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100+ Scientists, Public Health Experts & Civil Society Leaders: U.S. Failing to Address Global Pandemic

Two Year Letter

Dear President Biden,

More than two years into the Covid-19 pandemic and more than one year into your presidency, we are distressed to write that the United States is failing in its efforts to adequately address the worldwide pandemic. Responsibility for this failure is widely shared among nations, but the United States has a singular leadership role in global health; it has unique capacities and thus responsibilities; and a special duty to lead the world’s response. So far, we have failed.

From the outset of the pandemic, there was widespread recognition that vaccines offered the best hope to end the worldwide health crisis as rapidly as possible and reduce the levels of global illness, death, disruption and impoverishment. There was recognition, too, that special efforts would be needed to deliver vaccines to low- and middle-income countries – financing, enhanced distribution capacity and, above all, expanded production of vaccines.

Vaccine development succeeded. Building on years of public investment and spurred by billions of dollars in Covid-related research and development and advance purchase commitments, effective vaccines made their way to market in record time.

But the effort to deliver vaccines to low- and middle-income countries has failed. The facts are stark: Even at this late date, only 19 percent of Africans have received a single shot. The vaccination rate among low-income countries is 14 percent – about one-sixth the rate in rich nations. And even those data disguise the extent to which people in poorer countries are receiving less efficacious vaccines.

The true toll of this failure will never be known, but at this point almost surely includes tens of millions of avoidable cases and hundreds of thousands of deaths from Covid. It also includes extreme disruption of poorer countries’ economies and societies. The World Bank estimates roughly 100 million additional people living in extreme poverty (less than $2/day) due to Covid. Some of this was unavoidable, but the Bank expects that low-income countries and African nations – exactly the nations with lowest vaccination rates – will have evidenced further increases in poverty in 2021.

There are two key explanations for this devastating failure: First, the United States and other rich countries not only, reasonably, prioritized domestic needs; they refused to pay appropriate attention to global solutions to the global pandemic, because of political concerns or otherwise. Second, the United States and other rich countries failed to expand vaccine supply sufficient to meet global need. Without adequate supply, efforts to bolster low-income country distribution and delivery systems consequently have lagged and been similarly under-resourced. Instead, governments permitted the multinational pharmaceutical companies to maintain a monopoly on the most advanced vaccines, declining to use existing authority to force those companies to share vaccine recipes and failing to invest in new vaccine production facilities.

There is no turning the clock back. We write now to plea with you to reverse course. We are highly supportive of vaccine donations from rich countries to low-income nations. But the donations have not been – and will not be – a substitute for sharing technology and increasing the overall supply of vaccines and implementing a plan to get shots into arms.

We write at this moment with great trepidation. With the Omicron wave fading in the United States, there is an understandable desire by everyone to “put the pandemic behind us.” On the one hand, this risks leaving poor countries out in the cold. Without concerted and determined efforts, vaccination rates will remain low in these nations. On the other hand, “put the pandemic behind us” risks repeating failures we cannot afford to replicate. If much of the world remains unvaccinated, the odds of new and dangerous Covid variants increase. Such variants will inevitably make their way to the United States, as Delta and Omicron have done in turn. We can certainly hope that this scenario won’t occur, but it is beyond reckless to rely only on hope – rather than a strategy of getting as much of the world vaccinated as possible.

Going forward, we urge your administration to:

• Use its authorities and request sufficient funding from Congress to share vaccine technology with other countries and support the scale up of vaccine manufacturing facilities in the United States and around the world. This remains an immediate need, but it is also crucial to create an infrastructure capable of dealing with evolutions of the virus, or other possible viruses.

• Augment your request for funding from Congress to fully resource support for vaccine distribution in low-income countries, including resources to support adequate “last mile” delivery of vaccines, effective public health messaging, and frontline healthcare workers.

• Act urgently to expand production and sharing of effective Covid therapeutics. Especially while vaccine access remains so inequitable, equitable access to effective therapeutics is crucial. The maker of the most important available therapeutic, Pfizer, plans to make far too little to meet global need.

President Biden, we write this letter reluctantly. We recognize the inherent difficulties in addressing a global pandemic with no recent historic parallel. We certainly appreciate this administration’s commitment to science and public health. But we have long urged effective action to address the worldwide pandemic, including in countless meetings with and communications to the administration. So far, our efforts have failed to spur appropriate action from your administration. We hope that this letter can help change that and look forward to working with your team in any way possible to meet the global challenge. 




Gregg Gonsalves, PhD, Associate Professor  Yale School of Public Health 
Gavin Yamey, Professor of Global Health and Public Policy  Duke Global Health Institute 
Michael O’Loughlin, Ph.D.  Adelphi University 
Ntama Bahati, Policy Analyst   Africa Faith and Justice Network  
John Hassell, National Director of Advocacy  AIDS Healthcare Foundation 
John Steen  American Health Planning Association 
Mitchell Warren, Executive Director  AVAC 
Jamila Headley, Co-Executive Director  Be A Hero 
Ady Barkan, Co-Executive Director  Be A Hero 
Avik Chatterjee, MD, MPH  Boston Medical Center/Boston University School of Medicine 
Andrea Boggio, JSD   Bryant University 
Alan D. Levine, PhD, Professor  Case Western Reserve University 
Ellen R. Shaffer PhD, Co-Director  Center for Policy Analysis on Trade and Health (CPATH) 
Scott Pytluk, PhD, ABPP, Psychoanalyst   Chicago Center for Psychoanalysis  
Sarah E. Baker, PhD  Children’s Hospital of Michigan 
Kim Maxa, PharmD, MBA, BCOP  Children’s Minnesota 
Carlyn Cowen, Chief Policy and Public Affairs Officer  Chinese-American Planning Council (CPC)  
Pamela Behrman, PhD  College of Mt. St. Vincent 
Betty Wolder Levin, Professor Emeritus  Graduate School of Public Health and Health Policy, City University of New York 
Catherine Stanger, Ph.D. Professor  Dartmouth College 
Rachel Cohen, Regional Executive Director  Drugs for Neglected Diseases initiative (DNDi), North America 
Sally Guttmacher, PhD   Emerita Professor of Public Health, New York University 
Robert A Bednarczyk, Associate Professor of Global Health  Rollins School of Public Health, Emory University 
Kenneth G. Castro, MD  Rollins School of Public Health & School of Medicine, Emory University 
Dr. Tim K. Takaro  Faculty of Health Sciences, Simon Fraser University 
Kenneth Mayer, Medical Research Director and Professor   Fenway Health 
George M. Carter, Founder/Director  Foundation for Integrative AIDS Research (FIAR) 
Jhumka Gupta, ScD, MPH  College of Health and Human Services, George Mason University  
James Recht, MD  Harvard Medical School 
Nancy Krieger, PhD, Professor of Social Epidemiology  T.H. Chan School of Public Health, Harvard University 
Alicia Ely Yamin, Lecturer and Senior Fellow on Global Health and Rights  Harvard University 
Asia Russell, Executive Director   Health GAP 
Nina (Cornelia) Kammerer, Senior Lecturer  Heller School, Brandeis University 
Joan Rosenhauer, Executive Director  Jesuit Refugee Service USA 
Karyn Pomerantz  Justice is Global; Public Health Awakened 
George J. DuPaul, PhD, Professor of School Psychology  Lehigh University 
Susan Gunn, Director  Maryknoll Office for Global Concerns 
Kelly Hirko, PhD  Michigan State University 
Sheela Maru, MD, MPH  Mount Sinai School of Medicine 
Ravi Gupta, MD  National Clinician Scholarship Program, University of Pennsylvania 
Samuel R Friedman  Department of Population Health, Grossman School of Medicine, New York University 
Laura Peralta-Schulte, Senior Director of Public Policy and Government Relations   NETWORK Lobby for Catholic Social Justice 
Wendy E. Parmet, Matthews Distinguished University Professor of Law  School of Law, Northeastern University 
Jonathan Kahn, Professor of Law and Biology  Northeastern University 
Mari Armstrong-Hough  School of Global Public Health, New York University 
Andrew Goldstein MD, MPH, Assistant Professor  School of Medicine, New York University 
Kenneth D. Rosenberg, MD, MPH  Oregon Health & Science University 
Alexis Dinno, Associate Professor  OHSU-PSU School of Public Health 
Abby Maxman, President & CEO  Oxfam America 
Joshua B Mendelsohn  Pace University 
Andréa Sonenberg, PhD, WHNP, CNM-BC, FNAP, FNYAM  Pace University 
George William Letson, MD  PATH 
Anne-Emanuelle Birn, Professor of Global Health  People’s Health Movement-Canada and University of Toronto 
Mary Ann Castle, PhD, Senior Associate  Planning Alternatives for Change 
Michael Friedman, MPH, PhD, Visiting Assistant Professor  Pratt Institute 
Christian Urrutia  PrEP4All 
Robert Weissman, President  Public Citizen 
Paul Davis, Policy Director  R2H Action (Right to Health) 
Jon Shaffer, Founder and Co-Organizer  R2H Action (Right to Health) 
Lara E Sucheston-Campbell, PhD  Roche Diagnostics 
Dabney P. Evans  Rollins School of Public Health, Emory University 
Jodie Guest, Professor  Rollins School of Public Health, Emory University 
Beth S. Linas, PhD, MHS  RTI International 
Shauna Downs, Assistant Professor   School of Public Health, Rutgers University 
Stephan Schwander, MD, PhD, Associate Professor  School of Public Health, Rutgers University 
Rachel E. Kreier PhD  Saint Joseph’s College  
Supriya Misra, Assistant Professor of Public Health  San Francisco State University 
Maureen Benjamins, PhD, Epidemiologist  Sinai Urban Health Institute 
Scott Burris  Center for Public Health Research, Beasley School of Law, Temple University  
Cynthia Golembeski, PhD Candidate, Executive Board Member   The New School; New Jersey Public Health Association 
Benjamin Mason Meier  The University of North Carolina at Chapel Hill 
Kimberly A. Powers, PhD, Associate Professor of Epidemiology  The University of North Carolina at Chapel Hill 
Trude Bennett, DrPH  School of Public Health, The University of North Carolina at Chapel Hill 
Mark Harrington, Executive Director   Treatment Action Group 
Ippolytos Kalofonos MD, PhD, MPH  University of California, Greater Los Angeles  
Steffanie Strathdee, PhD, Associate Dean of Global Health Sciences  University of California, San Diego 
Maria L Ekstrand, PhD, Professor   Department of Medicine, University of California, San Francisco 
Kim Yi Dionne, Associate Professor of Political Science  University of California, Riverside 
Hannah Leslie, Assistant Professor  University of California, San Francisco 
Parya Saberi, PharmD, MAS, Associate Professor  University of California, San Francisco 
Regina Day Langhout, PhD  University of California, Santa Cruz 
Harold Pollack, Helen Ross Professor of Social Work, Policy, and Practice  University of Chicago 
Jimi Adams, Associate Professor of Health & Behavioral Sciences  University of Colorado, Denver 
Sarah S. Willen, PhD, MPH, Associate Professor of Anthropology  University of Connecticut 
Wendy Bostwick, Associate Professor  University of Illinois, Chicago 
Mary K. Anglin, PhD, MPH, Associate Professor Emerita  University of Kentucky  
Carmen Velez Vega  University of Puerto Rico Medical Campus  
Colleen A. Redding, PhD, Research Professor  University of Rhode Island 
Theodore M. Brown  University of Rochester 
Sofia Gruskin  Institute on Inequalities in Global Health, University of Southern California 
Keshet Ronen, PhD, MPH  University of Washington 
Nora Kenworthy, Associate Professor  University of Washington, Bothell 
Jenna Loyd, Associate Professor  University of Wisconsin, Madison 
Lance Gable, Professor of Law  Wayne State University Law School 
Kevin Larkin, Professor of Psychology  West Virginia University 
Mardge Cohen  Women’s Equity in Access to Care and Treatment  
Catherine DeLorey DrPH  Women’s Health Institute 
Margaret Holland, PhD, MPH, Research Scientist  Child Study Center, Yale University 
Michael Skonieczny, Deputy Director  Yale Institute for Global Health 
Poonam Daryani, MPH  Yale Law School 
Sandra A. Springer, MD, Associate Professor of Medicine  Yale School of Medicine 
David Vlahov, PhD, RN  Yale School of Nursing 
Gina Novick, PhD, CNM  Yale School of Nursing 
Shelley Geballe, JD, MPH  Yale School of Public Health 
Taiga Christie, MPH, EMT  Yale School of Public Health 
Alyssa Parpia  Yale School of Public Health 
Joseph S. Ross, Professor of Medicine and Public Health  Yale University