America’s startups deserve much of the credit for beating back COVID-19. Small businesses were responsible for nearly three-quarters of COVID-19 diagnostic innovations—more than 600 inventions in all, according to a new report from the U.S. Patent and Trademark Office. Unfortunately, we might not be able to count on small businesses the next time a public health crisis strikes. That’s because our government may soon vote to betray startups by sabotaging their business model. The moment of reckoning will come in February, when the WTO decides whether to adopt a proposal to waive patent rights for COVID-19 tests and treatments. It can’t do so without U.S. support. The proposal would have no upside at all. Global COVID-19 cases are dramatically lower than at the peak of the crisis; drug manufacturing capacity hasn’t been an issue for over a year; and countries around the world already have access to the most advanced treatments, thanks to patent-sharing agreements.