Letter Urging U.S. to Share Smallpox Vaccines


June 13, 2022

The Honorable Jake Sullivan

National Security Advisor

The White House

1600 Pennsylvania Avenue, NW

Washington, D.C. 20500

Dear Mr. Sullivan,

We are writing to urge you to fulfill the U.S. pledge to share smallpox vaccines with the World Health Organization (WHO) and help lead the global response against monkeypox.

As you know, in 2004, the U.S. committed 20 million doses of smallpox vaccine to the global stockpile managed by the WHO.[1] According to the Department of Health and Human Services (HHS), the 20 million doses of vaccine pledged by the United States would “physically remain in the U.S. Strategic National Stockpile, but [would] be available for the WHO to use in the event of an emergency.”[2] The emergency contemplated at the time was smallpox.

Now, a monkeypox outbreak has emerged. While more research is needed, smallpox vaccines are considered to provide some protection against monkeypox. The U.S. has a stockpile of more than 100 million smallpox vaccines.[3] Governments around the world, including the U.S., have responded to the outbreak by placing additional orders for vaccines. The WHO has said it would like to “revisit” the status of earlier smallpox pledges and see how it can access vaccines.[4] The organization is developing a coordination mechanism for the “distribution of supplies based on public health needs and fairness.”[5]

The U.S. can share vaccines and rally support for this mechanism—much like it encouraged its international partners in 2003.[6] A U.S. decision to withhold the vaccines it pledged because a related-but-different disease was spreading would undermine its claim to be an “arsenal of vaccines.”

Sharing vaccines with the WHO should be accompanied by a larger strategy to help the world combat monkeypox. In addition to supporting greater research, the U.S. can help ramp up production of monkeypox medical countermeasures by requiring corporations that benefit from public funding to share technology with manufacturers around the world. Tests, treatments and vaccines should be a global public good. Their use should be dictated by science, not scarcity.

When the U.S. announced its smallpox vaccine pledge, the HHS Secretary noted that “in this age of global interconnectedness, we need to take extra steps to be prepared for threats around the world.”[7] The threat has emerged. It is now time for the U.S. to deliver on its commitments.


Peter Maybarduk

Director, Access to Medicines Program

Public Citizen


[1] https://web.archive.org/web/20050207012802/http://www.hhs.gov/news/press/2004pres/20041210a.html

[2] https://web.archive.org/web/20050207012802/http://www.hhs.gov/news/press/2004pres/20041210a.html

[3] https://www.statnews.com/2022/06/09/how-much-medicine-does-the-us-have-to-fight-monkeypox/

[4] https://twitter.com/WHO/status/1530128122225430528

[5] https://twitter.com/WHO/status/1534529867131256834

[6] https://web.archive.org/web/20050207012802/http://www.hhs.gov/news/press/2004pres/20041210a.html

[7] https://web.archive.org/web/20050207012802/http://www.hhs.gov/news/press/2004pres/20041210a.html