White House to seek more covid funding in lame session

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The White House is mounting another push to get billions of dollars from Congress for a new generation of coronavirus vaccines and treatments, though Republicans remain skeptical about how past allocations have been spent.

Biden officials are finalizing a request this week for about $10 billion in public health funds by the end of the year, part of a larger request during the lame session of Congress that would include also funding for Ukraine and disaster relief for hurricane damage in Florida, according to six people who spoke on condition of anonymity to describe confidential budget discussions.

This request includes $8.25 billion for covid response efforts, including a successor to Operation Warp Speed ​​some are calling “Project Covid Shield”, intended to kick-start development of the coronavirus. vaccines and treatments that would be effective against an evolving virus. Officials are also debating about $2 billion for other health efforts, including about $1 billion for the global covid response, as well as about $750,000 to fight diseases such as hepatitis C. and monkeypox.

Senior health officials and outside experts say more funding for the covid response is desperately needed, pointing to the delayed uptake of new coronavirus booster vaccines that could benefit from public education campaigns, the diminishing effectiveness of existing antivirals and the demand for new vaccines and treatments that will work against future virus variants.

“As COVID-19 is no longer the disruptive force it once was, we are facing new sub-variants in the United States and around the world that have the potential to cause a surge in infections, hospitalizations and deaths…” wrote a person familiar with the budget discussions. “That’s why we’re asking for $10 billion to meet immediate, short-term national needs for resources like treatment; accelerate research and development of next-generation vaccines and therapies; increase research on long COVID; and to support the global response to COVID-19.

Officials had initially targeted between $15 billion and $20 billion in additional covid funding, before scaling back their planned request after President Biden issued a note of caution late last week, given the failure of previous attempts to secure covid funding from Congress. The timing of the new request has also been fluctuating as officials wait to see which party will control the legislature next year, with the outcome of more than a dozen House races yet to be determined. The Democrats’ best chance of success may come from the lame duck since they still control both houses of Congress.

“The extra demands we keep making…just because they’re not going anywhere doesn’t mean their need is going away,” Anthony S. Fauci, the government’s top infectious disease expert, said in a statement. interview last week.

But the push to secure more covid funding comes amid waning public interest in tackling the virus. Just 2% of those polled exiting the polls in last week’s election said the pandemic was the most important issue facing the country; pharmaceutical companies have started pulling out of covid-related product lines as government funding dries up; and charities are also moving away from prioritizing the virus response.

“What we see with many foundations is that there are cycles of panic and neglect: put a lot of money and a lot of effort into the crisis of the day, and then…the funding comes is drying up,” Rick Bright, who recently left the Rockefeller Foundation after integrating his pandemic institute into a larger initiative, told Science magazine in October.

A spokesperson for the Rockefeller Foundation highlighted more than $60 million in pandemic-related investments, including a $55 million donation earlier this year to help with the global rollout of the vaccine.

The push for more covid funds is expected to meet resistance from the GOP, after Republicans have repeatedly called on the Biden administration this year to explain how it spent billions of dollars previously allocated to the fight.

In a previously unreported flashpoint, Republicans on the Senate Health Committee this summer focused on a nearly $150 million contract awarded to accounting firm KPMG last year to help distribute monoclonal antibodies, a treatment covid that needs to be administered in a healthcare facility.

While federal authorities had already distributed the intravenous treatments to more than 5,000 hospitals, doctors’ offices and other care facilities, White House officials first trumpeted the contract with KPMG, saying the staffing expertise and in company logistics would enable him to complement federal efforts to expand access to treatment, especially in medically underserved areas.

“This new effort will accelerate assistance to hard-hit communities, truly increasing the use and delivery of monoclonal antibody therapies, preventing hospitalization and death,” said Marcella Nunez-Smith, who oversaw the White House’s health equity efforts. information session in March 2021.

Participating health centers, such as UMass Memorial Medical Center and Baptist Memorial Health Care in Jackson, Miss., worked with KPMG on efforts to promote treatment, such as producing radio ads and distributing flyers.

“I think it’s been very beneficial,” said Vicki Brownewell, an executive nurse who oversaw monoclonal infusion centers for Houston Methodist Health System. Brownewell said the partnership with KPMG allowed Houston Methodist to implement free virtual visits in the summer of 2021, which helped the system quickly schedule infusion appointments for covid patients.

“Two hundred and eleven patients took advantage of these free virtual urgent care visits – but we know we’ve reached many, many more patients than that,” Brownewell added.

But four current and former administration officials who spoke on condition of anonymity to outline the federal covid strategy said the KPMG contract produced work that was ultimately found to be duplicative. For example, KPMG created a now-defunct website – crushcovid.com – that explained the benefits of monoclonal antibodies and encouraged patients to seek them out, providing a list of possible treatment sites. But the website only listed hospitals working with KPMG in 18 states, rather than providing the full list of thousands of monoclonal infusion centers across the country, which was available on another managed website. by the federal government. The KPMG website also did not allow patients to register for treatments, instead urging them to contact health centres.

Overall, the KPMG contract resulted in approximately 55,000 infusions of monoclonal antibodies, representing approximately 3% of the more than 1.5 million infusions performed. across the country during the same period, two of the former officials said.

The contract was quietly suspended in September 2021 as the Biden administration overhauled its broader monoclonal antibody strategy, and was canceled late last year amid questions from Senate Republicans about why. which the funds were allocated in the first place — with GOP lawmakers saying they still don’t have sufficient answers.

“I, once again, ask your agency to explain why up to $142 million was spent with an accounting firm to administer drugs to sick Americans,” wrote Senator Richard Burr, the top Republican on the Senate Health Committee. Health and Human Services in a July letter shared with The Washington Post, along with a memo. “This is completely unacceptable.”

In response to questions from the Post, HHS defended the arrangement with KPMG as an appropriate effort to boost monoclonal antibody infusions and said the government spent about $45 million on the contract. About $98 million in additional funding was withheld because the contract was canceled, HHS said.

Two administration officials briefed on the KPMG contract privately conceded that it was not a good use of federal money. But they say the current covid funding needs are clear and urgent – including the need for a new generation of treatments, such as monoclonals that are supposed to be more durable than those currently used — a position echoed by outside experts and allies.

Tom Inglesby, who resigned as White House coronavirus testing coordinator earlier this year and who heads the Johns Hopkins Center for Health Security, pointed to the declining effectiveness of Evusheld, a treatment on which million immunocompromised people relied on as long-term protection. against the coronavirus, but which has shown less potency against newer omicron variants. Biden officials warned earlier this year that without more congressional funding, they would not be able to replace Evusheld.

“There is a scientific path to get the next generation Evusheld so it can protect immunocompromised people – but they are not able to move forward on that path because they need research dollars, development dollars “said Inglesby, adding that similar issues are delaying other urgent needs.

“This whole chain of support, from developing vaccines and delivering vaccines to encouraging people to get vaccinated, whether it’s all winding down or coming to a halt, due to lack of funding “, did he declare.

Jeff Stein contributed to this report.

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