In search of Covid pills, poor countries fear a repeat of the AIDS crisis
Paxlovid’s cost to UNICEF — including Pfizer’s insistence that UNICEF keep the amount it pays confidential — remains a sticking point, Dr. Philippe Dunton, which leads the therapeutic arm of the WHO consortium. In announcing its “strong recommendation” for Paxlovid, the WHO took the highly unusual step of publicly chastising Pfizer for its “lack of transparency”, making it difficult to know which countries have the drug and what they pay for.
“We need to have better price visibility,” Dr. Duneton said.
Manufacturers often prefer the details of their sales agreements to be kept secret so as not to weaken their hand with other potential buyers. Pfizer chief executive Albert Bourla reported last week that Paxlovid had been a “key growth engine” for the company, which uses a “tiered pricing approach” in which low- and lower-middle-income countries will get Paxlovid at a not-for-profit price.
In response to a New York Times investigation, Pfizer released a statement saying it was “deeply disappointed with the sentiment expressed by our partners”, adding, “We have in good faith heard and addressed many of their concerns.” .
Pfizer and Merck have also moved to make inexpensive generic versions of their pills available, signing license agreements with the Medicines Patent Pool, which was created during the global AIDS crisis to bring low-cost medicines to low- and middle-income countries. It took years and fierce battles between activists and corporations to reach such deals on HIV drugs.
But the agreements for Covid antivirals do not apply to many middle-income countries, including much of Latin America and parts of North Africa and Asia. The upshot, experts say, is that poor and rich nations alike will have access, but countries in between will have to negotiate with the companies — or force the drugmakers to hand over their intellectual property.
So far, 36 companies from 12 countries have signed up to manufacture generic Paxlovid. Companies in India are already making generic versions of Paxlovid and molnupiravir. Both drugs are expected to eventually be available in around 100 low- and middle-income countries, covering around half of the world’s population. Companies will not receive royalties from sales while the WHO’s declaration of the pandemic as a global health emergency remains in effect.
“Given the severity of the pandemic and the fact that vaccines had a very uneven penetration rate, we felt this was a very important contribution the company could make,” said Paul Schaper. , Executive Director of Global Public Policy at Merck.