A potentially intense competition to get their hands on them.
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"Which countries get the vaccine are, I mean, I'm going to tell you, it's going to be those who can pay for it," says UCSF researcher Dr. Eric Goosby, M.D.
Dr. Goosby has seen the struggle for resources before, as U.S. Global AIDS coordinator, and U.N. special envoy for tuberculosis. He says it's critical that vaccines are distributed on a needs basis first.
"It shouldn't just be available in a free for all fight. Even though I told you how it's going to unfold. It should be done in a way that allows for a prioritization of needs. The sickest people should get it first," Goosby argues.
Already, countries like Britain have secured millions of potential doses, signing a reported deal with vaccine partners GlaxoSmithKline and Sanofi. While Japan is reportedly doing the same with Pfizer, and several members of the European Union have signed with Astrazeneca. All, prompting concerns over what some global health experts are calling, vaccine nationalism.
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"It means that every nation, instead of cooperating as we hope they will, instead decides to compete and prioritize their own people first," says David Relman, M.D., a senior fellow at the Freeman Spogli Institute for International Studies at Stanford
Dr. Relman worries about developing countries being initially left behind and what their options might be if hundreds of thousands of lives are on the line.
"Those countries that have not been able to develop their own vaccines from the start will simply beg, borrow and perhaps steal," Dr. Relman believes.
And those issues could be even trickier in this crisis. Since many of the vaccine patents will be held by major drug companies with research and manufacturing centers spread across multiple countries.
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Populations who might feel an ethical, if not legal, right to a share of the vaccine.
The U.S. is reportedly requiring some of the company's it's financing, to produce a vaccine domestically and has shifted its focus away from at least one major global player, with President Trump announcing a withdrawal from the World Health Organization.
While groups like the World Health Organization may no longer have U.S. cooperation, they'll still likely have international support. And researchers like Stanford vaccine expert, Dr. Yvonne Maldonado, M.D. say that could be significant, given that vaccines are now in development in some 30 countries.
"I think we're going have great vaccines, but I think others will as well," says Dr. Maldonado.
China's leaders have already pledged to share vaccines they're developing with countries in need at an affordable price, possibly driving down costs internationally. And many experts believe a coordinated worldwide response is still possible and necessary to eradicate a virus that ultimately doesn't respect nationalities.
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