Are Biden’s global vaccine targets sufficient – and will they mobilize real action?

On September 22, the United States will host a long-standing summit on the global response to COVID-19 at the United Nations General Assembly, with great potential to further extend American leadership to end the pandemic.

But despite multiple summits on this issue over the past year, including the G7, none have generated the global action the world needs to address the massive global imbalance in access to vaccines and other tools. medical. Will this one be different?

The news follows the efforts of Global Citizen and more than 30 other organizations to develop and promote a comprehensive framework for global action against COVID-19, with the aim of setting the standard for success for any summit convened. We have also shared key requests, with organizations based in the United States, with the White House.

The Washington Post yesterday published a set of new US-led goals and calls to action that the White House has shared with countries invited to the summit, covering global access to vaccines, tests and treatments, as well as as pandemic preparedness and funding. Let’s take a look at how some of the key things measure up:

Vaccinate the world

The headline is the call to fully immunize at least 70% of people in all countries by the same time next year. That’s three months faster than the target set by British Prime Minister Boris Johnson at the G7 summit last June, but three months slower than a widely backed $ 50 billion plan released by the International Monetary Fund (IMF) in May (although to reach a target of at least 60%).

When it comes to vaccines, it is as much about timing as it is about supply and execution. A dose given now means a lot more to saving lives and slowing the spread of the virus than a dose given in three months.

According to Airfinity, a scientific analysis company, the world is expected to produce more than 12 billion doses of vaccines in 2021 alone. By the end of March 2022 (Q1), that total will increase to 18.4 billion. This is not only more than enough to fully immunize 70% of the people in each country; it suffices to give each of them three doses.

Thus, a delivery time by September 2022 can and should be accelerated. Unless there are unforeseen changes in the production landscape or insufficient delivery support, we need a more ambitious goal of vaccinating at least 70% of people in all countries between April and June (Q2) next year. That being said, the summit’s success will likely depend on the commitment of world leaders to supporting the goal.

Closing the vaccine access gap

The United States calls on high-income countries to support low-income countries this fall by purchasing or donating an additional billion doses of vaccine and accelerating delivery of around 2 billion previously committed doses – likely a combination of the 1.425 billion doses COVAX is now expected to deliver plus the roughly 575 million in-kind doses that the G7 and the EU have pledged to share before the end of this year. Ways to achieve this include converting existing dose-sharing commitments into short-term deliveries, exchanging delivery dates, and removing cross-border bottlenecks in supply.

If achieved, that could lead to the sharing of nearly 1.6 billion doses with low-income countries in 2021 – an ambitious amount, and G7 and EU countries could do so. According to Airfinity, if these countries reserved two doses for 80% of their population aged 12 and over, as well as boosters for high-risk people like those with immunodeficiencies, they would still have over 1.7 billion excess and unused doses in 2021.

But the challenge with dose sharing is getting governments to commit what they can and follow through. As of September 8, the G7 and the EU have reportedly delivered just over 170 million doses to low- and middle-income countries out of a total pledged of 575 million doses for 2021, including nearly 125 million per dose. the United States alone. .

The G7 and the EU are expected to heed the United States’ call and increase their dose-sharing ambition by increasing existing commitments for 2021 to 1 billion doses by the end of September and delivering them this year . But in addition by the end of the year, they are expected to further increase pledges to 2 billion doses and deliver by the end of the first quarter of 2022. Doses are expected to be shared through or in coordination with COVAX and a schedule transparent delivery should also be made public.

Getting gunshots

In addition to having access to enough doses, another issue is that developing countries have the logistics and capacity to get vaccines from tarmac to gun, including having enough trained health workers to administer. doses (without compromising other health needs). Reluctance is also a factor, so community outreach efforts are essential. To support vaccine delivery readiness, the United States is calling for at least $ 3 billion to be pledged for 2021 and an additional $ 7 billion for 2022.

The IMF’s plan called for at least $ 6 billion in financial support for vaccine readiness and awareness to be delivered urgently this year. If low-income countries are to wait for the bulk of this support throughout 2022, this will only delay efforts to scale up logistics and health systems capacity and get the doses up to speed as quickly as possible. possible. It will take time, so there can be no delay on this crucial funding.

On funding more broadly, after more than a year of unsuccessful efforts to fully fund the COVID-19 Tool Access Accelerator (ACT) and additional elements of the IMF plan, there is still a funding gap of $ 25 billion, including for testing, treatment, PPE and support for health systems in low-income countries to fight COVID-19. It’s unclear if the U.S. targets are enough to fill this gap, so the White House should shine a light on it and put pressure on countries to finally step up.

From vaccine charity to vaccine justice

As mentioned above, the world is expected to produce 12 billion doses in 2021 alone, but only a handful of countries and companies are controlling access to this supply. This limited group effectively decides who gets the doses, how much, and when, with human lives, global economic recovery and a return to normalcy for everyone at stake.

To make matters worse, countries like the United States are already planning to offer third-dose boosts to their general population, which, combined with the recall supply contracts already signed for next year and beyond, increases the potential for continued cycles of vaccine inequity.

So, in addition to funding, dose sharing and delivery support, the vaccine nationalism that we have seen during this pandemic has underscored how much we need to give countries and all regions of the world the opportunity, the technology and know-how to produce vaccines and other vital medical tools they need for themselves.

On these issues, US targets lack clarity and bite. They recognize a need for medium and long-term dose manufacturing that all countries need to access, except for offering only vague calls to “support sufficient global and regional production” and to expand manufacturing and technology transfer, including for mRNA vaccines.

The problem is, pharmaceutical companies have had over a year to voluntarily engage in open sharing of their technology – they just don’t want to, even with ready-made opportunities to do so through the access pool. WHO’s COVID-19 technology and now Africa’s new mRNA technology transfer hub (for which they could still be financially compensated). They need to be coerced, and that means the US, UK, and Germany are putting legal and political pressure on companies within their jurisdiction to cooperate.

U.S. targets also avoid mentioning a proposal by South Africa and India to forgo intellectual property over the production of COVID-19 vaccines and other medical tools – backed by more than 100 countries. This would allow new producers to help expand the supply of and access to vaccines around the world, especially for low-income countries. The Biden administration declared its support for a vaccine intellectual property waiver in May, but has done little since to change the minds of other powerful countries.

Calls for a waiver are underscored by the billions of public funds these companies have received from governments to speed up R&D and reduce risks in the manufacturing process. A waiver would open up opportunities for new producers to help expand the supply of these vital tools to countries in need around the world.

Today, the Council for Trade-Related Aspects of Intellectual Property Rights (TRIPS) of the World Trade Organization (WTO) resumed debate on the waiver after a break in August. Three hundred thousand people have died from COVID-19 worldwide during this time. After 11 months of debate, the United States is expected to reinvigorate its support for the proposal and use the opportunity of next week’s summit to build consensus ahead of the key WTO ministerial meeting that begins on November 30.

Transparency and accountability

The US targets call for establishing “a robust global dashboard for vaccines, consumables and ancillary supplies in 2021,” which Global Citizen and others have been calling for for months. He also calls on pharmaceutical companies to provide production data and projections to be included in the scorecard.

If we are to navigate this historic global crisis, the global public needs basic information updated in real time. How many doses were produced? What is the priority queue for deliveries and when do they take place? At what prices were they sold? What are realistic projections for the amount of doses produced this year and beyond? We also need transparency around dose sharing, so the dashboard should include real-time updates on delivery against commitments made.

Will leaders answer the call?

It’s one thing to set goals, it’s another to achieve them. For the US summit to be successful, the Biden administration will need to energetically own and mobilize commitments, reflecting the urgency of the crisis the world continues to face.

There have been many injustices in this pandemic, with the poorest and most vulnerable disproportionately affected, but one of the most egregious concerns access to vaccines. Humanity has succeeded in rapidly discovering and mass producing several safe and effective vaccines, with even more in the pipeline. Yet we have failed miserably to ensure equitable distribution, leaving us all at risk of seeing an elusive variant of the vaccine emerge and bring us back to square one. After everything we’ve been through, we can’t let this happen.

You can join the Global Citizen Live campaign to defend the planet and end poverty by act here, and be part of a movement led by citizens around the world who are taking action with governments, businesses and philanthropists to make a difference.

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