mastermind
Rest In Power Kobe
A draft proposal, which Vanity Fair has obtained, calls for the U.S. to aggressively ramp up vaccination readiness efforts around the world, to make sure donated vaccines actually get administered and the virus can’t mutate freely. So far, the Biden administration has not moved on it.
BY KATHERINE EBAN
DECEMBER 3, 2021
For the past year, public health experts have warned that leaving swaths of the world unvaccinated would be a recipe for incubating dangerous variants that could evade vaccines and prolong the fight against COVID-19. It’s still too early to tell whether omicron is the escape variant of virologists’ nightmares, but its sudden emergence has refocused attention on the lagging effort to vaccinate the globe.
Activists and even some federal health officials have criticized President Biden for slow-walking global vaccine donations, micromanaging distribution efforts through a small White House team (as first reported in Vanity Fair), and not forcing vaccine makers to share their technology with the developing world. But Biden has embraced the World Health Organization’s target of vaccinating 70% of the globe by next September, and the U.S. leads the world in its pledge to donate 1.2 billion doses, 275 million of which have already been shipped.
This summer, however, a disquieting reality began spreading within federal health agencies. A number of middle- and low-income countries, lacking robust public health systems, had difficulty absorbing and administering the donated vaccines—a failure of what experts call “vaccination readiness.”
To tackle this problem, in September, the National Security Council asked the U.S. Agency for International Development (USAID) to prepare a detailed strategy to increase global vaccination readiness. A draft of the plan, which Vanity Fair has obtained, was designed by Boston Consulting Group contractors and had begun circulating within federal health agencies by October. It proposed covering operational
costs in recipient countries, strengthening data systems, ensuring cold chains, and deploying rapid-response teams to identify bottlenecks. In short, it spelled out the need for a boots-on-the-ground effort similar to what has been required within the United States. “On-the-ground uptake challenges will become the most critical constraint within months,” the plan stated, adding, “We are seeing uptake challenges firsthand in countries receiving Pfizer and other bilateral donations.”
Describing the obstacles to global vaccination, the plan cited “weak leadership, coordination, planning, and accountability at [a] global level.” It also distinguished between countries that have low, medium, and high needs for support. And it identified 23 countries, including Afghanistan, Haiti, and Chad, whose budgetary shortfalls account for 90% of the global financing gap.
The plan estimated that the U.S. government would need to invest $2.5 billion, as part of a larger, global $10 billion effort to fully or partially vaccinate nearly 3 billion more people. It stated that “a significant ramp-up of support is required to meet the 70% target in 2022.” But with agencies’ funds dwindling, the money would likely need to be allocated by Congress, which has been consumed by debates over Biden’s domestic agenda.
“A global COVID vaccination [plan] does exist, but it hasn’t been released,” said one federal health official. “Our entire strategy is on hold” because the Biden administration has yet to ask Congress for the funds, the official said. “They wanted to get the infrastructure bill passed. You’re seeing the politics of the narrow margin in the Senate play out very poorly.”
An administration official told Vanity Fair the vaccination plan is a working document and “predecisional. You should not interpret it as final or a statement of administration policy.”
On Thursday morning, the White House issued a long list of new actions it would take to protect against the omicron variant. Most had to do with domestic policy, but one addressed the ongoing need to “turn vaccines into vaccinations.” Though a White House spokesperson declined to say whether the Biden administration would request new funding to pursue this goal, another spokesperson told Vanity Fair, “It is time for other countries to match America’s speed and generosity. It’s the only way to beat this global pandemic.”
No one yet knows how and where omicron originated. It was first detected in Botswana on November 11. South Africa, which has the most sophisticated sequencing capabilities on the continent, as well as plentiful vaccines but low vaccination rates, alerted the world to the variant’s alarming set of mutations on November 24.
Without an aggressive investment in vaccination readiness, experts say the world is likely to remain a checkerboard of struggling public health systems and unprotected populations—fertile ground for more omicron-like variants to develop. “We have been sounding the alarm all year that this is not charity,” said Rachel Hall, executive director of U.S. government advocacy at the global humanitarian organization CARE. “This is in the U.S. and global best interest to do a rapid, fast, fair, and equal vaccination campaign around the world. The more time we give for this virus to mutate, the worse off everybody is going to be.”
On Tuesday, when asked at a White House COVID-19 press briefing whether he thought the U.S. was doing enough to help vaccinate the world, Dr. Anthony Fauci responded, “The word enough is a very, very unusual word because it really...compared to what? Are we doing a lot? We are doing a lot.” But he acknowledged that “one of the frustrating aspects of this is that the logistic capability of getting vaccines into people’s arms in Southern African countries and in other low- and middle-income countries is really very difficult.”
Within federal health agencies, it has been clear for months that dropping crates of vaccines on airport tarmacs is not enough. Many countries lack the infrastructure, staff, and funding to administer the vaccines.
CARE has been studying the actual “tarmac-to-arm” cost in numerous countries. In South Sudan, for example, it found that there was an additional $22 cost for each person vaccinated—six times more expensive than current global estimates, it noted in a July study.
In September, at a global COVID-19 summit convened by the U.S. on the margins of the United Nations General Assembly, Biden committed an additional $370 million to improving vaccination readiness overseas. But that’s only a fraction of what federal health agencies estimate is actually needed, and what is already allocated for other global-health needs.
BY KATHERINE EBAN
DECEMBER 3, 2021
For the past year, public health experts have warned that leaving swaths of the world unvaccinated would be a recipe for incubating dangerous variants that could evade vaccines and prolong the fight against COVID-19. It’s still too early to tell whether omicron is the escape variant of virologists’ nightmares, but its sudden emergence has refocused attention on the lagging effort to vaccinate the globe.
Activists and even some federal health officials have criticized President Biden for slow-walking global vaccine donations, micromanaging distribution efforts through a small White House team (as first reported in Vanity Fair), and not forcing vaccine makers to share their technology with the developing world. But Biden has embraced the World Health Organization’s target of vaccinating 70% of the globe by next September, and the U.S. leads the world in its pledge to donate 1.2 billion doses, 275 million of which have already been shipped.
This summer, however, a disquieting reality began spreading within federal health agencies. A number of middle- and low-income countries, lacking robust public health systems, had difficulty absorbing and administering the donated vaccines—a failure of what experts call “vaccination readiness.”
To tackle this problem, in September, the National Security Council asked the U.S. Agency for International Development (USAID) to prepare a detailed strategy to increase global vaccination readiness. A draft of the plan, which Vanity Fair has obtained, was designed by Boston Consulting Group contractors and had begun circulating within federal health agencies by October. It proposed covering operational
costs in recipient countries, strengthening data systems, ensuring cold chains, and deploying rapid-response teams to identify bottlenecks. In short, it spelled out the need for a boots-on-the-ground effort similar to what has been required within the United States. “On-the-ground uptake challenges will become the most critical constraint within months,” the plan stated, adding, “We are seeing uptake challenges firsthand in countries receiving Pfizer and other bilateral donations.”
Describing the obstacles to global vaccination, the plan cited “weak leadership, coordination, planning, and accountability at [a] global level.” It also distinguished between countries that have low, medium, and high needs for support. And it identified 23 countries, including Afghanistan, Haiti, and Chad, whose budgetary shortfalls account for 90% of the global financing gap.
The plan estimated that the U.S. government would need to invest $2.5 billion, as part of a larger, global $10 billion effort to fully or partially vaccinate nearly 3 billion more people. It stated that “a significant ramp-up of support is required to meet the 70% target in 2022.” But with agencies’ funds dwindling, the money would likely need to be allocated by Congress, which has been consumed by debates over Biden’s domestic agenda.
“A global COVID vaccination [plan] does exist, but it hasn’t been released,” said one federal health official. “Our entire strategy is on hold” because the Biden administration has yet to ask Congress for the funds, the official said. “They wanted to get the infrastructure bill passed. You’re seeing the politics of the narrow margin in the Senate play out very poorly.”
An administration official told Vanity Fair the vaccination plan is a working document and “predecisional. You should not interpret it as final or a statement of administration policy.”
On Thursday morning, the White House issued a long list of new actions it would take to protect against the omicron variant. Most had to do with domestic policy, but one addressed the ongoing need to “turn vaccines into vaccinations.” Though a White House spokesperson declined to say whether the Biden administration would request new funding to pursue this goal, another spokesperson told Vanity Fair, “It is time for other countries to match America’s speed and generosity. It’s the only way to beat this global pandemic.”
No one yet knows how and where omicron originated. It was first detected in Botswana on November 11. South Africa, which has the most sophisticated sequencing capabilities on the continent, as well as plentiful vaccines but low vaccination rates, alerted the world to the variant’s alarming set of mutations on November 24.
Without an aggressive investment in vaccination readiness, experts say the world is likely to remain a checkerboard of struggling public health systems and unprotected populations—fertile ground for more omicron-like variants to develop. “We have been sounding the alarm all year that this is not charity,” said Rachel Hall, executive director of U.S. government advocacy at the global humanitarian organization CARE. “This is in the U.S. and global best interest to do a rapid, fast, fair, and equal vaccination campaign around the world. The more time we give for this virus to mutate, the worse off everybody is going to be.”
On Tuesday, when asked at a White House COVID-19 press briefing whether he thought the U.S. was doing enough to help vaccinate the world, Dr. Anthony Fauci responded, “The word enough is a very, very unusual word because it really...compared to what? Are we doing a lot? We are doing a lot.” But he acknowledged that “one of the frustrating aspects of this is that the logistic capability of getting vaccines into people’s arms in Southern African countries and in other low- and middle-income countries is really very difficult.”
Within federal health agencies, it has been clear for months that dropping crates of vaccines on airport tarmacs is not enough. Many countries lack the infrastructure, staff, and funding to administer the vaccines.
CARE has been studying the actual “tarmac-to-arm” cost in numerous countries. In South Sudan, for example, it found that there was an additional $22 cost for each person vaccinated—six times more expensive than current global estimates, it noted in a July study.
In September, at a global COVID-19 summit convened by the U.S. on the margins of the United Nations General Assembly, Biden committed an additional $370 million to improving vaccination readiness overseas. But that’s only a fraction of what federal health agencies estimate is actually needed, and what is already allocated for other global-health needs.
Biden got the worst logistics I’ve seen in a long time
