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