White House to seek more covid funding in lame-duck session


The White House is making another bid to raise billions of dollars from Congress for a new generation of coronavirus vaccines and treatments, even as Republicans remain skeptical about how past allocations were spent.

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

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

Senior health officials and outside experts say more money for the covid response is desperately needed, pointing to lagging adoption of new coronavirus booster shots that could benefit from public education campaigns, the declining efficacy of existing antivirals and demand for new vaccines and treatments that will work against future virus variants.

“While COVID-19 is no longer the disruptive force it once was, we are facing new sub-variants in the US and around the world that have the potential to cause a wave of infections, hospitalizations and deaths…” , wrote a person familiar with the budget discussions. “That is why we are asking for $10 billion to meet immediate, short-term domestic needs for resources such as treatments; to accelerate research and development of next-generation vaccines and therapies; do more 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 reversing their planned request after President Biden issued a warning late last week, given the failure of previous efforts to push covid funding from Congress. to secure. The timing of the new request has also been in flux as officials waited to see which party would control the legislature next year, with the outcome of more than a dozen House races still to be determined. The Democrats’ best chance of success may be in the lame duck, as they still control both chambers of Congress.

“The additional requests that we continue to make … just because they aren’t going anywhere doesn’t mean the need for them is going away,” Anthony S. Fauci, the government’s top infectious disease expert, said in an interview last week.

But the effort to secure more covid funding comes amid waning public interest in fighting the virus. Only 2 percent of respondents who exited the polls in last week’s election said the pandemic was the main issue facing the country; pharmaceutical companies begin to withdraw from covid-related product lines as government funding dries up; and charitable organizations are also pivoting away from prioritizing the virus response.

“What we see in many foundations is 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 dries up,” said Rick Bright, who recently left the Rockefeller Foundation after merging its pandemic institute into a broader initiative, Science magazine reported in October.

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

The push for more covid funds is expected to clash with GOP resistance, after Republicans this year repeatedly called on the Biden administration 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 stepped in on a nearly $150 million contract awarded last year to accounting firm KPMG to help distribute monoclonal antibodies, a covid treatment that should administered in a healthcare setting.

While federal officials had already distributed the intravenous treatments to more than 5,000 hospitals, doctors’ offices and other healthcare facilities, White House leaders initially trumpeted the contract with KPMG, saying the company’s personnel and logistics expertise would enable it to addition to federal efforts to expand access to treatment, particularly in medically underserved areas.

“This new effort will accelerate aid to hard-hit communities, truly increase the use and delivery of monoclonal antibody therapies, prevent hospitalization and death,” said Marcella Nunez-Smith, who oversaw White House efforts on health equality. briefing in March 2021.

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

“I think it was very helpful,” says Vicki Brownewell, a nurse who oversees monoclonal infusion centers in the Houston Methodist health system. Brownewell said the KPMG partnership enabled Houston Methodist to set up free, virtual visits in the summer of 2021, allowing the system to quickly schedule appointments for infusions for covid patients.

“Two hundred and eleven patients took advantage of those free, virtual emergency care visits — but we know we touched many, many more patients,” Brownewell added.

But four current and former government officials who spoke on condition of anonymity to describe the federal covid strategy, said the KPMG contract produced work that was ultimately considered duplicate. For example, KPMG set up a now-defunct website — crushcovid.com — that explained the benefits of monoclonal antibodies and encouraged patients to seek them out, listing potential treatment sites. But the website listed only the hospitals that worked with KPMG in 18 states, rather than giving the full list of thousands of monoclonal infusion centers across the country, which was available on another website. by the federal government. The KPMG website also prevented patients from registering for treatments, instead urging them to contact health centers.

In total, the KPMG contract resulted in approximately 55,000 monoclonal antibody infusions, representing approximately 3 percent 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 when the Biden administration reviewed its broader monoclonal antibody strategy, and was phased out late last year amid questions from Senate Republicans about why the funds were awarded in the first place — with GOP lawmakers said they still don’t have enough answers.

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

In response to questions from The Post, HHS defended the agreement with KPMG as an appropriate attempt to boost monoclonal antibody infusions, saying the government spent about $45 million on the contract. About $98 million in additional funds were not awarded because the contract was canceled, HHS said.

Two government officials who knew about the KPMG contract privately admitted that it was not a good use of federal money. But they say current covid funding needs are clear and urgent – including the need for a new generation of treatments, such as monoclonal drugs that are intended to be more sustainable than those currently used – a position echoed by outside experts and allies.

Tom Inglesby, who stepped down earlier this year as White House coronavirus testing coordinator and who heads the Johns Hopkins Center for Health Security, pointed to the declining efficacy of Evusheld, a treatment millions of immunocompromised people have relied on for long-term protection against the coronavirus, but which has proven to be less potent against new Omicron variants. Biden officials warned earlier this year that they would not be able to provide a replacement for Evusheld without more funding from Congress.

“There’s a scientific path to getting the next generation of Evusheld so it can protect people with suppressed immune systems — but they can’t go further down that path because they need research dollars and development dollars,” Inglesby said, adding that similar issues have other postpone urgent needs.

“This entire chain of support, from vaccine development and vaccine distribution to encouraging people to get vaccinated, is all being phased out or shut down because of the lack of funding,” he said.

Jeff Stein contributed to this report.

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