Biden can’t achieve more ambitious targets with the same failing strategy
Refusing to fight for the TRIPS waiver and to compel COVID-19 vaccine technology transfer is resulting in preventable deaths and prolonging the pandemic
Ahead of Biden speech at UNGA in NY, on Monday activists will protest Biden policies driving vaccine apartheid
Ahead of President Joe Biden’s speech at the United Nations General Assembly (UNGA) on Tuesday and his summit on the global COVID-19 response on Wednesday, Health GAP released the following analysis of Biden’s summit targets and global COVID-19 response to date.
President Biden’s global COVID-19 response has been characterized by unquestioning faith in pharmaceutical companies to fix the current crisis of artificial supply scarcity, unaffordable prices, and inequitable distribution to disastrous effect. Despite widespread evidence that voluntary measures by the U.S. and other high-income countries such as dose sharing and vaccine donations are not working, Biden is citing these same measures as hallmarks of the draft plan prepared for his COVID-19 Global Summit. For example, Biden is calling for an additional 1 billion vaccine doses. But of 554 million vaccine doses promised to the Global South so far, only 16%, or 90.8 million, have been delivered. These inadequate interventions also deny low-income countries access to knowledge developed with significant public funding and government research.
Experts are demanding Biden compel technology transfer immediately to save lives, a move he has refused to make to avoid upsetting the pharmaceutical lobby. Status quo protection of the intellectual property rights of profiteering pharmaceutical companies will not save us from this pandemic. Biden has the power to mandate the transfer of technology in order to scale up manufacturing capacity in the Global South. Instead of using this power, he is acting like a puppet of big pharma.
Biden’s Summit will be doomed to failure absent a fundamental reset in the United States’ approach to ending the COVID-19 pandemic. Attaining his stated goal of reaching 70% of the world by 2022 hinges on that. Under the current strategy, more than 80% of vaccine doses have gone to high-income and upper-middle-income countries, while only 1% of people in low-income countries have received at least one dose. More of the same strategy will result in more of the same failure to control the pandemic – no matter how ambitious Biden’s targets are on paper.
Protest on Monday
Activists will protest Biden’s failed pandemic response and demand an end to vaccine apartheid during a protest in New York at 12 pm on Monday, September 20 at Dag Hammarskjold Plaza. More information about the protest is available here.
Analysis: Biden’s summit targets versus what is needed to equitably end the pandemic
News reports revealed Biden’s targeted outcomes from the summit, including several benchmarks related to global vaccination and testing. However, the leaked documents do not reveal a roadmap for achieving those targets. Biden’s summit targets fall short or leave serious questions regarding:
Biden’s target: At least 70% of the world’s population fully vaccinated in all country income categories by UNGA 2022 (Q4 2022).
What’s needed: According to experts, the world is projected to produce more than 12 billion vaccine doses in 2021, with the total increasing to 18.4 billion by March 2022, more than enough for 70% coverage, indicating a delivery timeline by September 2022 is not only realistic—it is too slow and should be advanced to June 2022. But pharma companies have consistently failed to meet promised delivery targets for doses earmarked for COVAX and there is no reason to believe they will start to keep their promises to low- and middle-income countries now while demand from wealthy countries paying higher prices holds steady.
Given that reality, Biden’s coverage target cannot be achieved without technology transfer by drugmakers, compelled by Biden. Relying on drug manufacturers to set the terms of supply, price and distribution has had disastrous and deadly consequences up to now. Biden’s refusal to support using all available means to share mRNA production know-how makes him complicit in the deaths of millions.
Interim goals must also be set as benchmark targets, especially since COVAX has announced a 25% reduction in its vaccine supply forecast. Although Biden’s summit goal is more ambitious than the World Bank, IMF, WHO, WTO joint target of 60% by the middle of 2022, it is still neither specific enough nor does it describe the mechanisms of mandatory technology transfer and investments needed to increase vaccine supply and equitable distribution.
Biden must confront pharma greed and catalyze Global South vaccine manufacturing. The World Health Organization-backed mRNA vaccine manufacturing hub, recently launched in South Africa, is focusing on producing the vaccine currently made by Moderna. Moderna has announced it will not enforce its patents, but it has refused to share information essential to manufacturing the vaccine and has refused to engage with the manufacturing hub. Experts have determined that the U.S. government holds rights to intellectual property critical to the Moderna vaccine, whose research and development was 99% funded by taxpayer subsidy. President Biden must compel Moderna to engage in tech transfer to facilitate additional manufacturing at the South Africa hub and in other locations in the global South.
In May, the Biden administration announced it would support a limited intellectual property rights waiver on COVID-19 vaccines at the World Trade Organization (WTO), but this superficial support has been meaningless in the face of Biden’s refusal to challenge world leaders that are still blocking it. With unfettered power over vaccine supply, price, and distribution, big pharma companies – Moderna and Pfizer, in particular – are holding hostage billions of people in countries around the world that will not have sufficient supply of COVID-19 vaccines for years. Meanwhile, they have heaped spurious and racist claims on the prospect of urgently sharing knowledge and expanding production capacity with African manufacturers, even while the continent has been systematically blocked from self-sufficient manufacturing.
At every turn, Biden has relinquished his power to big pharma companies and CEOs rather than confronting pharma greed to expand global manufacturing of life-saving vaccines and provide access to the billions of people who are still unprotected – without a reasonable end in sight. Biden must stop abetting the deadly harm Moderna, Pfizer and other big pharmaceutical companies are doing if he truly aims to get the pandemic under control.
Biden’s target: Ensure a minimum of 1 per 1,000 people are tested per week before the end of 2021 or test positivity rates are less than 5% per week in all countries.
What’s needed: Biden’s global testing goals are too unambitious. The test kit quantities and frequency of testing specified are significantly less than what is needed for community and outbreak surveillance and for a new test-and-treat strategy when outpatient treatment of early mild and moderate disease is approved. Testing continues to be insufficient in the U.S., causing additional community spread and burdening the healthcare system. These failed strategies must not be exported to the rest of the world.
Biden’s target: Ensure all countries have timely access to authorized safe and effective therapeutics by ensuring they are available to all low-income countries/lower-middle-income countries in 2021, and effective new non-IV treatments are available in 2022.
What’s needed: The treatment goals are partially focused on in-patient severe cases with a goal of making outpatient therapies more available, but no concrete targets are provided: the quantities of treatments are unclear. Outpatient management is crucial for communities in the global South, where access to formal care in hospital settings is typically prohibitively expensive and overstretched before COVID-19. Biden offers no clear strategy on how to expand production and lower costs of monoclonal antibody therapies through measures such as mandated technology transfer, nor on what steps there will be taken to ensure access to antiviral medicines if approved.
Biden’s target: Establish and fund a global health security financial intermediary fund (FIF) in 2021. Commit to seed funding level (e.g. $10 billion) and host (e.g. World Bank.)
What’s needed: The U.S. must support multilateral funding for pandemic preparedness building on evidence-based models of what works. Health experts are recommending that the U.S. support investments for pandemic preparedness and pandemic response by building on the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), a funding mechanism with a 20-year, proven track record of accountability to directly impacted communities, with a governance structure that establishes an equal say in decision making for governments from the global South, civil society and high-income countries. Instead of wasting precious time creating a siloed, potentially duplicative, and unaccountable new fund, the administration should build on what is working, and leverage the platforms that are delivering health impact.
Funding pledged by the U.S. for pandemic preparedness and pandemic response – as well as any new funding for dose donations – must be additional. The White House has already been guilty of “robbing Peter to pay Paul,” with a $500 million payment to Pfizer by the State Department paid out by taking funds already committed to USAID for vaccine distribution.