Dear President Biden,

Despite significant progress in the United States (US), the coronavirus pandemic continues to threaten lives and security across the globe. Without urgent and immediate scale up of vaccine production and distribution, millions more will be infected and die. The emergence of the Delta variant is resulting in a surge in increasing infection rates in Africa, Latin America and Asia, where vaccines are least available. This  highlights the risk of newer, emerging variants, some of which may turn out to be resistant to current vaccines, which will threaten the progress made to date on the pandemic in the US and elsewhere. The time is now for ambitious leadership to vaccinate the world.

The need to be on a “wartime footing” to secure the world against this pandemic viral threat is paramount. Any global COVID vaccination program must be structured to address multiple interlinked priorities. First, the manufacturing capacity of mRNA vaccines in the US must be rapidly scaled up to reach approximately 4 billion people by the end of 2021. The US government has the capacity and the authority to act now and expand current manufacturing facility capacity as well as to develop mRNA vaccine manufacturing facilities, particularly as funding for this effort is already allocated by Congress. Second, it is equally important at the same time to use technology transfer and financing support to allow for further scale up of vaccine manufacturing capacity in all regions of the world. The latter will address the anticipated need for continued COVID-19 vaccination efforts, as well as prepare for the next potential pandemic.

Specifically, the US government should:

• Commit to establishing 8 billion doses per year of mRNA vaccine  capacity within six months using existing federal resources. A plan for this should be announced within one month.
  
  While multiple types of vaccines have been shown to be safe and effective and will have an important role to play in global vaccination efforts; to date, mRNA vaccines have proven to be faster and more reliable to produce than other vaccine technologies and are more effective against current variants. The U.S. investment in the development of mRNA vaccines, along with its co-ownership of the patents of this new technology, make mRNA vaccines the best first choice for the US role in global scale up. Based on past experience, newly retrofitted US owned facilities can be on-line to produce large numbers of doses within six months. Initial federal funding already allocated by Congress can help support this task.

• Simultaneously, the US government should develop and implement training and technology transfer for the development and manufacture of mRNA and other vaccines in hubs around the world. Such training and tech transfer can begin immediately in the U.S.-based facilities, at the proposed WHO-supported hub in South Africa, at facilities in India that can be quickly retrofitted for mRNA production capacity or at other locations (e.g., in South Korea). The US government should also compel originators to transfer technology and, in collaboration with other governments, provide financing for vaccine manufacturing around the world.

  The United States should explore all legal options to  compel mRNA manufacturing originators to share technology and voluntarily license their technology to contract manufacturers around the world, including mRNA manufacturing hubs. Funding, along with international partners, should also be allocated to scale up manufacturing hubs around the world. In addition, training at USG owned facilities could be used to seed the manufacturing hubs. We cannot pursue one strategy alone and need to operate on multiple fronts and creating new capacity in the US and abroad at the same time is the most sustainable way forward.

• Begin immediate export of vaccine doses — within one week — to COVAX or through other international distribution mechanisms — of at least 10 million doses per week.

  The United States currently has over 55 million doses of mRNA vaccines in storage, while only vaccinating approximately 900,000 people per day. At this rate, it would take over two months to administer just the vaccine doses currently stored. Despite this, mRNA vaccine manufacturers are delivering over 17 million new doses each week to jurisdictions across the US. Ten million excess doses could be immediately donated each week, while ensuring that the nation’s mRNA vaccine dose stockpile remains constant in size.

We urge you to act now. Announcing within the next 30 days an ambitious global vaccine manufacturing program is the only way to control this pandemic, protect the precious gains made to date, and build vaccine infrastructure for the future.

Signatories

Individuals:

Gregg Gonsalves, PhD, Professor, Yale School of Public Health; Adjunct Professor of Law, Yale Law School; Co-Director, Global Health Justice Partnership; Co-Director, Collaboration for Research Integrity and Transparency

Amy Kapczynski, Professor of Law, Yale Law School; Co-Director, Global Health Justice Partnership; Co-Director, Collaboration for Research Integrity and Transparency; Co-Director, Law and Political Economy Project; Co-Founder, Law and Political Economy Blog

Tom Frieden, MD, MPH, President and Chief Executive Officer, Resolve to Save Lives

Paul Farmer, MD, PhD, Co-Founder and Chief Strategist, Partners in Health; Chair, Department of Global Health and Social Medicine, Harvard Medical School; Chief, Division of Global Health Equity, Brigham Women’s Hospital

Linda P Fried, MD, MPH, Dean, Columbia University’s Mailman School of Public Health; DeLamar Professor of Public Health Practice, Senior Vice President, Columbia University Medical Center

Sten Vermund, MD, PhD, Dean, Anna M.R. Lauder Professor of Public Health, Yale School of Public Health; Professor of Pediatrics, Yale School of Medicine

Wafaa El-Sadr, MD, MPH, MPA, University Professor of Epidemiology & Medicine, Dr. Mathilde Krim-amfAR Chair of Global Health, Columbia University; Director, ICAP

Stephen Gloyd, MD, MPH, Professor, Global Health, Health Services, Epidemiology, Family Medicine, Industrial Systems Engineering, University of Washington; Associate Director, University of Washington, Department of Global Health; Founder, Health Alliance International

Judd Walson, MD, MPH, Vice Chair & Professor of Global Health, University of Washington, Department of Global Health; Professor of Medicine (Allergy & Infectious Diseases), Professor, Pediatrics, Adjunct Professor, Epidemiology, University of Washington

Ann Kurth, PhD, CNM, MPH, FAAN, Dean & the Linda Koch Lorimer Professor of Nursing, Yale School of Nursing, Yale University

Larry Corey, MD, President and Director Emeritus, Fred Hutch;  Fred Hutch Professor Vaccine and Infectious Disease Division, Fred Hutch Professor Clinical Research Division, Fred Hutch Professor Public Health Sciences Division,  University of Washington

Carlos Del Rio, MD, Executive Associate Dean, Emory School of Medicine & Grady Health System; Distinguished Professor, Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine; Professor, Hubert Department of Global Health, Rollins School of Public Health; Co-Director, Emory Center for AIDS Research

Saad Omer, MBBS, MPH, PhD, FIDSA, Director and Professor, Yale Institute for Global Health; Associate Dean (Global Health Research), Professor of Medicine (Infectious Diseases), Yale School of Medicine; Susan Dwight Bliss Professor of Epidemiology of Microbial Diseases, Yale School of Public Health

Philip J. Landrigan, MD, MSc, FAAP, Professor, Boston College; Director, Program for Global, Public health and the Common Good

Rebecca Zash, MD, Assistant Professor, Harvard Medical School; Co-Director, Placental Scientific Working Group, Harvard University Center for AIDS Research

Quentin Eichbaum, MD, PhD, MPH, MFA, MBA, Professor & Program Director, Vanderbilt University Medical Center; Director, Vanderbilt Pathology Program in Global Health

Judith Wasserheit, MD, MPH, Chair & Professor of Global Health, Professor of Medicine & Epidemiology, University of Washington, Department of Global Health

Kenneth Mayer, MD, Medical Research Director & Co-Chair, The Fenway Institute; Professor, Harvard Medical School

Els Torreele, PhD, Visiting Fellow, Institute for Innovation and Public Purpose, University College London

Suhaib Siddiqi, MD, MSc, PhD, Former Director of Chemistry, Moderna Therapeutics Inc.

James Krellenstein, Co-Founder, PrEP4All

Christian Urrutia, Co-Founder, PrEP4All

Mitchell Warren, Executive Director, AVAC

Sheila Davis, Chief Executive Officer, Partners In Health

Zoltan Kis, PhD, Research Associate, Imperial College London

Nikole Allen, MPH, Senior Program Director, Yale Institute for Global Health

Loren Galvao, MD, MPH, Senior Scientist, Global Health, University of Wisconsin Milwaukee Colleve of Nursing Center for Global Health Equity; Honorary Fellow, Population Health Sciences, University of Wisconsin Madison School of Medicine and Public Health

David Barr, Fremont Center

Soham Sankaran, Founder and Chief Executive Officer, Pashi/PopVax

Joseph Williams, MPH Candidate, Yale School of Public Health

Ulysses Burley, MD, MPH, Founder, UBtheCURE LLC

Stephaun E. Wallace, PhD, MS, Staff Scientist, Vaccine & Infectious Disease Division, Fred Hutch; Director of External Relations, HIV Vaccine Trials Network, Fred Hutch; Clinical Assistant Professor, Department of Global Health, University of Washington

Shahin Lockman, MD, Associate Professor, Brigham and Women’s Hospital, Harvard TH Chan School of Public Health

Steven Shea, MD, MS, Hamilton Southworth Professor of Medicine, Columbia Mailman School of Public Health

Rajesh Gandhi, MD, Director, HIV Clinical Services and Education, Massachusetts General Hospital; Professor of Medicine, Harvard Medical School

Tecla Temu, MD, PhD, Clinical Assistant Professor, University of Washington, Department of Global Health

Lisa Rosenbaum, MD, National Correspondent, New England Journal of Medicine

Miriam Sabin, MS, PhD, Senior Editor, The Lancet

Gregory Whitman, MBBS, LLM, MPH, Chief Executive Officer, Blended Value Health

Donna Patterson, PhD, Professor and Chair, Department of History, Political Science, and Philosophy, Delaware State University

Tawanda Marufu, MD, MSc, DPH, Centre for Public Health Development

Nader Hijazi, MD, FCCP, Abdali Hospital

Amra Uzicanin, MD, MPH, FIDSA

Nagesh Borse, EIS, PhD, MS, MA, Director Global Health, US Pharmacopeia

Amina Khawja, MPH, Monitoring and Evaluation Advisor, AARP Foundation

Richard Jorgensen, MS, PhD, Professor Emeritus, University of Arizona

Penny Kessler, MPH, CHES, Contact Tracer, St Clair County Health Department

Jonathan Hursh, Founding Partner, Utopia

Alex Esteves Jaramillo, MPH, Senior Principal Scientist, Vaccine Clinical Development, Merck

Keith Martin, MD, PC, Executive Director, CUGH

Kirkby Tickell, MBBS, MPH, Research Scientist, University of Washington

Ann Van Haney, MBA, Research Administrator, University of Washington

Amy Roll, MPH, Data Analyst, University of Washington

Keshet Ronen, PhD, MPH, Acting Assistant Professor, University of Washington, Department of Global Health

Katherine Rankin, MPA, Managing Director, Global Center for Integrated Health of Women, Adolescents, and Children, University of Washington

Bryan Verity, Director of Human Resources, International Training and Education Center for Health, University of Washington, Department of Global Health

Jennifer Gilvydis, MPH, Business Development Associate, University of Washington, Department of Global Health

Zarna Marfatia, Research Coordinator, University of Washington, Department of Global Health

Emily Yoshioka, MPH, Research Coordinator, Gut Health and Child Survival, University of Washington, Department of Global Health

Christina Sherry, MPH, Research Coordinator, Gut Health and Child Survival, University of Washington, Department of Global Health

Casey Iiams-Hauser, Senior Digital Health Specialist, lead for OpenELIS Global, University of Washington, Department of Global Health

Kayla Cody, Program Officer, University of Washington, Department of Global Health

Frances Petracca, PhD, Research Scientist & Clinical Instructor, International Training and Education Center for Health, University of Washington, Department of Global Health

Lisa Querido, MPH, Technical Officer, Capacity Building and Training Development, International Training & Education Center for Health, University of Washington

Susan Mello, EMPA, Associate Director, Center for AIDS Research, University of Washington

Alex McGee, Managing Director, Global Health E-Learning Program

Julie Brunett, Assistant Director, Academic Programs Student Services, University of Washington, Department of Global Health

Misti McDowell, MPA, Program Director, InternationalAIDS Education and Training Center, International Training & Education Center for Health, University of Washington, Department of Global Health

Caitlin Scoville, MPH, International Research Manager, International Clinical Research Center, University of Washington

Julia Dettinger, MPH, Research Scientist, University of Washington, Department of Global Health

Deborah Confer, Program Manager, International Training & Education Center for Health, University of Washington, Department of Global Health

Sonora Stampfly, MPH, Program Coordinator, University of Washington, Department of Global Health

Hailey Bednar, MPH, Emergency Response Specialist, CDC Foundation

Anupa Fabian, PhD, MPA, Program Evaluator, Health & Human Services

Alexander Lankowski, MD, Infectious Diseases Physician-Researcher, Fred Hutchinson Cancer Research Center, University of Washington

Wilmot James, PhD, Senior Research Scholar, ISERP; Interim Chair, Center for Pandemic Research, Columbia University

Mariana Mazzucato, PhD, Professor in the Economics of Innovation and Public Value, Director of the Institute for Innovation and Public Purpose, University College London

Virginia Gonzales, MSW, MPH, EdD, Senior Lecturer Emeritus, University of Washington, Department of Global Health

Chloe Morozoff, MPH, Implementation Science Research Consultant, University of Washington, Department of Global Health

Aaron Lord, MD, MSc, Chief of Neurology, NYU Langone-Brooklyn; Associate Professor of Neurology and Neurosurgery, NYU Langone School of Medicine; Co-Founder,  PrEP4All

Moisés Agosto-Rosario, Director of Treatment, NMAC

Joseph Osmundson, PhD, Clinical Assistant Professor, Biology, New York University

David Gold, Co-Founder and Chief Executive Officer, Global Health Strategies

Andrew Goldstein, MD, Assistant Professor, NYU School of Medicine; Progressive Doctors

Udom Likhitwonnawut, Member, Thailand NCAB

Peter van Rooijen, Board member, Joep Lange Institute

Zachary Harvanek, MD, PhD, Psychiatry Resident, Yale University, Department of Psychiatry

Carl Sciortino, MPA, Executive Vice President of External Relations, Fenway Health

George Brown, MD, MPH, Self-employed

Julius Kachidza, Member, Network of ARV Users

Amanda Lugg, Director of Advocacy and LGBTQ Programming, African Services Committee

Veronica Noseda, Operational Research Project Manager, L’Initiative/Expertise France

Simon Collins, HIV i-Base

Karyn Kaplan, MA, Executive Director, Asia Catalyst

Edwin Bernard, Executive Director, HIV Justice Network

Paul Kasonkomona, Executive Director, Centre for Tolerance and Peace

Filippo Schloesser, Chair, Nadir onlus

Luís Mendão, President, Grupo de Ativistas em Tratamentos

Bill Lober, MD, MS, Professor, Global Health, Biobehavioral Nursing and Health Informatics, Biomedical Informatics and Medical Education, University of Washington, Department of Global Health

Nancy Jecker, PhD, Professor of Bioethics & Humanities, University of Washington School of Medicine; Fulbright U.S. Scholar for South Africa

Indi Trehan, MD, MPH, DTMH, Associate Professor of Pediatrics, Adjunct Professor of Global Health, Adjunct Associate Professor of Epidemiology, University of Washington

Alison Roxby, MD, MSc, Associate Professor, Global Health, Medicine – Allergy and Infectious Diseases, Adjunct Associate Professor, Epidemiology, University of Washington, Department of Global Health

Melissa Mugambi, MD, PhD, Assistant Professor, Global Health, University of Washington, Department of Global Health

Kelli O’Laughlin, MD, Assistant Professor of Emergency Medicine and Global Health, University of Washington, Department of Global Health

Grace John-Stewart, MD, MPH, PhD, Professor, Global Health, Epidemiology, Medicine – Allergy & Infectious Diseases, Pediatrics, University of Washington

Adrienne Shapiro, MD, PhD, Acting Assistant Professor, Global Health, Medicne – Allergy and Infectious Diseases, University of Washington

Michael Skonieczny, MPA, Deputy Director, Yale Institute for Global Health

Jorge Beloqui, Secretary of the Board, GIV

James Pfeiffer, PhD, MPH, Professor, Global Health, Anthropology, Health Services, University of Washington, Department of Global Health; Executive Director, Health Alliance International

Leslie Goo, PhD, MPH, Assistant Professor, Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center

Michael Arndt, PhD, MPH, Research Scientist, IHME, University of Washington

Adam Akullian, PhD, Affiliate Associate Professor, University of Washington, Department of Global Health

Karen Levy, PhD, MPH, MSc, Associate Professor, University of Washington School of Public Health

Yunda Huang, PhD, Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center; Affiliate Associate Professor, University of Washington Department of Global Health

Pamela Kohler, PhD, MPH, RN, Associate Professor, Global Health, Child, Family, and Population Health Nursing, University of Washington Department of Global Health

Marilyn Parsons, PhD, Professor Emeritus, University of Washington, Department of Global Health

Sara Curran, PhD, MS, Professor, Director Center for Studies in Demography & Ecology, University of Washington

Pradip Rathod, PhD, Professor, University of Washington, Department of Chemistry

Joia Mukherjee, MD, MPH, Chief Medical Officer, Partners In Health; Associate Professor of Global Health and Social Medicine, Harvard Medical School,

K. J. Seung, MD, Associate Physician, Brigham and Women’s Hospital

Joseph Rhatigan, MD, Associate Professor, Brigham and Women’s Hospital

Bram Wispelwey, MD, Senior Technical Lead, Partners In Health

Emily Wroe, MD, MPH, Senior Advisor, COVID response; Associate Physician, Partners In Health; Brigham & Women’s Hospital; Harvard Medical School

Jane Simoni, PhD, Professor, Global Health, Psychology, Gender, Women, and Sexuality Studies, University of Washington

Bruce Gellin, MD, MPH, Chief, Global Public Health Strategy, The Rockefeller Foundation

Ruanne Barnabas, DPhil, MSc, Professor, Global Health, Medicine – Allergy and Infectious Diseases, Adjunct Epidemiology; University of Washington, Department of Global Health

Michelle Averill, PhD, RD, Associate Teaching Professor, University of Washington

Judit Marsillach, PhD, Acting Assistant Professor, Medical Genetics, University of Washington

Terrance Kavanagh, PhD, Professor, University of Washington, Department of Environmental & Occupational Health Sciences; Associate Director, University of Washington Interdisciplinary Center for Exposures, Diseases, Genomics and Environment

Abraham Flaxman, PhD, Associate Professor, Global Health, Health Metrics Sciences University of Washington, Department of Global Health

Terry Gordon, PhD, Professor, Department of Environmental Medicine, NYU Langone Health

Suzinne Pak-Gorstein, PhD, MD, MPH, Associate Professor, Pediatrics – General Pediatrics, Adjunct Associate Professor, Global Health, University of Washington; Advisor, International Rescue Committee

Anjuli Wagner, PhD, Assistant Professor, University of Washington, Department of Global Health

Prakash Tyagi, MD, Clinical Professor, University of Washington, Department of Global Health; Executive Director, GRAVIS

Annette Ghee, PhD, MPH, Affiliate Assistant Professor, University of Washington, Department of Global Health

Sara Schwanke Khilji, MD, MPH, FACP, Assistant Professor of Medicine, Division of Hospital Medicine, Oregon Health & Science University; Assistant Professor, Oregon Health & Science University School of Public Health; Internal Medicine Director, Botwsana Global Health Program, Botswana-Harvard AIDS Institute Partnership

Giampaolo Rossi, Forum AIDS Italia

Anthony Feliciano, Executive Director, Commission on the Public’s Health System

Anne Mitchell, Board Member, Commission on the Public’s Health System

Anne Bove, RN, Board Member, Commission on the Public’s Health System

Teresita Rodriguez, Chief Executive Officer, Apicha Community Health Center

Catherine Hankins, PhD, MD, MS, Professor, School of Population and Global Health, Faculty of Medicine and Health Sciences, McGill University

Pooja Gala, MD, Assistant Professor, New York University, Grossman School of Medicine

Beth Rivin, MD, MPH, Clinical Associate Professor, University of Washington, Department of Global Health; President & Chief Executive Officer, Uplift International

Kathleen Powers, Board Member, Northside Action for Justice

Salvador Campos Correa, Caminhos PositHIVos

Rouzeh Eghtessadi, MPH, Executive Director, SAfAIDS

Merith Basey, MSc, Executive Director, Universities Allied for Essential Medicines

Ben Levenson, Deputy Director, Justice is Global

Salmaan Keshavjee, MD, PhD, ScM, Director, Center for Global Health Delivery; Professor, Global Health & Social Medicine, Harvard Medical School

Mercedes Becerra, ScD, Professor, Global Health & Social Medicine, Harvard Medical School

Robert Lawrence, MD, MACP, Center for a Livable Future Professor Emeritus, Johns Hopkins Bloomberg School of Public Health

Will Fenton, Senior Campaigns Advisor, Oxfam America

Veronika Wirtz, PhD, MSc, Professor, Boston University School of Public Health

Deborah Gleeson, MPH, PhD, Associate Professor, Department of Public Health, La Trobe University

Suhayl Omar, Campaign Lead, People’s Vaccine Kenya

Praman Adhikari, Advocacy and Campaign Officer, South Asia Alliance for Poverty Eradication (SAAPE)

Rachel Thrasher, JD, Researcher, Global Development Policy Center, Boston University

Gerard van Mourik, Co-Executive Director, GNP+

Max Hadler, MPH, MA, COVID-19 Senior Policy Expert, Physicians for Human Rights

Cate Oswald, Chief Policy and Partnership Officer, Partners In Health

Mary T. Bassett, MD, MPH, Professor, FXB Center for Health and Human Rights, Harvard University

Regan Marsh, MD, MPH, Director of Clinical Systems, Partners In Health

Brook Baker, Senior Policy Analyst, Health GAP (Global Access Project); Professor, Northeastern University School of Law

Michael Helms, Senior Advisor, Government Relations, Oxfam America

Patricia Asero Ochieng, Executive Director, DACASA

Erick Okioma, Chief of the Party, Nelson Mandela TB HIV Community Information and Resource Center CBO Kisumu

Chikosa Banda, University of Malawi

Martha Akello, Programme Manager Media for Social Change, Refugee Law Project

Fatima Hassan, LLM, Director, Health Justice Initiative (HJI), South Africa

Vuyiseka Dubula, Africa Centre for HIV/AIDS Management

Othoman Mellouk, Intellectual Property and Access to Medicines Lead, International Treatment Preparedness Coalition ITPC

Primah Kwagala, Director, Women’s Probono Initiative-Uganda

Michelle Benes, MS

Raúl Ramírez, INSP

Jayne Nyirenda, MSc

Dolores Pino, Attorney at Law

Brittany Allen, Grants Specialist

Patricia Beaumont-Owyang 

Patricia Hudelson

Juan Espinosa

Joshua Mugala

Katia Kayayan

Chris Vakkur

Stephen Parent

Nina Ruymaker

Bridget Mwewa

Organizations:

PrEP4All

Yale Global Health Justice Partnership

AVAC

Public Citizen

Partners In Health

Oxfam America

Health GAP (Global Access Project)

Resolve to Save Lives

Physicians for Human Rights

Columbia University’s Mailman School of Public Health

University of Washington, Department of Global Health

Fenway Health

Uplift International

Pashi

UBtheCURE LLC

Blended Value Health

Consortium of Universities for Global Health

Centre for Public Health Development

NMAC

Progressive Doctors

Thailand NCAB

Joep Lange Institute

African Services Committee

HIV i-Base

Asia Catalyst

HIV Justice Network

Nadir onlus

Grupo de Ativistas em Tratamentos

GIV

ACT UP New York

GRAVIS

Forum AIDS Italia

Commission on the Public’s Health System

Apicha Community Health Center

Caminhos PositHIVos

SAfAIDS

Universities Allied for Essential Medicines

Free the Vaccine for COVID-19

Justice is Global

People’s Vaccine Kenya

South Asia Alliance for Poverty Eradication (SAAPE)

GNP+

International Treatment Preparedness Coalition (ITPC)

Kenya Legal & Ethical Issues Network On HIV & AIDS (KELIN)

DACASA

Nelson Mandela TB HIV Community Information and Resource Center CBO Kisumu

Center for Education, Graduate Entrepreneurship and Empowerment (C4Gee)

Health Justice Initiative (HJI), South Africa

Africa Centre for HIV/AIDS Management

Foundation for Male Engagement Uganda (FOME)

Women’s Probono Initiative-Uganda