Wealthy nations falter on global vaccine commitments

A refrigerator housed a fresh shipment of a COVID-19 vaccine in Juba, South Sudan. In many countries, the infrastructure to actually administer the vaccines is lacking.LYNSEY ADDARIO/NYT

WASHINGTON — The West’s pandemic promises were grand, its goals ambitious, and from the early days of the virus’s spread, those commitments were trumpeted to the international community in a tone of solidarity.

President Biden promised the United States would be an “arsenal of vaccines” for the developing world.

United Kingdom Prime Minister Boris Johnson called on G-7 world leaders to pool their financial firepower to immunize the world against COVID-19 by 2022.

And in her State of the European Union Address, European Commission President Ursula Von der Leyen portrayed the EU as a champion of vaccine equity, pledging to invest millions into protecting the global poor from the virus on behalf of Team Europe.

But well into 2022, those countries defined as low-income by the World Bank continue to grapple with vaccination rates under 15 percent — well below the 70 percent World Health Organization benchmark — as the West’s promises to immunize the world have so far fallen flat.

In 2020 and 2021, wealthier nations contributed billions of dollars to distribute the vaccine, with the objectives of helping poorer countries protect their populations and slowing virus variants.

But the pace of Western aid commitments — particularly from the United States, the UK, and Europe — has slowed considerably since last year.

While the United States funneled over $6 billion into global vaccine aid in the last fiscal year, so far it has pledged under half a billion dollars this year, according to the ACT-Accelerator global COVID aid tracker. The UK contributed over a billion dollars last year, but has committed just $78 million this year. The EU’s commitments, cumulatively, are less than a fifth of what it committed the year prior, at nearly $5 billion.

There’s still much of the year left for the West to amp up its commitments — and a key pledging event, the second global COVID summit, is slated for next month. But experts say they’re concerned that wealthier nations dealing with heightened inflation and strained budgets after more than two years of providing COVID aid will no longer disburse the cash necessary to fight the virus.

“If you look at the funding numbers, it’s clear: the West has turned its back on Africa,” said Lusungu Kacheche-Dzinkambani, the just economies and inequality lead for Oxfam’s Pan Africa Program, who is based in Kenya. “The commitments were made, but they are not being met in terms of the funding. We’ve seen a dramatic slowdown in aid.”

Nativism. Competing budgetary priorities. Political fatigue. Strategic failures and dilapidated supply chains. All have snarled the West’s efforts to keep its word, analysts said. And in 2022, many wealthy nations have pulled inward — taking the money with them.

“There’s clearly been a slowdown in interest and commitment,” said Dr. Krishna Udayakumar, who tracks global vaccine distribution at Duke University’s Global Health Institute. “It’s partially driven by fatigue, partially driven by a desire to declare the pandemic over, and it’s also driven by other developments such as the Ukraine invasion, which has diverted a significant amount of funding assistance from Europe and North America.”

But for Kacheche-Dzinkambani, the reason isn’t just fatigue.

“The West is focusing on their backyard, looking at America first, Europe first,” she said. “There’s a lack of commitment to reducing inequalities, and even in terms of aid, the cuts have been to say, let us address our local COVID-19 needs first.”

The pledged aid would go to COVAX, UNICEF, the WHO, and other international groups to help organize vaccine campaigns, pay for COVID-19 tests, and facilitate access to personal protective equipment and treatments.

In the United States, the Biden administration will soon run out of money to fight the virus abroad after being unable to persuade Congress to authorize more funds.

After days of negotiations, senators finally agreed in early April on a slimmed-down $10 billion COVID relief package, less than half what Biden requested. Among the cuts: An extra $5 billion requested by USAID to expand its global vaccination program to 20 new countries — and ramp up health services for more than 100 million people.

Top USAID officials warned Congress that leaving foreign aid out of the agreement would endanger the agency’s ability to deliver vaccines to the lowest-income countries.

“Barring additional funding, the United States would have to turn its back on the countries that need urgent help to boost their vaccination rates” USAID administrator Samantha Power said the day the deal was cut. “By not helping these countries get shots into arms, we would leave their populations unprotected.”

Even the downsized $10 billion in domestic COVID relief aid may be stalled for longer, as the package could be bogged down by a controversial immigration measure some lawmakers are pushing to tack onto the aid.

USAID launched the GlobalVax program in December 2021 to help immunize the world and bolster vaccine supply chains. But with its funding on the chopping block, the program could disappear long before the virus does, analysts fear.

“Without more money, the programs will seize up in a short period of time,” said Stephen Morrison, director of the Global Health Policy Center at the Center for Strategic and International Studies think tank. “It will stall momentum, and America’s credibility and reputation will also suffer.”

Similarly, the UK also slashed foreign aid in late 2021, down 4.5 billion pounds from 2020.

A government audit of the aid cuts found the resulting changes “undermined efforts to protect those who were most vulnerable to the impacts of COVID-19.”

Despite uneven results, Europe, the United States, and the UK have donated at least 900 million vaccines to poorer countries since 2020 through the COVAX program. But simply getting vaccines to poor countries isn’t enough, Udayakumar said. Infrastructure is needed to deliver the vaccines, and consistent aid to pay for it.

“In 2021, we saw donations coming too late, in unpredictable ways, in floods of doses with short shelf-lives,” he said. “And while donations have a role to play, it’s not the model that will solve the pandemic — it’s inequitable in its design and its execution.”

Udayakumar added that failure to invest in vaccine delivery systems meant that even when vaccine supply was high enough to make meaningful gains in Africa, the shots were never given.

Emily Bass, author of the book “To End a Plague” on the United States’ AIDS effort in Africa, said shortages of clinics, staff, and robust health communication infrastructure are still hurting the West’s delivery efforts in sub-Saharan Africa.

Throughout the pandemic, health experts have emphasized the global cost to inaction on vaccine equity beyond leaving millions without protection. Waiting too long could enable the development of more dangerous virus mutations, like Omicron.

“We have a long way to go,” Udayakumar said of the West’s response. “We have not done well on any front, and we are missing the chance to save lives.”

Morrison added: “Our leadership is being tested.”