WASHINGTON, United States (AP) — For much of the past two years, America has been first in line for COVID-19 vaccines and treatments. Now, as drugmakers develop the next generation of therapies, the White House is warning that if Congress doesn’t act urgently the US will have to take a number.

Already the congressional stalemate over virus funding has forced the federal government to curtail free treatment for the uninsured and to ration monoclonal antibody supplies. And Biden administration officials are expressing increasing alarm that the US is also losing out on critical opportunities to secure booster doses and new antiviral pills that could help the country maintain its reemerging sense of normalcy, even in the face of potential new variants and case spikes.

Japan, Vietnam, the Philippines, and Hong Kong have all placed o, Unders for treatments and vaccine doses that the US can’t yet commit to, according to the White House.

Months ago, the White House began warning that the country had spent through the money in the $1.9 trillion American Rescue Plan that was dedicated directly to COVID-19 response. It requested an additional $22.5 billion for what it called “urgent” needs in both the US and abroad.

The Senate last month closed in on smaller $10 billion package focused on domestic needs. But even that deal fell apart as lawmakers objected to an announcement from the Centers for Disease Control and Prevention that it would end Trump-era border restrictions related to the pandemic.

The US used similar advance-purchase agreements to boost the domestic supply and manufacture of COVID-19 vaccines, through what was known in the Trump administration as “Operation Warp Speed.”

Now, with a new generation of treatments on the horizon, the US is falling behind.

The Biden administration has said that while the U.S. has enough vaccine doses for children under 5, once they are approved by regulators, and for fourth shots for high-risk people over 50, it doesn’t have the money to order the new generation of doses.

Earlier this month, former White House COVID-19 coordinator Jeff Zients said Japan, Vietnam, the Philippines, and Hong Kong had already secured future booster doses.

Republicans have shown no signs of backing down from their insistence that before supplying the 10 GOP votes needed for the COVID-19 funding package to pass the Senate, the chamber must vote on their effort to extend the Trump-era Title 42 order. That COVID-linked order, which requires authorities to immediately expel nearly all migrants at the border, is set to be lifted on May 23.