Inside warehouses in Ohio and Maryland, tens of millions of doses of vaccines that could be used to help end the COVID-19 pandemic are stuck in limbo. They haven't been approved for Americans to receive, but the White House is refusing to allow them to be shipped elsewhere in the world—to countries where they would be used immediately.
It's a frustrating mix of two problems that have plagued the global response to the pandemic: bureaucracy and nationalism.
The United States has already purchased tens of millions of doses of the COVID-19 vaccine produced by AstraZeneca, even though the Food and Drug Administration (FDA) has not yet approved that vaccine for use alongside the vaccines from Pfizer, Moderna, and Johnson & Johnson. But the vaccine has been approved by the public health authorities in more than 70 other countries—including Brazil, where a major outbreak is threatening to overwhelm the country's hospital system, and the European Union.
The New York Times reports that the Biden administration is refusing to allow America's unused doses of the vaccine to be shipped overseas, despite requests from foreign governments and AstraZeneca itself. The company has pledged to replace any donated doses of the vaccine once FDA approval has been granted, according to the Times.
This is nearly indefensible. On the long list of ways that the government has screwed up the COVID-19 response, hoarding lifesaving vaccines that it won't allow to be used deserves a place at or near the very top.
Since AstraZeneca has not even finalized its application for FDA approval and doesn't expect to be done for several more weeks, there's only one rational and ethical option available: Send those doses of the company's vaccine to places where they can legally be injected into human beings as quickly as possible. Every day that they languish in a warehouse, unused, adds to the pandemic's length and unnecessarily increases the final death toll.
What's particularly frustrating about the millions of doses of unused AstraZeneca vaccines sitting in American warehouses is that logistical issues with the delivery of the same company's vaccines have caused problems in Europe. The company has delivered fewer doses than it had previously promised, and national governments have reacted by engaging in "vaccine nationalism" that does more harm than good.
Last week, for example, Italy blocked the export of 250,000 doses of the AstraZeneca vaccine to Australia by invoking new emergency powers the European Union approved in January. Italy's government cited concerns about vaccine availability and the slow rollout of vaccination programs across Europe, but Australia is even farther behind when it comes to distributing vaccines.
Elsewhere, the E.U. accused both Britain and the United States of benefiting from imports of European-made vaccines while banning exports to Europe.
Even when trade continues flowing, nationalist policies slow the spread of vaccines. The Economist notes that those new E.U. rules involve more paperwork and greater government oversight of distribution, leading to greater uncertainty about future exports.
All of this feels painfully familiar. Last year, as the pandemic was sweeping the globe, governments imposed trade restrictions targeting everything from medical equipment to pharmaceutical drugs. Data collected by Simon Evenett, a professor of international trade at the University of St. Gallen and the coordinator of research for Global Trade Alert, show that 102 new limits on the export of medical gear were imposed by 75 different governments during the first four months of 2020, as COVID-19 struck.
But those restrictions often caused other problems. The Swiss medical supply outfit Hamilton Medical, for example, ramped up production by 50 percent in response to the outbreak in Europe. But a key component of its ventilators came from Romania, a member of the European Union. Because the E.U. had imposed export restrictions on medical equipment and component parts, Hamilton Medical's suppliers could no longer ship their wares to Switzerland, which is not an E.U. member.
Getting as many vaccines into as many bodies—not American bodies or European bodies, but human bodies—as quickly as possible is the best way to end the pandemic. But governments are naturally going to prioritize domestic demand for vaccines, and rich countries have an inside track to getting vaccines first. That's why it is even more important for countries like the United States to set a global example of not hoarding limited supplies of vaccines, behavior which will only encourage others to do the same.
"With all governments expecting their counterparts to act as nationalists and hoard early supplies of vaccines, no one has had an incentive to buck the trend," warned Chad Bown, a senior fellow at the Peterson Institute for International Economics, and Thomas Bollyky, director of the global health program at the Council on Foreign Relations, in an article published in Foreign Affairs just as vaccines were coming on the scene late last year. "In this environment, ensuring equitable access to early doses of vaccines globally has been treated as a charitable matter—a second order issue to political leaders more concerned about potential opposition at home than outrage abroad."
Politicians might be able to defend trade restrictions on the grounds that they are looking after their own citizens first. But the Biden administration cannot even make that claim when it comes to the unused AstraZeneca vaccines idling in warehouses.
If those shots cannot legally be given to Americans, they should be sent to places that will use them.