The first way is unfolding in the United States — with two promising coronavirus vaccines by Pfizer and Moderna on the cusp of approval — as the Trump administration focuses on domestic distribution from private labs.
The European Union and other wealthy democracies have bought up much of what’s left of the initial doses, but they also will lend support to a World Health Organization-linked effort to eventually expand supplies to countries in need.
The other approach comes from China and Russia, which have rushed to share their own state-backed vaccines with nations scrambling for supply, positioning themselves to possibly expand their political and economic interests in the process.
The contrast goes well beyond the crisis of the pandemic, reflecting how the post-World War II world order is challenged by the rise of authoritarian powers and the retreat of the United States during the outgoing Trump administration.
“Global health and pharmaceutical interventions are getting sucked into balance-of-power politics,” said David Fidler, senior fellow for global health at the Council on Foreign Relations. “For the U.S., this creates geopolitical nightmares, because we are not in the game.”
