As the COVID-19 pandemic continues to rage across the world, the United States and its allies are pushing for answers about the virus's origins while China rebuffs inquiry into its early handling of the outbreak. Meanwhile, a growing U.S. stockpile of vaccines has opened new avenues for “vaccine diplomacy,” and the Biden administration has thrown its weight behind an effort to suspend cross-border intellectual property (IP) rules for vaccine manufacturing. In the near term, however, experts expect vaccination rates and access will continue to vary widely between countries depending on their wealth.Footnote ¹

In March 2021, the World Health Organization (WHO) and China jointly completed “part one” of an investigation into the origins of the novel coronavirus.Footnote ² The investigative team that conducted the study included seventeen Chinese experts and seventeen international experts.Footnote ³ Their report did not identify the origin of the virus but instead assigned probabilities to four working theories. The report concluded, first, that introduction of the virus to humans through an intermediate animal host was “likely” or “very likely” the pathway of origin.Footnote ⁴ Under that scenario, the virus would have jumped from an animal such as a bat or pangolin, then to an animal that is in closer contact with humans, such as livestock, and then to humans themselves.Footnote ⁵ Second, the report said it was “possible to likely” that a bat or pangolin transmitted the virus directly to humans, a scenario known as “direct zoonotic spillover.”Footnote ⁶ Next, introduction through contaminated frozen food imports—China's favored theoryFootnote ⁷—was rated “possible.”Footnote ⁸ Finally, the experts concluded that an accidental laboratory leak was “extremely unlikely” because there was no record of viruses closely related to COVID-19 in any lab before December 2019.Footnote ⁹ They also pointed to the high-level safety ratings of labs in Wuhan, the city where the virus was first identified.Footnote ¹⁰ The group did not consider the hypothesis that the virus was deliberately engineered or intentionally released, citing scientists who ruled out the theory based on genomic analysis.Footnote ¹¹

The United States and its allies criticized the study for its delayed start and lack of original data that could have provided more definitive answers. In a joint statement after the WHO report's release, Australia, Canada, Czechia, Denmark, Estonia, Israel, Japan, Latvia, Lithuania, Norway, the Republic of Korea, Slovenia, the United Kingdom, and the United States pressed for “expert-driven phase 2 studies.”Footnote ¹² Although the statement did not directly criticize China, the countries stated:

The European Union (EU) ambassador to the United Nations expressed similar concerns, noting that “[e]very lack or delay in sharing public health information can have worldwide adverse impact.”Footnote ¹⁴

The WHO acknowledged deficiencies in the report, too. WHO Director-General Tedros Adhanom Ghebreyesus told reporters in July that there was a “premature push” to rule out the lab leak theory.Footnote ¹⁵ He called on China to be transparent and to cooperate with international experts in the second phase of the investigation to probe the lab accident theory more fully.Footnote ¹⁶

Thus far, however, China has refused to cooperate with phase two.Footnote ¹⁷ The vice minister of China's National Health Commission said the WHO's plan “disregards common sense and defies science.”Footnote ¹⁸ The White House slammed China's position as “irresponsible” and “dangerous” and promised that phase two of the study, unlike the first, would be “scientific, transparent, expert-led, and free from interference.”Footnote ¹⁹ For its part, the WHO called on governments to “depoliticize the situation and cooperate to accelerate the origins studies.”Footnote ²⁰ Notwithstanding the first report's conclusion that a lab leak was “extremely unlikely,” the WHO defended further analyzing the possibility, explaining that “in order to address the ‘lab hypothesis,’ it is important to have access to all data and consider scientific best practice and look at the mechanisms WHO already has in place. WHO is only focused on science, providing solutions and building solidarity.”Footnote ²¹

Still, within the United States, China's accountability and apparent intransigence remain hotly political. Republicans on the House Foreign Affairs Committee, citing circumstantial evidence, released a report in August claiming that the novel coronavirus likely leaked from the Wuhan Institute of Virology laboratory in September 2019.Footnote ²² At least two U.S. states, Missouri and Mississippi, have joined dozens of plaintiffs in suing China and the Chinese Communist Party for negligence and other tort claims.Footnote ²³ For the suits to proceed, plaintiffs must show that an exception to foreign sovereign immunity applies,Footnote ²⁴ specifically, that the suit involves either “commercial activity” by Chinese officials in the United States or a tort committed by Chinese officials in their official capacity in the United States.Footnote ²⁵ Many legal observers are skeptical that the suits fall within these exceptions.Footnote ²⁶

With no conclusive answers from the WHO's origin-tracing efforts, President Biden turned to his intelligence agencies. In March, Biden “task[ed] the Intelligence Community to prepare a report on their most up-to-date analysis of the origins of COVID-19.”Footnote ²⁷ In a statement at the end of May, Biden explained that “[a]s of today, the U.S. Intelligence Community has ‘coalesced around two likely scenarios’”—spillover from contact with an infected animal and a laboratory accident—“but has not reached a definitive conclusion on this question.”Footnote ²⁸ Biden asked them “to redouble their efforts to collect and analyze information that could bring us closer to a definitive conclusion, and to report back . . . in 90 days.”Footnote ²⁹

The report that resulted from Biden's directive in late August did not pinpoint the origin of COVID-19, but shed light on how U.S. intelligence agencies assessed various theories. The Office of the Director of National Intelligence (ODNI) released an unclassified summary of the report and said it intended to release a declassified version of the entire report “in the near future.”Footnote ³⁰ Like the WHO-convened group, the intelligence community agreed that “the virus was not developed as a biological weapon.”Footnote ³¹ The report also assessed that Chinese officials “did not have foreknowledge of the virus before the initial outbreak of COVID-19 emerged.”Footnote ³² A majority of the intelligence community elements concluded the virus “probably was not genetically engineered,” but only with low confidence, while “two agencies believe there was not sufficient evidence to make an assessment either way.”Footnote ³³

The intelligence agencies remain divided on the most likely origin but agreed that a laboratory incident or exposure to an infected animal were both “plausible” theories.Footnote ³⁴ Four agencies and “the National Intelligence Council assess[ed] with low confidence” that the virus jumped from an animal to a human through natural exposure.Footnote ³⁵ One agency assessed “with moderate confidence” that the first case was caused by “a laboratory-associated incident, probably involving experimentation, animal handling, or sampling by the Wuhan Institute of Virology.”Footnote ³⁶ Other intelligence community “elements remain unable to coalesce around either explanation without additional information.”Footnote ³⁷ The report concluded that in order to answer the origin question authoritatively, “China's cooperation most likely would be needed,” but the Chinese government

In a statement responding to the report, Biden sharply criticized China for blocking access to information that could provide definitive answers.Footnote ³⁹ He said:

Biden called on China “to fully share information and to cooperate with the World Health Organization's Phase II evidence-based, expert-led determination into the origins of COVID-19—including by providing access to all relevant data and evidence.”Footnote ⁴¹

As a definitive answer on COVID-19's origin evades government officials, scientists, and the WHO, countries everywhere are tackling the pressing matter of vaccinating their populations—an effort that has underscored global inequities in vaccine access. In May, the Biden administration reversed a prior U.S. position that would have kept in place IP protections for the pharmaceutical companies that developed the vaccines. Along with other wealthy nations, the United States had previously opposed waiving the IP rules in the World Trade Organization's Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) out of concern that doing so would disincentivize scientific development.Footnote ⁴² Advocates of the proposed waiver, led by India and South Africa, however, argue that the extraordinary circumstances of the pandemic warrant a departure from typical IP rulesFootnote ⁴³ and that it would help low- and middle-income countries gain access to vaccines, medical devices, diagnostics, and personal protective equipment by scaling up manufacturing capacity.Footnote ⁴⁴ On May 5, U.S. Trade Representative Katherine Tai announced U.S. support for a vaccine waiver specifically, a narrower position than what India and South Africa have advocated. Tai stated:

The EU said it was “ready to discuss any option that helps end the pandemic” but was “not convinced that this would provide the best immediate response.”Footnote ⁴⁶ Ultimately, the decision rests with the WTO, whose members have yet to agree on a waiver or its potential scope.

As a more immediate measure, the United States has responded to calls for international assistance by allocating a greater number of vaccines to foreign countries. After facing criticism earlier in the year for failing to share vaccines abroad,Footnote ⁴⁷ Biden promised in a speech to a joint session of Congress at the end of April that the United States would “become an arsenal of vaccines for other countries—just as America was the arsenal of democracy in World War 2.”Footnote ⁴⁸ After a slow start, the Biden administration announced in August that the United States had donated and shipped more than 110 million doses abroad, an amount greater than the combined donations of all other countries, according to the United Nations.Footnote ⁴⁹ So far, the United States has pledged to donate 500 million doses by the summer of 2022.Footnote ⁵⁰ While touting its newfound position as the leader in “vaccine diplomacy,” the White House acknowledged the figure was only a fraction of the billions of vaccines needed to get the virus under control globally.Footnote ⁵¹

For the most part, the donated vaccines are not shipped directly to recipient countries. Instead, the United States is working through the COVAX Initiative, a public-private partnership that the Biden administration joined within hours of Biden's inauguration.Footnote ⁵² Despite the commitment, the administration has faced criticism for holding onto vaccines when so many in the United States have turned down the shot and so many abroad are desperate to get it.Footnote ⁵³ Though the United States shared four million doses with Mexico and Canada in the spring, the donations to COVAX did not start in earnest until mid-summer.Footnote ⁵⁴ Even equipped with vaccines—though far fewer than its target—COVAX has struggled to deliver doses to rural communities in poor countries.Footnote ⁵⁵ Wealthy countries have also taken from the COVAX supply, which was intended to aid poor countries.Footnote ⁵⁶

Beyond the humanitarian goal of saving lives, the vaccine donations could also produce diplomatic dividends. Early in 2021, Russian and Chinese vaccine donations outpaced those of the United States.Footnote ⁵⁷ Announcing in May that the United States would ship 80 million vaccine doses abroad by the end of June, Biden emphasized that the amount was “five times more than any other country” had shared and “more than Russia and China.”Footnote ⁵⁸ Biden said:

Biden and his deputies have repeatedly said that U.S.-donated vaccines would be free and would come with “no demands, no conditions, no coercion attached,” apparently drawing a contrast to Russia and China.Footnote ⁶⁰ Scientists and health officials have questioned the efficacy of the Chinese-made shots, leading some Southeast Asian countries that received China's vaccines to seek doses from Western drug-makers such as Moderna and Johnson & Johnson.Footnote ⁶¹ The demand has created a diplomatic opening for the United States in the region to send vaccine donations.Footnote ⁶²

Vaccination efforts are racing against the emergence and spread of new variants. As of late August, the worldwide tallies stood at more than 216 million confirmed cases of COVID-19 infections, 4.5 million deaths, and some five billion vaccine doses administered.Footnote ⁶³