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But the 72-year-old Honduran lawyer, like so many others in his country, is still waiting. And increasingly, he is wondering why the United States is not doing more to help, particularly as the American vaccine supply begins to outpace demand and doses that have been approved for use elsewhere in the world, but not in the U.S., sit idle.

This stark access gap is prompting increased calls across the world for the U.S. to start shipping vaccine supplies to poorer countries. That’s creating an early test for President Joe Biden, who has pledged to restore American leadership on the world stage and prove to wary nations that the U.S. is a reliable partner after years of retrenchment during the Trump administration.

J. Stephen Morrison, senior vice president and director of the Global Health Policy Center at the Center for Strategic & International Studies in Washington, said that as the U.S. moves from vaccine scarcity to abundance, it has an opportunity to “shape the outcomes dramatically in this next phase because of the assets we have.”

The White House is aware that the rest of the world is watching. Last month, the U.S. shared 4 million vaccine doses with neighboring Canada and Mexico, and this past week, Biden said those countries would be targets for additional supplies. He also said countries in Central America could receive U.S. vaccination help, though officials have not detailed any specific plans.

The lack of U.S. vaccine assistance around the world has created an opportunity for China and Russia, which have promised millions of doses of domestically produced shots to other countries, though there have been production delays that have hampered the delivery of some supplies. China’s foreign minister Wang Yi said this month that China opposes “vaccine nationalism” and that vaccines should become a global public good.

The U.S. has also faced criticism that it is not only hoarding its own stockpiles, but also blocking other countries from accessing vaccines, including through its use of the law that gives Washington broad authority to direct private companies to meet the needs of the national defense.

Adar Poonawalla, chief executive of the Serum Institute of India, the world’s largest maker of vaccines and a critical supplier of the U.N.-backed COVAX facility, asked Biden on Twitter on April 16 to lift the U.S. embargo on exporting raw materials needed to make the jabs.

There are also concerns that the U.S. might link vaccine sharing to other diplomatic efforts. Washington’s loan of 2.7 million doses of AstraZeneca’s shots to Mexico last month came on the same day Mexico announced it was restricting crossings at its southern border, an effort that could help decrease the number of migrants seeking entry into the United States.

Those sort of parallel tracks of diplomacy will be closely watched as the Biden administration decides with whom to share its surplus vaccine, particularly in Central America, home to many countries where migrant families and unaccompanied children are trying to make their way to the U.S.

Last week, a private business group announced it would try to buy 1.5 million vaccine doses to help government efforts, though it was unclear how it might obtain them. In March, authorities in Mexico seized 5,700 doses of purported Russian vaccines found in false bottoms of ice chests aboard a private plane bound for Honduras. The company owner who chartered the plane said he was trying to obtain vaccines for his employees and their families. The vaccine’s Russian distributor said the vaccines were fake.

There’s plenty of blame to go around, said Marco Tulio Medina, coordinator of the COVID-19 committee at the National Autonomous University of Honduras, noting his own government’s lackadaisical approach and the ferocity of the vaccine marketplace. But the wealthy can do more.

Miller reported from Washington. Associated Press journalists Christopher Sherman in Mexico City, Cara Anna in Nairobi, Aniruddha Ghosal in Delhi, Huizhong Wu in Taipei, David Biller in Rio de Janeiro, Gisela Salomon in Miami, Sonia Pérez D. in Guatemala City and Andrew Meldrum and Mogomotsi Magome in Johannesburg contributed to this report.

This content was originally published here.

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