Biden Is Reasserting the U.S.’ Role in Vaccine Distribution. Is It Enough?

President Joe Biden has talked a lot about America’s re-emergence as a world leader since he took office during a global pandemic. On Thursday, standing before the G7 summit in the United Kingdom during his first foreign trip as President, Biden is set to lay out a deal to back up that lofty rhetoric with action.

Biden will announce that the U.S. has purchased 500 million doses of the Pfizer-BioNTech COVID-19 vaccine to donate to 92 low- and lower middle-income countries, according to the White House. Two hundred million doses will be distributed this year and the remaining 300 million by the first half of 2022.

“The goal of today’s donation is to save lives and end the pandemic,” the White House said in a statement. It said that “additional actions” would be announced in the coming days.

The vaccine will be manufactured at Pfizer’s facilities in Michigan, Kansas, Missouri and Massachusetts, and be distributed through COVAX, the global initiative focused on vaccine equity backed by the World Health Organization.

The move marks a clean break from Biden’s predecessor Donald Trump, who regularly lambasted these types of international institutions. “It shows we’re taking a leadership role and that’s been badly missing,” says Chris Skopec, executive Vice President at Project HOPE, a global health and humanitarian relief organization. “We are one of the largest manufacturing countries in the world when it comes to vaccines. We have the most resources to help produce this.”

Public health experts have been pushing the Biden Administration to take a bigger role in the global vaccination effort for months. While parts of life are slowly returning to normal in the U.S., where over half of the adult population is now fully vaccinated, other countries continue to suffer. Just one month ago, India, where under 4% of the population has been vaccinated, was seeing record-high tolls of over 4,000 deaths per day. Countries with some of the world’s lowest GDPs, including Afghanistan, Gambia, and Mozambique, have vaccinated less than 1% of their population, according to data from Johns Hopkins University, And in a handful of other low-income countries, including Haiti, not a single person has been vaccinated.

“The needs are tremendous,” says Skopec. “The scale of this is unbelievable.”

That glaring discrepancy, which has come come into sharp focus in recent weeks, has put increasing pressure on the Biden Administration to come up with a plan to distribute America’s surplus of vaccines to countries in need. But public health experts have long argued that a full domestic recovery is predicated on a global one, and that inequitable vaccination distribution amplifies the risks of a variant that could evade immunization.

“Thankfully we haven’t seen [those types of variants],” says Dr. Krishna Udayakumar, founding Director of the the Duke Global Health Innovation Center. “But it’s really a matter of time.” There are also strong economic incentives for the Administration to ramp up distribution, Udayakumar says. “We know our economic growth and recovery will not be as strong if there’s not a global recovery that’s associated with it.”

While that urgency was clearly shared by some Biden Administration officials heading into the G7 summit, there has been an ongoing debate inside Biden’s national security team over how much ownership the U.S. should take over the global pandemic, according to one senior administration official. “The key question is, is the United States going to step up and take charge of the global pandemic? That’s what’s needed,” says the official, who has been arguing internally for the U.S. to take a more prominent global leadership role in smothering the virus. “As we get a handle on the pandemic at home, it’s just critical.”

Prior to this week, the Biden Administration had been taking a more gradual approach. In February, the Administration announced its intended allocation of $4 billion to COVAX. In April, it said it would disseminate 60 million doses of unused AstraZeneca vaccine, pending an approval from the Food and Drug Administration. And it has promised to distribute a further 80 million surplus doses by the end of the June.

So far, public health experts have been dissatisfied with these efforts, saying the richest country in the world could be doing more. “While those are good steps, they are quite small relative to the scale of the need and also not quite meeting the urgency of the situation,” says Udayakumar.

After hearing about the Pfizer deal, Skopec was optimistic, and adamant that more could be done. “Showing that level of leadership is a great start, but thats all it is—a start,” says Skopec. “Five hundred million vaccines is not enough. It needs to be a pipeline, it needs to be something we keep committing to.”

—With reporting by Brian Bennett/Washington