Beyond Vaccine Diplomacy: The U.S. Push for Expanded Access to COVID Vaccines

Photo by The Focal Project, retrieved from
Photo by The Focal Project, retrieved from

As the pace of vaccinations slows in the U.S.,[1] countries like India are eager to get their hands on extra vaccine doses currently sitting in storage in the U.S.[2] On May 17, 2021 President Biden announced an expansion in COVID-19 vaccine exports, bringing the total number of vaccine doses exported to 80 million by the end of June.[3] Unlike Russia, China, India, and other countries that made vaccine exports a priority from the start, vaccines are more than “the new currency for international diplomacy” to the U.S.[4] The U.S. is revving up efforts to fight COVID worldwide and poised to reassert its leadership in global health and humanitarian efforts.

Global vaccine distribution and the promotion of global health are a net positive: something good for the whole world. Wealthier countries – those that can afford to pay – have “locked up” most of the world’s vaccines. 48 of every 100 adults in North American have received at least one vaccine dose; in Africa, that number is 1.3 of every 100 adults.[5] Wealthy countries like the U.S. must contribute their resources to countries that don’t have substantial market power. Only by inoculating vast swaths of the global population (not just the population of wealthy countries) will the fight against COVID be successful. Roughly 70% of the world’s population must be vaccinated to reach herd immunity, or 11 billion shots.[6] At present, only around 1.53 billion vaccine doses have been administered (nowhere near enough).[7] The question facing the global community today is how to vaccinate the greatest number of people in the shortest amount of time. Three approaches dominate: vaccine exports, loosening patent protections, and technology transfer.

Vaccine Exports

Most experts view vaccine exports as the fastest way to get people in low-and-middle-income counties vaccinated quickly.[8] On February 18, 2021 President Biden committed $4 billion to the COVID-19 Vaccine Global Access Facility (COVAX), “a collaborative international effort working to buy COVID-19 vaccines in bulk and distribute them to the world’s poorest countries.”[9] Additionally, some of the 80 million vaccine doses the U.S. plans to export by the end of June will go to COVAX.[10] Standing in the way of vaccine exports are exporting countries’ concerns that they will need a vaccine stockpile if COVID booster shots are needed in the future and pharmaceutical companies’ concerns about profits.

Waiving Patent Protections

President Biden has come out in support of loosening patent protections on COVID-19 vaccines. The U.S. joins over 100 other countries that support the waiver; the European Union, siding with the majority of the pharmaceutical industry, opposes loosening restrictions.[11] The World Trade Organization (WTO) member countries must come to a unanimous agreement to change these intellectual property rules.[12] The argument for waiving patent protections is that waivers enable more vaccines to be produced, lowering prices and expanding access.[13] The argument for keeping patent protections is that loosening intellectual property protections discourages private investment in new technologies that result in “lifesaving innovation.”[14] Without private investment and industry, the COVID vaccines would not have been developed nearly as quickly as they were.[15] Pharmaceutical companies also argue patent waivers “could be dangerous for the public, raising the risks of a wave of counterfeit doses.”[16] Even if WTO members do not reach a consensus, the threat of patent waiver itself is serving to motivate pharmaceutical companies to step up and provide vaccines to poorer countries either at no charge or at a not-for-profit price so that waiver won’t be necessary.[17]

Technology Transfer

Technology transfer essentially entails vaccine manufacturers helping other manufactures learn to replicate the vaccines.[18] There are real questions about how helpful patent waivers alone would be to new manufacturers wanting to start vaccine production. Some have compared patent waivers to “publishing a complex recipe” and tech transfer to “sending a master chef to someone’s kitchen to teach them how to cook the dish.”[19] WTO director-general Ngozi Okonjo-Iweala even opined that without tech transfer, expanding vaccine production to more manufacturers won’t work.[20] In addition to the tech transfer, supply chain logistics pose a challenge.[21] Pfizer’s vaccine requires “280 components from 86 suppliers in 19 countries, as well as highly specialized equipment and personnel.”[22] Ultimately, technology transfer is the key to making patent waivers worthwhile.


Today, the U.S. is exporting vaccines and advocating for patent waivers.  “Even with waivers, technology transfers and expanded access to raw materials, experts say it would take about six months for more drug makers to start churning out vaccines” though.[23] In the short-term, direct vaccine exports and contributions to COVAX are the best way to inoculate the maximum number of people worldwide.[24] By expanding vaccine distribution to the world’s poorest countries, rather than just to strategic allies, the U.S. is reasserting its leadership in global health and humanitarian efforts.

[1] David Wainer and Josh Wingrove, Biden Gets U.S. Into Vaccine Diplomacy Race as Stockpiles Rise, Bloomberg Politics (May 4, 2021),

[2] See Benjamin Mueller, While rich countries come back to life, the virus is ravaging poorer nations, NY Times (May 5, 2021),

[3] Melissa Quinn & Kathryn Watson, U.S. will send 20 million more COVID-19 vaccine doses abroad, CBS News, (updated May 17, 2021).

[4] Mujib Mashal and Vivian Yee, The Newest Diplomatic Currency: Covid-19 Vaccines, NY Times (Feb. 11, 2021),

[5] Matina Stevis-Gridneff, Biden’s Support for Vaccine Patent Waivers Faces Uphill Effort in Europe, NY Times (May 6, 2021),

[6] Peter S. Goodman, Apoorva Mandavilli, Rebecca Robbins & Matina Stevis-Gridneff, What Would It Take to Vaccinate the World Against Covid?, NY Times (May 15, 2021),

[7] Josh Holder, Tracking Coronavirus Vaccinations Around the World, NY Times, (updated May 19, 2021).

[8] See Goodman, supra note 6.

[9] Katherine Eban, “We Are Hoarding”: Why the U.S. Still Can’t Donate COVID-19 Vaccines to Countries in Need, Vanity Fair (Apr. 6, 2021),

[10] Jason Beaubien, ‘It’s The Right Thing To Do’: Biden Announces U.S. To Share Vaccine Doses Globally, NPR (May 17, 2021),

[11] Goodman, supra note 6.

[12] Thomas Kaplan, Sheryl Gay Stolberg & Rebecca Robbins, Taking ‘Extraordinary Measures,’ Biden Backs Suspending Patents on Vaccines, NY Times (May 5, 2021),

[13] Stevis-Gridneff, supra note 5.

[14] Goodman, supra note 6.

[15] Goodman, supra note 6.

[16] Stevis-Gridneff, supra note 5.

[17] Stevis-Gridneff, supra note 5.

[18] Goodman, supra note 6.

[19] Goodman, supra note 6.

[20] Goodman, supra note 6.

[21] Kaplan, supra note 12.

[22] Kaplan, supra note 12.

[23] Goodman, supra note 6.

[24] See Goodman, supra note 6.