White House transparency disputes imperil funds to buy Covid therapeutics

WASHINGTON — The White House hasn’t publicly detailed exactly how it’s spent the more than $4 trillion Congress authorized for Covid-19 relief — and now, that lack of transparency could imperil its request for more money to fight the pandemic and buy therapeutics.

Amid heated negotiations over a government funding bill, three dozen Republican senators including Senate Minority Leader Mitch McConnell (R-Ky.) are refusing to consider more Covid-19 relief funding unless the federal government provides a full accounting of how funds have been spent. The White House disputes the accusations that there has been a lack of transparency, and an administration official said the White House briefs Congress on a regular and bipartisan basis about details of the status of relief funding.

If lawmakers aren’t able to reach a deal for more Covid-19 funding, that’s a big problem for the Biden administration. The White House on Thursday acknowledged its Covid-19 response money has nearly run out and it needs $22.5 billion more, or it won’t be able to secure treatments, vaccines and tests for the future.

And the budget crunch is even more severe than the administration has let on. The White House has held off on buying millions of courses of Pfizer’s highly effective antiviral drug that the White House already committed to buy due to budget constraints, according to public contract disclosures and the Department of Defense, which issues the contracts.

In January, the White House announced that it was doubling its order of Pfizer’s antiviral, named Paxlovid, committing to buy an extra 10 million courses. But according to public contracts, the White House has only actually contracted for 835,000 of those courses to date.

“Contract options will be exercised when funding becomes available,” Department of Defense spokesperson Jessica Maxwell said in a statement to STAT.

Pfizer said the company believes it will get paid for the full commitment.

“We continue to collaborate with the U.S. government to help broaden patient access to this potentially game-changing therapy, and we are confident that the Administration will fulfill its purchasing commitments,” Pfizer spokesperson Sharon Castillo said.

The additional 9 million courses are not available for distribution if they were contracted right now, as Pfizer is still ramping up manufacturing capacity.

Pfizer CEO Albert Bourla told STAT in late January that the company expects to make 6 million courses globally by March, and 24 million courses between March and June. White House coronavirus response coordinator Jeff Zients recently said that the U.S. government will have 1 million treatment courses available in March, and that amount is expected to double in April.

White House Press Secretary Jen Psaki on Friday said the administration’s funding request is urgent, and estimated its stock of antivirals will be exhausted by September without additional funding. House Speaker Nancy Pelosi (D-Calif.) on Thursday alluded to the need for more funding to buy therapeutics, specifically.

“The fact is, the $22 billion for Covid is absolutely necessary. In fact, we will probably need more as we need more therapies. One of the pieces of this is to buy the pills,” Pelosi said.

Public Citizen Research Director Zain Rizvi, who has reviewed dozens of contract disclosures, criticized the “gap between rhetoric and reality” from the White House, and said the incident underscores the need to fund Covid-19 response efforts domestically and globally.

“The contract details are clear evidence that the Biden administration has known for months that new Covid money was needed. It has already taken far too long for new COVID funding to be requested. This is still an emergency,” Rizvi said.

The path forward for additional funding for Covid-19 relief is unclear. Lawmakers are scrambling to finish a government funding package by March 11, including possible extra money for Covid-19 and aid to Ukraine. Democrats need to rally at least 10 Republican votes to pass the legislation.

Some of the motivation behind the transparency complaints is blatantly political, as Republicans in past negotiations have pushed to repurpose Covid-19 relief funds for other purposes.

But American Public Health Association Executive Director Georges Benjamin said more transparency could also help advocates who want to push for more public health funding but haven’t been privy to the documentation provided privately to Congress.

“The more clarity we get on what is needed and what it’s for, the more I can make the value argument,” Benjamin said.

Transparency concerns have plagued Covid-19 relief spending on health care issues across both the Trump and Biden administrations.

In the absence of comprehensive public disclosure, reporters, auditors and congressional staff have assembled a partial picture of how money has been spent outside the purposes Congress originally intended for billions of dollars.

Both administrations funneled far more money than Congress allocated to Operation Warp Speed, in particular, and to its successor efforts to buy vaccines and therapeutics.

Nearly 10% of the funding Congress set aside to support hospitals and health care providers, or $17 billion, was funneled to buy vaccines and therapeutics, as STAT first reported. Other funding for Operation Warp Speed was taken from money designated for the Centers for Disease Control and Prevention and the Strategic National Stockpile, as Bloomberg reported. An additional $5 billion came from a fund for Covid-19 testing efforts, according to a document obtained by STAT.

Some $3 billion in Covid-19 relief money for testing and the Strategic National Stockpile was also routed to pay for costs related to the Department of Health and Human Services’ efforts to house unaccompanied children at the border, as Politico first reported and further documents obtained by STAT confirm.

Nicholas Florko and Matthew Herper contributed reporting.

This article has been updated with statements from Public Citizen, the White House, and White House Press Secretary Jen Psaki.