Washington, DC Update

Posted 11 February 2021

Almost immediately upon taking office, President Biden reversed President Trump’s decision to withdraw the U.S. from the WHO. He also issued an executive order titled “Organizing and Mobilizing the United States Government to Provide a Unified and Effective Response to Combat COVID-19 and to Provide United States Leadership on Global Health and Security.” That order recreates the Directorate on Global Health Security and Biodefense within the National Security Council and requires a comprehensive report on emerging biological risks, both foreign and domestic, within 180 days from the National Security Advisor and “relevant agencies.”
 
Separately, in a National Security Memorandum issued on his second day in office, President Biden committed the U.S. to joining the Access to COVID-19 Tools Accelerator (ACT-A) and COVAX Facility. 
 
WHO Sets NTD Reduction Target
On January 28, the WHO set a target of reducing neglected tropical diseases (NTDs) by 90% worldwide by 2030. Other goals in the NTD Roadmap include having at least 100 countries eliminate at least one NTD, eradicating dracunculiasis and yaws outright, and reducing disability-adjusted life years related to NTDs by 75%.
 
WHO Falling Short on Malaria Goals
According to its World Malaria Report 2020, the WHO will not meet its 2020 goals for reducing malaria mortality and case rates. The WHO had aimed to reduce both by 40% compared to 2015. The goals to eliminate malaria from at least 10 countries and to prevent re-establishment of malaria in malaria-free countries are on track, however. On an interim basis, the WHO is aiming to reduce malaria mortality and case rates by 90% each compared with 2015 by the year 2030, while eliminating malaria entirely from at least 35 countries.
 
Biden Administration Takes Shape
The Senate confirmed Antony Blinken as Secretary of State on January 26. Other Cabinet-level picks are moving slowly in the Senate due to the lack of an agreement on how to run committees in the evenly split chamber. With a power-sharing agreement now in place, appointments will continue to be slow due to the second impeachment trial of Donald Trump.  Key nominees including U.N. Ambassador-designate Linda Thomas-Greenfield and USAID Administrator-designate Samantha Power may not receive approval for several more weeks.
 
President Biden has not nominated a USAID assistant administrator for global health as of the time of writing.
 
Science Advisor Elevated to Cabinet Level
President Biden has elevated the Director of the Office of Science and Technology Policy (OSTP) to a cabinet-level position. This is the first time the OSTP director will serve in a presidential cabinet. President Biden has tapped geneticist Eric Lander for the position, which requires Senate confirmation.
 
Biden Proposes $1.9 Trillion “American Rescue Plan,” Congress Tees Up Reconciliation
President Biden, following up on campaign promises, has proposed a $1.9 trillion COVID-19 relief bill to supplement the previous relief bill passed in December. Though the details of the plan will likely change somewhat when Congress turns it into legislative text, Biden’s plan as proposed includes (not exhaustive):
  • $20 billion for a national COVID-19 vaccine distribution system, including mobile units
  • $50 billion for COVID-19 testing and adding 100,000 public health workers
  • $10 billion for domestic pandemic supplies production
  • $11 billion to support the international COVID-19 response
The plan also calls for $1,400 stimulus checks, emergency paid leave, a $400 federal unemployment insurance supplement and $350 billion in aid to state and local governments. With the exception of stimulus checks, previous attempts to pass these items have met stiff opposition from Republicans. For that reason, Democrats have passed a budget resolution in the House and Senate that starts the reconciliation process. Under reconciliation, if strict budgetary rules are met, the Biden plan could be passed with simple majorities in each house without Republican support. The process avoids the 60-vote threshold in the Senate usually needed to overcome a filibuster.
 
Johnson & Johnson COVID-19 Vaccine Progresses
Johnson & Johnson has officially filed for an Emergency Use Authorization with the FDA for its COVID-19 vaccine, with an advisory committee meeting scheduled for February 26 to review the application. Phase 3 trials showed the Johnson & Johnson vaccine candidate is less effective at preventing moderate to severe COVID-19 compared with Pfizer and Moderna, but at 66% efficacy it is still well above the FDA’s benchmark. The Johnson & Johnson candidate is a one-shot regimen that can be stored at regular refrigerator temperatures, which should help boost global vaccine supplies.
 
Health and Human Services Special Counsel Slams BARDA
The HHS Office of Special Counsel issued a scathing report on the Biomedical Advanced Research and Development Authority (BARDA) in response to a whistleblower complaint. Millions of dollars intended for vaccine research and pandemic preparedness were diverted by HHS officials to administrative expenses and the salaries of employees elsewhere in HHS, dating back to shortly after BARDA’s creation in 2006. The diversion of funds was such a widespread problem that some employees referred to the Authority as the “Bank of BARDA.”
 
NIAID Vaccine Research Center to Expand
NIH will expand the NIAID Vaccine Research Center, literally; it will add six stories to the Center’s building. The Center will double in size, thanks to funding in regular NIH appropriations and the supplemental funding passed by Congress over the last year. The expansion will be operational in November 2024.