A European Union fundraising drive to support medical research into treatments and vaccines for the coronavirus met its initial goal Monday of raising $8 billion despite a lack of involvement by the United States.

Even with the initial fundraising goal met, U.S. absence from the EU-led effort, which will provide monetary support to the World Health Organization and other multilateral global public health efforts, has many experts and lawmakers worried about U.S. participation in coordinating research and developing a vaccine.

“The U.S. historically in the post-World War II-era has been the leader at the table pushing the world to do the right thing,” Rep. Ami Bera, D-Calif., who leads the House Foreign Affairs Asia subcommittee, said in an interview. “The absence of U.S. participation at the government level [at these international vaccine coordination events] is just shocking, and is noticeable.”

The European Commission, the leadership body of the EU, on Monday called the $8 billion raised through donations from wealthy countries including Norway, Japan, France, Germany and Saudi Arabia a “solid starting point,” for the pledging marathon to defeat the coronavirus. It was not immediately clear how much of the raised funds represented new monies or commitments made earlier in the year.

“The truth is, none of us can succeed alone,” British Prime Minister Boris Johnson, newly recovered from his own serious bout of COVID-19, said in his virtual remarks. “To win this battle, we must work together to build an impregnable shield around all our people and that can only be achieved by developing and mass producing a vaccine. The more we pull together and share our expertise, the faster our scientists will succeed.”

Notably absent from the virtual fundraising event featuring the heads of states and ministers of dozens of countries was anyone representing Russia, India or the United States. China was represented by its ambassador to the European Union, Zhang Ming.

Former top officials with the U.S. Agency for International Development say the lack of U.S.-leadership on the international stage is startling, particularly after the role the Obama administration played in directing a global response to contain and wipe out the 2014 West Africa Ebola epidemic.

“What we’ve seen from the United States throughout this outbreak has been an aversion to any sort of international collaboration,” Jeremy Konyndyk, a top USAID disaster assistance official during the Obama administration, said in an interview.

The State Department held a press call Monday to defend and champion its efforts in the global coronavirus response. While top department and administration officials listed numerous statistics about the amount of humanitarian, development and global health assistance funding the United States has provided the international community over the years, they would not, despite repeated questioning from reporters, offer a rationale as to why the Trump administration had chosen not to participate in the vaccine fundraising drive or recent leadership coordination efforts convened by the World Health Organization.

A senior administration official, who the department said could not be named under the terms of the press call, described a Trump administration technology effort to release and analyze more than 52,000 scientific articles about the coronavirus and said the government is dedicating its most powerful supercomputers to coronavirus research through public-private cooperation agreements that have resulted in more than 30 domestic and global research projects.

“There’s really a tremendous amount of international coordination that is ongoing on vaccine, therapeutic and diagnostic efforts, so we have had an extraordinary ramp-up of international coordination, including through the G7 and the G20 and many other multilateral efforts,” the official said. “We … are going to work very closely with European partners and others around the world.”

Konyndyk, now a senior policy fellow at the nonpartisan think tank, Center for Global Development, said the lack of U.S. participation in the EU’s coronavirus pledging drive was disappointing but not surprising given that the World Health Organization is slated to receive a portion of the raised funds.

The Trump administration last month announced it was pausing funding to the U.N. health body while it examines its initial response to the coronavirus and China’s influence over the agency.

“They are clearly on the warpath against the WHO right now and so anything that reflects WHO playing a useful and constructive role, which it absolutely is doing, they cannot accept and they cannot engage with,” Konyndyk said. “They cannot say on the one hand ‘this organization has irredeemably botched the virus and is performing so poorly we are going to give them no money whatsoever’ and then say on the other hand ‘that this conference that they are organizing is useful.’ If they participate, it reveals the hypocrisy of their own position.”

Coordination needed on vaccine

Joe Cerrell, managing director for global policy and advocacy for the Bill and Melinda Gates Foundation, said the money raised Monday by the fundraising drive should be thought of more as a “down payment” toward one or more eventual vaccines that can be mass-produced and distributed around the world.

“We need to put in place a massive amount of capacity to develop vaccines so that when we get a vaccine, it is able to be developed at a huge and unprecedented scale,” Cerrell said in a video call with reporters last week organized by the anti-global poverty ONE Campaign. 

With roughly 100 vaccine candidates in various stages of the pipeline, Cerrell said international coordination is vital to reach agreement on criteria for eventual vaccines.

More than one vaccine may be needed to eradicate the pandemic as some vaccines may not be safe enough for the elderly or children and others may not be suitable for administering in developing countries where refrigeration can be an issue. Once vaccine criteria are agreed to, it should encourage a global focusing of resources on those few vaccines that are the most promising, he said.

“The important thing now is to really start thinking about the manufacturing costs that are going to be needed,” Cerrell said, adding that is why he supports WHO’s efforts to coordinate research on the most promising vaccines. “We don’t want to have a lot of inefficient money thrown out there at dozens of things.”

While President Donald Trump and Secretary of State Mike Pompeo remain steadfast in their criticism of WHO, Bera is promoting other efforts he hopes could prove more palatable to congressional Republicans, who also want to support Trump. 

“The easy, low-hanging fruit would be for folks to support the U.S. donation to CEPI,” Bera, himself a physician, said referring to the Coalition for Epidemic Preparedness Innovations.

Bera and the ranking member of the Foreign Affairs Asia-Pacific subcommittee, Rep. Ted Yoho of Florida, in March introduced legislation that would authorize U.S. government funding to CEPI.

Started in 2017 with funding from the Bill and Melinda Gates Foundation, Norway and India, CEPI is dedicated to supporting promising research into vaccines against emerging infectious diseases that the private sector needs additional incentives to undertake because of uncertain market demand.

CEPI requires that vaccines produced through its funding support be equitably shared around the world. The coalition receives a mixture of private and public funding from the likes of Germany, Japan, Canada and Denmark but, thus far, not the United States.

The Bera-Yoho bill does not establish a level of funding to CEPI but would require a report on funding plans within six months.

“Now is the time for the United States to show leadership and contribute the funding necessary to support research and vaccine development for not only tackling COVID-19, but many other future diseases to come,” Yoho said in a statement. “Most importantly, we must work with the international community to quickly deliver a safe vaccine so that people, economies and countries can return to some form of normalcy.”

Bera and Yoho sent a letter to Pompeo on Friday that warned about the risks of pursuing a winner-take-all approach to not only the search for a vaccine but also the manufacturing of one.

“We should prepare ourselves for the potential consequences if a U.S. vaccine candidate is not the winner of the international vaccine race,” the duo said. “The market for the SARS-CoV-2 vaccine will truly be a global one. It will require international supply chains for material ranging from preservatives to glass vials, which the U.S. may not have the capacity to produce solely on its own.”

Winning the cooperation of countries that control large quantities of vital vaccine materials will be critical to ensuring that once a vaccine is available, it can be quickly mass produced without fear of bottlenecks or export bans, they said.

“It is for this reason that we urge U.S. participation in efforts to ensure development, production and distribution of a SARS-CoV-2 vaccine is coordinated among international purchasers,” Bera and Yoho wrote in their letter. “Coordinated action would help manage and accelerate component sourcing, production and coproduction, and determine mechanisms for pricing and distribution. Most importantly, it would also develop a prioritization scheme to ensure the world’s health care and other essential workers are immunized first, regardless of whose nation’s vaccine wins.”

Bera said he hopes to see the legislation included in the next supplementary coronavirus relief bill being negotiated by lawmakers.