Biden's domestic Covid-19 vaccine push stalled. Now his global campaign has, too

This faltering campaign raises the risk that more dangerous variants of the virus will yet emerge. PHOTO: EPA-EFE

WASHINGTON (BLOOMBERG) - US President Joe Biden's effort to vaccinate the world against Covid-19 is falling short, echoing the faltering campaign to inoculate Americans and raising the risk that more dangerous variants of the virus will yet emerge.

Secretary of State Antony Blinken acknowledged in a virtual meeting with other countries on Monday (Feb 14) that the globe is not on pace to meet a goal of vaccinating 70 per cent of the entire human population by later this year, a target set in 2021 both by Mr Biden and the World Health Organisation.

Low-income countries - particularly in Africa, where the Omicron variant was first detected - remain overwhelmingly unvaccinated.

Wealthy nations awash in shots were slow to equitably share vaccines; as they have, developing nations have run headlong into familiar challenges like hesitancy and logistical barriers.

Stubborn disparities are flaring up anew as effective therapeutic treatments are cleared for use.

Only about 54 per cent of the global population is vaccinated so far, according to Our World In Data, a service by a UK non-profit that advocates of international vaccination use to track progress. Signs are mounting that the problem is increasingly less about supply than last-mile distribution.

"The world is completely failing to reach the goals of getting the vaccine out to the people who need it," said Mr Tom Hart, president of the ONE Campaign, an anti-poverty group. "We need a massive new infusion of vaccine distribution in the poorest parts of the world."

Mr Biden administration officials believe supply is no longer the chief bottleneck and is out-pacing global demand. Instead, getting shots into arms is the chief concern, one US official said. The person asked not to be identified discussing internal administration deliberations.

US plan

Mr Blinken announced a "Global Action Plan" on Monday intended to jump-start international vaccine efforts. The US has donated the most doses abroad, contributing about half of the world total, data compiled by Unicef show.

"We know that increasing supply is not enough to turn vaccines into vaccinations. We must also solve last-mile challenges," Mr Blinken said.

Covax, a global vaccine-sharing initiative, announced this month that it has shipped half a billion doses donated by high income countries so far.

Mr Biden's administration has pledged to donate a total of 1.2 billion doses globally, and has shipped about 435 million so far, some of which went through Covax.

"The US has been doing more than any other country," said Mr Krishna Udayakumar, founding director of the Duke Global Health Innovation Centre. "It's just not enough."

Mr Biden announced his goal last September during a virtual summit in which he called on other countries to step up their own donations as part of a renewed global push.

"And in the four months since that, nothing has happened," Mr Hart said. "Dose-pledging is no longer the appropriate end of the conversation. We need to be talking about vaccine production all around the world."

Biden is due to hold another international vaccine summit next month.

Patent restrictions

There's been little progress on easing patent restrictions on Covid-19 vaccines to expand international production, a strategy the Biden administration has announced support for but that is opposed by the European Union and shot makers.

In a potential answer to the troubled international campaign, a group of Texas lawmakers asked Mr Biden on Feb 1 to throw the administration's weight behind a new, patent-free vaccine, Corbevax, based on technology developed by Texas Children's Hospital and Baylor College of Medicine but not yet authorised for US use.

They say the shot could fill yawning demand internationally and counter China, which has sold its vaccines while sometimes using them as leverage for foreign policy objectives.

"Let's get this out to save lives, but let's also get this out in terms of a foreign policy effort to counter what China's engaged in," Representative Michael McCaul, a Texas Republican among a bipartisan group that wrote Mr Biden, said in an interview.

The Indian government is the only regulatory authority in the world that has cleared the shot so far, and has ordered 300 million doses from Biological E. Limited.

"As we have seen with the emergence of Delta and Omicron, Covid-19 variants will continue to threaten our own domestic health security and full economic recovery," the lawmakers wrote.

"While we recognise existing administration efforts to supply Covid-19 vaccines around the world, the global supply is woefully insufficient to meet urgent and pressing demands."

Promoting boosters

Experts say that there's probably enough doses of Covid vaccines in the pipeline to give two doses to 70 per cent of the world's population, but not yet enough for booster shots as well.

The US and other wealthy nations have aggressively promoted boosters to their own populations, while insisting the campaign doesn't detract from international vaccination efforts.

Dr Peter Hotez, dean at Baylor's National School of Tropical Medicine and one of the researchers behind Corbevax, said the world still needs billions of doses of vaccine to quell the pandemic.

And wider availability of vaccines based on older technology - as opposed to the more advanced messenger RNA technology that underlies shots by Pfizer Inc-BioNTech SE and Moderna Inc - could ease hesitancy, he said.

"The scope and the magnitude of the problem has not been adequately articulated," Dr Hotez said. "There's not quite that recognition of the urgency."

The administration's US$6.9 billion (S$9.3 billion) deal with Pfizer to buy one billion vaccines specifically earmarked for donation abroad has created a steady flow of shots, allowing predictable US donations, the US official said.

Advocates say there's a debate brewing about whether to change the 70 per cent target - abandon it, lower it or add an interim goal, such as vaccinating the vulnerable. Manufacturing and disproportionate access to supply are both problems, but the defining issue is how to get shots into arms as supply ramps up.

"That challenge will be huge. It can be done, but it's a big one," said Ms Jennifer Kates, director of global health & HIV policy at the Kaiser Family Foundation. "This is still a global crisis."

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