ROME — With pandemic inequities deepening, the leaders of rich nations on Friday called the divide in vaccine access unacceptable, shameful, even immoral, but offered few new commitments that would close the gap in an immediate way.

Instead, at a virtual summit in which some statements were prerecorded, leaders took turns offering sometimes-conflicting ideas for expanding vaccine access, and countries announced a drip-drip of largely unilateral and not entirely new moves.

Italy and Germany said they would donate doses to lower-income countries, adding to previous promises from France, New Zealand, the United States and a handful of other countries.

The European Union said it would expand its vaccine diplomacy, helping Africa build new manufacturing hubs.

E.U. leaders also promoted their role in encouraging vaccine makers to increase supply to lower-income countries at reduced prices. Johnson & Johnson on Friday announced 200 million doses for COVAX, a struggling WHO-backed initiative to distribute vaccines. Pfizer, meanwhile, pledged 2 billion doses for lower-income countries over the next 18 months, though a spokesman told The Washington Post that the portion for this year was not a new allocation. And while E.U. leaders mentioned 100 million doses from Moderna, the U.S. company did not release a statement about any new deals.

“We welcome the generous announcements made today; in the coming weeks and months, we will need hundreds of millions more doses,” the World Health Organization’s general director, Tedros Adhanom Ghebreyesus, said. “We need companies to help make donations happen fast, and to give COVAX the first right of refusal on all uncommitted doses now, in 2021.”


The summit, one of the most notable global gatherings to date to address the pandemic, comes at a time when the fortunes of rich countries are diverging dramatically from those of the rest of the world. While the United States, Europe and a handful of other developed nations have curbed the virus with well-funded vaccine campaigns, some poorer countries — without an adequate supply of doses — are being ravaged like never before.

That has led to an increasingly pitched debate about how to contend with the inequities — which stem from the initial push by wealthy countries to cut deals directly with vaccine-makers, gaining overwhelming control of the global supply.

Of the roughly 1.5 billion coronavirus vaccine doses administered worldwide, only 0.3 percent of the inoculations have taken place in low-income countries.

The meeting Friday, co-hosted by Italy and the European Union, showed that there are certain points of agreement for how to help poorer nations catch up, including the sharing of surplus doses, when available, and funding for improved, across-the-world vaccine manufacturing.

But countries remain at odds over other points.

The Biden administration earlier this month said it supported waiving intellectual property protections for coronavirus vaccines — a notion that would allow developing countries to potentially produce generic versions. But leaders in Europe, where some of the world’s biggest pharma companies are based, have objected that would not be not a quick-fix solution and could stifle innovation. The summit’s final declaration mentioned voluntary, as opposed to compulsory, technology transfers.

Numerous leaders on Friday emphasized instead the need to ensure the free flow of vaccine materials across borders — a jab at the United States, which public health experts and some foreign governments have accused of prioritizing domestic orders and hindering the global supply chain.


The declaration released after the Friday summit, which included the United States, mentioned the importance of a “reliable global supply chain” during health emergencies.

Italian Prime Minister Mario Draghi, in a news conference after the summit, noted that it should be easier for the United States to remove export hurdles, now that it has such a wide availability of doses and a large percentage of its population has been inoculated.

The challenge, he said, would come during the next emergency — “the next surprise,” he said.

“So, we should use this time,” Draghi said, “to make sure that somehow countries bind themselves, not only on this occasion, but also in the future.”

At a summit to secure pandemic pledges last May, the United States was notably absent. This time, it was in the mix, though represented by Vice President Harris rather than President Biden. She touted previous promises while also talking about the need for a “U.N. facilitator for high-consequence biological threats.”

Even nations that have tamed the virus have an incentive to help others, leaders noted Friday. Scientists warn that countries with major outbreaks can become breeding grounds for new variants, including ones that might resist current vaccines.


“Not only are these disparities unacceptable, they are also a threat,” Draghi said. “So long as the virus continues to circulate freely across the world, it can mutate dangerously and undermine even the most successful vaccination campaign.”

COVAX, which has been struggling with a funding shortage, was dealt a further blow when India — counted on to be the foremost manufacturer and exporter of COVAX doses — decided to limit exports while it tried to contain its enormous domestic outbreak.

The summit, overall, provided “too little, without the needed urgency of action,” said Krishna Udayakumar, founding director of the Duke Global Health Innovation Center, in an email. “Commitments should be brought forward to enable sharing and delivery of doses in days to weeks, not months to years,” he continued.

Jenny Ottenhoff, senior policy director at the Washington-based ONE Campaign, which advocates for the end of preventable disease and extreme poverty, said the summit had led to some “important new commitments,” but it was just a start — and after more than a year into this pandemic, “a good start is not enough.”

“We have the tools to end the pandemic in months rather than years — but there is still a massive gap between commitments made and what is really needed to get these tools everywhere,” Ottenhoff said.

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Rauhala reported from Washington.