The discussions around vaccine delivery to Myanmar, including those that took place during Richardson’s trip, raise questions about how the U.S. is making decisions about its donations, whether officials are factoring in political considerations in that process and why the U.S. is earmarking doses for specific countries rather than relying strictly on COVAX — an organization that uses its own algorithm and factors in a country’s ability to distribute doses locally.

Richardson’s trip is not the first to draw attention internally within the Biden administration among officials tapped to work on the international distribution effort. In June, a group of senators flew to Taiwan for a congressional member trip and announced, to the surprise of officials, that the U.S. would send Taipei more than 700,000 doses.

The Taiwan announcement fueled concerns that the administration was holding out the possibility of help in fighting Covid-19 in order to obtain diplomatic favors such as reassuring Taipei about the level of U.S. commitment in protecting it against a possible Chinese invasion.