Secretary of State Marco Rubio indicated on Tuesday that the United States may resume its funding of a global vaccines alliance that Health Secretary Robert F. Kennedy Jr. pulled the United States out of last year, an unusual public rebuke of Mr. Kennedy’s involvement in matters of global health.
Testifying on Capitol Hill, Mr. Rubio told senators that President Trump had asked the State Department to allow Mr. Kennedy to “play a leading role” in the decision on whether to fund Gavi, an organization that provides immunizations for low-income nations and maintains the global Ebola vaccine stockpile.
But Mr. Rubio suggested in pointed testimony that he was reclaiming control of the U.S. relationship with Gavi, which has historically been managed by the State Department.
The State Department is “going to re-engage on the issue of Gavi,” Mr. Rubio told the Senate Foreign Relations Committee. He said that the department was not going to “yank” the matter from Mr. Kennedy, a longtime vaccine skeptic, or ignore “his points of view.” But he said that a few weeks ago, he had made the decision to resume management of the relationship.
About Mr. Kennedy, Mr. Rubio added: “I wouldn’t use the word defer, but we have certainly allowed him to play a leading role in determining what we’re going to do next. But right now, we’re sort of at a stage where we are going to re-engage. We need to drive this to an outcome.”
Mr. Rubio’s reassertion of authority is part of a broader effort by the State Department to reclaim control of global health from the Department of Health and Human Services, said J. Stephen Morrison, a global health expert at the Center for Strategic and International Studies in Washington.
Although the Trump administration has moved to sharply reduce the amount the United States spends on foreign aid, including money for global health and disease surveillance, Congress has continued to fund these areas.
Congress has appropriated $600 million for Gavi that has been blocked by Mr. Kennedy, despite the State Department’s usual role in handling the relationship.
“We are very encouraged by Secretary Rubio’s remarks that the U.S. intends to re-engage on the issue of funding Gavi,” Dr. Sania Nishtar, Gavi’s chief executive, said after the hearing. “Unlocking the funds that Congress has appropriated to Gavi would enable us to keep the world safe from infectious disease threats.”
At the hearing, Senator Jeanne Shaheen, Democrat of New Hampshire, pressed Mr. Rubio on funding for Gavi in the context of the current Ebola outbreak in central Africa. While there is no vaccine against the species of virus, Bundibugyo, causing this outbreak, Gavi has committed up to $40 million to back production of promising vaccine candidates — the kind of global health security measure that the Trump administration has said it wishes to support.
“How are you making sure that Secretary Kennedy, who has been sitting on those funds for months now, is going to release them so that they can go to help develop a vaccine to address the Ebola outbreak?” Ms. Shaheen asked.
Mr. Rubio replied that Mr. Trump wanted Mr. Kennedy to play a role in decisions about Gavi “because of the strongly held views with regards to vaccine safety, and he wanted them to conduct some reforms.”
But Mr. Rubio said that “we’d like to get this issue resolved in an outcome that’s acceptable both to Congress and also to our goals on global health.”
The State Department refused to comment on whether Mr. Rubio’s reference to re-engagement meant a return to previous levels of funding for Gavi, or on what timeline that might occur.
Andrew Nixon, a spokesman for the Department of Health and Human Services, said that the State Department and health department “continue engaging directly with Gavi and remain cautiously optimistic that ongoing discussions can produce greater transparency, accountability and a constructive path forward.”
A year ago, Mr. Kennedy sent a video address to a meeting of world leaders gathered to raised funds for Gavi, and announced that the United States, a major funder, would no longer be supporting the organization.
“When vaccine safety issues have come before Gavi, Gavi has treated them not as a patient health problem, but as a public relations problem,” Mr. Kennedy said in the address. He offered no evidence for the allegation. It was the first indication that the Trump administration’s decision to end funding for Gavi may be motivated by mistrust of vaccines, in addition to a desire to reduce foreign aid.
Gavi’s operations have been constrained over the past 18 months, since the United States and other international donors cut their aid. The reduced budget — from a planned $11.9 billion to $10 billion — has affected the organization’s ability to maintain stockpiles for critical diseases such as cholera, and other work such as support for an expanded use of malaria vaccines in Africa.
Dr. Nishtar said the work to speed up a Bundibugyo vaccine showed the urgency of Gavi’s work, adding that U.S. support would “also enable us to accelerate the rollout of powerful new tools like the malaria, hexavalent and meningitis vaccines.”
Ms. Shaheen welcomed Mr. Rubio’s pledge to restore a relationship with Gavi. “Congress directed the State Department — not Secretary Kennedy — to work with Gavi, so I appreciate Secretary Rubio’s commitment to re-engage and move this issue toward a resolution,” she said.
Ms. Shaheen has been attempting to broker a deal between the health department and Gavi to address Mr. Kennedy’s concerns about Gavi’s use of multi-dose vaccine vials that contain thimerosal, a mercury-based preservative. Gavi prefers to use these vials in low-income nations because they are cheaper and do not require the same temperature control that single-dose, thimerosal-free vaccines used in the United States require.
Gavi submitted a proposal to the health department to more quickly phase out vaccines containing thimerosal, in an attempt to persuade Mr. Kennedy to unblock the $600 million.
Mr. Morrison said the Gavi issue is one piece of a broader conflict that Mr. Rubio needs to resolve. “There’s been a huge amount of ill will between State and H.H.S. in this period that has not been repaired, and Rubio is awakening to this,” he said, adding that if Mr. Rubio “wants to restore global confidence in our leadership on pandemic response and preparedness, he’s got to fix this.”
Michael Crowley contributed reporting from Washington.
Stephanie Nolen is a global health reporter for The Times.
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