Hundreds of millions of dollars in US foreign aid for global vaccines are at risk of expiring in just a few months—thanks to the unprecedented intervention of US Secretary of Health and Human Services Robert F. Kennedy Jr.
The famous anti-vaccination chief of America’s domestic health organization has inserted himself into the aid-giving process, despite having no legal authority to do so. Now, Gavi, the Vaccine Alliance—which provides vaccines to low-income countries for childhood vaccination campaigns—is facing a severe funding shortfall that it says could lead to child deaths. more than 1 million children.
Hundreds of millions of dollars in US foreign aid for global vaccines are at risk of expiring in just a few months—thanks to the unprecedented intervention of US Secretary of Health and Human Services Robert F. Kennedy Jr.
The famous anti-vaccination chief of America’s domestic health organization has inserted himself into the aid-giving process, despite having no legal authority to do so. Now, Gavi, the Vaccine Alliance—which provides vaccines to low-income countries for childhood vaccination campaigns—is facing a severe funding shortfall that it says could lead to child deaths. more than 1 million children.
Congress in the last two fiscal years has directed a total of $600 million for Gavi. But the funds have not yet been released due to an unusual and legally questionable favor that US Secretary of State Marco Rubio has given to Kennedy, who is pressuring Gavi make a change for his vaccine portfolio.
In the middle of escalating Ebola outbreak East Africa, Democrats and even some Republicans they are getting confused in holding aid funding and have emphasized Rubio’s long-term coverage and Gavi suggested his time in the Senate—overthrew Kennedy. Congressional funding authorization expires at the end of September.
“This is Secretary Rubio’s authority and Secretary Rubio’s authority alone, and so we’re about to find out who’s in charge,” Sen. Brian Schatz, the top Democrat on the Senate appropriations panel that sets foreign aid levels, said in an interview. “The law requires the money to be released. … I have high hopes that he will show that he is leading soon.”
Schatz pressed Rubio for a recent hearing on foreign aid to explain why he allowed Kennedy to intervene in an area where Congress had not authorized the secretary of health to have responsibility. Aid funding was previously administered by the United States Agency for International Development (USAID), but management was transferred to the State Department last year following the disbandment of USAID.
Rubio justified giving Kennedy and the Department of Health and Human Services (HHS) a role in President Donald Trump’s “directive.”
“Ultimately, we would like to see this problem resolved, and we think we can,” Rubio said, noting that the US government last year lost its longtime Gavi board seat due to failure to pay its corporate fees. “We will certainly try, because we want to be resolved.”
The Gavi officer told Foreign Policy that the organization has not yet received concrete indications of when the $600 million would arrive.
Gavi, which was founded in 2000 by the United States government, the United Nations, and the Bill and Melinda Gates Foundation, an international fund for global health that, among other duties, organizes emergency vaccine stocks around the world for diseases such as yellow fever and Ebola (though not for the Bundibugyo strain currently circulating in the Democratic Republic of the Congo, where there not yet coverage for).
“Gavi, as you know, plays an important role in preventing the spread of infectious diseases around the world and helps protect public health in our country also by stopping outbreaks before they reach our borders, and that is very important right now as the world is dealing with the Ebola outbreak in the DRC,” Republican Senator Susan Collins, Senator of the Senate at the Rubiopri summit said. $600 million as directed by Congress.
It is unusual for the State Department to consult with HHS and its scientists on global public health issues, said a Democratic Senate aide, who was not authorized to be quoted. “The unusual part is the HHS secretary has veto power over funds that have been directed by Congress to the State Department for payments to Gavi,” the staffer continued.
Kennedy highlights Gavi’s use of the preservative thimerosal in part of his vaccine portfolio. The mercury-based ingredient is used in high-dose reactors as part of the mass vaccination campaigns that Gavi runs in poor and hard-to-reach rural areas where refrigeration is difficult. While Gavi and other organizations, including the US Centers for Disease Control and Prevention, have published studies on safety of thimerosal in vaccines, the preservative has been phased out in the United States.
But public health lawyers to defend Gavi continues to use thimerosal, because maintaining constant cold storage of the vaccine is not realistic in the low-income countries where it works. Still, Gavi has announced a strategy to phase out thimerosal vaccines due to the development of new vaccine technologies.
“We have always said that we are very confident in the safety and programmatic use of the thimerosal vaccine. That has not changed,” said a Gavi official, who would speak only on background. “The stated goal is to migrate some of our vaccines that contain thimerosal to a new generation of more potent vaccines that do not contain thimerosal.”
Sen. Jeanne Shaheen, the top Democrat in charge of foreign aid policy, in April questioned Kennedy during the health policy session about his reasons for preventing the provision of those funds. He warned that the loss of the promised US funding could cause many children to die needlessly.
“It’s your department and you personally hold the Gavi funding,” Shaheen said. “Gavi estimates that the loss of that funding could result in 75 million children not receiving routine immunizations over the next five years, and that would result in more than 1.2 million child deaths.”
Kennedy defended himself and called Gavi “natural.” He said he feared Gavi could use some of its US funding, which could be discovered, to provide support to the World Health Organization (WHO). Kennedy is a strong critic of the agency, which the Trump administration has withdrawn from on disagreement with the policies of the United Nations organization to deal with the epidemic.
“Gavi has a lot of money. In fact, Gavi is giving hundreds of millions of dollars to the WHO, which we pulled out of because it was doing a bad job,” Kennedy told Shaheen. “I asked them, our money goes to you so you can send it to WHO? They refused to answer.”
WHO has a relationship with Gavi as does the United Nations health organization one of its founders.
“The Gavi coalition structure is built on leveraging unique work from the public and private sectors, including WHO,” a Gavi official said. “We are proud of the impact these diverse skills have had, helping us halve the number of children under 5 and protect more than 1.2 billion children since 2000.”
But Gavi is facing a funding shortfall after its most recent fundraising drive garnered pledges of $10 billion against a goal of $11.9 billion, according to a Gavi official, who attributed the shortfall to the freeze in U.S. funding as well as the broader trend of donors reducing their foreign aid spending.
“The truth is we’re short,” the official said, adding that US funding is needed to “unlock” Gavi’s plans to phase out thimerosal-containing vaccines and replace them with newer, stronger versions.
The State Department declined to answer questions about the matter.
“HHS and the State Department continue to work directly with Gavi and remain hopeful that ongoing discussions can provide greater transparency, accountability, and a positive path forward,” HHS press secretary Emily Hilliard said in a statement.
