulatory approvals and lack the extensive public data necessary to determine their efficacy and safety, Jha said.

“Part of our job is to give people alternatives so they do not have to choose between an unapproved vaccine or nothing,” he said.

The U.S. — working through the G-7 and possibly the G-20 groups of nations to mobilize partners — needs to tackle three key areas to improve global vaccine efforts, Bollyky said.

The first is launching a global version of Operation Warp Speed, the domestic U.S. effort to boost vaccine production. It could make advanced purchases, match suppliers with sponsors so that inputs are guaranteed, mobilize raw materials, and build out supply chains, Bollyky said.

The U.S. should also help improve surveillance systems to reduce the hoarding of medical supplies. Shortages of raw materials are causing manufacturing delays and hindering vaccination efforts. Those challenges are exacerbated by export restrictions imposed by a number of countries, including the U.S., Bollyky added.

Lastly, the U.S should announce the terms and conditions it will now use to donate surplus doses “so people can rely on the promise” and build the infrastructure necessary to ensure that those donations are properly labeled, regulated, and distributed to where they are needed, Bollyky said. Not setting out a plan for surplus U.S. doses only hurts the country, especially as others continue to donate vaccines, he said.

On Thursday, the U.S. government announced its first plans to share vaccines with other countries, with a goal of providing about 4 million doses of the AstraZeneca vaccine to Mexico and Canada.

While this was the first indication that the U.S. may look to provide surplus supplies to other countries, the choice to provide vaccines to Canada has raised some questions.

Canada has already procured about 400 million doses for its population of roughly 38 million people. While the number that has been delivered to the country is not known, Canada is very likely to have a considerable surplus. Why the U.S. would provide doses to Canada when other nations are struggling to purchase vaccines is unclear.