How RFK Jr. Managed to Block Millions in Global Vaccine Funds

Get audio access with any FP subscription. Hundreds of millions of dollars in U.S. foreign aid for global vaccines are at risk of expiring in just a few months—thanks to an unprecedented intervention by U.S. Health and Human Services Secretary Robert F. Kennedy Jr. The famously anti-vaccine head of the U.S. domestic health agency has inserted himself into the aid disbursement process, despite having no legal authority to do so. Now, Gavi, the Vaccine Alliance—which provides vaccines to low-income countries for child immunization campaigns—is facing a critical funding shortfall that it says could result in the deaths of more than 1 million children. Hundreds of millions of dollars in U.S. foreign aid for global vaccines are at risk of expiring in just a few months—thanks to an unprecedented intervention by U.S. Health and Human Services Secretary Robert F. Kennedy Jr. The famously anti-vaccine head of the U.S. domestic health agency has inserted himself into the aid disbursement process, despite having no legal authority to do so. Now, Gavi, the Vaccine Alliance—which provides vaccines to low-income countries for child immunization campaigns—is facing a critical funding shortfall that it says could result in the deaths of more than 1 million children. Congress over the last two fiscal years has directed a total of $600 million to Gavi. But those funds have yet to be provided due to the unusual and legally questionable deference U.S. Secretary of State Marco Rubio has extended to Kennedy, who is pressuring Gavi to make changes to its vaccine portfolio. Amid the escalating Ebola outbreak in East Africa, Democrats and even some Republicans are increasingly frustrated at the aid funding holdup and have pressed Rubio—a longtime vaccine and Gavi proponent during his time in the Senate—to overrule Kennedy. The funding’s congressional authorization expires at the end of September. “This is Secretary Rubio’s authority and Secretary Rubio’s authority only, and so we’re about to find out who’s in charge,” Sen. Brian Schatz, the top Democrat on the Senate spending panel that sets foreign aid levels, said in an interview. “The law requires that the money be released. … I’m very hopeful that he will demonstrate that he is in charge very shortly.” Schatz pressed Rubio at a recent foreign aid hearing to explain why he had permitted Kennedy to interfere in an area in which Congress has not authorized the health secretary to have a role. Gavi funding was previously administered by the U.S. Agency for International Development (USAID), but oversight was transferred to the State Department last year following USAID’s dismantlement. Rubio justified giving Kennedy and the Department of Health and Human Services (HHS) a role at the “directive” of President Donald Trump. “Ultimately, we would like to see this problem solved, and we think we can,” Rubio said, noting that the U.S. government in the last year had lost its longtime Gavi board seat because of the failure to pay its organizational dues. “We’re certainly going to try, because we want it to be solved.” A Gavi official told Foreign Policy that the organization has yet to receive any firm indication of when the $600 million would arrive. Gavi, which was established in 2000 by the U.S. government, the United Nations, and the Bill and Melinda Gates Foundation, is a multilateral global health financing entity that, among other functions, hosts global emergency vaccine stockpiles for diseases such as yellow fever and Ebola (though not for the Bundibugyo strain currently circulating in the Democratic Republic of the Congo, which there is not yet a vaccine for). “Gavi, as you well know, plays a critical role in preventing the spread of infectious diseases around the globe and helps to protect public health in our country as well by stopping outbreaks before they reach our borders, and that’s particularly important right now as the world is responding to the Ebola outbreak in the DRC,” Republican Sen. Susan Collins, the Senate’s top appropriator, said to Rubio at the hearing, pressing him to distribute the $600 million as directed by Congress. It’s not that unusual for the State Department to consult with HHS and its scientists about matters of global public health, said a Democratic Senate aide, who was not authorized to be quoted. “The abnormal part is the HHS secretary having veto power over funds that are congressionally directed to go to the State Department for disbursement to Gavi,” the staffer continued. Kennedy is focused on Gavi’s usage of the preservative thimerosal in a portion of its vaccine portfolio. The mercury-based ingredient is used in multidose vials as part of mass vaccination campaigns that Gavi runs in poor and hard-to-reach rural areas where refrigeration is logistically difficult. While Gavi and other organizations, including the U.S. Centers for Disease Control and Prevention, have published studies on the safety of thimerosal in vaccines, t

How RFK Jr. Managed to Block Millions in Global Vaccine Funds

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