[Under pressure to play catch-up on
“vaccine diplomacy,” President Biden says he will help finance vaccine
manufacturing capacity but is still resisting exports of doses.]
By Sheryl Gay Stolberg and Michael Crowley
In a deal announced at the
so-called Quad Summit, a virtual meeting of leaders of the four countries, the
Biden administration committed to providing financial support to help
Biological E, a major vaccine manufacturer in India, produce at least 1 billion
doses of coronavirus vaccines by the end of 2022.
That would address an acute vaccine
shortage in Southeast Asia and beyond without risking domestic political
blowback from exporting doses in the coming months, as Americans clamor for
their shots.
The United States has fallen far
behind China,
India and Russia in
the race to marshal coronavirus vaccines as an instrument of diplomacy. At the
same time, Mr. Biden is facing accusations of vaccine hoarding from global
health advocates who want his administration to channel supplies to needy
nations that are desperate for access.
Insisting that Americans come
first, the president has so far refused to make any concrete commitments to
give away American-made vaccines, even as tens of millions of doses of the
vaccine made by the British-Swedish company AstraZeneca sit
idly in American manufacturing facilities.
“If we have a surplus, we’re going
to share it with the rest of the world,” Mr. Biden said this week, adding,
“We’re going to start off making sure Americans are taken care of first, but
we’re then going to try and help the rest of the world.”
In fact, the president has a lot of
work ahead of him domestically to make good on the promises
he has made in recent days: that all states must make all adults
eligible for vaccinations by May 1, that enough vaccine doses will exist by the
end of May to inoculate every American adult, and that by July 4, if Americans
continue to follow public health guidance, life should be returning to a
semblance of normalcy.
Vaccine supply appears on track to
fulfill those goals, but the president must still create the infrastructure to
administer the doses and overcome reluctance in large sectors of the population
to take them.
Still, Mr. Biden has also made
restoring U.S. leadership a centerpiece of his foreign
policy agenda after his predecessor frayed alliances and strained
relationships with allies and global partners. His secretary of state, Antony
J. Blinken, said in a recent BBC
interview that a global vaccination campaign would be part of that
effort; Washington, he said, was “determined” to be an “international leader”
on vaccinations.
Foreign policy experts and global
health activists see clear diplomatic, public health and humanitarian reasons
for doing so.
“It’s time for U.S. leaders to ask
themselves: When this pandemic is over, do we want the world to remember
America’s leadership helping distribute lifesaving vaccines, or will we leave that
to others?” said Tom Hart, the North America executive director of the One
Campaign, a nonprofit founded by the U2 singer Bono and dedicated to
eradicating world poverty.
The federal government has
purchased 453 million excess vaccine doses, the group says. It has called on
the Biden administration to share 5 percent of its doses abroad when 20 percent
of Americans have been vaccinated, and to gradually increase the percentage of
shared doses as more Americans receive their vaccines.
As of Friday, 13.5 percent of
people in the United States who are 18 or older have been fully
vaccinated, according
to the Centers for Disease Control and Prevention.
The authoritarian governments of
China and Russia, which are less buffeted by domestic public opinion, are
already using vaccines to expand their spheres of influence. While the Biden
administration plans its strategy to counter China’s growing global clout,
Beijing is burnishing its image by shipping vaccines to dozens of countries on
several continents, including in Africa, Latin America and particularly in its
Southeast Asian backyard.
Russia has supplied vaccines to
Eastern European nations, including Hungary, the Czech Republic and Slovakia,
at a time when Biden officials want to keep the European Union unified against
Russian influence on the continent.
“We may be outcompeted by others
who are more willing to share, even if they’re doing it for cynical reasons,”
said Ivo H. Daalder, a former NATO ambassador and the president of the Chicago
Council on Global Affairs. “I think countries are going to remember who was
there for us when we needed them.”
With worrisome and highly
infectious new
variants emerging in the United States and around the world, public
health experts say vaccinating people overseas is also necessary to protect
Americans.
“It has to be sold to Americans as
an essential strategy to make Americans safe and secure over the long term, and
it has to be sold to a highly divided, toxic America,” said J. Stephen
Morrison, a global health expert at the Centers for Strategic and International
Studies. “I don’t think that’s impossible. I think Americans are beginning to
understand that in a world of variants, everything that happens outside our
borders ups the urgency to move really fast.”
Mr. Blinken said as much to the
BBC: “Until everyone in the world is vaccinated, then no one is really fully
safe.”
The Quad Vaccine Partnership announced
at the summit meeting on Friday involves different commitments from each of the
nations, according to the White House.
Beyond assistance for the Indian
vaccine manufacturer, the United States pledged at least $100 million to
bolster vaccination capacity abroad and aid public health efforts. Japan, it
said, is “in discussions” to provide loans for the Indian government to expand
manufacturing of vaccines for export and will aid vaccination programs for
developing countries. Australia will contribute $77 million to provide vaccines
and delivery support with a focus on Southeast Asia.
The four countries will also form a
Quad Vaccine Experts Group of top scientists and government
officials who will work to address manufacturing hurdles and financing plans.
Mr. Morrison said the
administration deserved “some credit” for the effort, adding, “It shows
diplomatic ingenuity and speed.” But a spokesman for the One Campaign, which
focuses on extreme poverty, said his group would still like to see a plan for
the United States’ vaccine stockpile and noted that Africa had administered far
fewer doses per capita than Asia.
Mr. Biden’s efforts to ramp up
vaccine production have helped put the United States on track to produce as
many as a billion doses by the end of the year — far more than necessary to
vaccinate the roughly 260 million adults in the United States.
A deal the administration brokered
to have the pharmaceutical giant Merck manufacture Johnson & Johnson’s
one-dose vaccine, which the president celebrated at the White House on
Wednesday, will help advance that goal. Also on Wednesday, Mr. Biden directed
federal health officials to secure
an additional 100 million doses of Johnson & Johnson’s vaccine.
The administration has said those
efforts are aimed at having enough vaccine for children, booster doses to
confront new variants and unforeseen events. But Jeffrey D. Zients, Mr. Biden’s
coronavirus response coordinator, told reporters on Friday that the deal
between Johnson & Johnson and Merck would also “help expand capacity and
ultimately benefits the world.”
In addition to resisting a push to
give away excess doses, Mr. Biden has drawn criticism from liberal Democrats by
blocking a request by India and South Africa for a temporary waiver to an
international intellectual property agreement that would give poorer countries
easier access to generic versions of coronavirus vaccines and treatments.
“I understand why we should be
prioritizing our supply with Americans — it was paid for by American taxpayers,
President Biden is president of America,” said Representative Ro Khanna, a
liberal Democrat from California. “But there is no reason we have to prioritize
the profits of pharmaceutical companies over the dignity of people in other
countries.”
Mr. Biden recently announced a donation
of $4 billion to Covax, the international vaccine initiative backed by the
World Health Organization. David Bryden, the director of the Frontline Health
Workers Coalition, a nonprofit aimed at supporting health workers in low- and
middle-income countries, said money was also desperately needed to help train
and pay those workers to administer vaccines overseas.
But that donation, and the
announcement on Friday of the Quad’s financial support for vaccine production,
still falls short of the urgent calls by public health advocates for the United
States to immediately supply ready-to-use doses that can quickly be injected.
The Quad’s focus on Southeast Asia,
however, most likely reflects an awareness of the gratitude to China in the
region, which Beijing has made a focus of its vaccine distribution efforts.
If Mr. Biden is widely seen as
helping the world recover from the coronavirus pandemic, it could become part
of his legacy, as when President
George W. Bush responded to the AIDS crisis in Africa in the 2000s
with a huge investment of public health funding. More than a decade later, Mr.
Bush and the United States remain venerated across much of the continent for
the President’s Emergency Plan for AIDS Relief, or Pepfar, which the
government says spent $85 billion and saved 20 million lives.
Michael Gerson, a former White
House speechwriter under Mr. Bush and a policy adviser who helped devise the
Pepfar program, said that its effect had been both moral and strategic, and
that the program had earned the United States “a tremendous amount of good
will” in Africa.
“I think the principle here should
be that the people who need it most should get it no matter where they live,”
he said. “It doesn’t make much moral sense to give a healthy American
24-year-old the vaccine before a frontline worker in Liberia.”
But, he added, “that’s very hard
for an American politician to explain.”
Ana Swanson contributed
reporting
