Many of the donated doses bound for use in Africa, for example, were meant to come from the Serum Institute of India. But five months ago, the Indian government blocked the company from exporting any vaccines, ordering that the supply instead be directed to trying to stanch a raging second Covid wave in that country. (India now says it will allow exports to resume next month.)

“We keep hearing, ‘The vaccines are coming, the vaccines are coming,’ but three million people have died since the Pfizer vaccine was first authorized by the F.D.A.,” said Zain Rizvi, an expert on access to medicines with the advocacy organization Public Citizen.

Moderna and Pfizer have a direct financial interest in keeping their technology to themselves and guarding a competitive advantage not just in the sale of Covid vaccines, which are on track to bring in more than $53 billion in revenue this year, but also other potentially lucrative mRNA vaccines…

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