Cash shortage threatens White House global vaccine effort

The incident points to a growing sense of frustration at the agency at a time when the Biden administration has begun positioning the U.S. as a leader in the global pandemic response. Fulfilling the White House’s pledges has fallen largely on USAID, an agency that often finds itself on the losing end of Washington funding battles.

Officials who spoke to POLITICO for this story requested anonymity because they were not authorized to talk publicly about the matter. They also feared their words would stoke tensions within the administration while the U.S. is trying to maintain its status as a leading world donor in Covid-19 assistance while fighting surging cases at home.

“If we and others are not investing adequately in a forward way on readiness we’re going to have a catastrophe on our hands with doses piling up at the gate,” said Stephen Morrison, a global health expert at the Center for Strategic and International Studies. “We need a strategic plan. We need some sort of leadership structure that doesn’t rob Peter to pay Paul.”

Before Biden announced the purchase of the Pfizer shots in June, officials from the White House, the Centers for Disease Control and Prevention, State Department and USAID deliberated how best to split the cost of buying and shipping the doses and ensure that recipient countries would be ready to use them.

Top White House officials eventually decided that USAID would foot the $3.5 billion bill, according to three senior administration officials familiar with those conversations. Two billion dollars would come from money Congress set aside last year in a relief package for USAID to donate vaccine through COVAX, the global vaccine aid program. The rest — $1.5 billion — would be taken from funds appropriated to USAID in March to help countries fight Covid-19, including by distributing vaccines, a senior administration official said last month.

“Given the growing imbalances in global vaccination coverage, the administration is working hard to further expand vaccine availability as it is essential to shortening the lifespan of the pandemic,” a USAID spokesperson said, adding that the agency was consulting with Congress on “budget trade-offs” that could help make up for the $1.5 billion funding gap.

The agency is considering whether to ask lawmakers for the full $1.5 billion in supplemental funding, a person familiar with the conversations said. That would ensure USAID could continue helping countries build the infrastructure needed to roll out shots and to treat severely ill Covid-19 patients. Another senior administration official said the purchase of the 500 million Pfizer doses covers the delivery of the vaccine to the recipient countries.

But it’s not clear how quickly USAID could recoup the money, raising the risk that some countries that have sought America’s help securing vaccines won’t be ready when they arrive, and could struggle to save lives in the meantime.

“We work with health ministries to make sure that those ministries are actually ready to receive doses,” USAID Administrator Samantha Power said during a recent podcast interview with Ben Rhodes, former chief of staff to President Barack Obama. “We are making sure there’s that receptivity when those vaccines are actually shipped.”

Over the past six months USAID and State Department officials have worked in tandem to coordinate shipments of vaccines and other life saving medical supplies. The two received $11 billion in March for international pandemic response and other urgent humanitarian needs. The $1.5 billion USAID is spending on the Pfizer doses is a small portion of that total.

But the agency is doing a significant portion of the leg work involved in helping other nations fight the pandemic, including sourcing medical components and therapeutics. USAID officials are overwhelmed by the number of requests from countries for vaccine donations and other Covid-19 assistance, two of the senior administration officials said.

The Biden administration’s recent purchase of 500 million Pfizer doses is meant to supplement 80 million vaccine doses the administration had already set side for direct donations abroad.

The federal government so far has doled out tens of millions of doses directly to countries across the globe, including India, South Korea, Canada, Mexico and the Philippines. Officials said the agency, along with the State Department and the White House, are set to announce more direct donation shipments in the coming weeks.

Nahal Toosi contributed to this report.