Is Biden's pledge to donate 500m vaccine doses too little, too late?

US President Joe Biden has pledged to donate 500 million more doses of the Pfizer-BioNTech vaccine to developing countries starting from next year.

The President’s pledge at a virtual Covid-19 summit on the sidelines of the UN General Assembly (UNGA) will see the total number of doses donated by the US as part of vaccine-sharing commitments exceed one billion.

"For every one shot we've administered to date in America, we have now committed to do three shots to the rest of the world," Biden said at the summit, adding that the goal is to vaccinate 70 percent of the world's population by this time next year.

"We're not going to solve this crisis with half-measures or middle-of-the-road ambitions. We need to go big," he added, “and we need to do our part: governments, the private sector, civil society leaders, philanthropists.”

EU Commission President Ursula von der Leyen also pledged to work with the United States to provide overall an additional 900 million doses to low and lower-middle income countries by September 2022, bringing their total pledge to over 1.6 billion doses.

“Yes, today’s summit produced large pledges of vaccines that will eventually save lives, but inexplicably delays delivering the vast majority of them until well into 2022,” Amnesty International’s Secretary General Agnes Callamard said in response to the summit. “Why wait to act when hundreds of millions of doses are available today and people are dying right now?”

More than 11 billion doses are needed to vaccinate 70 percent of the world’s population.

Biden’s call was likely an attempt for the President to re-establish the United States as a global health leader after former President Donald Trump severed ties with the World Health Organisation (WHO) last year. 

Biden has also faced recent criticism for his decision to go ahead and administer booster doses to Americans while 90 percent of the population in African countries is still waiting for their first dose.

Vaccine inequity unlikely to be addressed at current pace

Biden’s call is also nothing new. The WHO had already set goals to vaccinate 40 percent of the world’s population by the end of the year, and 70 percent by the middle of next year, calling for genuine cooperation to address vaccine inequity if that target is to be met. Only 2 percent of 5.7 billion doses administered globally so far went to African countries.

“On the one hand, we see the vaccines developed in record time — a victory of science and human ingenuity,” the UN Secretary-General António Guterres said in his opening remarks at the UNGA this week.

“On the other hand, we see that triumph undone by the tragedy of a lack of political will, selfishness and mistrust. A surplus in some countries. Empty shelves in others,” he added, “this is a moral indictment of the state of our world. It is an obscenity. We passed the science test. But we are getting an F in Ethics.”

According to the University of Oxford’s Our World in Data project, 79 percent of global  vaccine doses have been administered in high- and upper-middle-income countries.

Meanwhile the WHO-backed vaccine-sharing initiative Covax is behind schedule to meet its distribution targets. In the latest supply forecast, it is estimated that Covax will have distributed 1.425 billion vaccine doses by the end of 2021, significantly less than the target of 2 billion doses it set last January. The programme purchases and then sells vaccines at a low cost to middle income countries while donating them to poor countries.

Vaccine hoarding and Big Pharma

Research firm Airfinity found that rich countries could have 1.2 billion spare vaccine doses by the end of the year – including over one billion that have not been earmarked for donation. The research is based on available supply of vaccines in the US, UK, EU, Canada and Japan, and assumes their vaccination campaigns continue at the current pace, including administering booster shots.

In June, G7 countries and the EU pledged to donate over 1 billion doses to poor countries over the next year, but only 15 percent has so far been delivered. 

"Currently doses tend to get shared in low volumes, at short notice, and with shorter than ideal expiry dates - making it a huge logistical lift to allocate and deliver these to countries able to absorb them," Aurelia Nguyen, managing director of the Covax facility, told the BBC.  

The result is that millions of doses risk going to waste.

As the issue is no longer production but distribution, experts have been calling for poor nations to be put in front of the line for vaccine purchase on the one hand, and pushing for a global patent waiver on the other.

"Vaccine sharing is good but we shouldn't have to be relying on vaccine sharing. Particularly when we can come to the table, put structures in place and say, we also want to buy,”said Strive Masiyima, the African Union’s Special Envoy for Covid-19. 

"American taxpayers, European taxpayers, they financed some of this intellectual property and it should be for the common good. So, it is not wrong that we say there should be waivers, it was for the common good."

An Amnesty International report published this week put the blame for unfair vaccine distribution squarely on Big Pharma. The report accuses six major vaccine providers, AstraZeneca, BioNTech, Johnson & Johnson, Moderna, Novavax and Pfizer of “fuelling an unprecedented human rights crisis through their refusal to waive intellectual property rights and share vaccine technology,” while for the most part failing to prioritise vaccine deliveries to poorer countries in what the human rights group’s secretary general Agnès Callamard called “wheeling and dealing in favour of wealthy states.”

“It’s plunging parts of Latin America, Africa and Asia into renewed crises, pushing weakened health systems to the very brink and causing tens of thousands of preventable deaths every week,” Callamard said. “In many low-income countries not even health workers and people at-risk have received the vaccine.”