Biden Urges Global Leaders to ‘Go Big’ on Covid Response

President Biden called on other world leaders, pharmaceutical executives and philanthropists to band together to fight the pandemic. Here’s the latest.,

LiveUpdated Sept. 22, 2021, 2:39 p.m. ETSept. 22, 2021, 2:39 p.m. ET

President Biden declared “we need to go big” as he cited two challenges: vaccinating the world and solving a global oxygen crisis. At a high-stakes meeting, a CDC advisory panel is considering whether booster shots should go to most Americans or a limited few.

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Biden Presses Global Partners to Amplify Pandemic Response

President Biden called for a heightened, unified global response to the pandemic as he convened a virtual Covid-19 summit in conjunction with the United Nations General Assembly meeting in New York.

Nothing is more urgent than all of us working together to defeat Covid-19, and that world is going to be much better prepared for future pandemics — we have to do both. This summit is about supercharging our efforts in three key areas: vaccinating the world by dramatically ramping up vaccine production, donations, delivery and administering the vaccine, which is a logistical — it’s a logistical challenge. Addressing the oxygen crisis in many hospitals around the world, making other treatments more accessible and increasing the availability of public health tools like masks and tests, and building back better so that our global health security infrastructure is more resilient than it is today. We’ve all suffered. The United States has lost more than 670,000 of our fellow Americans, worldwide, the death toll is above 4.5 million people — 4.5 million people. And this is a global tragedy, and we’re not going to solve this crisis with half measures or middle of the road ambitions. We need to go big and we need to do our part, governments, the private sector, civil society leaders, philanthropists. This is an all hands on deck crisis. And the good news is we know how to beat this pandemic — Vaccines, public health measures and collective action.

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President Biden called for a heightened, unified global response to the pandemic as he convened a virtual Covid-19 summit in conjunction with the United Nations General Assembly meeting in New York.CreditCredit…Dedi Sinuhaji/EPA, via Shutterstock

Declaring “we need to go big,” President Biden on Wednesday called on other world leaders, pharmaceutical executives, philanthropists and civil society organizations to band together to forge a global consensus around a plan to fight the coronavirus crisis.

Speaking at the opening of a virtual Covid-19 summit he is convening in conjunction with the United Nations General Assembly meeting in New York, Mr. Biden cited two especially urgent challenges: vaccinating the world against Covid-19, and solving a global oxygen crisis, which is leading to unnecessary deaths among Covid-19 patients who might survive if oxygen were available.

“We’re not going to solve this crisis with half measures or middle of the road ambitions — we need to go big,” the president said, adding, “It’s an all hands on deck crisis.”

But it may be hard to turn Mr. Biden’s words into reality. Less than 10 percent of the population of poor nations — and less than 4 percent of the African population — has been fully vaccinated against Covid-19. Worldwide, 79 percent of shots that have been administered have been in high- and upper-middle-income countries, according to the Our World in Data project at the University of Oxford. Covax, the W.H.O.-backed international vaccine initiative, is behind schedule in delivering shots to the low- and middle-income nations that need them the most.

Around the world, more than 4.5 million people have died of Covid-19 — a “global tragedy,” Mr. Biden said. The president also announced a new partnership with the European Union aimed at expanding access to vaccines. And Vice President Kamala Harris announced that the United States would contribute $250 million to start a new global fund that the administration hopes will raise $10 billion to fight future pandemics.

But critics of the administration had low expectations for the gathering.

“This summit deserves to be, needs to be, a debate of historic dimensions,” Peter Maybarduk, access to medicines director for Public Citizen, the consumer advocacy organization, which has been urging the administration to adopt a $25 billion plan to scale up vaccine manufacturing around the world.

“But it won’t be that kind of debate,” he added, adding that he thought the hosts would unlikely to be significantly challenged by less powerful governments and vulnerable people. “It will not produce the transformative response needed to end the pandemic,” he said.

The summit was to begin with Mr. Biden and other world leaders, including Antonio Guterres, the secretary general of the United Nations, gathering virtually for a small panel discussion entitled “Call the World to Account and Vaccinate the World,” moderated by Linda Thomas-Greenfield, Mr. Biden’s ambassador to the United Nations. Participants include other presidents and prime ministers, including President Cyril Ramaphosa of South Africa and Prime Minister Boris Johnson of Britain, according to an agenda obtained by The New York Times.

White House officials have said that Mr. Biden’s message to the group will be that the United States cannot fight the pandemic, or address the global vaccine shortage, on its own. Earlier Wednesday, Pfizer-BioNTech announced that it had struck a deal with the Biden administration to sell the United States an additional 500 million doses of its coronavirus vaccine, to be donated to nations that need them.

Mr. Biden heralded the deal in his opening remarks, saying it would bring to 1.1 billion the total number of doses his administration has purchased for donation. “Put another way, for every one shot we’ve administered to pay in America, we have now committed to do three shots to the rest of the world,” he said.

Drug company executives, philanthropists and leaders of nonprofit organizations have also been invited to the summit, which administration officials say is the largest gathering of heads of state to date to address the global pandemic.

Mr. Biden has been under intense pressure from global health experts to do more to address the vaccine shortage — and in particular expand manufacturing around the world. Mr. Biden said the U.S. is doing so, through a partnership with India, Japan and Australia that, he said, “is on track to produce at least 1 billion vaccine doses in India to boost the global supply by the end of 2022.”

Drug manufacturers are also under pressure to do more. The Biden administration has urged both Pfizer and Moderna to enter into joint ventures where they would license their technology to contract manufacturers with the aim of providing vaccines to low- and middle-income countries, according to a senior administration official.

Those talks led to the Pfizer donation, but the talks with Moderna have not borne fruit, the official said.

At a briefing held by Physicians for Human Rights earlier this week, Dr. Soumya Swaminathan, the chief scientist of the World Health Organization, sounded a note of urgency and issued a plea for nations to work together to distribute vaccines in a coordinated — and equitable — fashion. She also urged countries to share their excess supplies.

“A country by country approach, a nationalistic approach, is not going to get us out of this pandemic,” she said. “And that’s where we are today.”

Waiting to receive the Moderna Covid-19 vaccine in Quezon City, Philippines. Officials say attempts to discuss sharing technology with the company have been fruitless so far.Credit…Rolex Dela Pena/EPA, via Shutterstock

As President Biden convenes heads of state for a Covid-19 summit on Wednesday, pressure is growing on American drug companies — particularly Moderna, the upstart biotech firm that developed its coronavirus vaccine with billions of dollars in taxpayer money — to share their formulas with manufacturers in nations that desperately need more shots.

Last year’s successful race to develop vaccines in extraordinarily short order put companies like Moderna and Pfizer in a favorable light. But now, with less than 10 percent of the population in many poor nations fully vaccinated and a dearth of doses contributing to millions of deaths, health officials in the United States and abroad are pressing the companies to do more.

The Biden administration has privately urged both Pfizer and Moderna to enter joint ventures with contract manufacturers with the aim of providing vaccines to low- and middle-income countries, according to a senior administration official.

Those talks led to an agreement with Pfizer, announced Wednesday morning, to sell the United States an additional 500 million doses of its vaccine at a not-for-profit price — rather than license its technology — to donate overseas.

The discussions with Moderna have not been fruitful, said the official, who expressed deep frustration with the company but requested anonymity to discuss sensitive information.

A coalition of major drug and vaccine manufacturers in developing countries around the world is drafting an appeal to Mr. Biden asking him to press the companies more aggressively.

The World Health Organization has also had trouble getting Moderna to the negotiating table, according to Dr. Martin Friede, a W.H.O. official, and Charles Gore, who runs a United Nations-backed nonprofit organization, Medicines Patent Pool. Both are working with a W.H.O.-backed technology transfer hub in South Africa.

“We would love to get a discussion with Moderna, about a license to their intellectual property — this would make life so much simpler, but for the moment all attempts have resulted in no reply,” Dr. Friede said.

Mercedes Carrera, 71, received an additional Covid shot at Rosewood Family Health Center in Portland, Ore.Credit…Alisha Jucevic for The New York Times

Scientific advisers to the Centers for Disease Control and Prevention are meeting on Wednesday and Thursday to decide which Americans should get booster shots of the Pfizer-BioNTech coronavirus vaccine — and when.

The committee’s discussions are normally a scientific affair of little interest to most people. But this meeting is likely to be closely watched — the stakes are high. It follows a dramatic exchange at the Food and Drug Administration on Friday, when advisers overwhelmingly rejected a proposal to offer Pfizer booster shots for Americans over 16, but then voted unanimously in favor of third doses for some high-risk people and those older than 65.

The role of the C.D.C. advisers at the two-day meeting is to decide who belongs in those high-risk groups. Depending on their verdict, booster shots could be offered to most Americans — or only to a select few.

On Wednesday, the discussion zeroed in on the types of immunity. Natalie Thornburg, a C.D.C. scientist, presented results from a series of studies suggesting that declining levels of antibodies may have little impact on protection from severe illness. Some subsets of antibodies are needed to prevent infection, but immune cells that prevent the illness from progressing are stable, she said.

“Antibodies decrease over time as we expected, in all age groups, but cellular memory is maintained,” she said. Immunity is known to drop off in adults over 80, however, suggesting that boosters may be needed for that age group.

Dr. Sarah Long, a pediatric infectious disease expert at Drexel University College of Medicine in Philadelphia, urged fellow committee members to focus on how well the vaccines prevent severe illness and hospitalization.

“I would just encourage us not to lump infection and hospitalization,” she said. “I don’t think there’s any hope that vaccines such as the ones we have will prevent infection, after the first maybe couple weeks that you have those extraordinary immediate responses.”

Boosters can reduce cases among nursing home residents, who are among those at highest risk, according to results from a modeling study described at the meeting. But even with highly effective boosters, cases in nursing homes will persist when community transmission is high, said Rachel Slayton, a C.D.C. scientist who presented the model. Vaccinating staff at nursing homes, and other prevention strategies to limit transmission, will continue to be important, she said.

If the F.D.A. authorizes the Pfizer-BioNTech booster dose for some high-risk groups and older adults, advisers to the C.D.C will vote on Thursday to make their recommendations. But it is likely to be too late for the Biden administration, which had planned to begin offering third doses this week to most fully vaccinated adults in the United States.

At the meeting on Friday, senior scientists at Pfizer and the Israeli Ministry of Health presented data they said indicated waning immunity in people who received the Pfizer vaccine months earlier. Boosting immune defenses with a third shot has made a difference in Israel, they said, and could stem the tide of infections in the United States.

The F.D.A. advisers also evaluated data from the C.D.C. on the trajectory of the virus in the United States, as well as summaries from several studies on the effectiveness of the vaccines.

But after reviewing the evidence, the scientists on the committee concluded that while protection against infection may be waning, especially in older adults, the original two-shot regimen still offers excellent protection against severe illness and hospitalization in most people.

“It’s unclear that everyone needs to be boosted, other than a subset of the population that clearly would be at high risk for serious disease,” said Dr. Michael G. Kurilla, a committee member and official at the National Institutes of Health.

One key difference between Israel and the United States may explain why the two countries have had different experiences with the vaccine: The countries define severe illness differently.

In Israel, anyone with an accelerated respiratory rate and an oxygen level of below 94 percent is severely ill. By contrast, the C.D.C. reserves that category for people who are sick enough to be hospitalized, said Dr. Sara Oliver, a C.D.C. scientist who presented the American data.

Some committee experts said they also did not feel comfortable offering booster shots to young people who may not need them, when the risks of a third dose are unknown.

The vaccines have been tied to rare cases of myocarditis, inflammation of the heart, in younger people. The risk is very small, and studies have shown that Covid-19 is much more likely to cause the condition.

Last week brought other research in support of the F.D.A. committee’s decision, including one paper by an international team of scientists that analyzed dozens of studies and concluded that the world would be better served by using vaccine doses to protect the billions who remain unvaccinated.

The authors of that study included the top two vaccine experts at the F.D.A., who announced plans to leave the agency this fall. Their departure is in part in protest of the Biden administration’s push for boosters before federal scientists and regulators had reviewed the evidence.

The Brazilian health minister, Marcelo Queiroga, in August. He tested positive for the coronavirus on Tuesday in New York.Credit…Adriano Machado/Reuters

Brazil’s health minister said that he had tested positive for the coronavirus on Tuesday in New York, where he was attending the United Nations General Assembly along with the country’s unvaccinated president, Jair Bolsonaro.

The health minister, Marcelo Queiroga, tweeted that he would quarantine in the United States and was “following all health safety protocols.” Dr. Queiroga, who is a cardiologist, received the CoronaVac vaccine, made by Beijing-based Sinovac, early this year.

The entire Brazilian delegation “has decided to self-quarantine for 14 days,” said Stephane Dujarric, a U.N. spokesman.

Dr. Queiroga had accompanied Mr. Bolsonaro during his visit to New York for the U.N. meeting. Before testing positive, he was seen on video shaking hands with Britain’s prime minister, Boris Johnson, when Mr. Johnson met Mr. Bolsonaro on Monday.

Contrary to earlier reports, Dr. Queiroga did not meet this week with Secretary General Antonio Guterres, Mr. Dujarric said.

“We have looked into the potential exposure to U.N. staff” in the General Assembly hall, “and contact tracing is being finalized,” Mr. Dujarric said. “At present, no close contacts amongst U.N. staff have been identified.”

On Monday night, Dr. Queiroga made headlines in Brazil after he was filmed giving anti-Bolsonaro demonstrators the middle finger as he and other members of the government delegation left a dinner at the residence of the country’s ambassador to the United Nations.

The president’s office said in a statement issued late Tuesday that Dr. Queiroga would remain in the United States while he recovers and said he was “doing well.”

“We also inform that the other members of the delegation tested negative for the virus,” the statement said.

Dr. Queiroga had a busy agenda in New York. He had breakfast with a group of investors; participated in a meeting with Brazil’s first lady, Michelle Bolsonaro; paid tribute at the Sept. 11 memorial; and spoke to senior officials at the World Health Organization.

In March, he became Mr. Bolsonaro’s fourth health minister in less than a year; the first two were forced out after disagreeing with the president on handling the pandemic. Dr. Queiroga’s tenure has been marred by allegations that senior ministry officials sought kickbacks as they negotiated the purchase of Covid-19 vaccines.

Mr. Bolsonaro’s handling of the pandemic in South America’s largest country has been widely criticized. On Tuesday, he used his speech at the General Assembly to defend the use of ineffective drugs to treat the coronavirus and argued that doctors should have had more leeway in administering untested medications for Covid-19.

Mr. Bolsonaro, who had a mild case of Covid-19 in July of last year, has said he was in no hurry to get vaccinated, which made for an awkward exchange during his meeting with Mr. Johnson, who hailed the AstraZeneca vaccine, which was developed in Britain at Oxford University.

“Get AstraZeneca vaccines,” said Mr. Johnson, who survived a serious case of Covid last year. “I’ve had it twice.”

Mr. Bolsonaro pointed to himself and said: “Not yet.”

Waiting to receive a Covid-19 vaccine in Munich. On Wednesday, the government announced that it will no longer subsidize quarantines for the unvaccinated.Credit…Laetitia Vancon for The New York Times

In a move that may help boost the country’s flagging vaccination campaign, German health authorities announced on Wednesday that the country’s state governments will no longer pay for unvaccinated people to quarantine, ending subsidies that employers can draw on to cover salaries when workers have to stay home.

The policy is directed at people who are forced to quarantine after having contact with an infected person or after returning to Germany from a designated high-risk country. People in those situations who are not vaccinated will no longer be eligible for the subsidies.

Jens Spahn, the country’s health minister, noted that vaccination remains entirely voluntary in Germany, but “with this decision also comes the responsibility to bear financial consequences.”

The announcement that the subsidies would be cut off by Nov. 1 follows news that a widely publicized national vaccine drive had failed to yield a significant increase in vaccinations.

Currently, 67 percent of Germany’s population has received at least one dose of coronavirus vaccine. The most recent surge in virus cases in the country peaked earlier this month, but appeared to be on the decline in recent weeks.

The new policy is not the first action taken by the German government to discourage people from remaining unvaccinated. Officials announced last month that Germany would end a program that allows any German resident to get a free antigen test. Unvaccinated people are required to show a recent negative test result to enter businesses like indoor restaurants, gyms and hair salons; starting Oct. 12, they will have to pay for the tests themselves.

Dr. Eric Lander, director of the White House Office of Science and Technology PolicyCredit…Alexander Drago/Reuters

President Biden is convening a panel of 30 scientific advisers — in fields as diverse as agriculture, biochemistry and computer engineering, ecology, nanotechnology and neuroscience — to advise the White House on addressing future pandemics, addressing climate change and a range of other global challenges.

Mr. Biden announced the new President’s Council of Advisors on Science and Technology — to be known by the acronym PCAST — in a video the White House released Wednesday morning. The White House describes the group as a “direct descendant” of the scientific advisory committee established by President Dwight Eisenhower in 1957 after the Soviet Union launched the first Sputnik satellite, beating the United States in the race to space.

The new council includes two Nobel laureates and five MacArthur “genius” grant recipients, as well as two former Cabinet secretaries and a former astronaut who was the first woman to dive into the deepest part of the Earth’s oceans. Half of its members, including two of its three co-chairs, are women. (The other co-chair is Eric Lander, who heads the White House Office of Science and Technology Policy).

“This PCAST will see new possibilities to create good jobs, and power American workers, and grow the economy for everyone, to change the course of human health and disease, to tackle the climate crisis with American innovation and to lead the world in technologies,” the president says in the video.

The panel has been nine months in the making. Mr. Biden asked Frances Arnold, a Nobel Prize-winning biochemical engineer, and Maria T. Zuber, a geophysicist and planetary scientist who was the first woman to lead a NASA planetary mission, to be co-chairs before he was inaugurated.

Dr. Arnold and Dr. Zuber spent months combing through resumes to submit to the president, and said in a joint interview that scientists were eager to serve, particularly in the wake of the administration of former President Donald J. Trump, who many scientists feel devalued their profession. No one they asked said no, and all are serving as volunteers.

“The almost utter dismissal of science as the basis for decision-making by the previous administration was tremendously dispiriting, and played a large role in the alacrity with which I made that decision to take on this new job,” said Dr. Arnold, a professor of chemical engineering, bioengineering and biochemistry at the California Institute of Technology.

The group has not yet held its first meeting or set an agenda. But Dr. Lander, who served on former President Barack Obama’s PCAST, said he would be surprised if the group “did not have a lot of interest in using the learning from this pandemic to think really fundamentally about public health system and how it could be improved.”

Correction: Sept. 22, 2021

An earlier version of this item misstated the timing of President Biden’s video announcing the new advisory council. The White House planned to release it Wednesday morning, not Thursday morning.

A vaccination clinic in New Delhi on Tuesday.Credit…Manish Swarup/Associated Press

The Organization for Economic Cooperation and Development said on Tuesday that a global economic recovery from the pandemic was finally taking hold, but it inched back its forecast for worldwide economic growth and warned that the rebound was benefiting wealthier countries more than the developing world as vaccine distribution occurs at an uneven pace.

Countries that have made big strides toward vaccinating most of their populations are bouncing back much more quickly than those that are still struggling to obtain shots, the organization said, raising a host of related economic problems that are affecting global supply chains and pose a risk for the future.

“The global shock that pushed the world to the worst recession in a century is now fading, and we’re now projecting the recovery will bring growth back to its pre-crisis trend,” Laurence Boone, the organization’s chief economist, said in a news briefing.

But vaccination rates remain varied, and many low-income countries and emerging markets, with the exception of China, are still far behind, Ms. Boone added. “A failure to vaccinate globally puts all of us at risk,” she said.

The warnings came as the O.E.C.D. released its semiannual economic forecast, in which it lowered its outlook for global growth, the U.S. economy and emerging markets, but raised its outlook for Europe.

The global growth outlook for 2021 was revised down slightly to 5.7 percent, from 5.8 percent.

A classroom for 2-year-olds at Wilcox’s Academy of Early Learning in New Orleans last month.Credit…Kathleen Flynn/Reuters

Schools have largely reopened this fall, but life is far from normal for parents of young children. One reason is that child care — for children too young for school, and for the hours before and after school — is operating at 88 percent of its prepandemic capacity. Even before the pandemic, child care did not cover everyone who needed it.

The shortage is partly because of the pandemic. Some centers went out of business after lockdowns early on. Because children under 12 are not yet eligible for vaccines, many programs are enrolling fewer children to limit potential exposure.

But the biggest reason for the shortages, child care providers across the country said, is that they can’t find people to hire.

Eight in 10 providers said they were experiencing a staffing problem, and half said hiring was harder than before the pandemic, according to a survey over the summer of 7,500 of them by the National Association for the Education of Young Children.

Half said they were serving fewer children as a result of hiring problems, and a quarter had reduced their hours. The lack of child care is also contributing to other labor shortages, because many parents who can’t find reliable child care can’t return to work.

Child care providers face challenges like those in many other service industries that are unable to find enough workers: low pay and little job stability. The median hourly pay is $12, and 98 percent of occupations pay more, according to data from the Center for the Study of Child Care Employment at the University of California, Berkeley.

Turnover is high in early childhood education, and jobs caring for school-aged children are only a few hours a day and often end in the summer.

Child care has additional challenges. Some people are hesitant to work with unvaccinated children. The job requires more qualifications, including background checks, certifications and even college degrees in some areas, than the stores and restaurants that are paying more.

Yet child care centers have not responded the way some other industries have — by significantly raising wages and expanding benefits.

Avelina Mendes, of Brockton, Mass., continues to work on the college campus where she has been a custodian for over 20 years despite her fears of Covid.Credit…Gretchen Ertl for The New York Times

Day after day, they went to work.

While white-collar America largely worked from the cocoons of their homes, these workers left for jobs elsewhere. Most had no choice.

“They’re the people who often are working around the public, often working in jobs that are requiring them to be at particular risk from the virus,” said Eliza Forsythe, an economist at the University of Illinois. “All of these types of jobs where you’re not sitting at a computer — that’s what’s really been the backbone for allowing the rest of the economy to go remote.”

More than a year and a half after the pandemic disrupted nearly all aspects of everyday life, one of the starkest economic divides to emerge has been between workers who can work from home and those who cannot.

Those who could not work from home were employed in a wide array of industries, including health care, agriculture, leisure and hospitality, retail, transportation, construction and manufacturing. Many were considered part of the army of frontline and essential workers, with jobs that were considered so critical that they could not be put on hold even during a public health crisis. They were typically lower-wage, less educated and disproportionately people of color.

The New York Times talked with six never-remote workers about their experiences: an airport wheelchair attendant, a college custodian, a homeless shelter case manager, a commuter rail custodian, a pet store worker and an airport security guard.

Global roundup

In Sydney on Sunday. Australia has kept its borders almost entirely closed through the pandemic.Credit…Joel Carrett/EPA, via Shutterstock

Australia, which had planned to retain heavy international travel restrictions until mid-2022, now plans to open up months ahead of schedule.

In a speech on Tuesday, Dan Tehan, the minister for trade, tourism and investment, encouraged Australians to keep getting vaccinated and “to stick to the national plan that will see our international border open up, at this rate, by Christmas, at the latest.”

Mr. Tehan’s remarks at the National Press Club of Australia were a departure from the country’s earlier plans to keep its severe lockdown and travel restrictions in place.

Australia’s borders “are closed,” according to the Department of Health’s website. “There is a ban on all overseas travel,” it says, unless an exemption from the government is granted.

The only people allowed inside the country, according to the site, are Australian citizens, permanent residents and their immediate family members. Quarantine-free travel to and from New Zealand was temporarily suspended on Tuesday.

In his speech on Tuesday, Mr. Tehan also said that “hopefully, at the latest by Christmas,” Australians would be able to travel “with a QR code linked to their passport which will be able to show a proof of vaccination.”

In other news from around the globe:

  • New Zealand, which has pursued a zero-Covid strategy, may not get back to eliminating all coronavirus cases in the community, a senior health official there said, according to Reuters. “The important thing is we are going to keep finding any infections and basically continue to contact trace, test and isolate people so that we stop the virus circulating in the community,” Ashley Bloomfield, the director general of health, told Radio New Zealand.

The primary Covid-19 hospital in Kabul, Afghanistan, earlier this month.Credit…Victor J. Blue for The New York Times

Nearly one-quarter of the hospitals treating Covid-19 in Afghanistan have closed in recent weeks, and the country’s efforts to respond to the pandemic have declined, World Health Organization officials said Wednesday.

The W.H.O. issued an urgent warning on Wednesday, saying that Afghanistan is on the brink of “an imminent humanitarian catastrophe.”

The notice followed a recent visit to Kabul, the capital of Afghanistan, where W.H.O. leaders met with the leadership of the Taliban, which is now in control of the country. The W.H.O. officials also met with United Nations partners, health care workers and patients.

“Cuts in donor support to the country’s largest health project, Sehetmandi, has left thousands of health facilities without funding for medical supplies and salaries for health staff,” Dr. Tedros Adhanom Ghebreyesus, director-general of the W.H.O., and Dr. Ahmed Al-Mandhari, the organization’s regional director for the Eastern Mediterranean, said in a joint statement on Wednesday.

Roughly two-thirds of the country’s health facilities are part of Sehatmandi, a three-year, $600 million project administered by the World Bank and financed by the U.S. Agency for International Development, the European Union, the World Bank and other donors.

Because funds for the project were funneled through the Ministry of Public Health, donors withdrew their support after the Taliban seized power. Now, only one-sixth of all Sehatmandi facilities are fully functional, according to the W.H.O.

“Many of these facilities have now reduced operations or shut down, forcing health providers to make hard decisions on who to save and who to let die,” the statement said.

Officials also said that nine of the 37 hospitals treating Covid-19 in Afghanistan have closed, and coronavirus surveillance, testing and vaccination efforts have contracted.

Afghanistan, which emerged from a surge in virus infections at the end of June, is starting to see cases rise again, this time involving the highly contagious Delta variant.

Before last month, the W.H.O. said, about 2.2 million people, or about 6 percent of Afghanistan’s population, had been vaccinated against Covid-19. But in recent weeks, the organization said, vaccination rates have slowed markedly, and some 1.8 million vaccine doses in the country remain unused.

The country’s acting health minister and last remaining holdover from the pre-Taliban Cabinet, Dr. Wahid Majrooh, stepped down on Tuesday.

Martin Griffiths, the U.N.’s under secretary for emergency relief, said on Wednesday that he was releasing $45 million to help prevent Afghanistan’s health care system from collapsing.

“Medicines, medical supplies and fuel are running out in Afghanistan,” Mr. Griffiths said in a statement. “Cold chains are compromised. Essential health care workers are not being paid.”

On top of the threat of a public health crisis, new figures released by the World Food Program suggest that 95 percent of Afghans lack secure access to adequate food, a situation that could worsen in the winter, when many remote communities are likely to be cut off from outside support for several months.

— Lauren Katzenberg

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