Mon, December 06, 2021


Why 20 million U.S. doses is good news for vaccine equity, but not nearly enough to close the global vaccine gap

President Joe Biden announced Monday that his administration will send at least 20 million doses of U.S.-authorized coronavirus vaccines abroad by the end of June, a decision that followed months of calls for the United States to do more to close the growing vaccine gap.

This is the first time the United States has agreed to share vaccines approved for domestic use, namely the Pfizer-BioNTech, Moderna and Johnson & Johnson shots. It will add to the 60 million doses of the AstraZeneca vaccine the country already pledged.

The decision to donate a share of the country's considerable surplus signals the administration's recognition that inequity in access may prolong the pandemic, as well as Biden's desire to engage in the type of "vaccine diplomacy" that China and Russia have been touting for months.

But 20 million, or even 80 million, doses represent just a tiny fraction of what experts say is need to end the pandemic.

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Is 20 million doses a lot?

It depends how you look at it.

For the large number of countries still scrambling to secure vaccines, any boost to global supply is good news. While the United States, Israel, Britain and a small number of other countries press ahead with well-stocked vaccination campaigns, most rollouts are just getting started. Reaching as many as possible, as quickly as possible, is critically important.

Biden also stressed that the number of doses the United States is donating exceeds what other countries are giving. He noted, for instance, that the country has promised to share 13% of vaccine produced domestically - five times more than any other country. (France has promised 500,000 doses by June and at least 5% of its total doses by the end of 2021; New Zealand pledged 1.6 million doses.)

Viewed from a different perspective, 20 million looks modest. The United States and other relatively wealthy countries bought up a disproportionate share of near-term supply, effectively cutting others out. Researchers from Duke University estimated last month that the United States could have 300 million surplus doses by this summer. Some argue that the U.S. should have shared more, sooner.

U.S. donations to date represent a fraction of what is needed to vaccinate the world. A World Health Organization-backed push to distribute vaccines, for instance, aims to deliver up to 2 billion doses this year, with an eye to vaccinating 20% of the populations of countries in need - a target it may not hit.

Citing a severe supply crunch exacerbated by the crisis in India, the initiative, known as Covax, said this week that it is expecting a 190 million-dose shortfall by June. India was expected to play a critical role in supplying Covax, but vaccine exports have plummeted amid a domestic surge in cases. A spokesman for India's Ministry of External Affairs said he had no information on the timeline for resuming exports.

"The clearest pathway out of this pandemic is a global, equitable distribution of vaccines, diagnostics and therapeutics," read a UNICEF statement published Monday. "But COVAX is undersupplied."

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Why not just increase supply?

Nearly everyone agrees that upping supply is essential, but there is little consensus on how to do it.

After months of criticism and accusations of "vaccine apartheid," the Biden White House recently threw its support behind a proposal to waive intellectual property protections for coronavirus vaccines, a decision seen by liberals as a step toward vaccinating those in need, but staunchly opposed by the pharmaceutical industry and some foreign governments.

Negotiations over the proposal are underway, but will probably take months. The head of the World Trade Organization said she will press member countries to reach an agreement no later than December - far away as the pandemic rages on.

After Biden's turnaround, the European Union said it was open to talks. Germany remains skeptical. "The protection of intellectual property is a source of innovation and must remain so in the future," a spokeswoman for the government recently said, according to German news media.

Even those who support the proposal emphasize that a waiver alone is not a meaningful step unless it is coupled with a broader effort to transfer technology and know-how to places where the doses are needed most.

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What comes next?

For next steps on vaccine equity, the world will be watching a health summit in Rome this week, when European officials are expected to sketch out their vision for vaccinating the world. Some anticipate that E.U. leaders will focus less on the waiver proposal and more on plans to boost manufacturing, particularly in low-income countries.

Those waiting for the next big U.S. move probably will have to wait longer. Biden hinted Monday that next steps will be coordinated with close allies, particularly at the Group of Seven meeting next month.

"I expect to announce progress in this area at the G-7 Summit in the United Kingdom in June which I plan on attending," he said Monday. "This is a unique moment in history, and it requires American leadership."


Covax is already urging participants to act quickly to donate doses and to sketch out plans to narrow the vaccine gap in the months and years ahead.

Published : May 18, 2021

By : The Washington Post · Emily Rauhala