In Return to Global Health Multilateralism, U.S. Joins COVAX at a Critical Moment

U.S. support for COVAX and other initiatives could prove to be critical in the global effort to end the devastation caused by COVID-19.


On January 21, 2021, the first full day of his presidency and exactly one year after the first COVID-19 case was confirmed in the United States, President Joe Biden announced a “wartime effort” to defeat COVID-19. In addition to its domestic strategy, the Biden administration is taking important steps toward restoring the United States’ position as a global leader in matters of public health. These steps include retracting the previous administration’s announced withdrawal from the World Health Organization (WHO) and joining COVAX, the COVID-19 Vaccine Global Access Facility.

COVAX launched in April of last year with the aim of ensuring equitable access to COVID-19 vaccines. By the end of 2020, 190 countries were participating in the initiative, which is coordinated by Gavi, the Vaccine Alliance, the Coalition for Epidemic Preparedness Innovations, and the WHO. For wealthier countries, the COVAX Facility incentivizes vaccine manufacturers to scale up production and negotiates competitive prices through ordering doses at scale. For 92 lower- and middle-income countries, the Gavi COVAX Advance Market Commitment (AMC) ensures vaccine access to countries that would otherwise struggle to secure supply.

According to current forecasts, COVAX AMC will provide 1.8 billion doses to lower- and middle-income countries by the end of this year, including 525 million doses for African countries. According to Gavi, the Vaccine Alliance, this volume of vaccines will be enough to inoculate all healthcare workers and the most vulnerable populations from infection, dramatically lowering the number of potential deaths from COVID-19 and slowing the rate of transmission.

But the initiative is facing urgent funding needs. COVAX AMC is mainly funded through official development assistance (ODA) from wealthier countries, but as of December, pledges covered barely half of the US$4.6 billion COVAX needs for vaccine procurement under the initiative. In fact, uncertainty about COVAX’s resources prompted the African Union (AU) to negotiate its own supply of 270 million vaccine doses outside of COVAX altogether—likely a prudent move in any event, but also a signal of doubts about international coordination beyond the continent.

U.S. reengagement in global health multilateralism will almost certainly provide a welcome boost to COVAX and other international initiatives aimed at ending the COVID-19 pandemic. In his remarks yesterday to the WHO Executive Board, Dr. Anthony Fauci, Chief Medical Advisor to President Biden, said, “The United States stands ready to work in partnership and solidarity to support the international COVID-19 response, mitigate its impact on the world, strengthen our institutions, advance epidemic preparedness for the future, and improve the health and wellbeing of all people throughout the world.”

In response, WHO Director-General Dr. Tedros Adhanom Ghebreyesus said, “This is a good day for the WHO, and a good day for global health.”

International civil society organizations are also welcoming the news from the Biden administration. Dr. David McNair, Executive Director for Policy at the ONE Campaign, tells COVID-19 Africa Watch, “The U.S. commitment to join COVAX is very welcome. This is an essential part of getting vaccines to the poorest countries, and it urgently needs more money. Because a global solution to this pandemic is the only way out of it.”

McNair emphasizes, “This pandemic will only end when everyone who needs a vaccine gets one. For as long as the virus is circulating anywhere, it can mutate and cause devastation everywhere.”

For Todd Moss, former Deputy Assistant Secretary for African Affairs at the U.S. State Department and now Executive Director of the Energy for Growth Hub, yesterday’s announcements are part of the Biden administration’s broader global reengagement, including in Africa. As he explains to COVID-19 Africa Watch, “The Biden administration has a lot of relationship repair and renewal ahead with our African partners. But I think most African leaders are anxious for better relations with the U.S., if we can build them upon mutual respect, mutual interests, and true partnership to tackle our common challenges, including strengthening democracy, rebuilding the global economy, and fighting the pandemic.”

And the COVID-19 pandemic is an increasingly pressing challenge across the region. In January, the continent has experienced its highest peak in new cases since the beginning of the pandemic, with about 30,000 new cases confirmed daily. In just the last few days alone, cabinet ministers in Malawi, South Africa, and Zimbabwe have died from the coronavirus, and new outbreaks are prompting additional lockdowns in Nigeria, Rwanda, and Sierra Leone—all while a new variant of COVID-19 is rapidly spreading in South Africa.

For the last year, the United States, long considered the world’s most powerful country, has been absent from the global fight against the virus, including in Africa. The new administration’s announcements suggest this is about to change. U.S. support for COVAX and other international initiatives could prove to be critical in the global effort to end the devastation caused by COVID-19.


About the Author

John Schellhase is a director of global market development at the Milken Institute, where he focuses on financial markets development in Africa and other emerging regions and manages

via COVID-19 Africa Watch
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