Why the US Needs to Fund Global Vaccine Efforts

As COVID-19 cases surge in many countries, the US needs to fund global vaccination efforts. In the US, 36.6% are fully vaccinated, and 47.3% have received a first dose. Meanwhile, many other countries such as India, Brazil, and Turkey are seeing significant rises in case numbers and death tolls, especially as variants become more infectious and fatal. African countries have received under 2% of the global supply of vaccines. We are also starting to see sharp infection rate increases in Southeast Asia and South America. While the US is still seeing surges in certain areas, many countries are reaching record highs of both case numbers and deaths for reasons including disparities in health infrastructure and access to resources like vaccines.

​India is currently overwhelmed with a surge in cases following a period of relaxed public health measures, a shortage of vaccines, and escalating variant rates. Significant vaccine shortages started being reported in early April, with many vaccination centers shutting down due to a lack of doses, despite India manufacturing a significant portion of AstraZeneca and Novavax vaccines. Daily deaths in India have risen to 4,000, but the rate appears to be stabilizing. After seeing what happened in India, the US needs to move faster in making vaccines affordable and accessible through funding doses in other countries to prevent more unnecessary deaths.

While the US recently agreed to help send vaccine manufacturing supplies and medical equipment to India, quicker and more significant global funding needs to be prioritized to prevent more surges, deaths, and variants, especially in areas of denser populations and crowded multigenerational housing. ​

As the US starts to re-open and maintains high vaccination rates, we need to set aside funding for global efforts. However, after the recent increases in federal spending with the American Rescue Plan and proposed $2.3 trillion infrastructure plan and $1.8 trillion American Families Plan, some legislators may be hesitant to set aside more money for international programs. 

Policy-makers and advocates can frame this issue as a public health emergency that needs immediate action for the sake of both the US and other countries. With the rise in variants, global hotspots need to be a priority for vaccination efforts. As seen with the B.1.1.7 variant, which originated in the UK, and the B.1.351 variant, first identified in South Africa, variants can easily spread back to the US even with limited travel and mostly closed borders. As normalcy begins to return, the spread will only get faster. This is most concerning because these other newly emerging variants with multiple mutations could become much less responsive to vaccines and antibody therapies. Further, double mutants would make all our progress for nothing, since the current antibody treatment and vaccines could be made ineffective if the virus mutates too much beyond the current strains, as seen with the new B.1617 variant in India. If these increasingly contagious strains continue to propagate in countries with high density populations, such as India, the pandemic will not be over in the US until it is under control globally. 
 
Because the US and other higher income nations bought out most of the global vaccine supply, doses are more limited for lower income countries. Duke Global Health Innovation Center Launch and Scale Speedometer  reports that even though wealthier countries only make up 19% of the world’s adult population, they have bought 54% of available shots. High-income countries have enough doses to inoculate their adult populations two times over. However, researchers expect there won’t be full global vaccine coverage until 2023 at the earliest. Our actions directly prohibited and crowded out these other countries and NGOs, so we have an even greater obligation to help fund manufacturing and distribution. 

Laying out infrastructure for manufacturing centers and proper storage now would create the opportunity for delivering other vaccines and addressing food delivery and safety issues in the future. Worldwide, there are 19.7 million under-vaccinated infants who are at risk of contracting preventable diseases. Further, the refrigeration necessary for keeping vaccines cold could serve a dual purpose to address food shortages. In Africa, where rural villages have limited access to cold storage units, 30-50% of harvested crops are wasted. The United Nations Environment Program’s Cool Coalition advocates for investing in cold chain management to address both vaccine storage and food supplies.

Funding global vaccination efforts is also an opportunity to repair damaged international relations and address past mistakes. This could be the way the Biden-Harris administration sets a new tone, with a new commitment to human rights and equity. For those concerned about the lack of action in President Biden’s foreign policies so far (such as in immigration and the yet-to-be-renewed Iran nuclear deal), this could be a concrete step to re-establishing international relations. For policy-makers concerned about US global power, vaccine distribution could act as a parallel to China’s Belt and Road Initiative.

From a policy perspective, the US can and has addressed public health as a national security defense against biological threats. The Department of Homeland Security’s Defense Logistics Agency (DLA) has been distributing influenza vaccines globally for 20 years, using established cold-chain management for storing these vials at proper temperatures. While a more locally-based, community-focused, non-military intervention is better, the DLA set a precedent for being able to use defense funds on medical supplies.

Funding vaccine efforts needs to be the main priority. While the U.S. has decided to support the World Trade Organization’s proposal for temporary waivers on vaccine patents (against the wishes of the powerful pharmaceutical industry), America must also aid in manufacturing vaccines and providing medical supplies.

Ideally, a more coordinated international response is needed to fully address the disparities and allow for the most number of people to be vaccinated. Over 24 countries, the European Union, and the World Health Organization drafted an international treaty in late March to create a system for equitable access, especially as future pandemics are becoming more likely. 

​The US needs to first set aside increased funding through WHO, Covax, and aid to individual countries based on need and priority. The US should first fund vaccines and manufacturing supplies in current global hotspots, then focus on infrastructure for distribution and manufacturing in areas that are harder to reach due to geography, shipment requirements (such as temperature or expiration dates), and geopolitics. Funding infrastructure for vaccine delivery through manufacturing centers and refrigeration now could also help eradicate other preventable diseases and address issues of water and food supplies, creating long-term benefits.
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Ramya Ravi

Ramya Ravi is a 4th year from Virginia studying Public Policy and Biochemistry. Her main policy interests include housing, equity, criminal justice reform, and healthcare. She looks forward to reading about and getting more involved with a wider range of policy issues and promoting Batten projects through VPR.

The views expressed above are solely the author's and are not endorsed by the Virginia Policy Review, The Frank Batten School of Leadership and Public Policy, or the University of Virginia. Although this organization has members who are University of Virginia students and may have University employees associated or engaged in its activities and affairs, the organization is not a part of or an agency of the University. It is a separate and independent organization which is responsible for and manages its own activities and affairs. The University does not direct, supervise or control the organization and is not responsible for the organization’s contracts, acts, or omissions.