Some countries could pay ten times the price of the generic equivalent of Paxlovid, as WHO chief calls for access to treatment to fight acute and long-lasting COVID-19
Rich countries got nearly three times as many courses of a World Health Organization (WHO)-recommended COVID-19 drug, Pfizer’s Paxlovid, according to a new analysis from Oxfam and the People’s Vaccine Alliance .
Using new data from Airfinity, they discovered that only a quarter of treatment orders will go to low- and middle-income countries, despite the fact that they represent 84% of the world’s population and have a much greater need because far fewer people are vaccinated against COVID, unlike wealthy nations that are largely protected.
On the eve of tense talks at the World Trade Organization (WTO) over intellectual property rules for COVID-19 treatments and tests, organizations warn we are seeing the same worrying trend of inequity we have seen with COVID vaccines.
Pfizer’s monopoly also means some middle-income countries could pay ten times more for Paxlovid than a generic equivalent, with reports of them being quoted up to $250 per course. This despite the fact that other low-income countries will have access to a Clinton Health Initiative (CHAI) deal with Pfizer and undisclosed generic companies, which means they could access the treatment for just $25 per Classes.
Dr Catherine Kobutungi, Executive Director of the African Center for Population and Health Research, said: “When vaccines were our primary medical tool to fight COVID-19, big pharma prioritized maximizing their profits by selling doses to the richest countries. Millions of people have died as people in low- and middle-income countries have been pushed to the back of the vaccine queue. And now we are seeing a repeat of the same inequity with COVID-19 treatments and testing. »
“Oral antiviral treatments are easy to administer. They reduce hospitalizations and deaths. And they can reduce the likelihood of a long COVID. Yet, at present, they are almost exclusively accessible to people in the wealthiest countries. The fact is, if you’re a vulnerable person with COVID-19 in a high-income country, you’ll likely have access to treatments that can help you survive. If you live in a low-income country, you probably won’t. It is a grotesque inequality and it kills,” she added.
WHO recommends using Paxlovid to reduce COVID-19 hospitalization and death rates, and called for equitable global access to COVID-19 drugs as part of a long COVID strategy . A recent unexamined study suggests that Paxlovid may reduce the risk of patients developing long COVID.
There are hundreds of other potential COVID-19 drugs in development, including at least 77 in late-stage clinical trials that may be more effective and have a wider scope of use. However, intellectual property rules give a small number of companies a monopoly over supply, distribution and price, which means that low- and middle-income countries are unlikely to have affordable access to Neither do these drugs.
Because far fewer people in low-income countries are vaccinated than in rich countries, they are more vulnerable to hospitalization and death from COVID-19. These countries have already seen the highest death toll of the pandemic, a trend that could continue without access to treatments like Paxlovid.
Jennifer Reid, Senior Health and Vaccine Equity Advisor at Oxfam, said: “After the inequity they faced with the rollout of the vaccine, developing countries are now experiencing access and affordability for COVID treatments. It’s a shame that those who need it most get the least and that patent laws give Pfizer a long monopoly on this life-saving drug.
“Tackling both acute COVID and long COVID is critical – and the WHO has made it clear that countries need treatments like Paxlovid to reduce deaths and hospitalizations. But the patent minefield is a huge barrier preventing many developing countries from getting the medicines and tests they need now and in the future to save lives.
In June, after a year and a half of negotiations, the WTO rejected proposals to waive intellectual property rules for all COVID-19 medical technologies, adopting a much more limited text that only covers vaccines. Ahead of talks in Geneva tomorrow, civil society organizations are urging WTO member states to immediately agree to an extension to include treatment and testing, which would allow developing countries to produce for their own populations and export for others in need, ensuring essential tools are accessible and affordable.
Mohga Kamal Yanni, co-policy officer of the People’s Vaccine Alliance, said: “Decades ago, governments allowed pharmaceutical companies to control the price, allocation and supply of life-saving drugs against HIV – and millions of people have died without affordable access. Today, the same thing is happening again with COVID-19 vaccines and drugs. Corporations have been allowed to decide who lives and who dies. WTO member states must ensure that public health takes precedence over commercial interest.
Notes to Editors
A new People’s Vaccine Alliance briefing note on the case for extending the WTO Ministerial Decision to therapeutics and diagnostics is available here.
Data from Airfinity shows that the wealthiest countries which represent only 16% of the world’s population will receive 74% of all courses ordered from Paxlovid. Low- and middle-income countries that represent 84% of the world’s population will receive only 26%. Although it was first licensed in December 2021, reports suggest few doses are available to people in developing countries.
Although there is little data available on how many doses of Pfizer’s antiviral treatment have actually been delivered to low- and middle-income countries, they have been waiting for months to receive doses through Paxlovid supply agreements d global initiatives like UNICEF and the Global Fund. Pfizer reportedly insisted that the prices of these agreements remain secret, and the initiatives did not reveal the prices charged by Pfizer for the courses under their agreements.
Allocation to high-income countries versus low- and middle-income countries
[See attached pdf for table]
According to the World Intellectual Property Organization (WIPO), there are at least 1,465 patents on treatments and 417 on vaccines for COVID-19, making it a “minefield” for developing countries.
Two years ago, South Africa and India proposed a waiver from the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) for medical technologies related to COVID-19, including vaccines, tests and treatments. The waiver was backed by more than 100 low- and middle-income countries, but was blocked by a small number of wealthy countries, including the EU, UK and Switzerland.
After 18 months, the WTO finally decided in June 2022 to streamline existing rights to use compulsory licenses to produce generic COVID-19 vaccines for domestic use and for export without authorization from the patent holder. . The June decision required member states to reach a decision on testing and treatment by December 2022. Negotiations to reach a decision on testing and treatment are ongoing. The WTO TRIPS Council will then meet on Tuesday 22 November.
A selection of letters which went to WTO member states, urging them to support the extension of the June decision to cover treatment and testing, is available here.
The execution of the UNICEF Paxlovid order has would have delayed for several months.
A Global Fund deal for Paxlovid was only finalized at the end of September.
Pfizer allegedly under pressure UNICEF will keep Paxlovid’s prices secret.
According Follow-up of BIO’s COVID-19 therapeutic developmentthere are 77 antivirals and treatments in the “late-stage clinical” phase as of November 14.
Reports indicate that many countries ranked at WTO as ‘developing’ and ‘least developed’ countries remain unable to access affordable treatment in the volumes needed. A report of the ACT-Accelerator Facilitation Council working group finds that “equitable deployment of COVID-19 diagnostics and treatments continues to be inadequate and threatens to undo the public health gains made throughout the pandemic.” Nature similarly says, “Limited supplies and high costs have limited the flow of COVID-19 antivirals to low- and middle-income regions.”
Pharmaceutical companies say licensing deals and donations announced in recent months will ensure doses reach low-income countries, but those deals exclude many developing countries, particularly in Latin America. It is despite Latin America accounting for a large part of the world’s population estimate of avoidable deaths related to COVID-19.
Four times as many people have died from COVID-19 in low-income countries than in rich countries. Per capita deaths in low- and lower-middle-income countries are almost a third higher than in high-income countries.
According to World Intellectual Property Organization (WIPO)there are at least 1,465 patents on treatments and 417 on vaccines against COVID-19.
For more information or to arrange an interview, please contact:
Oxfam Press Office, [email protected] + 44 7748 761999
Joe Karp-Sawey, Senior Media Advisor, People’s Vaccine Alliance, [email protected] +44 7428 985985