U.S. Finally Offers to Send Vaccines Abroad, But Lack of Global Plan Leaves Poorer Nations in Crisis

JUNE 04, 2021

The Biden administration on Thursday announced that the U.S. will donate 25 million surplus doses of COVID-19 vaccines to developing countries, pledging to donate a total of 80 million doses by July. Economist Jeffrey Sachs says rich countries have enough production capacity to speed up vaccine distribution and immunize the whole world within the next year. “There’s massive supply, but there’s no plan for allocation,” he says. We also speak with South African health justice activist Fatima Hassan, who says the global vaccine imbalance comes down to political will. “Even now countries are still sitting around a table and talking and having long conversations instead of figuring out an urgent way to ramp up manufacturing, scale up production and get as many doses to as many people as possible all over the world.”

This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: The Biden administration announced plans to send 25 million COVID vaccine doses to dozens of countries in Latin America, Africa and Asia, where COVID cases continue to surge. The majority of the vaccines will be distributed through COVAX, a program backed by the World Health Organization. National security adviser Jake Sullivan said the administration plans to send a total of 80 million doses by the end of the month.

JAKE SULLIVAN: We’re sharing them in a wide range of countries within Latin America and the Caribbean, South and Southeast Asia, and across Africa in coordination with the African Union. This includes prioritizing our neighbors here in our hemisphere, including countries like Guatemala and Colombia, Peru and Ecuador and many others.

AMY GOODMAN: The Biden administration’s announcement comes just before the president heads to Britain to take part in a G7 summit. Many public health experts say the U.S. plan falls far short of what’s needed to address the global crisis, which has killed at least 3.7 million people, though public health researchers say the true toll is likely approaching 8 million deaths.

According to the People’s Vaccine Alliance, more than a million COVID deaths have occurred in the past four months, since the leaders of the G7 failed to collectively back a waiver of intellectual property rules for COVID vaccines. The United States now backs the waiver, but other G7 nations and the pharmaceutical industry continue to oppose the waiver.

Based on current vaccination rates, the People’s Vaccine Alliance estimates it could take 57 years to fully vaccinate everyone in low-income nations. The New York Times reports 85% of vaccine doses have gone to people in high- and middle-income countries. On Thursday, the World Health Organization warned, quote, “The threat of a third wave in Africa is real and rising.” Cases are rising in at least 14 African nations over the past two weeks.

In moment, we’ll go to Cape Town to speak with Fatima Hassan, a South African human rights lawyer and HIV/AIDS and social justice activist, founder and director of Health Justice Initiative. But first we begin with economist Jeffrey Sachs, the director of the Center for Sustainable Development at Columbia University, president of the U.N. Sustainable Development Solutions Network. Jeffrey Sachs is also the author of several books, including The Ages of Globalization. He led the WHO’s Commission on Macroeconomics and Health from 2000 to 2001.

Jeffrey Sachs, welcome to Democracy Now!

JEFFREY SACHS: Thanks a lot, Amy.

AMY GOODMAN: Start off by responding to Biden’s plan to immediately send out 25 million doses, then hit 80 million by the end of the month.

JEFFREY SACHS: Well, we need a comprehensive strategy. What’s happened is, the United States is reaching the target levels of immunization within our own country, but the amount of production is massive, so there is vaccine available for mass distribution around the world. The same is happening in Europe, in the U.K., in China.

We need a global plan. We can estimate that there are hundreds of millions of doses being produced each month now, but there is no plan for getting them to the people in need. You quoted a study that said it would take — it could take 57 years. I would put it a different way. We could get comprehensive immunization around the world certainly within the next 12 months. Certainly. Let me underscore that. And it could be even faster, given the scale of production.

But we do not have an allocation plan. We don’t even have transparency right now. We have the companies that have been approved. How much are they producing per month? What contracts do they have? Where are these doses going right now? How should they be allocated across the world for prioritization? This is basic stuff, but the United States is not sitting down with China, with Russia, with the European Union, with the United Kingdom, with the WHO as the overall orchestrator, to make sure that there is a just, inclusive, rapid, comprehensive coverage. It’s unbelievable, actually, that we don’t have this sorted out. It’s a matter of a spreadsheet. And it’s a matter of disclosure and transparency by companies. And it’s a matter of the United States talking with China, not just yelling at China. And this is what’s missing right now to this moment.

AMY GOODMAN: So, what would it actually require?

JEFFREY SACHS: Ah, it would not require much. It would require some Zoom meetings of senior officials in China, the United States, the European Union, the United Kingdom, the United States, together with WHO, together with representatives of the producing companies — Moderna, Pfizer, BioNTech, Sinopharm, Sinovac. How many doses are you producing per month right now? What are your contractual relations, which may have to be overridden because the public sector has paid for all of this?

We don’t have that clarity. When I make rough calculations with my colleagues on this, we have enough production globally to get comprehensive immunization within the next 12 months. But then, when I ask WHO or U.S. officials, they say, “Well, we don’t really know exactly where Pfizer is selling.” Are you kidding? We’re in a global emergency of unprecedented dimension. How can you not know precisely what is happening? And why is there no plan to this date?

AMY GOODMAN: And can you explain what the —

JEFFREY SACHS: That’s — that’s the amazing situation.

AMY GOODMAN: Can you explain what the most efficient way to do this — not necessarily to send doses from the United States, but to make a deal, like Biden made with Merck and Johnson & Johnson? Merck didn’t develop the vaccine; Johnson & Johnson/Janssen did. But Merck then also helps to reproduce that vaccine, to manufacture that vaccine. The idea that there are many pharmaceutical companies in the world that didn’t develop vaccines, but if they’re given the recipe and the means of — it’s also a lot of hardware — they can help to manufacture these millions and millions of doses that are needed.

JEFFREY SACHS: That is correct. That’s why the IP waiver is, in a way, a no-brainer right now, period. But I would say, even in addition to that, there is a production flow that is underway that is sufficient to immunize the adult population worldwide comprehensively.

The mistake, Amy, is to think that this is about markets, that this is about the secret deals that Pfizer-BioNTech can make with high-paying customers, that there can be no transparency because that’s a trade secret. This is mind-boggling. Governments have paid for all of this.

We need a global distribution system for worldwide safety, not only given the fact that people are dying in surge countries, but given the fact that variants are developing in surge countries and spreading worldwide. This requires a systematic political mobilization. But in the middle of this, we have a crazy kind of Cold War that we’re not speaking with China about a coordinated strategy. We don’t have the main players at the table. And these days you don’t even need a table; you need a Zoom. And that’s all that is needed, actually, to get this done.

Financing can also be arranged. These companies also should abide by normal pricing. It’s not that this should be — the word is “free market.” It’s insane. This is not even a market. It’s like auctioning seats on a lifeboat, the way they’re doing it right now.

In other words, the most basic standards of management logic are not being applied right now, even though this is the greatest global emergency in modern history. Why is Jake Sullivan announcing just what the United States is going to do, without transparency, for July, for August, for September? And why is he saying it not in the context of a globally agreed plan, but of the United States announcing some number? Beats me, because when I look at this — and I’m involved in it day to day — what is needed is a strategy over six months. Countries need to know when doses are going to arrive. They need to have supply chains locally ready. They need to train. They need to have the capacity to get the vaccines into operation.

So, this is an operational challenge. It is not some market mania, which is the way that it has been treated 'til now, as if companies have the right and the prerogative to do what they want, sign what secret contracts they want, without any disclosure. That's the situation we’re in right now.

AMY GOODMAN: So, the People’s Vaccine Alliance reports profits from COVID vaccines have helped at least nine people become billionaires during the pandemic, with a combined wealth of over $19 billion, more than enough to cover the cost of fully vaccinating all people in low-income countries.

I want to bring in Fatima Hassan, founder and director of the Health Justice Initiative in South Africa, speaking to us from Cape Town. We just had in headlines the World Health Organization warning of a sharp increase in COVID-19 in many parts of Africa, cases rising in at least 14 countries. Talk about what this means, the fact that it is so difficult to get vaccines to the developing world, that it would take something like — what was the estimate? Fifty-seven years?

FATIMA HASSAN: Yeah. Thanks. And I think, you know, the previous speaker is right: We could be addressing this in the next few months, if there was the political will to ensure that many of these front-runner vaccine companies would actually share the knowledge and share the vaccine know-how. In my own country, we’re still waiting for supplies from Johnson & Johnson because of an issue that has arisen in the U.S., and we’re waiting for the FDA clearance. That has halted half of our vaccination program, because we are totally reliant on supplies from two pharmaceutical companies who refuse to issue multiple voluntary licenses, who refuse to allow others to manufacture the vaccines, to share the knowledge and to allow others to be able to be part of the supply chain system.

So, the situation that we have around the number that it will take — the number of years that it will take to vaccinate everybody in the Global South is one of artificial, self-created scarcity. There aren’t enough supplies, because there is knowledge hoarding. And where there are supplies, they’re not coming fast enough. In my own country — it’s June 2021 — we’ve only vaccinated just over 1 million people, half of whom who were part of a study trial. So that tells you there’s something fundamentally wrong with the supply chain system, which is very tenuous in the world at the moment. And despite the WHO saying, you know, in the first half of 2021, let’s at least use available supplies for all healthcare workers around the world or all people over 80, that has not happened. So, you know, I agree there isn’t a prioritization. There’s definitely a scarcity of supplies. But that scarcity can be addressed, and it is self-created.

AMY GOODMAN: So, explain how it could work in South Africa. What would it require of the wealthiest countries, like the United States? I mean, you have the G7 meeting today. That’s the Group of 7: Canada, France, Germany, Italy, Japan, the United Kingdom and the United States. What do you want to see come out of that meeting? What are your demands?

FATIMA HASSAN: So, all of those countries, except the U.S., are actually blocking what we call the TRIPS waiver. The U.S. has indicated partial support for the waiver only in relation to vaccine, not in relation to diagnostic technologies or not in relation to therapeutics or other kind of interventions that could actually help us manage the epidemic. For over eight months, the G7 have been sitting on a proposal for the TRIPS waiver that would allow other manufacturers around the world, wherever there is untapped capacity, to be able to make versions of these vaccines so that we can get millions of doses into many different parts of the world. So they’re blocking that, while their own populations are quite advanced in terms of vaccination levels. In some parts of the G7 member states, they’re actually vaccinating younger, healthy people. In my own country, people who are over 80 are still waiting for an appointment for a vaccine.

So, it tells you that the G7 could do a lot more. Many of them have co-invested in some of these vaccines. They actually own the technology. But they’re really fearful. They are deferential to pharmaceutical intellectual property interests. And even with the current state that we’re in, with a number of countries facing a wave three — some may also be facing a wave four — with the hospitalization data that we’re seeing, the morbidity figures that we’re seeing, particularly in Africa, even now countries are still sitting around a table and talking and having long conversations instead of figuring out an urgent way to ramp up manufacturing, scale up production and get as many doses to as many people as possible all over the world.

AMY GOODMAN: I wanted to just share some figures that are pretty astounding. The People’s Vaccine Alliance made calculations with the Health Justice Initiative, Oxfam and UNAIDS. They found last month people living in G7 countries were 77 times more likely to be offered a vaccine than those living in the world’s poorest countries. Between them, G7 nations were vaccinating at a rate of 4.6 million people a day in May. Meanwhile, if this rate continues, everyone living in G7 nations will be fully vaccinated by January. At the current rate, 63,000 people a day, it would take low-income countries 57 years. How many millions of people had to die, Jeffrey Sachs — have to die to make these pharmaceutical drug company billionaires?

JEFFREY SACHS: Let me put it in a somewhat different perspective, if I might. The United States has now vaccinated more than half of the population. Sadly, we have vaccine resistance, which is another tragedy. And I’ll put that aside for the moment. The U.S. has been producing hundreds of millions of doses per month. That is now available for the rest of the world. And that’s why this announcement has been made. But there is no plan of allocation. A similar situation applies in Europe, though Europe is six to eight weeks lagging the United States. A similar situation applies to the U.K., which is also a producing country. China is producing a lot of vaccine now and getting a lot of coverage within China. What it means is that we’re producing globally at a rate maybe of immunizing half a billion people a month. That’s the rate if you add across the companies, roughly. That is plenty of production. But there’s no plan for allocating these vaccines right now. That is unbelievable to this moment.

So, I think the production levels are actually high. They have gone overwhelmingly to the rich countries in the early months, but the rich countries are saturated, essentially, or becoming saturated with coverage, because they have reached, or close to reaching, targets. And that means that this production is available for the world, which needs it urgently, where people are dying without it.

But countries don’t even know a target date right now. They have no idea. They’re completely in the dark. Should they wait for COVAX? Should they go try to sign some agreement with Pfizer at some incredibly marked-up price? Should they make side deals? Should they accept this one or that one? Nobody knows, because there’s no system. And I think that that is largely the fault of the United States and its failure to cooperate transparently and publicly with China, with Russia, with the European producers, with India and with the United Kingdom. In other words, there’s massive supply, but there’s no plan for allocation.

AMY GOODMAN: Final comment, Fatima Hassan, on the issue of the vaccines and what’s happening in South Africa, what’s happening in Uganda, what’s happening in different African countries, what people need to know, on the continent and outside?

FATIMA HASSAN: So, I would say two things. I would slightly disagree: We don’t think the production levels are sufficient, which is why we’re having a supply crisis in almost all of Africa, which also explains why less than 3% of people in Africa have actually received supplies and have actually been vaccinated.

And COVAX is obviously not the solution, even if the U.S. puts in a trickle of 20 million doses into COVAX. COVAX has indicated that by the end of 2021, it’s only likely to cover about 27 to 30% of vulnerable populations in low-income countries. So, COVAX, I think, is a tremendous failure.

The supplies are not sufficient. We don’t believe production levels are enough. And we really need to ramp up manufacturing through the sharing — and urgent sharing — of the vaccine know-how and knowledge. And, you know, the waiver is just one part of that. There now has to be moves for governments, particularly the G7 member states, to compel pharmaceutical companies to share the technology and to transfer the technology, as well.

AMY GOODMAN: Finally, is there concern that the U.S. will be sending, for example, AstraZeneca, when it hasn’t even approved it itself in the United States? And also, the fact that even Moderna and Pfizer vaccines only have emergency use authorization; they haven’t been fully approved. Do you understand the reason for that?

JEFFREY SACHS: Hey, are you asking me?

FATIMA HASSAN: So, in relation — 

JEFFREY SACHS: Oh, I’m sorry.

AMY GOODMAN: Well, let’s go to Fatima, and then I’ll end with Jeffrey Sachs.

FATIMA HASSAN: Sorry, Jeffrey. But in relation to South Africa, Moderna hasn’t even submitted its regulatory dossier. So we wouldn’t, for example, be able to take their supplies right now. They refuse to enter low-income countries. South Africa has taken a decision not to use AstraZeneca. So, at the moment, you know, like I said in the beginning, we’re reliant on Pfizer and Johnson & Johnson. So the issue of vaccine selection in Africa is as equally important. And I think Jeffrey is right. Where is the conversations with Russia and with China? We now know some dossiers from Sputnik, Sinopharm, Sinovac have been submitted. But there seems to be, in some parts of the world, a reluctance to use those vaccines and to rely primarily on vaccines that come from Pfizer and Johnson & Johnson. And that, I think, is going to be our undoing, because certainly don’t have enough supplies of vaccines to go around the world expeditiously.

AMY GOODMAN: Your response, Jeffrey?

JEFFREY SACHS: Just to be clear, I agree on the need for ramping up, but what I’m saying is the reason that Africa has gotten so little, in part, is that the rich countries used all the production in the beginning. And that phase is at an end. It was not an appropriate way to do things. It was the way it was done. Now there is a massive supply that could be brought to bear, and that is the point that I wanted to make. So it’s not a disagreement on what to do. It is a point that we have a massive supply coming available, but without a plan to bring it about.

On the question, should AstraZeneca, should Moderna and others be used, I would say yes. From everything we know about the clinical evidence and the practical efficacy, we need to get comprehensive coverage as rapidly as possible. We are in an unprecedented crisis, but also an unprecedented situation where vaccines have come online for a new disease in a record time. Is there some uncertainty? Yes. But does that merit delay? In my view, absolutely not.

AMY GOODMAN: Well, I want to thank Fatima Hassan, founder and director of the Health Justice Initiative in South Africa, joining us from Cape Town, and ask Jeffrey Sachs to stay with us after break. I want to ask you about the G7 finance ministers, expected to agree on support for a global minimum corporation tax, and also your criticism of President Biden for backing off of his massive infrastructure plan, what’s being compromised. Stay with us.