The U.S. Has the Power to Tamp Down Coronavirus Variants — If We’re Willing to Use It

The United States is in a race against the coronavirus, trying to vaccinate a critical mass of the population against Covid-19 before new variants take hold. That might suggest that the Biden administration should double down on vaccinating U.S. residents and not worry about the pace of vaccination elsewhere in the world. In fact, the opposite is true: Unless we speed up global vaccination, the U.S. will be at risk.

The emergence of new variants that could evade vaccine protection risks a prolonged pandemic here as well as elsewhere, because uncontrolled spread anywhere in the world allows the virus more opportunity to mutate and more dangerous variants to emerge and spread. The only way to reduce the risk of vaccine-escape mutations here is to increase vaccination and control measures everywhere.

Unfortunately, vaccination is going far too slowly in the rest of the world to accomplish that. There is simply not enough supply yet to meet global demand, and wealthy countries are currently monopolizing most of the vaccine supply. More than 100 countries, with more than 2 billion people, have yet to administer a single dose of vaccine, and at the current pace, much of the world may not be vaccinated until 2024.

The only realistic way to accelerate vaccination elsewhere in the world is to expand vaccine manufacturing, and it turns out that the U.S. has a unique ability to make this happen.

The two vaccines that may be best suited for accelerated manufacturing are the mRNA vaccines marketed by Pfizer and Moderna. That’s because mRNA vaccine production processes require smaller manufacturing facilities than conventional vaccine production, and these facilities can be built in less than half the time and with far lower capital costs. Additionally, mRNA facilities are more likely to be able to be repurposed against new variants and even new threats.

Although it is possible that other vaccine platforms could also be expanded, including the promising protein-based approach such as that of Novavax and the vector-based platforms of the Johnson & Johnson, AstraZeneca/Oxford and Russian/Sputnik V vaccines, their vaccine processes are more difficult to replicate and their products less adaptable to variants of this coronavirus and other threats. No other vaccine platform may offer the flexibility and relatively low barrier to entry of mRNA technology.

In an effort to develop vaccines with unprecedented speed, U.S. taxpayers made substantial public investments in research and development for Covid-19 vaccines. The results have exceeded the most optimistic projections, but with public investment come both collective responsibility and unique opportunities.

The U.S. has a significant interest in sharing the outcomes of this research to protect both global health and our own health security.

Vaccine manufacturers have not been able to meet the urgent health needs of the global pandemic. Therefore, the United States should take steps so that facilities in low- and middle-income countries can manufacture mRNA vaccines. The U.S. government should strongly encourage companies to safely share their intellectual property and provide detailed technology transfer to new global manufacturers, and should compensate originators with a reasonable royalty and payment for sharing their intellectual property and know-how.

Moderna is in a unique position, as their technology was developed by the National Institutes of Health and they accepted advanced development dollars from Operation Warp Speed. As a smaller and newer company, Moderna may be more willing to explore new models of collaboration. If they and other manufacturers adopt this approach, it would benefit the world and their reputations.

(If carrots don’t work, the U.S. government has a stick with the Bayh-Dole Act. Under that legislation, the government has the right to issue additional licenses for technology whose development was supported with taxpayer dollars. But that would be a slow, cumbersome and politically fraught process; a voluntary arrangement would be faster.)

A sensible approach would be to establish a competitive process to select producers in four regions of the world to make mRNA vaccines. Sites accepting funding and know-how would do so in exchange for agreeing to produce reasonably priced products that meet stringent quality standards and for ensuring that these products are distributed in underserved regions. This effort can focus on countries with prior demonstrated capacity to meet the needs for speed, stringent quality controls, and regional impact. This includes India, Brazil, Indonesia, Senegal, and others which have produced pre-qualified WHO vaccines, or South Africa and Vietnam, which have displayed leadership in health technology. Countries such as South Korea could also play a major role.

Congress and the Biden administration should provide an initial budget of about $500 million, possibly through USAID, to upgrade at least four facilities in different regions of the world to manufacture Covid-19 vaccines. This seed investment will not only support the fight against Covid and encourage other countries and development banks to invest, but also better prepare us for the next pandemic. Between pandemics, these facilities could maintain capacity and sustainability if they produce both public goods products such as low-cost routine vaccines, and, potentially, commercially competitive products for use in their regions.

Improving vaccine access is just one of a series of measures that must be taken to apply the lessons of the Covid pandemic. Stronger systems to find, stop and prevent health threats are needed. This will require sustained funding and technical assistance, including to strengthen systems that would detect a new threat — whether a variant of the virus that causes Covid-19 or a new pathogen — as well as systems to deliver treatments and vaccines.

Transferring technological know-how and setting up production lines around the world is one of the most important steps the Biden administration can take to bring the Covid-19 pandemic under control. Such an investment would save lives, revive economies, protect Americans from both the risk of variants and new threats, and restore the U.S. position as a reliable and trustworthy partner while advancing global health security and diplomacy.