- The Trump administration said the US wouldn’t participate in COVAX, an international WHO-backed effort to develop and distribute coronavirus vaccines.
- Trump has pledged to withdraw the US from WHO entirely, calling the group’s pandemic response “China-centric.”
- Health experts are concerned that the US’s absence from COVAX could impede the country’s access to vaccines developed in other countries.
When the World Health Organization announced COVAX last week — a major international effort to develop, manufacture, and distribute coronavirus vaccines — 172 countries had already signed on.
One was conspicuously absent: the US.
The US, historically a global leader in fighting infectious diseases like HIV and smallpox, has distanced itself from WHO since the pandemic began. In May, President Donald Trump announced the US would pull its funding and membership from the organization, an agency of the United Nations specializing in international public-health issues. Trump called WHO’s coronavirus response “China-centric.”
White House spokesman Judd Deere told Reuters on Tuesday that the US wouldn’t join COVAX because the WHO is “corrupt.”
Instead, the Trump administration’s focus is on funding vaccine research and development on its own, then striking deals to buy the resulting shots. In the US, vaccine candidates developed by AstraZeneca and the University of Oxford, Moderna, and a Pfizer-BioNTech partnership have reached phase-three trials.
But COVAX is the only global initiative working with multiple countries to develop, manufacture, and distribute a coronavirus vaccine — and make sure it reaches vulnerable populations, like older people and healthcare workers.
The project’s larger goal is to have 2 billion vaccine doses by the end of 2021. That effort, which involves both governments and manufacturers, also hopes to help wealthier countries distribute vaccines to poorer ones, thereby discouraging vaccine hoarding and ensuring all countries get access to a vaccine.
A lack of US collaboration undermines these goals, according to public-health experts.
“The US has always been a leader in global health, going back to smallpox eradication or polio eradication or HIV,” Bill Gates, who’s helping to fund Gavi, one of the organizations that’s leading COVAX, told Business Insider in July. “Without the US, the coalition to stop the disease globally just doesn’t come together.”
The US also needs the international community, according to experts. Opting out of COVAX is a risky gamble, since it could limit the US’s access to vaccine candidates developed by other countries and manufacturing facilities abroad. In other words, if domestic vaccine candidates fail, the US could be out of luck.
Even if the US makes a successful vaccine on its own, some experts say that by staying out of COVAX, the country might hurt its economy by not helping other countries get their populations properly protected and back to work.
“It’s a double-edged sword,” Jennifer Huang Bouey, an epidemiologist and senior policy researcher at Rand Corp., told Business Insider. “It hurts the US, and it also probably hurts COVAX.”
The US is betting on less-established types of vaccines
Globally, developers are testing at least eight types of vaccines. The most established kind involves injections of weakened or inactivated virus to generate an immune response.
The two strongest candidates in this traditional area so far are from the Chinese companies Sinopharm and Sinovac. (China also hasn’t signed on to COVAX but gave WHO a “positive signal” this week, according to Reuters.)
With its refusal to participate in COVAX, the US “basically let go of the most traditional, most mature technology — that’s a risk,” Bouey said.
The US’s two strongest candidates so far, from Moderna and the Pfizer-BioNTech collaboration, are mRNA vaccines, a type that’s never before been approved by the Food and Drug Administration. These vaccines use a technology called messenger RNA to create doses using only a virus’ genetic code.
If successful, mRNA vaccines could be easier to produce and more effective than traditional ones, since they may prompt a stronger immune response and don’t need to be incubated the way traditional vaccines do. But that’s a big if — there’s a possibility the mRNA vaccines will trigger inadequate immune responses or come with harmful side effects.
The US could lose access to international manufacturing
A big challenge authorities around the world are still tackling is how to manufacture and distribute a vaccine after it’s proved safe and effective. The Coalition for Epidemic Preparedness Innovation — a foundation that funds vaccine research and is one of COVAX’s main backers — announced in June that it had identified enough vaccine manufacturers to produce 4 billion doses in a year.
The US’s refusal to participate in COVAX means it could lack access to that infrastructure, though the country is working to expand its own manufacturing capacity.
“It’s really just US versus all these other countries,” Bouey said. “The US will be left on its own.”
The US’s absence could limit COVAX’s manufacturing capacity as well — the initiative could distribute more vaccines if it had early access to successful candidates and facilities in the US.
The US’s economy and reputation could suffer
Even if the US creates a successful vaccine, it could suffer economic repercussions if it hoards all the doses, or if its supply chain can’t effectively distribute extra doses worldwide.
That’s because countries without a vaccine would continue to struggle with the economic impacts of COVID-19, and their economic fates are intertwined with the US’s.
“We will continue to suffer the economic consequences — lost US jobs — if the pandemic rages unabated in allies and trading partners,” Thomas Bollyky, a senior fellow at the Council on Foreign Relations, told The Washington Post.
Then there are larger long-term questions about the US’s global reputation as a public-health leader, Bouey said, if the country stays out of international collaboration efforts.
“Even during the height of the Cold War, US and Soviet Union scientists were working collaboratively with WHO on eradicating polio in 1950s to 1980s,” she said. “Right now, in the middle of the COVID pandemic, the US is really changing the track.”
Hilary Brueck contributed reporting.