With the coronavirus killing an estimated 15 million people worldwide, including nearly 1 million in the United States, the Biden administration, despite a lack of funding for domestic and international pandemic response, is set to mobilize a global effort to end the acute phase of COVID-19.

The U.S. will co-host the second Global COVID-19 Summit on May 12, following the first in September 2021. The virtual summit will mark a shift from a crisis management strategy to the more sustainable approach of building resilient public health systems.

“The virus — after omicron particularly — has shown us that we have to evolve our strategy,” a senior administration official told VOA. The goal, the official said, is to reduce transmission, deaths and hospitalizations rather than eradicate the virus.

The summit will focus on “supporting locally led solutions” toward global goals, which include getting shots into arms, enhancing access to tests and treatments, and generating sustainable financing for future pandemic preparedness.

“We cannot have just one solution, which might fit all of these different situations,” Dr. Thierno Baldé of the World Health Organization’s Africa regional office told VOA. “The reality is to try to understand that, and therefore to have the most appropriate solution constructed commonly, with different countries, with different partners.”

To galvanize international support, the U.S. will co-host the event together with CARICOM (Caribbean Community) chair Belize; Group of Seven president Germany; Group of 20 President Indonesia, and African Union chair Senegal.

No pandemic funding

The U.S., however, will bring no new pledges to the summit table. The administration’s request for $22.5 billion in additional COVID-19 response money, including $5 billion for global pandemic funding, has been stuck for weeks largely because of Republican lawmakers who insist they won’t pass it unless the administration brings back Title 42. The Trump-era order allows authorities at the Mexican border to turn away migrants during a pandemic emergency.

The lack of funding jeopardizes the administration’s global pandemic response, including Global Vax, an international initiative launched in December to turn vaccines into vaccinations in 11 African countries, and which is set to run out of money in September. It could also undermine the administration’s ability to galvanize other countries’ commitments, particularly at an event that has been designed with a “step up to speak up” approach, meaning that countries can secure a speaking role only if they bring either financial pledges or policy commitments to support summit goals.

White House press secretary Jen Psaki told VOA the summit would highlight to Congress the need for more funding so that the U.S. “can continue to be the arsenal of vaccines for the world.” She noted that even without the additional funding, the U.S. remains the largest contributor to the global fight against the pandemic.

Lack of global coordination

The first two years of the pandemic were marked by rich countries stockpiling more doses than they needed for boosters and protection against new variants, which threatened supplies to lower-income countries, where vaccination rates were low.

Now, with 2 billion doses of vaccine being produced each month, the problem is not a lack of supply but slowing demand and poor delivery capacity — problems that activists argue also stem from lack of coordination.

“If we’d had a coordinated global plan to end the pandemic, we wouldn’t now be in the situation where there’s quite a lot of vaccine doses but not enough money to actually distribute them in countries that need them,” Tom Hart told VOA. Hart is president of the ONE Campaign, an advocacy organization that fights preventable disease.

Beyond vaccines, the summit will also seek to improve access to testing and treatment, including by scaling up production and diversifying local and regional manufacturing capacity. Current efforts to achieve that include technology transfer agreements and the so-called TRIPS (Trade-related Aspects of Intellectual Property Rights) waiver proposal by South Africa and India at the World Trade Organization that called for intellectual property waivers on COVID-19 therapeutics and diagnostics. While the proposal is supported by more than 100 member countries, negotiations have been gridlocked for months.

Test to treat

Meanwhile, the Biden administration has recently rolled out a national “test to treat” program that tests people for COVID-19 and immediately treats them with the Pfizer antiviral drug Paxlovid if results are positive. It now aims to introduce similar pilot projects in other countries.

“The exact model may be different because the health systems are different,” the administration official said, noting that additional hurdles need to be addressed, including securing supplies of the generic drugs nirmatrelvir and ritonavir, which make up Paxlovid — a drug that is prohibitively expensive for lower- to middle-income countries.

Dr. Krishna Udayakumar, founding director of the Duke Global Health Innovation Center, told VOA that it would be up to Pfizer, Merck and other companies that already have antivirals on the market to work with countries and existing multilateral systems to get these “test to treat” pilot projects in place so when the money and the supply ramp up, countries can scale up quickly.

In March, the Medicines Patent Pool, a United Nations-backed organization, signed agreements with 35 manufacturers in 12 countries to produce nirmatrelvir and ritonavir, but these are unlikely to be on the market until 2023. Udayakumar said the U.S. was working to make an affordable generic version of Paxlovid available within several months.

The Global COVID-19 Summit aims to secure pledges to help close the gap of about $15 billion in funding that the WHO says the world needs. While those pledges will be made, advocates are pessimistic.

“It’s not clear whether that’s being coordinated, whether one country or one region will have more than it needs and another region will go without,” Hart said. “That’s the problem with no coordination and no global plan.” 

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