Biden Dips Into U.S. Vaccine Supply to Send 20 Million Doses Abroad

WASHINGTON — President Biden, heeding widespread calls to step up his response to the pandemic’s surge abroad, said on Monday that his administration would send 20 million doses of federally authorized coronavirus vaccine overseas in June — the first time he has pledged to give away doses that could be used in the United States.

The donation is another step toward what Mr. Biden promised would be an “entirely new effort” to increase vaccine supplies and vastly expand manufacturing capacity, most of it in the United States. He also put Jeffrey Zients, the White House coronavirus response coordinator, in charge of developing a global strategy.

“We know America will never be fully safe until the pandemic that’s raging globally is under control,” Mr. Biden said in a brief appearance at the White House. “No ocean’s wide enough, no wall’s high enough, to keep us safe.”

With new cases and deaths plummeting as vaccination rates rise in the United States, the epicenter of the crisis has moved to India and other nations. A growing and bipartisan chorus of diplomats, health experts and business leaders has been pushing the president to do more to end what the AIDS activist Asia Russell calls “vaccine apartheid.”

There is a huge disconnect growing where, in some countries with the highest vaccination rates, there appears to be a mind-set that the pandemic is over, while others are experiencing huge waves of infection,” Dr. Tedros said.

Variants like B.1.617, first discovered in India and recently designated a variant of concern by the W.H.O., are contributing to the spread of infections and worry many researchers.

Dr. Tedros called for well-supplied nations to send more of their vaccine allocations to harder-hit countries, and for vaccine developers and manufacturers to hasten delivery of hundreds of millions of doses to Covax, an international initiative dedicated to equitable distribution of the vaccine, noting an appeal by Henrietta Fore, UNICEF’s executive director.

Mr. Biden took office vowing to restore the United States as a leader in global public health, and he has taken certain steps to do so: rejoining the World Health Organization, pledging $4 billion to an international vaccine effort and providing financial support to help Biological E, a vaccine manufacturer in India, produce at least one billion doses of coronavirus vaccines by the end of 2022.

To broaden supply further, Mr. Biden recently announced he would support waiving intellectual property protections for coronavirus vaccines. But activists say simply supporting the waiver is not enough; Mr. Biden must create the conditions for pharmaceutical companies to transfer their intellectual property to vaccine makers overseas, they argue. They view his efforts as piecemeal.

“We’re after 100 days into the administration, and what Biden should be delivering is a global battle plan against vaccine apartheid, and the announcement today is lines on a Post-it note,” Ms. Russell said, adding, “There must be a global strategy led by the U.S. that’s based on technology transfer, on forcing pharma to come to the table to share the recipe.”

assert that a fix is already at hand as they aggressively expand production lines and contract with counterparts around the world to yield billions of additional doses.

An open letter to the president, made public last week by a bipartisan group including business leaders, diplomats and a former defense secretary, argued that such a waiver “would make little difference and could do harm.”

While global health activists are strongly in favor of the waiver, some said they welcomed the views of the business community. They see clear parallels to their work fighting the global AIDS epidemic.

“It shows an unprecedented willingness of pharma and its allies in the private sector to admit what all of us having been saying for months — the private sector alone cannot and will not ensure global vaccine access,” James Krellenstein, a founder of PrEP4All, a nonprofit aimed at ensuring universal access to H.I.V. prevention and treatment, wrote in an email on Sunday. “It really shifts the burden to the Biden administration,” he added.

The organizer of the open letter, Hank Greenberg, the chairman of Starr Companies and former chairman of American International Group, the insurance industry giant, said in an interview on Monday that Mr. Biden’s announcement did not go far enough.

Mr. Greenberg, 96, a veteran of World War II, said he was inspired to write after a former chief executive of an A.I.G. subsidiary who later became the ambassador from the Philippines to the United States told him he was not able to get vaccinated. Like Mr. Biden, he used language that evoked the war effort.

“If we don’t do it,” he asked, “who will?”

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Why Vaccinating the World Against Covid-19 Will Be Hard

In delivering vaccines, pharmaceutical companies aided by monumental government investments have given humanity a miraculous shot at liberation from the worst pandemic in a century.

But wealthy countries have captured an overwhelming share of the benefit. Only 0.3 percent of the vaccine doses administered globally have been given in the 29 poorest countries, home to about 9 percent of the world’s population.

Vaccine manufacturers assert that a fix is already at hand as they aggressively expand production lines and contract with counterparts around the world to yield billions of additional doses. Each month, 400 million to 500 million doses of the vaccines from Moderna, Pfizer and Johnson & Johnson are now being produced, according to an American official with knowledge of global supply.

But the world is nowhere close to having enough. About 11 billion shots are needed to vaccinate 70 percent of the world’s population, the rough threshold needed for herd immunity, researchers at Duke University estimate. Yet, so far, only a small fraction of that has been produced. While global production is difficult to measure, the analytics firm Airfinity estimates the total so far at 1.7 billion doses.

dangerous new variants emerge, requiring booster shots and reformulated vaccines, demand could dramatically increase, intensifying the imperative for every country to lock up supply for its own people.

The only way around the zero-sum competition for doses is to greatly expand the global supply of vaccines. On that point, nearly everyone agrees.

But what is the fastest way to make that happen? On that question, divisions remain stark, undermining collective efforts to end the pandemic.

Some health experts argue that the only way to avert catastrophe is to force drug giants to relax their grip on their secrets and enlist many more manufacturers in making vaccines. In place of the existing arrangement — in which drug companies set up partnerships on their terms, while setting the prices of their vaccines — world leaders could compel or persuade the industry to cooperate with more companies to yield additional doses at rates affordable to poor countries.

Those advocating such intervention have focused on two primary approaches: waiving patents to allow many more manufacturers to copy existing vaccines, and requiring the pharmaceutical companies to transfer their technology — that is, help other manufacturers learn to replicate their products.

more than 100 countries in asking the W.T.O. to partially set aside vaccine patents.

But the European Union has signaled its intent to oppose waivers and support only voluntary tech transfers, essentially taking the same position as the pharmaceutical industry, whose aggressive lobbying has heavily shaped the rules in its favor.

Some experts warn that revoking intellectual property rules could disrupt the industry, slowing its efforts to deliver vaccines — like reorganizing the fire department amid an inferno.

“We need them to scale up and deliver,” said Simon J. Evenett, an expert on trade and economic development at the University of St. Gallen in Switzerland. “We have this huge production ramp up. Nothing should get in the way to threaten it.”

Others counter that trusting the pharmaceutical industry to provide the world with vaccines helped create the current chasm between vaccine haves and have-nots.

The world should not put poorer countries “in this position of essentially having to go begging, or waiting for donations of small amounts of vaccine,” said Dr. Chris Beyrer, senior scientific liaison to the Covid-19 Prevention Network. “The model of charity is, I think, an unacceptable model.”

halting vaccine exports a month ago. Now, as a wave of death ravages the largely unvaccinated Indian population, the government is drawing fire at home for having let go of doses.

poses universal risks by allowing variants to take hold, forcing the world into an endless cycle of pharmaceutical catch-up.

“It needs to be global leaders functioning as a unit, to say that vaccine is a form of global security,” said Dr. Rebecca Weintraub, a global health expert at Harvard Medical School. She suggested that the G7, the group of leading economies, could lead such a campaign and finance it when the members convene in England next month.

Pfizer expects to sell $26 billion worth of Covid vaccines this year; Moderna forecasts that its sales of Covid vaccines will exceed $19 billion for 2021.

History also challenges industry claims that blanket global patent rights are a requirement for the creation of new medicines. Until the mid-1990s, drug makers could patent their products only in the wealthiest markets, while negotiating licenses that allowed companies in other parts of the world to make generic versions.

Even in that era, drug companies continued to innovate. And they continued to prosper even with the later waivers on H.I.V. drugs.

“At the time, it rattled a lot of people, like ‘How could you do that? It’s going to destroy the pharmaceutical industry,’” recalled Dr. Anthony S. Fauci, President Biden’s chief medical adviser for the pandemic. “It didn’t destroy them at all. They continue to make billions of dollars.”

Leaders in the wealthiest Western nations have endorsed more equitable distribution of vaccines for this latest scourge. But the imperative to ensure ample supplies for their own nations has won out as the virus killed hundreds of thousands of their own people, devastated economies, and sowed despair.

The drug companies have also promised more support for poorer nations. AstraZeneca’s vaccine has been the primary supply for Covax, and the company says it has sold its doses at a nonprofit price.

stumbled, falling short of production targets. And producing the new class of mRNA vaccines, like those from Pfizer-BioNTech and Moderna, is complicated.

Where pharmaceutical companies have struck deals with partners, the pace of production has frequently disappointed.

“Even with voluntary licensing and technology transfer, it’s not easy to make complex vaccines,” said Dr. Krishna Udayakumar, director of the Duke Global Health Innovation Center.

Much of the global capacity for vaccine manufacturing is already being used to produce other lifesaving inoculations, he added.

But other health experts accuse major pharmaceutical companies of exaggerating the manufacturing challenges to protect their monopoly power, and implying that developing countries lack the acumen to master sophisticated techniques is “an offensive and a racist notion,” said Matthew Kavanagh, director of the Global Health Policy and Politics Initiative at Georgetown University.

With no clear path forward, Ms. Okonjo-Iweala, the W.T.O. director-general, expressed hope that the Indian and South African patent-waiver proposal can be a starting point for dialogue.

“I believe we can come to a pragmatic outcome,” she said. “The disparity is just too much.”

Peter S. Goodman reported from London, Apoorva Mandavilli from New York, Rebecca Robbins from Bellingham, Wash., and Matina Stevis-Gridneff from Brussels. Noah Weiland contributed reporting from New York.

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What Would It Take to Vaccinate the World Against Covid?

In delivering vaccines, pharmaceutical companies aided by monumental government investments have given humanity a miraculous shot at liberation from the worst pandemic in a century.

But wealthy countries have captured an overwhelming share of the benefit. Only 0.3 percent of the vaccine doses administered globally have been given in the 29 poorest countries, home to about 9 percent of the world’s population.

Vaccine manufacturers assert that a fix is already at hand as they aggressively expand production lines and contract with counterparts around the world to yield billions of additional doses. Each month, 400 million to 500 million doses of the vaccines from Moderna, Pfizer and Johnson & Johnson are now being produced, according to an American official with knowledge of global supply.

But the world is nowhere close to having enough. About 11 billion shots are needed to vaccinate 70 percent of the world’s population, the rough threshold needed for herd immunity, researchers at Duke University estimate. Yet, so far, only a small fraction of that has been produced. While global production is difficult to measure, the analytics firm Airfinity estimates the total so far at 1.7 billion doses.

more than 100 countries in asking the W.T.O. to partially set aside vaccine patents.

But the European Union has signaled its intent to oppose waivers and support only voluntary tech transfers, essentially taking the same position as the pharmaceutical industry, whose aggressive lobbying has heavily shaped the rules in its favor.

Some experts warn that revoking intellectual property rules could disrupt the industry, slowing its efforts to deliver vaccines — like reorganizing the fire department amid an inferno.

“We need them to scale up and deliver,” said Simon J. Evenett, an expert on trade and economic development at the University of St. Gallen in Switzerland. “We have this huge production ramp up. Nothing should get in the way to threaten it.”

Others counter that trusting the pharmaceutical industry to provide the world with vaccines helped create the current chasm between vaccine haves and have-nots.

The world should not put poorer countries “in this position of essentially having to go begging, or waiting for donations of small amounts of vaccine,” said Dr. Chris Beyrer, senior scientific liaison to the Covid-19 Prevention Network. “The model of charity is, I think, an unacceptable model.”

Pfizer expects to sell $26 billion worth of Covid vaccines this year; Moderna forecasts that its sales of Covid vaccines will exceed $19 billion for 2021.

History also challenges industry claims that blanket global patent rights are a requirement for the creation of new medicines. Until the mid-1990s, drug makers could patent their products only in the wealthiest markets, while negotiating licenses that allowed companies in other parts of the world to make generic versions.

Even in that era, drug companies continued to innovate. And they continued to prosper even with the later waivers on H.I.V. drugs.

“At the time, it rattled a lot of people, like ‘How could you do that? It’s going to destroy the pharmaceutical industry,’” recalled Dr. Anthony S. Fauci, President Biden’s chief medical adviser for the pandemic. “It didn’t destroy them at all. They continue to make billions of dollars.”

Leaders in the wealthiest Western nations have endorsed more equitable distribution of vaccines for this latest scourge. But the imperative to ensure ample supplies for their own nations has won out as the virus killed hundreds of thousands of their own people, devastated economies, and sowed despair.

The drug companies have also promised more support for poorer nations. AstraZeneca’s vaccine has been the primary supply for Covax, and the company says it has sold its doses at a nonprofit price.

stumbled, falling short of production targets. And producing the new class of mRNA vaccines, like those from Pfizer-BioNTech and Moderna, is complicated.

Where pharmaceutical companies have struck deals with partners, the pace of production has frequently disappointed.

“Even with voluntary licensing and technology transfer, it’s not easy to make complex vaccines,” said Dr. Krishna Udayakumar, director of the Duke Global Health Innovation Center.

Much of the global capacity for vaccine manufacturing is already being used to produce other lifesaving inoculations, he added.

But other health experts accuse major pharmaceutical companies of exaggerating the manufacturing challenges to protect their monopoly power, and implying that developing countries lack the acumen to master sophisticated techniques is “an offensive and a racist notion,” said Matthew Kavanagh, director of the Global Health Policy and Politics Initiative at Georgetown University.

With no clear path forward, Ms. Okonjo-Iweala, the W.T.O. director-general, expressed hope that the Indian and South African patent-waiver proposal can be a starting point for dialogue.

“I believe we can come to a pragmatic outcome,” she said. “The disparity is just too much.”

Peter S. Goodman reported from London, Apoorva Mandavilli from New York, Rebecca Robbins from Bellingham, Wash., and Matina Stevis-Gridneff from Brussels. Noah Weiland contributed reporting from New York.

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Cameroon Sentences Transgender Women to 5 Years in Prison

Two transgender women were sentenced to five years in prison in Cameroon this week after they were found guilty of “attempted homosexuality” and public indecency, the latest example of an increasing crackdown on gay and transgender people in the West African nation, human rights groups say.

Shakiro, identified in police documents as Loïc Njeukam, and Patricia, referred to as Roland Mouthe, both identify as transgender and were arrested in February as they were having dinner at a restaurant in Douala, Cameroon’s economic capital. On Tuesday, they were also found guilty of failing to show proof of identity and given the maximum fine of 200,000 CFA francs, or $370.

Shakiro, a social media personality who has amassed tens of thousands of followers through her posts calling for more tolerance toward gender minorities in Cameroon, has stopped eating and shared plans to die by suicide since the verdict, according to her mother, Joséphine Marie Njeukam, who visited her in prison on Wednesday.

Ms. Njeukam said her child told her, “‘Mum, I won’t survive here for five years.’” She said her child didn’t kill anyone or steal, and that her sexuality “shouldn’t be a crime.”

according to Human Rights Watch, and several of those arrested were subjected to beatings and other forms of abuse.

“There has long been an anti-L.G.B.T. sentiment in Cameroon,” said Ilaria Allegrozzi, a researcher at Human Rights Watch who documents abuses in the country. “Now the judicial system contributes to the perception that homosexual and transgender people are criminals.”

The sentence for Shakiro and Patricia, who both go by a single name, is the maximum punishment under Cameroon’s penal code for engaging in sexual intercourse with a person of the same sex. But the women’s lawyer says they were detained while they were having dinner in a public space, and were not intimate or attempting to be.

Shakiro, 23, and Patricia, 27, were at a restaurant in Douala on Feb. 8 when police officers arrested them on charges of failing to provide identity documents. The two remained in prison for two months awaiting trial, according to their lawyer, Alice Nkom, and were sentenced on Tuesday.

Human Rights Watch.

Prosecutors in Cameroon and several other countries in Africa where homosexuality is criminalized, including Kenya, Tunisia and Uganda, among others, have in recent years commissioned anal examinations to allegedly prove that a person had engaged in homosexual intercourse, even though the outdated practice has been widely discredited by health care professionals and amounts to sexual assault.

attracted a wide following on social media, where she has repeatedly called for more tolerance against homosexual and transgender people in Cameroon.

“My sexual orientation and my sexuality aren’t choices,” she wrote in March. “But your baseless hatred and your homophobia are.”

Linda Noumsi, a makeup artist and friend of Shakiro’s, said her activism had attracted many critics. “She has a strong personality, and she can be quite vocal about her cause, which brought real supporters, fake friends, and enemies,” Ms. Noumsi said.

Ms. Nkom, the lawyer, said the verdict sent a pernicious message to the public in Cameroon: “It says, ‘If you don’t like someone’s appearance because they are different, you can just call the police, and they’ll have them arrested.’”

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The Growing Frustration Over Pandemic Restriction Cheaters

Tied to that is an apparent frustration and anger toward people who break or bend the rules. Anti-mask protests that have popped up in many parts of the country, particularly in Alberta, don’t appear to have advanced their cause with the general public and, in some cases, appear to have also been spreading racist messages. And there’s little obvious sympathy for the 536 air travelers who have been fined 3,000 Canadian dollars each for dodging the mandatory quarantine period in hotels that is required at entry.

This week, some of that anger and frustration spilled over into a sentencing hearing in Vancouver. The case involved a man who defied restrictions in British Columbia by turning a penthouse apartment into a makeshift nightclub, complete with topless dancers and a dancing pole. When the police entered on Jan. 31, there were 78 people squeezed inside.

according to the CBC.

She didn’t stop there as she sentenced him to 11 days in jail, which included the 10 he had already served while waiting for bail; 18 months probation for violating two parts of the Public Health Act; and 50 hours of community service. He was also fined for breaking liquor laws by running an unlicensed bar.

“What you did, sir, is comparable to individuals who sell fentanyl to the individuals on the street who die every day,” she said. “There’s no difference. You voluntarily assumed a risk that could kill people in the midst of a pandemic.”

brazenly broken lockdown restrictions during the pandemic, the actions of Mr. Movassaghi, who pleaded guilty, stood out.

The police began receiving complaints about large and loud parties at Mr. Movassaghi’s apartment, even though lockdown rules in British Columbia allowed people to entertain only one other person outside the household. No one, however, would open the door for officers who, among other things, observed one night the delivery of about 100 McDonald’s hamburgers.

After they finally obtained a search warrant and got inside, the police found menus for “Granny’s Exotic Bar” listing drinks priced from 26 Canadian dollars to 1,500 dollars for a bottle of liquor. A prosecutor told the court that lap dances were offered for 46 dollars.

The police fined people at the party a total of 17,000 dollars as they arrested Mr. Movassaghi.

Mr. Movassaghi’s lawyer and brother, Bobby Movassaghi, told the court that it was merely a party that had gotten out of hand after guests brought uninvited friends along.

Judge Gordon dismissed that argument, saying that when she hosts a party: “I don’t have stripper poles. I don’t have chairs around for people to watch. I don’t charge admission. I don’t charge for liquor. I don’t have point-of-sale devices attached to my cellular telephones.”

(Bobby Movassaghi did not respond when asked for comment.)

As for Judge Gordon’s move into the realm of the hypothetical, Isabel Grant, a professor at the Peter A. Allard School of Law at the University of British Columbia, told me that “it’s very unusual for a judge to comment on liability for a crime that was not before the court.”

nytcanada@nytimes.com.

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John C. Martin, 69, Dies; Led Drugmaker in Breakthroughs

John C. Martin, who became a billionaire by developing and marketing a daily single-dose pill that transformed H.I.V. into a manageable disease and who popularized another drug that cures hepatitis C, died on March 30 in Palo Alto, Calif. He was 69.

His death, in a hospital, was confirmed by Gilead Sciences, based in Foster City, Calif., where he was chief executive from 1996 to 2016 and executive chairman from 2016 until he retired two years later. The cause was head injuries suffered the day before, when he fell on a sidewalk while walking home in Old Palo Alto, according to the Santa Clara County medical examiner.

A chemist who rocketed from research director to chief executive of Gilead in six years, Dr. Martin turned a struggling pharmaceutical firm with a staff of 35 into a $100 billion company based in Foster City, Calif., with some 12,000 employees.

Gilead jolted the industry with several major scientific breakthroughs, beginning with the development of the first anti-influenza pill, Tamiflu, which the company licensed to the Swiss drugmaker Hoffman-La Roche in 1996. Its advance against hepatitis C came in 2014, with the marketing of Sovaldi, which has been said to cure 90 percent of patients with that liver virus.

Atripla, which combined Truvada with Bristol-Myers Squibb’s Sustiva in a single pill, replacing as many as 32 separate medications that some patients were taking daily to treat the virus, which can lead to AIDS.

The single-pill treatment was meant to be more than a convenience. By making it easier for patients to self-medicate, they were more likely to take the full doses that were prescribed, reducing the risk that they could become breeding grounds for drug-resistant strains of the disease.

During Dr. Martin’s tenure, Gilead also created remdesivir in 2009, which proved ineffective in its original mission, to treat hepatitis C and other viruses, but which turned out to be a therapeutic weapon during the Covid-19 pandemic.

While the company’s annual revenue soared past $20 billion and its products were hailed as medical miracles, the federal Department of Health and Human Services successfully claimed that Gilead had infringed government patents in making Truvada. The company also drew fire from state and federal regulators over the prices it charged — $1,000-a-month for Sustiva and $1,000 for each hepatitis pill.

donated drugs in some cases and that it had partnered with local manufacturers in developing countries to produce discounted generic versions of some treatments for H.I.V. and hepatitis C.

“John’s legacy,” Daniel O’Day, the company’s chief executive, said in a statement, “will be felt for generations to come, living on through the scientific progress made under his leadership and the programs he championed that expanded access to medications for people around the world.”

the $11 billion takeover of Pharmasset, a developer of antiviral drugs, in 2012. In addition to running Gilead, Dr. Martin was president of the International Society for Antiviral Research from 1998 to 2000.

His marriage to Ms. Martin ended in divorce. Among his survivors are their son and daughter, his three siblings and his partner, Lillian Lien-Li Lou, who was listed in a recent filing as the secretary-treasury of the John C. Martin Foundation, whose stated mission is to improve health care for medically-underserved populations.

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