Health experts are hopeful that vaccines will stop the coronavirus outbreak in the U.S. But what will it take to make the 12 to 15 billion doses to cover the entire globe?

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MARY LOUISE KELLY, HOST:

Drug companies have created an effective vaccine for a new disease in record time. But for many people around the world, the wait for a COVID-19 vaccine could take years. What will it take to end the pandemic as a whole? NPR's Michaeleen Doucleff reports.

MICHAELEEN DOUCLEFF, BYLINE: As rich countries start to vaccinate their populations widely, the world runs the risk of turning COVID-19 into a disease of the poor, with the coronavirus still circulating in low-income countries but not in rich ones. That's according to Niko Lusiani. He's a senior adviser with the global aid organization Oxfam.

NIKO LUSIANI: We don't want to sit in an island in the world where a couple of rich countries are fully immunized where the rest of the world is dying from COVID. I mean, that's just not a morally convenient place to be for most people.

DOUCLEFF: To end the pandemic, the world needs about 12 to 15 billion doses of vaccine - about two per person. Right now there just aren't that many doses and likely won't be this year.

LUSIANI: When it comes to many pockets around the world, it's becoming increasingly unlikely that people will get access to this vaccine in 2021.

DOUCLEFF: Many people will have to wait until 2023 or 2024. Brook Baker is a law professor at Northeastern University. He studies how laws affect access to medicines. He says this unequal access to the vaccine has a root cause - international patents.

BROOK BAKER: The innovators hold patent rights and trade secret rights over those technologies, and they're unwilling to share them broadly to other manufacturers. So we have artificially constricted supply.

DOUCLEFF: The patent rights come from agreements within the World Trade Organization. Countries have agreed to honor patents for new pharmaceutical products 20 years after they're developed.

BAKER: This was the brainchild of the pharmaceutical industry back in the 1980s that ended up being a monopoly-based agreement, where instead of competition, we preserved the rights of the pharmaceutical industry.

DOUCLEFF: Baker says these patent laws have landed the world in the situation we have now, where a handful of companies have enormous power and control over a lifesaving vaccine. Baker says these companies, in many ways, decide which countries get the vaccine this year and can possibly end their outbreak and which ones are left fighting COVID-19 with only masks and social distancing.

BAKER: That's no way to respond to a pandemic emergency. It's actually not a very good way to respond to the need for medicines in general.

DOUCLEFF: Many leaders of developing countries agree with Baker. Back in October, India and South Africa asked the WTO for a waiver to lift the patent restrictions on COVID vaccines and medicines until the pandemic is over. But many rich countries - including the U.S., Japan, Norway and Canada - have blocked the waiver, saying there's no evidence that patent protection is inhibiting access to COVID vaccines.

Thomas Cueni directs the International Federation of Pharmaceutical Manufacturers and Associations. It's the leading trade association for brand-name drugmakers.

THOMAS CUENI: The temporary waiver would have zero impact on the pandemic. You wouldn't have a single vaccine more available now for COVID-19.

DOUCLEFF: He says the problem isn't patents, but rather the world just doesn't have the capacity to make enough doses for everyone this year.

CUENI: And you look at global vaccine manufacturing capacity, both India and South Africa among the 10 largest vaccine manufacturers in the world. There is no idle capacity.

DOUCLEFF: A big reason for this maxed-out capacity is that some of the companies that are developing vaccines, such as AstraZeneca and Johnson & Johnson, are sharing their patent recipes with a few other manufacturers.

Andrea Taylor is at Duke University. She's been closely tracking these agreements. She says they are helping to ensure that at least some people in poor countries, up to 20%, receive the vaccine this year.

ANDREA TAYLOR: It is definitely good, yeah. We have seen quite a bit open up in terms of manufacturing capacity in Southeast Asia as well as Latin America. So that is really encouraging.

DOUCLEFF: She says the world needs more patent sharing and increased manufacturing capacity.

Michaeleen Doucleff, NPR News. Transcript provided by NPR, Copyright NPR.