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Senior officials are warning the EU will fall far short of its promised coronavirus vaccine donations to poorer countries, risking both the spread of new deadly variants and a loss of geopolitical clout.
Driven by the recognition that the coronavirus pandemic can only be defeated if all countries get access to enough vaccines, the EU has promised to deliver 500 million shots by mid-2022, including 250 million by the end of this year.
In September, European Commission President Ursula von der Leyen upped the ante by announcing the gifting of another 200 million doses by the middle of next year as she stressed fighting the “injustice” in the global vaccine supply was “one of the great geopolitical issues of our time.”
Yet with little more than two months until the year’s end, actual vaccine deliveries are lagging dramatically behind: According to the latest figures, the bloc has only donated about 56 million doses to poor countries — less than a quarter of what it promised to supply this year.
This striking gap between words and deeds has triggered warnings from senior officials dealing with international cooperation and development aid.
“The EU and its member states must now do more,” Jutta Urpilainen, the European Commissioner for International Partnerships, and Tomas Tobé, the chair of the European Parliament’s Development Committee, wrote in a joint op-ed for POLITICO.
“Given that we have already secured sufficient doses to cover the full population of Europe, including a third-dose COVID-19 booster shot, we can and should step up donations of vaccines to our most vulnerable partners,” they wrote.
The German Health Ministry drove home the point in a pointed letter to the European Commission dated Monday. The world, the ministry wrote, risks facing a “global allocation emergency,” which “would be totally unacceptable and has to be avoided by any means.”
EU leaders meeting in Brussels on Thursday and Friday plan to “call for the rapid removal of obstacles hampering the global rollout of vaccines,” according to draft European Council conclusions seen by POLITICO. These obstacles have included liability concerns, short shelf life and extensive paperwork.
The urgency has deep geopolitical reasons: Already in July, EU foreign policy chief Josep Borrell warned “insufficient” vaccine shipments to Africa and Latin America meant the bloc risked losing influence to China.
“Who’s the big vaccine supplier to Africa? China. Who’s the big vaccine supplier to Latin America? China,” Borrell said, adding that “the problem” of the EU’s actions “isn’t just the commitment but the effectiveness.”
Three months later, the problem has become even more pressing, according to Udo Bullmann, a German Social Democrat and member of the European Parliament’s Development Committee. “The EU and member states urgently need to live up to their international commitments,” he said, warning Europe “will regret very much if others take its place and offer themselves as partners.”
Low vaccination rates in African countries such as Ethiopia or Nigeria, where less than 2 percent are fully protected against COVID-19, or in Haiti, where just 0.25 percent of people are fully vaccinated, also raise health concerns.
“A rapid and comprehensive global vaccination strategy is a humanitarian imperative,” said Bullmann. “Any further failure will backfire on us. Continually new and increasingly dangerous mutations also jeopardize the level of safety we have achieved so far.”
In a statement on Monday, von der Leyen tried to address the EU’s underperformance by putting a positive spin on the numbers: She said the bloc shipped over 1 billion vaccine doses to the world in the past 10 months — even though the bulk of the shots produced in the EU were sold to rich countries like Canada or New Zealand, and not donated to poorer nations.
“We always shared our vaccines fairly with the rest of the world. We have exported as much as we delivered to EU citizens,” von der Leyen said.
She also stated the EU had “delivered around 87 million doses to low- and middle-income countries through COVAX,” a program for equitable global access to vaccines.
When asked about this number, however, a spokesperson admitted that in fact not all of these 87 million doses were EU donations to poorer countries, as von der Leyen’s statement seemed to suggest. Instead, this number included doses procured by COVAX itself from factories in the EU. The actual number of doses donated by the EU to poorer countries, the spokesperson clarified, was 56 million.
EU countries insist it’s not a lack of political will holding them back from giving more. Instead, said one EU diplomat, there are many “bureaucratic hurdles to jump through in order to get vaccines delivered.”
The main problem on the road from promise to delivery is the very same issue that plagued the EU’s own negotiations with vaccine developers — liability. “One of the main difficulties in the negotiation of the [contract] was around liability,” explained a government adviser from an EU country involved in the negotiations.
Several people with knowledge of the negotiations described how the liability question loomed large in negotiations. Ultimately, before doses are donated from an EU member country to COVAX, liability needs to be transferred to the country receiving the doses, explained a development official with knowledge of COVAX’s work.
In an attempt to streamline donations, three framework contracts were drawn up: One with Sweden for doses of the Oxford/AstraZeneca vaccine; a second with Belgium for Johnson & Johnson and a third with France for BioNTech/Pfizer’s jab. The aim is for member countries to channel their donations through these deals rather than having 27 agreements for each vaccine.
The EU diplomat said, however, that the wording of the contract had led to fears it could leave the donating country on the hook.
A Finnish diplomat explained that, for Finland, “it has been of utmost importance that enough attention is given to ensuring sound legal and administrative arrangements so that no surprises will come up later.”
The German Health Ministry elaborated on these concerns in its Monday letter, warning that “the terms and conditions of the purchase agreements negotiation by the EU Commission for donation and resale may turn out to be a substantial obstacle to a fair and needs-based worldwide redistribution of the vaccines.”
Loopholes in the purchase agreements, the letter said, allowed manufacturers to “dictate minimum sales prices, impose exaggerated compensation schemes on recipients, reject swap procedures or prohibit distribution to international organizations.” The situation, it added, makes “a quick response to international requests for help almost impossible.”
The ministry urged the Commission to “increase the pressure on the manufacturers to show more flexibility regarding donation and resale.”
Many countries have simply decided to directly donate smaller batches, without going through COVAX. Yet, here again, liability concerns have been a sticking point. “There’s no doubt that this is the main topic,” said the government adviser.
While the EU is no stranger to bureaucracy, vaccine donations appear to be particularly cumbersome. The Finnish diplomat stressed the “amount of paperwork has been significant, both internally and towards COVAX and the manufacturers.”
Case in point: Ireland’s health ministry pointed to its aim to donate another one million vaccines through COVAX, saying they were working to finalize the legal documentation in “the coming weeks.”
On top of bureaucratic hurdles, there is also the issue of limited shelf life. COVAX generally only accepts doses with at least two months left before expiry. Vaccines nearing their use-by date can end up being destroyed, as happened with 385,000 doses delivered by COVAX thrown away between June and September 24, according to a document seen by POLITICO.
The concern around shelf life links to yet another conundrum: COVAX has been loath to receive doses directly from countries, stranding shots in EU warehouses. While it’s technically possible for EU countries to donate doses already handed over by the manufacturer, the threat to the integrity of the cold chain and expiry date concerns make this “very difficult to do,” said the development official.
Countries need to give “clearer, more transparent commitments and trajectory when they are pledging to donate,” said the government adviser. Manufacturers too, need to be “more transparent on what they’re going to deliver to COVAX.”
Those working with these donations are mostly optimistic deliveries will pick up as processes are streamlined. But another challenge looms on the horizon: Once doses start being delivered in larger quantities, countries may be unable to absorb them quickly enough.
“It’ll be the next challenge,” said the development official.
This article is part of POLITICO’s premium policy service: Pro Health Care. From drug pricing, EMA, vaccines, pharma and more, our specialized journalists keep you on top of the topics driving the health care policy agenda. Email [email protected] for a complimentary trial.