| | | | |  | | By Erin Banco and Ryan Heath | Follow Ryan on Twitter | Follow Erin on Twitter Next week: Global Insider will publish daily — from the United Nations General Assembly in New York, with Suzanne Lynch as co-author. The Global Insider podcast will be back for the week, also daily. Look forward to interviews with a range of presidents, prime ministers and leading activists.
| | | Today's Global Insider takes you inside a seven-month investigation by POLITICO and the German newspaper WELT about how global health organizations came to dominate the world's response to Covid. More on that below. BUT FIRST, PELOSI HEADS TO ARMENIA: Speaker Nancy Pelosi has been in Berlin for the G-7 Speakers' Summit, and will continue her streak of dramatic foreign travel when she arrives in Armenia this weekend, after a Russia-brokered ceasefire failed to contain deadly fighting with Azerbaijan. With Pelosi's days as speaker likely numbered — it's the worst-kept secret in Washington that President Joe Biden is keeping the Italy ambassador gig open for her — the trip is another example of her working to cement a legacy as a champion of human rights. The State Department insists that "diplomacy is the only way forward" in this conflict. It's not clear if they meant Pelosiplomacy. (We're still working on that, forgive us.) SWEDEN HEADED FOR RIGHT-WING GOVERNMENT: Ulf Kristersson , party leader for the center-right conservatives (Moderaterna), which finished third in a weekend national election, has begun negotiations to form a right-wing government that would include the far-right Swedish Democrats. Magdalena Andersson, whose Social Democrats finished first in the election but who could not muster a left-wing majority in parliament, has resigned as prime minister. What's next? Look for Kristersson to propose a cabinet next week. Foreign Minister Ann Linde is headed to New York to represent Sweden at UNGA. BY THE NUMBERS 14 hours — The wait time to say goodbye to Queen Elizabeth lying in state. It's the ultimate queue, and it's officially full. 60,000 square kilometers — the territory Ukraine has taken back from Russian forces in recent weeks.
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Global health organizations spent hundreds of millions of dollars this year alone — across both the U.S. and Europe — scrambling to position themselves as leaders in guiding the world's response to the next pandemic. | Win McNamee/Getty Images | INVESTIGATING A PANDEMIC RESPONSE RUN BY NGOs Are NGOs the new face of global pandemic responses? Check out our full story . Global health organizations spent hundreds of millions of dollars this year alone — across both the U.S. and Europe — scrambling to position themselves as leaders in guiding the world's response to the next pandemic. Six charts that show how money and influence shaped the world's Covid plans. It's an unfamiliar position for governments and they're trying to avoid what happened during Covid: a shift in power from overwhelmed and underprepared bureaucracies to a group of high-functioning non-governmental organizations. That shift enabled a quicker response that countries alone could have delivered — but without much accountability. Governments are beginning to support and invest in next-generation vaccines and are developing new models to help strengthen the health systems in countries in Africa. But many wealthy, Western governments are still sadly behind the times. The $65 billion strategy the White House Office of Science and Technology Policy developed last year is still not funded. That lack of government planning has left a gap for global health organizations to fill — again. We put four organizations under the spotlight The Bill & Melinda Gates Foundation, Gavi, the Vaccine Alliance, Wellcome Trust and the Coalition for Epidemic Preparedness Innovations, or CEPI, which have been at the center of the global response to Covid-19. Armed with decades of experience fighting infectious diseases such as ebola and polio, they came well equipped to advise countries and the World Health Organization and helped develop a plan to combat Covid internationally. They also came armed with unrivaled financial and political connections, our investigation found. Collectively, the organizations spent nearly $10 billion to fight Covid — the same amount as the leading U.S. agency charged with fighting the virus abroad. The groups also reshaped major global health priorities and made life-and-death decisions about the distribution of critical Covid shots and treatments. But many health advocates now say there's too little scrutiny about what the organizations did, and didn't, achieve. There's literally no international health community accountability system. While governments participate in various parts of these new organizations, those organizations are ultimately accountable only to their boards … democracy, it isn't. Pandemics run by NGOs? Since 2020, global health advocates have raised concerns about a small-group of Westerners running a large portion of the world's response to Covid with little transparency and minimal inclusion of civil society and local officials, particularly those in low-income countries. "Money buys influence. And this is the worst kind of influence … it's preferential access, behind closed doors,","said Lawrence Gostin, a Georgetown University professor who specializes in public-health law. "I think we should be deeply concerned," he said. Promises of fairness and equity, for example, were often not delivered. A WHO-backed iconsortium dubbed the Access to Covid-19 Tools Accelerator, or ACT-A, failed to meet its original 2021 goals on distribution. Bill Gates expressly stood against the idea of an intellectual property waiver on Covid vaccines — which prevented generics from entering the market en masse — though his foundation eventually reversed course. Today, millions across the globe still do not have access to life-saving medicines and shots. As of August 2022, roughly only 20 percent of Africans have received a Covid vaccine. Health advocates and officials across the world say it is difficult to criticize these organizations, in part because their work is central to the global health fight — saving lives across the world — and in part because it's far from clear that governments alone would have done a better job. It's also difficult for them to criticize the Gates Foundation because its industrial-scale philanthropy dominates the debate and funding landscape health experts and campaigners operate in. Gostin said that such power, even if propelled by good intentions and expertise, is "anti-democratic, because it's extraordinarily non-transparent, and opaque" and "leaves behind ordinary people, communities and civil society." While NGOs move more nimbly and get cash out the door quickly, they are not able to control how countries, particularly wealthy countries, show up.
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A lab technician works on blood samples taken from people taking part in a Johnson & Johnson Covid-19 vaccine test in Groblersdal, South Africa, in February 2021. | Jerome Delay/AP Photo | Different organizer, same unequal outcome Although global health organizations helped fill a gap during the pandemic, they couldn't convince wealthy, Western governments to do more to help low-income countries sooner. The U.S. and the EU, health advocates said, hoarded vaccine doses early on, limiting the ability of low-income countries to obtain doses. While donations from these governments eventually flowed to needy nations, they arrived far too late. Today, these four groups are positioning themselves as the gurus of pandemic preparedness, vying for billions of dollars from governments to help solidify their role in helping shapeshift the next outbreak. The next question: How much internal and external scrutiny will be applied to ensure these organizations reflect on the missteps of the past two years? Representatives of the organizations said they have all conducted some form of review of their work on Covid, but none of them have published official findings. Read Global Insider's interview with Mark Suzman, CEO at the Gates Foundation. Tell us what you think: How could accountability be improved? What are the right questions to ask in this complicated situation? rheath@politico.com U.N. GENERAL ASSEMBLY IN ACTION PRESSURE GROWS TO FINANCE THE GLOBAL FUND: Raising $18 billion for an existing crisis amid new crises hard enough. Making matters worse, the Biden administration and the Global Fund to Fight AIDS, Tuberculosis and Malaria have had to push their biggest fundraising event from Sept. 19 to 21 due to Queen Elizabeth's funeral. The goal: increase contributions by 30 percent. The U.S., Germany and Japan have done that (check out POLITICO's graphic snapshot) but the commitments from big donors such as France and the U.K. remain under question. For each $1 billion shortfall, around 1.6 million fewer people will have access to treatment they need, the One Campaign said Thursday. John Nkengasong, the U.S. global AIDS coordinator is hopeful: he thinks Covid has made it easier to make the case to taxpayers about that funding. "A disease threat anywhere in the world is a disease threat everywhere in the world," he told POLITICO's Carmen Paun. Monkeypox and polio are the latest examples of how diseases that usually threaten people in a few countries have now become a danger to people across the world, he said.
| | | | On Wednesday, September 21, the McCourt Institute will host an exclusive event in NYC on "The Future of Digital Governance," to positively shape the next digital era and anticipate how tech will be regulated in the Web3 generation. It is part of the Unfinished Live festival and will feature transatlantic policymakers, academics, and other experts including Cedric O, Stefan Berger, Camille Canon, Jeremy West, Primavera de Filippi, Eric Salobir, POLITICO's Mark Scott and others for discussions on digital governance, the decentralized web, competition, privacy, content and more. Tune into the live stream beginning at 1:00 pm EST on September 21 on the McCourt Institute's website. | | | | | | | | GAZPROM — CHINA IS NO EUROPE REPLACEMENT FOR MOSCOW: The Russian energy giant now supplies only 9 percent of Europe's natural gas (down from 40 percent), and China is taking only around 38 billion cubic meters of gas a year via the Power of Siberia I pipeline. Gazprom looking to increase that to around 100 bcm by 2025 through a Power of Siberia II and third smaller pipeline, neither of which are open yet, said Alex Gabuev, senior fellow at the Carnegie Endowment for International Peace. Gazprom's best case scenario: China replaces half of Europe's former demand. Beijing is also likely to push for bigger discounts than Europeans ever achieved. ROYAL RUMBLE: A Chinese government delegation has been refused permission by the House of Commons authorities to attend the queen's lying-in-state, opening a fresh diplomatic rift between London and Beijing. CRYPTO (SOME OF IT) GOES GREEN: The massive Ethereum network completed its "Merge" — a complicated upgrade that fuses together its original blockchain with a new one, running on new rules. No hitches so far, but a lot of political consequences, chiefly: a massive reduction in the network's energy usage, which had been a source of environmental concerns. Policymakers are tending to welcome Merge — "this is positive," the European Commission's financial policy chief, Mairead McGuinness, told POLITICO. There's been a lot of concern that crypto's enormous energy consumption will drive up prices or leave people without heating this winter. Backers of Ethereum's rival Bitcoin are less happy — they dismiss Merge as a centralization of network power. CATCH UP WITH GLOBAL INSIDER JOIN GLOBAL INSIDER AND DAVID MALPASS AT UNGA: The World Bank president will talk about Tipping Points: Confronting Global Multiple Crises in a one-to-one interview, Thursday, Sept. 22, at 10:30 a.m. ET. Register here. FOLLOW CONCORDIA: POLITICO is partnering with Concordia Summit Sept. 19-21. Following New York Mayor Eric Adams' opening speech, Global Insider will interview CEO of Siemens USA Barbara Humpton at 9.30 a.m. ET, on how to strengthen supply chains. VIDEO — IN CONVERSATION WITH MERIDIAN CENTER's PURU TRIVEDI PODCAST — REMEMBERING THE QUEEN, WITH STEPHANIE RUHLE WHITE HOUSE MEETS WORLD FOREIGN INVESTMENT GETS NEW SCRUTINY: There's a new executive order increasing scrutiny of foreign investments, based on possible national security risks. Biden already in 2021 broadened a Trump policy restricting Chinese investment. Now, the Committee on Foreign Investment in the United States, is ordered to consider national security factors. But wait … isn't that what CFIUS already did? (Global Insider presumes the administration presumably isn't admitting CFIUS was simply a tool for ensuring an unlevel playing field intending to hurt foreign companies.) Treasury Secretary Janet Yellen said Thursday that an additional purpose of the order is "strengthening our supply chains." CONGRESS MEETS WORLD
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Sen. Tim Kaine listens during a Senate Foreign Relations committee hearing in Washington, D.C. | Bonnie Cash/Pool Photo via AP | SENATE MOVES TO PROHIBIT ANY U.S. PRESIDENT LEAVING NATO: Legislation from Sen. Tim Kaine (D- Va.), to prohibit any president from withdrawing the United States from NATO without the Senate's advice and consent, has passed the Senate Foreign Relations Committee. The legislation also includes a provision to increase oversight of political appointments to U.S. ambassador roles (the provision is transferred from Kaine's draft Ambassador Oversight and Transparency Act). MENENDEZ URGES REFUGEE ADMISSION CHANGES: U.S. Senator Bob Menendez (D-N.J.), chair of the Senate Foreign Relations Committee, is "calling for a robust Presidential Determination on Refugee Admissions to lead efforts to address the growing global displacement crisis." Menendez is complaining that the U.S. has admitted only 15 percent of its 2022 refugee quota. "The Administration should expedite family reunifications, expand overseas refugee adjudication capacity, improve refugee vetting efficiencies, strengthen domestic resettlement capacity, and ensure due process and transparency," Menendez wrote in a letter to Biden. In addition to Ukraine, Menendez is particularly worried about displacement from Hong Kong and Afghanistan.
| | | AMSTERDAM SCHIPHOL AIRPORT CHIEF RESIGNS: He's the highest profile casualt y from a summer of rich country travel chaos, often the result of staff shortages. SPOTTED: The Meridian International Center hosted a "Welcome to Washington" reception Wednesday night for newly arrived Chiefs of Mission. We spotted Undersecretary of Commerce Marisa Lago; Ambassador Rebecca Gonzales, Meridian's Ann Stock, Stuart Holliday, Natalie Jones, Puru Trivedi; Kylie Atwood, David Barrosse, Margaret Brennan, Mark Vlasic, Bidjan Nashat, Andy Raben, Rina Shah; and Ambassadors of the Bahamas, Cambodia, Democratic Republic of Congo, Denmark, Indonesia, Ireland, Panama, Republic of Korea, Mali, Tunisia and Vietnam. MOVES CONFIRMED: Nathaniel Fick as U.S. ambassador-at-Large for Cyberspace and Digital Policy. Thanks to editor Ben Pauker, Carmen Paun, Ashleigh Furlong and producer Mallory Culhane. SUBSCRIBE to the POLITICO newsletter family: D.C. Playbook | Brussels Playbook | London Playbook | Paris Playbook| Ottawa Playbook| EU Confidential | D.C. Influence | EU Influence | London Influence | Digital Bridge | China Direct | Berlin Bulletin | Living Cities | | | | Follow us on Twitter | | | | Follow us | | | | |
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