When $5 billion is not enough

The people and politics driving global health.

Mar 31, 2022 View in browser   By Megan Wilson and Daniel Payne THE BIG IDEA Experts worry that, without adequate health investments around the world, new variants could continue causing societal disruptions and increased deaths. | A man walks underneath the marquee of the Alex Theatre in Glendale, Calif., which bears a message urging people to get Covid-19 vaccine booster shots, on Jan. 24, 2022. COST OF GLOBAL VACCINATION — Rep. Raja Krishnamoorthi doesn't think $5 billion is enough. During an oversight hearing Wednesday, the Illinois Democrat said the Biden administration needs more than it's requested for vaccine deployment overseas — even amid congressional gridlock over appropriating more funds toward the Covid-19 response both here and abroad. He also asked health department officials for more information to figure out the best way to fight the virus internationally — and how far the $5 billion would go toward fulfilling the government's promise to help vaccinate the rest of the world. But even that $5 billion is now at risk. The Senate Covid funding negotiators are reportedly scaling down the size of the package amid disagreements — and could be dropping the entire global portion of the package, The Hill's Jordain Carney tweeted late Wednesday. At the hearing, Dawn O'Connell, the assistant secretary for preparedness and response at the Department of Health and Human Services, noted that 500 million of the 1.2 billion vaccines that President Joe Biden has committed globally have been delivered to more than 100 countries. "Not only would [the funds] help get the next round of vaccines to the world, it would also make sure that they're administered — it's one thing to ship them to different countries; it's another thing to make sure that they actually enter arms," she added. The debate comes at a time when global health organizations are questioning which vaccination goals may actually be possible in the coming year — and as the Biden administration is warning of a slowdown in pandemic response worldwide if the request isn't funded. Centers for Disease Control and Prevention Director Rochelle Walensky, who also attended the hearing, emphasized that money isn't needed for just the shots — but also for administering them and scaling up "surveillance capacity, vaccine safety capacity, data capacity in all of these places." "I would just say I think we need a lot more than 5 billion dollars for that, honesty," responded Krishnamoorthi. "And that's where we need more transparency and more information from you on that." The backdrop: Congress has failed to authorize $15.6 billion in additional coronavirus funds for domestic use, including more than $4 billion to help fight Covid-19 globally — largely because Republicans demand that the additional spending be offset. That has sparked a debate about how the expenditure would be paid for. What USAID has asked for: The number is significantly less than the $19 billion the U.S. Agency for International Development initially requested from Congress to help create a global vaccination program. WELCOME TO GLOBAL PULSE WELCOME BACK TO GLOBAL PULSE, where we wonder whether you think $5 billion will be enough. Let us know — and share other tips with us — at dpayne@politico.com. Global Pulse is a team effort. Thanks to editors Eli Reyes and Barbara Van Tine. Follow us on Twitter: @ErinBanco and @_daniel_payne.   SUBSCRIBE TO NATIONAL SECURITY DAILY : Keep up with the latest critical developments from Ukraine and across Europe in our daily newsletter, National Security Daily. The Russian invasion of Ukraine could disrupt the established world order and result in a refugee crisis, increased cyberattacks, rising energy costs and additional disruption to global supply chains. Go inside the top national security and foreign-policymaking shops for insight on the global threats faced by the U.S. and its allies and what actions world leaders are taking to address them. Subscribe today.     BEYOND THE PANDEMIC PAY AND POLICY CHANGES FOR A PLATFORM — At its Global Covid-19 Summit, the White House will share the stage with other countries — at least with nations that agree to finance measures to fight the pandemic. Next month's summit, aimed at coordinating nations' efforts to fight the pandemic, will include a new plan to encourage funding pandemic programs: The White House will institute a "step-up-to-speak" strategy, Raj Panjabi, senior director of Global Health Security and Biodefense at the National Security Council, said at a Pandemic Action Network conference Tuesday. Panjabi said participants will be asked to make "significant" financial pledges to secure "speaking roles" in the summit. Financial contributions will go toward several efforts, including the new Global Health Financial Intermediary Fund at The World Bank and increased vaccine, testing and therapeutic access for countries worldwide. The asks go beyond finances, too. For low- and lower-middle-income countries to have a speaking role in the summit, they will be asked to shift their domestic pandemic policies. Shifts will include creating national plans to fully vaccinate at-risk populations, expand test-to-treat programs and bolster health systems to face future pandemics. "We're hopeful after the summit will have achieved a range of substantial financial and policy commitments," Panjabi said. GLOBAL PULSE NUMBER 160 metric tons Approximately the weight of supplies the WHO has sent in aid to Ukraine. The supply lines have started reaching additional locations in eastern Ukraine, but some cities — like Mariupol — are still inaccessible.   STEP INSIDE THE WEST WING: What's really happening in West Wing offices? Find out who's up, who's down, and who really has the president's ear in our West Wing Playbook newsletter, the insider's guide to the Biden White House and Cabinet. For buzzy nuggets and details that you won't find anywhere else, subscribe today.     AROUND THE WORLD EU members agree to IP deal — The 27 EU member states have agreed to an intellectual property deal that would open Covid-19 vaccines to some countries even without the patent holder's approval, POLITICO Europe's Ashleigh Furlong reports . Even though the EU members were agreeable to including testing and therapeutics in the deal, other parties didn't agree to measures beyond vaccines, Ashleigh reports. It comes after earlier reporting from POLITICO Europe about a compromise among the EU, South Africa, India and the U.S. that would open vaccine use beyond ordinary IP laws — a move that's long been contested and deadlocked at the World Trade Organization. It's not just Europe and the U.S. — Even in regions with low vaccination rates, some pandemic restrictions are being eased. It's a trend across Africa, where almost half of countries that banned mass gatherings a year ago have lifted that restriction, the WHO said in a recent statement . Contact tracing has decreased significantly in the region, too. And while mask mandates remain in most African countries, a few have rescinded those measures as well. Ghana is the latest in the trend,dropping many restrictions and hoping to boost a struggling economy — even as less than 30 percent of the population has received their first vaccine dose. China sticks to lockdowns — Shanghai's lockdown this week is the latest example of China's faith in its approach, even as frustration grows in the city of nearly 26 million people. Two new vaccines to watch — The Spanish pharmaceutical company HIPRA had its protein-based vaccine — meant to target multiple variants — sent to the European Medicines Agency, which began a rolling review of it this week. The vaccine is designed to be given after a full vaccination course to protect against new variants like Omicron. There's a new mRNA vaccine in the works, too. German biotech company CureVac and its partner GlaxoSmithKline are conducting a first clinical trial for a reworked vaccine. It's CureVac's second attempt at an mRNA Covid-19 vaccine; its first failed to meet expectations. More boosters for older Americans — The CDC now recommends a second booster for people ages 50 years and older and immunocompromised people, POLITICO's Katherine Ellen Foley reports. The recommendation comes as European health ministers urge leaders to back a similar measure for those over 60 on the continent — just months after the EU's drug regulator expressed doubt about needing fourth shots. WHAT WE'RE CLICKING Nature: The quest to prevent MS — and understand other post-viral diseases POLITICO: What skydivers can teach us about pandemic risk-taking The Washington Post: Biden administration to lift pandemic border restrictions   Follow us

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