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Global Funding must be in the next COVID-19 emergency supplemental

by Thomas J. Coates, opinion contributor - 12/15/20 4:30 PM ET

Urgently needed COVID-19 relief funding appears to be gaining traction in Congress, with an appropriate focus on protecting U.S. families, health care workers, local governments and businesses. It is in America’s interest that this legislation also include $20 billion to address the serious damage COVID-19 is doing globally.

COVID-19 is a global catastrophe and the U.S. needs to contribute to global solutions. I direct the University of California’s system-wide Global Health Institute and we collectively have learned that global problems require global collaboration. Past pandemics from HIV to MERS to Ebola show us clearly that we cannot guarantee pandemic control at home until COVID-19 is under control in all countries.

The U.S. contribution to the global COVID-19 pandemic amounts to only 0.1 percent of all COVID-19 funding passed so far. That simply makes no sense, particularly that given a usual year, our country devotes billions to lifesaving international assistance.

Lower-income countries around the world, and especially those in Africa, need support now. The impact of COVID-19 has been severe on the continent. African countries have repurposed health staff and resources from other priorities. Supply chains have been interrupted.

Research conducted by my colleagues and I in Africa shows that people are afraid to go to the clinics because they do not want to be in crowded spaces where other people might have COVID-19. HIV treatment initiation is down by 25 percent. Malaria deaths are rising as COVID-19 disrupts delivery of bed nets. The diagnosis and treatment of tuberculosis has fallen precipitously. Measles is surging due to reduced vaccination rates. Jus two weeks ago, in its World AIDS Day message, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) program noted that COVID-19’s, “impact on HIV, tuberculosis (TB), and malaria prevention programs has been devastating.”

Bill Gates warned recently that we have been set back a quarter century of progress on delivery on immunizations, a good marker for health systems overall, due to COVID-19. UNICEF called for averting a lost generation as COVID-19 threatens to cause irreversible harm to children’s education, nutrition and wellbeing.

We know where and how to make smart investments to avoid disaster in low-income countries and we need to do this as soon as possible. Gavi, the Vaccine Alliance, is leading global efforts to reserve, procure and deliver vaccines in 92 low-income countries. The Global Fund’s COVID-19 Response Mechanism helped over 100 countries mitigate damage to AIDS, TB and malaria programs, recruit health care workers and protect them with Protective Personal Equipment (PPE) and shore up fragile health systems. Africa Centers for Disease Control and Prevention has noted that the scale up of COVID-19 rapid diagnostic tests would significantly strengthen the continent’s response to COVID-19.

A global response to COVID-19 would represent a tiny fraction of overall expenditures on the pandemic. But the payoff would be enormous. The ONE Campaign and the U.S. Global Leadership Coalition have called on Congress to invest $20 billion immediately in the global COVID-19 response as part of the emergency supplemental legislation being developed right now. In October, Speaker of the House Nancy Pelosi (D-Calif.) included $9 billion in global funding overall, with $3.5 billion for Gavi and $3.5 billion for the Global Fund, in the House version of the COVID-19 stimulus bill. I applaud these efforts — which have strong bipartisan support — and now Gavi needs resources without delay to move forward with global vaccine access. The Global Fund’s COVID-19 response mechanism has run out of funds and is unable to help protect health systems. Rapid tests are ready for purchase, but the Global Fund has insufficient funds to purchase them at the scale required. Without these resources, we risk losing years of progress on global health and face the continued international circulation of COVID-19.

Funds for vaccines are essential, but not enough. The indirect impacts of COVID-19 need to be addressed as well. Safe health care workers and robust health systems are needed to deliver the vaccines. This month’s COVID-19 stimulus provisions must include protections for health systems and delivery of diagnostics and treatments and mitigation of damage to AIDS, TB and malaria programs (through the Global Fund and PEPFAR, among others). All these investments pave the way for vaccine delivery while preventing further health system disruption.

Congress must act immediately to include robust global funding as part of COVID-19 legislation. Doing this will make Americans safer, help revitalize the U.S. economy and allow our country to reassert its crucial leadership role in the world.

Thomas J. Coates, Ph.D., is director of the University of California Global Health Institute, which brings together the 10-campus U.C. system to solve global health problems and train future leaders. He is a Distinguished research professor of Medicine at the UCLA David Geffen School of Medicine and director emeritus of the UCLA Center for World Health.