On Sunday, US Secretary of State Anthony Blinken tweeted: “Our hearts go out to the Indian people in the midst of the horrific COVID-19 outbreak. We are working closely with our partners in the Indian government, and we will rapidly deploy additional support to the people of India and India’s health care heroes.”
The tweet comes amid several campaigns calling upon the US to do more to contribute to vaccine equality. One of the latest campaigns involves a stockpile of millions of AstraZeneca doses. Epidemiologists to industry leaders are urging the Biden administration to release the reserve to countries like India and Brazil, given the assertion that the doses won’t be used in the US.
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What is this stockpile?
According to Brown University School of Public Health Ashish Jha, the US is “sitting on 35-40 million doses of AstraZeneca vaccine Americans will never use”.
Last summer, the US and AstraZeneca entered into a deal to deliver 300 million doses. The rollout timeline has taken longer than expected, and been overshadowed by several safety and efficacy concerns.
What’s the argument for diverting it?
In early April, US chief medical adviser Anthony Fauci said the US will likely not need the AstraZeneca shot. The AstraZeneca vaccine has not been granted Emergency Use Authorization by the US Federal Drug Administration (FDA). With documented cases of blood clots in younger women in Europe correlated with the vaccine, FDA authorisation may be further delayed. By the time it would have gained clearance, most American adults will have already received a vaccine, experts note. There are at least three other shots readily available in the US.
The US has given four million of the AstraZeneca doses to Mexico and Canada.
On March 22, just as AstraZeneca concluded its US trial, Jha tweeted: “What? Don’t I care about vaccinating Americans? By time AZ is authorized by FDA, we’ll have LOTS of vaccines. The time to use AZ here would have been in January. By May, we won’t need it. Harvard Medical School Assistant Professor Adam Gaffney tweeted: “We should be diverting vaccine stock to India now.”
The US Chamber of Commerce issued a statement on Friday, with its executive vice president stating: “These vaccine doses will not be needed in the United States, where it’s estimated that vaccine manufacturers will be able produce enough doses by early June to vaccinate every American. This move would affirm US leadership, including in initiatives such as COVAX, and as we work with partners around the globe because no one is safe from the pandemic until we are all safe from it.”
What has the US said in response?
On Sunday, a White House spokesperson told Reuters that they will “race additional support to the Indian Government” and are in “active conversations”.
A reporter at the White House asked about the issue on Friday, stating, “That is a country that has been shipping AstraZeneca doses to other nations, now has quite a problem in its own backyard.”
Fauci responded: “The CDC is helping out by consulting with them — as they have in other countries in which there are situations — and giving technical assistance. But it is a dire situation that we’re trying to help in any way we can. We just have to see how things go. And obviously, they need to get their people vaccinated because that’s the only way we’re going to turn that around.”
Co-ordinator of the US Covid-19 taskforce Jeff Zients added: “The Quad partnership and team is providing assistance across government to the country. And, you know, this is a global pandemic, and India demonstrates the risk of what can happen if we don’t get the pandemic under control everywhere. And it’s why we made the biggest investment in COVAX and we are committed to sharing vaccine supply. As our confidence around our supply increases, we will explore those options.”
What are the other pressure campaigns on the US administration?
Serum Institute of India has said the US should lift an embargo on essential raw materials. CEO Adar Poonawalla later clarified it was for Covovax, not Covishield (which is a version of the AstraZeneca vaccine).
A network of think-tanks, including Carnegie India, Observer Research Foundation, IDFC Institute, and Takshashila, have requested the US to exempt India from aspects of the Defense Production Act to allow the export of these materials.
On a third front, there has been pressure on the US and other countries to support a patent waiver at the World Trade Organization to expedite production.
How are vaccines stocked around the world at present?
An overwhelming majority has been distributed in the richest countries, which negotiated directly with manufacturers early on.
According to Bloomberg’s Vaccine Tracker, highest income countries are vaccinating at a pace 25 times faster than the lowest ones. The US has 22.9% of the world’s vaccines but only 4.3% of the world’s population. China has 21.9% and 18.2% respectively, and India 13.8% and 17.7%, according to the tracker. Almost half of all vaccines have gone to 16% of the world’s population. The Washington Post reported that the world’s poorest 92 countries may not be able to vaccinate even 60% of their population for another three years.
India has vaccinated 8% per cent of the population with one dose and 1% with two. Brazil has vaccinated less than 12% with one.
In other concerns, India’s stalled vaccine exports have domino effects on the rollouts in African nations and other developing countries, as Serum’s productions were fuelling efforts globally before India’s second wave.