Substantial number of vaccine doses for India: US coordinator

India is set to receive “substantial numbers” of Covid vaccine doses through the US government’s latest global distribution strategy, though the final details are still being worked out, according to State Department Coordinator for Global Covid-19 Response Gayle E Smith.

The US will allocate doses to India based on factors such as the country’s vaccination plans, she said. Like with other countries, the Biden administration will make efforts to match the vaccines in its supply with India’s immunisation programme and cold-chain capabilities.

“We have done some notional planning, but the refinement of the actual dose numbers will be determined in consultation with the governments and their health experts, the state of their vaccine plans and delivery, and with Covax,” Smith said during a telephonic media briefing.

Below is a full rush transcript of the press conference by Special Briefing via Telephone with Gayle E. Smith State Department Coordinator for Global COVID Response and Health Security And Jeremy Konyndyk Executive Director of the USAID COVID-19 Task Force and Senior Advisor to the USAID Administrator.

Ms. Smith:  Great, thank. We wanted to talk briefly today about the milestone we’ve reached as an administration in an integral part of our response to the global pandemic, which is sharing vaccines from U.S. stocks.  As the President announced, we have just hit and are now surpassing 110 million doses shipped around the world to almost 60 countries.  This is something we started a couple of months ago based on the President’s announcement at the time that we would share 80 million doses.  Obviously, we have surpassed that and are still moving.  These are Pfizer, Moderna, and J&J doses and they are reaching literally every region in the world.  So we’re very proud of that.

That’s only one plank of what we’re doing on the vaccine side, because as you all know, there’s an urgent need for more vaccines all over the world.  Also rolling out this month will be the first lot of the 500 million Pfizer doses that the President announced that we would be donating to COVAX.  He announced that on the eve of the G7 summit as part of the G7 commitment.  We are a big donor to and proud to be a big donor to COVAX.  We are encouraging suppliers to produce more and faster.  And finally, through our Development Finance Corporation we are making investments in real time in vaccine production in Africa and other parts of the world that will yield vaccines before the end of the year, but will also lay the ground for better global coverage of vaccine production in the future.  

Mr. Konyndyk:  Thanks so much.  So as Gayle has said, the administration is intensely focused on improving the accessibility of vaccines in low-income and developing countries, and the President’s announcement represents a real milestone, but it really is just the beginning of this much, much larger effort.  We are now about to initiate the deliveries of the half-billion Pfizer doses that will be going to – initially rolling out this month, and they’ll begin to cover countries across the – what’s called the COVAX AMC 92; that’s the 92 low- and middle-income economies that are supported by COVAX with donor funding as well as several additional AU countries that are not part of the COVAX AMC 92.  And that’s going to fill critical supply gaps that COVAX has been facing between now and the end of the year, and continuing through the middle of next year.  So that’s an incredibly important contribution towards greater vaccine access for countries that have been really struggling to get enough doses.

But we’re also supplementing that with additional resources, and so the USAID Administrator Samantha Power was in Africa this week and she just announced during her trip to Ethiopia an additional $720 million in United States funding by USAID under the American Rescue Plan Act that is serving a few different purposes.  It is helping to address – it is helping to address needs with vaccine delivery.  So $400 million of the 720 is going towards support to health systems in developing countries with things like vaccine delivery, oxygen, therapeutics, and other – and diagnostic supplies to help health systems both deliver the vaccines as they become available, but also to continue to fight the pandemic in their countries that they are facing now in real time, especially if Delta is surging.  An additional 320 million of that is going to address some of the other non-health impacts of the pandemic, particularly on the humanitarian side, so things like emergency food assistance and dealing with COVID-19 in humanitarian settings.  And that’s on top, of course, of $4 billion that we’ve given to Gavi for the COVAX facility for vaccine procurement and delivery.

So it’s a really robust posture from the U.S. Government, from USAID, in continuing every month to further ramp up our support to fighting the pandemic.  

Question:  I’m just interested because while the United States has donated a lot of vaccines, Madam Gayle, how serious is the vaccine hesitancy across the globe?  And are there specific programs to counter this vaccine hesitancy?  And for Jeremy, I’d like to find out specific programs for the most vulnerable sectors affected by COVID-19. 

Ms. Smith:  Sure, vaccine hesitancy is a real challenge I think everywhere, including in this country, and we’re dealing with it at two levels.  One is a lot of the hesitancy is because people just need basic information.  They need to be reassured that vaccines are safe.  They need to understand how they work.  And so there’s a lot of work that we can do by just putting the science and the facts out there.  USAID does a great job of working with local communities so that trusted interlocutors and speakers are able to validate.  You hear about people getting their photographs taken when they get a vaccine to try to reassure people.

The second issue is there is a lot of disinformation out there where there are people I think deliberately trying to make the case against vaccines.  That’s a harder thing to counter.  But again, our approach is to put the facts and the science out there to demonstrate that those of us who are making the case for vaccines all over the world are getting vaccinated ourselves and strongly recommend it.  And I think, tragically, people are also seeing the evidence that things like the Delta variant are extremely dangerous if people aren’t vaccinated.

Mr. Konyndyk:  Thanks, Gayle. I would echo everything you said on vaccine hesitancy, and just that as well.  There’s hesitancy but there’s also accessibility, and so I think that any attempts to get vaccines to people – and particularly the people in these extremely vulnerable populations like you’re asking about – they need confidence, they need information, but they also just need access.  And so a lot of what we do, have done historically in global vaccination programs, is also focusing on that last mile of delivery and that last mile of accessibility so that people can easily access the vaccines in the course of their normal lives and are supported and enabled to do so.  And so a lot of USAID’s continuing and additional programming over the coming months is going to focus on those kinds of challenges.

But we’re also supporting the non-health needs of extremely vulnerable populations.  And so just to build a bit on what I was referencing with that humanitarian assistance, we are seeing in numerous countries around the world growing food insecurity, growing extreme poverty, and that is particularly acute in humanitarian environments.  So there are famine risks in multiple countries, and this humanitarian assistance will address those food needs, it will address water and sanitation needs, it will support some of the basic economic livelihood needs of crisis-affected populations, as well as things like addressing and supporting survivors of gender-based violence.  As I think we all know, there’s been a significant uptick in gender-based violence globally over the course of the pandemic.  

So we’re doing a range of things like that.  The announcement from the administrator this week focused particularly on the humanitarian funding, but we’re also orienting a lot of our ongoing development work to address those challenges as well.

Question:  You’ve outlined a lot of assistance from the U.S., but it’s clearly not coming in time to prevent severe inequality, and the previous administration made it clear it would not engage with the international response.  Europe has also prioritized its own population.  Meanwhile we’ve seen the World Health Organization face credibility issues and rich countries don’t seem inclined to follow their guidance – most recently, the call for a moratorium on booster shoots.  Some experts have declared the end of global health.  So to both of you, what do you make of this and what advice would you give the leader of a low-income country who’s trying to prepare for the next pandemic as far as what they can count on from the international institutions?  

Ms. Smith:  Thanks.  It’s a really important question.  And I think, look, this is a wakeup call for the entire world, and our effort, as we’ve described it, is to do everything we can – and as Jeremy said, this is the beginning and not the end; we’ve not checked the box and said, “Okay, we’re done” – to both do everything we can to expand that coverage, encourage our partners in the international community to expand that coverage, but also at the same time lay the ground for how the world prepares for and, ideally, prevents future pandemics.  And that’s going to take a number of things which, by definition, have to be multilateral and, by definition, have to be inclusive.  Because a virus doesn’t know what country it’s in, and so long as we’ve got a hole in the global net, we’re all at risk.

So we’re doing a number of things on that front.  One is we are engaged in the ongoing negotiations and deliberations about strengthening the WHO.  These investments that I mentioned by DFC we see as very critical not just for now, but for the future.  Because we’ve got to have better global coverage and geographic distribution of vaccine production if we are going to counter the global health threats we know we’re facing.  

So I would say it’s way premature to declare the end of global health.  It is really, really important – and I hope that all of you will cover this – that at the same time as we respond to this emergency, we’ve got to lay the ground for how the world is going to deal with these threats going forward in a manner that is efficient, effective, inclusive, and comprehensive, and we are also at work on that.  Happy to talk more about that at a later time, if helpful.

Question:  We’re going to take a question that was emailed to us in advance.  This is from Souber Hassan Abdi with La Nation newspaper in Djibouti.  He has a question for Director Konyndyk, and the question is:  “What has been done so far by USAID to ship vaccines to the African continent?  And how many African countries have already received their first shipments of vaccines so far?”

Mr. Konyndyk:  We have been supporting deliveries through COVAX since the new administration came in.  So one of the first things that we did when the Biden administration came in was to bring the U.S. into the COVAX initiative, the COVAX platform, and we very rapidly made a $2 billion contribution to COVAX, which then enabled them to begin securing supply and begin initiating deliveries of vaccines, particularly into Africa.  We know that COVAX has struggled since with some of their supply availability, so we’ve also taken the major step of then working with Pfizer and COVAX to secure this deal for half a billion doses of which about half of the – well, over actually half of the eligible recipient countries are African countries.  

And so a substantial share – we don’t have a number to give you yet from that total Pfizer dose set because this is going to be rolling out over a period between now and the middle of next year, but a substantial share of those vaccines will also be going to the African continent, and we have been partnering with the African Union, specifically with their African vaccine task force and with the Africa CDC, on how those vaccines as well as how the 110 million – that Africa share of the 110 million surplus U.S. doses are being targeted across the continent.  

In terms of sub-Saharan Africa, so far as I understand it, it’s about 18 and a half million doses to 24 countries in – from the 110 million shared doses the U.S. has already delivered. 

Question:  When the Biden administration did the announcement about the donation of the vaccines, there was a list of countries that will be receiving those doses, and the Dominican Republic was included in that list.  But we didn’t receive any of them, at least not yet.  Please, are we going to receive those doses or not?  Because they’re supposed to be here by the end of June and we didn’t receive it yet.  

Ms. Smith:  Yeah, I can – one of the things that we’ve learned in this process is sharing vaccine doses is complicated and there are a number of legal and regulatory steps that we need to work through with governments before the vaccines can be shipped.  So you’ve go to make sure, for example, that the kind of vaccine being provided is approved by the country in question, because each country goes through an approval process for the various types of vaccines out there.  There are a number of legal steps, there are public safety steps.  

So what we’ve been doing with governments one by one is building teams that include government representatives, our representatives, lawyers, public health experts, to move through that entire process and then the vaccines are packed and shipped.  You will get your vaccines.  As I understand, there’s still a couple of hurdles to clear, but I know the team is working on that to move those as quickly as possible.  And again, some of those are requirements we have as the United States in order to export a vaccine, but there are also requirements that governments have in receiving countries to accept and do the uptake of vaccines.  

Question:  It’s great to talk to you again, and congratulations on this important marker and sharing what’s been done on the vaccines in Africa.  My question is regarding volume.  So looking back now and where we’re at today, how much does Africa really need and what is that number in terms of versus what the globe needs?  I’m just trying to understand how big is the problem now, like how many doses should the continent be forecasting.  I know it might not be an exact number, but maybe give us an idea of what that number is. 

Gayle, thank you so much just now, and the previous speaker, for sharing some lessons you’ve learned regulatory-wise.  Can you possibly maybe share any additional lesson that you may have learned that the world could glean from, and possibly also any challenge? 

Ms. Smith:  Sure.  Thanks, Pearl.  And let me note one other important thing that is happening today that you may be aware of with South Africa, is that the African Union has itself purchased doses.  They did this many, many months ago.  And those are starting to roll out today also.  As Jeremy said, we’ve been working closely with the African Union to coordinate our shared doses and the Pfizer doses with the initiative the AU has taken to begin delivering what will ultimately be 400 million doses of J&J.  So we’re very excited about that and congratulate the AU for that.

As you know, I think, Pearl, the AU set a target and I think a very smart target, comparable to those set by other countries, of 60 percent coverage.  So there still is a substantial gap.  I think as you know, the coverage rate in Africa is among the lowest.  Jeremy may have the exact number; I don’t have it on hand.  We can get it to you.  But the gap is huge, which is why, as Jeremy said, of the 500 million Pfizer doses, we quite deliberately targeted those to low-income countries and our presumption is that Africa will get a significant portion of those.  

All of that said, we’ve got to do more and we are working on such things.  One of the investments I mentioned by the DFC was in South Africa.  As you know, the Aspen plant there produces J&J, and we’re pleased that we and our partners in the international community have made investments that are going to yield more production there.

We’ve got more to do, though, clearly, which is why the President made clear that this is the start, and we’ve got more to do, and we intend to do it.

Mr. Konyndyk:  Thanks, Gayle, and I would just – to your question on the coverage requirements, Pearl, the African Union is targeting 60 percent; the World Health Organization has talked about a goal of 70 percent of the global population covered by next year.  So if you apply that to about 1 and a quarter billion people in Africa, you’re talking about needing to cover seven – somewhere in the ballpark of 7- or 800 million people.  Four hundred million people will be covered by the J&J deal that the African Union has done, so that gets you about halfway there.  So it’s that other half, then, that needs to be covered by some combination of COVAX and dose-sharing and so on.  

So COVAX now has raised sufficient funds to cover about 30 percent of low-income and middle-income countries that are participating in the facility.  And so if you take that 30 percent from COVAX, additional dose-sharing from the U.S., as well as what the AU is procuring themselves, I think it’s not a bad picture.  It doesn’t look great at the moment with the coverage level, as Gayle referenced, but I think there’s a – there is a path to getting to pretty reasonable coverage in the first half of next year as long as we can ensure that the doses keep flowing.  

Question:  Could you tell us what your assessment is about the Chinese vaccine diplomacy or, let’s say, Chinese contribution to fix the inequality of vaccine access?  Some U.S. media criticized the Chinese that – saying that U.S. taxpayers have to pay to purchase Chinese vaccines through COVAX.  So I’m wondering what your assessment is. 

Ms. Smith:  Sure.  Look, I think it’s up to every country how they want to do this.  I think China has not been a funder of COVAX, and that’s unfortunate, I think, in our view.  I will – let me just make a comment by sharing with you our perspective on this.  The President believes – and rightly so – that the provision of vaccines from the United States, whether they are doses shared, provided through Pfizer, or funded through COVAX, need to be provided with no strings.  They are free.  There’s no condition.  This is a humanitarian mission guided by our belief in our common humanity and that these are the most powerful tools we have for bringing the pandemic to an end, which is in, obviously, the interest of every country in the world, including our own.

So our view is that vaccines should be provided particularly by the world’s major producing countries for free, with no requirements, with no strings, and in such a way that we get everybody covered as quickly as we can.  

Ms. Smith:  Sure.  I would just say, stay tuned.  There are some important events coming up over the coming months – obviously, the UN General Assembly, the G20 – and thank you for your coverage.  

And bear in mind – I want to just go back to a question embedded in the question that came from the Politico reporter – that while we are pushing out big and will continue to do so on the emergency response, we are also and must all be focused on how we prevent this from happening again.  And thank you.  As a former reporter myself, thank you for continuing to cover this story.

Mr. Konyndyk:  I don’t think I have anything to add.  I think there were great questions.  As Gayle said, we have a long road ahead but I think we’re building good momentum here, and we’ve got a lot more work that we’ll be rolling out in the coming months.