The United States and other wealthy members of the World Trade Organization have blocked a push by dozens of developing countries to waive patent rights in an effort to boost production of COVID-19 vaccines for poor nations. The proposal by South Africa and India was supported by hundreds of civil society organizations, including Doctors Without Borders, Oxfam and Amnesty International. Without the waiver, vaccine production will remain in the hands of only a few pharmaceutical companies. “Millions of us are basically going to have to wait for a vaccine, putting global immunity, as well as regional immunity, particularly in Africa, at severe risk,” says South African activist Fatima Hassan, founder and director of Health Justice Initiative. We also speak with Achal Prabhala, coordinator of the AccessIBSA project, which campaigns for access to medicines in India, Brazil and South Africa. He says one of the barriers to spreading vaccine production to other parts of the world has to do with perceptions of scientific expertise. “The entire world — not just the West — is incredulous at the idea that you could have useful science in this pandemic come out of places not in the West,” says Prabhala.