<html><head><meta http-equiv="Content-Type" content="text/html; charset=utf-8"></head><body style="word-wrap: break-word; -webkit-nbsp-mode: space; line-break: after-white-space;" class=""><a href="https://foreignpolicy.com/2021/04/29/covid-biden-vaccine-failure-global-leadership/" class="">https://foreignpolicy.com/2021/04/29/covid-biden-vaccine-failure-global-leadership/</a><div class=""><br class=""></div><div class=""><a href="https://foreignpolicy.com/category/news/report/" class="department-name">
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<span class="hed-heading" href="https://foreignpolicy.com/2021/04/29/covid-biden-vaccine-failure-global-leadership/">
<h1 class="hed">Health Experts Slam Biden’s ‘Massive’ Global Leadership Failure</h1>
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<h2 class="dek-heading">Biden’s speech to Congress ignores his dithering
on COVID-19 vaccine patents, jeopardizing millions of lives in other
nations, critics say.</h2>
<div class="author-bio">
By <strong class=""><a href="https://foreignpolicy.com/author/michael-hirsh/" class="">Michael Hirsh</a></strong>, a senior correspondent and deputy news editor at <em class="">Foreign Policy</em>. </div></div><div class=""><br class=""></div><div class=""><div class="shares-position post-content-main">
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<time pubdate="" datetime="2021-04-29" title="April 29th, 2021" class="date-time"> April 29, 2021, 7:39 PM</time>
</div><p class="">U.S. President Joe Biden, riding high in the polls, touted his administration’s 100-day record in a <a href="https://www.whitehouse.gov/briefing-room/speeches-remarks/2021/04/29/remarks-by-president-biden-in-address-to-a-joint-session-of-congress/" class="">speech</a>
to a joint session of Congress on Wednesday. Focusing his remarks
largely on the COVID-19 crisis, Biden spoke of how the United States was
“leading the world again” in getting vaccines to “hard-to-reach
communities.” </p><p class="">But Biden, striking a nationalist
tone, said nothing of helping the rest of the world in what continues to
be a global pandemic. And with the president’s first
priority—COVID-19—now raging out of control in India and other
developing nations, health experts say Biden is neglecting his own
promise to stop at nothing in getting vaccines to nations most in need.
In the end, that will only prolong an unprecedented health crisis and
come back to endanger the United States itself, critics say.</p><p class="">A key issue is whether the
administration will agree to a six-month-old proposal by India and South
Africa to temporarily waive patents and intellectual property rights in
order to quickly step up vaccine production around the world. Critics
say Biden is too willing to cater to major pharmaceutical companies,
despite active efforts being made to find a compromise led by U.S. Trade
Representative Katherine Tai. In a speech earlier this month, Tai
herself warned of a “gaping divide between developed and developing
countries when it comes to access to medicines.”</p><p class="">“Biden is starting out his tenure in
the White House bringing despair to millions who will have to wait years
for a vaccine,” said Gregg Gonsalves, an epidemiologist at the Yale
School of Public Health. “We need to crush COVID now, not in 2022, 2023,
or 2024. Right now, Biden is punting, relying on theatrics—pledging 60
million doses from AstraZeneca when billions are in need—rather than
stepping up with a bold policy.”</p><p class="">Such a policy would entail rapid
transfer of technical knowhow to India and other countries in need,
along with production capability. These views are widely shared by other
global health experts who say the pharmaceutical industry has less
claim on intellectual property rights to vaccines than usual because
billions of U.S. taxpayer dollars went into developing these vaccines
quickly. The U.S. government, for example, <a href="https://default.salsalabs.org/Tb158e8cb-7a6d-4c58-8432-8f16960460b6/c917afa3-6898-41f7-a50b-5833a0a3c6f1" class="">funded 100 percent</a>
of Moderna’s vaccine project to get U.S. Food and Drug Administration
approval, reported Public Citizen, an advocacy group. Pfizer got a $1.95
billion government deal. </p>
<div id="adPlaceholder-0" class="in-article-dynamic-ad"></div><p class="">“I
am completely baffled by the massive gap in leadership on this issue,”
said Matthew Kavanagh of Georgetown University’s Global Health Policy
and Politics Initiative. “I would have thought this would have certainly
been done in the first months, and here we are approaching the first
100 days. The world is waiting.”</p><p class="">India and Brazil in particular are
suffering from new COVID-19 strains, and Indian Prime Minister Narendra
Modi pleaded with Biden in a phone call this week to support a waiver on
patents in the face of a massive second wave of the pandemic. India has
reported at least 300,000 new infections every day in the past week,
and crematoria there are said to be operating nonstop. </p><p class="">Ironically, India is the world’s
biggest vaccine maker, and Modi offered free vaccines to the world under
a controversial “vaccine diplomacy” policy starting in January. But
suddenly, India is a desperate state, having vaccinated less than 6
percent of its nearly 1.4 billion population as new mutations of
COVID-19 appear—and experts believe these strains are now spreading to
other countries, including the United States. </p><p class="">Administration officials say Tai has
been actively trying to resolve the patent issue, having solicited
opinions in recent days from major pharmaceutical companies like Pfizer,
Moderna, and AstraZeneca; the administration’s COVID-19 point man,
Anthony Fauci; Seth Berkley of Gavi, the Vaccine Alliance, a global
public-private health partnership overseeing vaccine distribution; Bill
Gates; and other public health advocates. There appears to be room for
compromise: Last fall Moderna President Stephen Hoge <a href="https://www.wsj.com/articles/moderna-vows-to-not-enforce-covid-19-vaccine-patents-during-pandemic-11602154805#:~:text=Moderna%20Inc.,to%20others%20after%20the%20pandemic.&text=%E2%80%9CWe're%20quite%20studiously%20not,Hoge%20said%20in%20an%20interview." class="">said</a>
the company wouldn’t enforce patents related to its COVID vaccine as
long as the pandemic continued. Gates, who has personally spent billions
of dollars on global health as part of his foundation, said waiving IP
rights too quickly could create safety problems.</p><div class="related-articles--no-video fp-related-wrapper"><div class="related-articles"><div class="blog-list-layout" data-post-id="1040462"><div class="content-block excerpt-content--list" data-post-id="1040462"><div class="list-text"><div class="meta-data -excerpt"><address class="author-list -excerpt"></address>
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</div><p class="">The president has been pushing for a
solution, administration officials say, but in the end he needs to work
with the same pharmaceutical corporations that, to their credit,
delivered vaccines in record time. “I don’t believe we’re dealing with
callous human beings here,” said Priti Krishtel, co-founder of I-MAK, a
major advocacy group supporting wider access to medicines. “I think we
live in a market-based system. This pandemic has further exposed that
the ways in which we have structured our economy are fundamentally
inequitable.”</p><p class="">Still, some critics suggest that Biden, by hesitating so long over the issue, may be in danger of <a href="https://www.youtube.com/watch?v=V4CLoiA3vfQ" class="">breaking a promise</a> he made last
July when the then-Democratic candidate said he would “absolutely,
positively” not let intellectual property rights stand in the way of
getting vaccines to the world. At the time, Biden criticized his
predecessor, Donald Trump, for doing so, saying his patent-protecting
policies lacked “any human dignity.” Biden added: “It’s not only a good
thing to do. It’s overwhelmingly in our interest to do.”</p><p class="">Vaccine advocates say Biden is trying
to avoid confronting the pharmaceutical industry and the Republicans at
a time when he is consumed with getting his big domestic programs
passed. In his speech Wednesday, Biden trotted out his third nearly $2
trillion plan in as many months. To help pay for it, he’s asking
Congress to approve $1.5 trillion in tax hikes that will fall on wealthy
Americans, and Republicans are balking.</p><p class="">For weeks, the administration has
failed to give a direct response to questions about patent waivers.
Officials have pointed instead to Biden’s signing of a $4 billion
investment in COVID-19 Vaccines Global Access (COVAX), a United
Nations-orchestrated plan for wealthier nations to buy up and share
vaccines worldwide, and Monday’s announcement that Biden would send <a href="https://www.washingtonpost.com/politics/us-to-share-up-to-60-million-doses-of-astrazeneca-coronavirus-vaccine-with-other-countries-official-says/2021/04/26/b2dab8a0-a694-11eb-bca5-048b2759a489_story.html" class="">60 million AstraZeneca vaccines</a> to nations in need. </p><p class="">“Along with our investments in COVAX,
we are working with our global partners to explore pragmatic and
effective steps to surge the production and equitable distribution of
vaccines,” Adam Hodge, a spokesperson for Tai, told <em class="">Foreign Policy.</em></p><p class="">But the COVAX program is barely a
drop in the bucket, health experts say, and is already well short of
effort to supply a target of two billion doses for 2021. “COVAX is
wholly unequipped to resolve many of the most pressing threats,” <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00617-6/fulltext" class=""><i class="">The Lancet</i></a>
said in an editorial in March. “COVAX’s current conservative aim is to
immunize 20 percent of people in each country, which it estimates is
enough to cover high-risk groups and health workers.”</p><p class="">Meanwhile, vaccine inequities are only widening. A February <a href="https://www.lse.ac.uk/News/Latest-news-from-LSE/2021/b-Feb-21/COVID-19-vaccination-potential" class="">study</a>
published by scholars at the London School of Economics and other
academics reported that states representing only 16 percent of the
global population have secured 70 percent of the available doses for the
five leading vaccines this year.</p><p class="">Under the waiver proposed by India
and South Africa last October, World Trade Organization (WTO) member
nations would have the right to bypass intellectual property licenses in
cases of national emergency. The proposal was based on the <a href="https://www.who.int/medicines/areas/policy/doha_declaration/en/" class="">Doha Declaration</a>
on the Trade-Related Aspects of Intellectual Property Rights (TRIPS)
Agreement. The TRIPS declaration evolved out of the HIV/AIDS crisis,
during which nations were unable to get necessary medicine because of
patents for years. </p><p class="">Yet the Biden administration is
shying away from that plan, and since several of the major
pharmaceutical companies producing vaccines are from the United States,
including Moderna, Pfizer and Johnson & Johnson, no one can do much
without Washington’s say-so.</p><p class="">World Health Organization
Director-General Tedros Adhanom Ghebreyesus has supported the TRIPS
plan, saying the United States’ “me first” approach is self-defeating.
Even new World Trade Organization Director-General Ngozi Okonjo-Iweala
has pledged to “forget business as usual,” though she has stopped short
of endorsing the India-South Africa proposal outright. The TRIPS
proposal is also supported by leading progressive senators like Bernie
Sanders and Elizabeth Warren.</p><p class="">In the past month, Sanders sent
several letters to Biden about the issue and discussed it with Secretary
of State Antony Blinken, but he has received no response, said an aide.
“Our vaccination efforts here at home will only be successful if
vaccination efforts in the developing world happen simultaneously,”
Sanders said in an <a href="https://www.murphy.senate.gov/newsroom/press-releases/murphy-blumenthal-senators-urge-biden-to-approve-covid-19-vaccine-patent-waiver-to-boost-production-and-end-pandemic" class="">April letter</a> signed by Warren and nine other Democratic senators. </p><p class="">In her <a href="https://ustr.gov/about-us/policy-offices/press-office/press-releases/2021/april/ambassador-katherine-tais-remarks-wto-virtual-conference-covid-19-vaccine-equity" class="">speech</a>
to the WTO in mid-April, Tai herself said the U.S. government should
not repeat the mistakes it made during the HIV/AIDS epidemic, “where
various policies and actions constrained access to medicines,
contributing to unnecessary deaths and suffering. We must learn from,
and not repeat, the tragedies and mistakes of the past.”</p>
<div id="adPlaceholder-2" class="in-article-dynamic-ad"></div><p class="">But
critics say that is just what is happening—only this time it may be
worse in that COVID-19 is so much more infectious than HIV, and the
global economy can’t fully restart while much of the world is
under-vaccinated and producing new strains. “India’s health system has
collapsed,” said Krishtel, who just returned from a trip to India. “So
are others. New variants are going to emerge, and then what are we going
to do?”</p><p class="">“The Biden administration is making
the same mistakes made during the AIDS crisis by dragging its feet on
the calls to scale-up access to life-saving medical interventions. Then
it was anti-retroviral drugs. Today, it is COVID vaccines,” Gonsalves
said. “But this is far worse than AIDS. An enormous coalition of
scientists, world leaders, advocates—far larger than the one that
emerged 20 years ago to push for AIDS drugs for Africa—has emerged for
COVID vaccine scale-up, and the Biden administration has turned its back
on all of us.”</p><p class="">Biden could also do a lot more even
without backing the TRIPS proposal. The National Institutes of Health
(NIH) owns some of the vaccines’ intellectual property, and Barney
Graham, deputy director of the NIH’s Vaccine Research Center, has
suggested that could be used as leverage with the pharmaceutical
companies. Graham <a href="https://www.ft.com/content/d0c70cc2-0ffa-42dd-b0d0-0f76eeb273f0" class="">told</a> the <em class="">Financial Times</em>
in an interview this week that “virtually everything that comes out of
the government’s research labs is a nonexclusive licensing agreement so
that it doesn’t get blocked by any particular company.” </p><p class="">The U.S. government could easily
deploy its own intellectual property rights “to get companies to the
table to start a process of tech transfer to companies in India, South
Africa, and elsewhere,” Gonsalves said. “They could announce a global
scale-up plan—coordinating supplies, procurement of precursor materials,
identifying manufacturing sites, subsidizing their retrofitting, etc.
None of this is on the table.”</p><p class="">The pharmaceutical industry argues
that preserving intellectual property rights is only helping facilitate
the industry’s pandemic response, since companies will agree to
cooperate only if they know their property rights are secure. In a
letter to Biden in March, the Pharmaceutical Research and Manufacturers
of America, a trade organization, said there is no evidence a waiver
would boost vaccine production or access; instead, the group said, it
would only “polarize legitimate conversations on countries’ engagement
to combat the pandemic.” </p><p class="">Critics dismiss this argument.
Although lifting intellectual property restrictions won’t solve the
issue by itself, Krishtel said: “It’s the first step. Based on all the
pandemics of the past, IP is the first barrier. You’ve got to transfer
intellectual property to make manufacturing capacity available.” </p><p class="">“There’s no way to get to vaccine
equity without radically scaling up production of vaccines in lower- and
middle-income countries,” Kavanagh added, and for that, these nations
need the waiver. “The really remarkable thing about this pandemic is
that we are talking about how to allocate vaccines globally but have put
that power completely into private hands.”</p><p class="">In his speech on Wednesday, Biden
called on U.S. corporations to pay their “fair share” for the public
good, but he said nothing of the pharmaceutical industry. Nor did he
mention global cooperation, focusing a small part of his speech on
“competition” with other nations, especially China. Critics contend
Biden is also backing down from a fight with the pharmaceutical industry
and the health insurance lobby over his just-announced <a href="https://www.nytimes.com/2021/04/28/us/politics/biden-american-families-plan.html" class="">American Families Plan</a>, a $1.8 trillion package that avoids progressive proposals to lower prescription drug prices and expand Medicare benefits. </p>
<div id="adPlaceholder-3" class="in-article-dynamic-ad"></div><p class="">Administration
officials insist various proposals are being considered to pressure
companies to share their know-how on vaccines. “There are a lot of
different ways to do that. Right now, [the TRIPS waiver] is one of the
ways, but we have to assess what makes the most sense,” White House
spokesperson Jen Psaki said Tuesday. She said U.S. officials were still
studying whether to boost existing manufacturing of vaccines in the
United States rather than transfer know-how abroad.</p><p class="">But in his speech, Biden sounded a
neo-isolationist theme that was somewhat reminiscent of his predecessor,
Trump. He spoke of his plan to “buy American” and of “winning the
future for America,” barely mentioning the rest of the world except to
warn of the threat from China and Russia. He also spoke of the United
States dominating the technologies of the future, which appeared to
underline his reluctance to encumber U.S. pharmaceutical companies.
Indeed, critics say, Biden’s new theme of competition with the rest of
the world runs in direct contradiction to the resurgent global threat
from COVID-19.</p><p class="">The issue may be resolved at least
somewhat at a May 5 WTO meeting, but it could linger at least until
early June, when the WTO’s TRIPS Council, which monitors intellectual
property issues, is scheduled to meet. </p><p class="">In the meantime, thousands more are
dying around the world. “How can they ignore the suffering of millions?”
Gonsalves asked. “I’ll tell you why. … It’s a surrender to the market.”</p>
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<section class="bio-no-photo">
<div class=""><p class=""><strong class="">Michael Hirsh</strong> is a senior correspondent and deputy news editor at <em class="">Foreign Policy</em>. Twitter: <a href="http://www.twitter.com/michaelphirsh" target="_blank" class="">@michaelphirsh</a></p> </div></section></div><div class=""><br class=""></div><div class=""><br class=""><div class="">
Arthur Stamoulis<br class="">Citizens Trade Campaign<br class="">(202) 494-8826<br class=""><br class=""><br class=""><br class="">
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