A World Health Organisation-led program to ensure poorer countries get fair access to Covid-19 vaccines, tests and treatments aims to secure antiviral drugs for patients with mild symptoms for as little as $10 per course, a draft document seen by Reuters says.
Merck & Co's experimental pill molnupiravir is likely to be one of the drugs, and other drugs to treat mild patients are being developed.
The document, which outlines the goals of the Access to Covid-19 Tools Accelerator (ACT-A) until September next year, says that the program wants to deliver about 1 billion Covid-19 tests to poorer nations, and procure drugs to treat up to 120 million patients globally, out of about 200 million new cases it estimates in the next 12 months.
The plans highlight how the WHO wants to shore up supplies of drugs and tests at a relatively low price after losing the vaccine race to wealthy nations which scooped up a huge share of the world's supplies, leaving the world's poorest countries with few shots.
A spokesperson for the ACT-A said the document, dated Oct 13, was still a draft under consultation and declined to comment on its content before it is finalized. The document will also be sent to global leaders ahead of a G20 summit in Rome at the end of this month.
The ACT-A asks the G20 and other donors for additional funding of $22.8 billion until September 2022 which will be needed to buy and distribute vaccines, drugs and tests to poorer nations and narrow the huge gaps in supply between wealthy and less advanced countries. Donors have so far pledged $18.5 billion to the program. The financial requests are based on detailed estimates about the price of drugs, treatments and tests, which will account for the program's biggest expenses alongside the cost of distributing vaccines.
Although it does not explicitly cite molnupiravir, the ACT-A document expects to pay $10 dollar per course for "novel oral antivirals for mild/moderate patients". Other pills to treat mild patients are being developed, but molnupiravir is the only one which has so far showed positive results in late-stage trials. The ACT-A is in talks with Merck & Co and generics producers to buy the drug.
The price is very low if compared with the $700 per course that the United States has agreed to pay for 1.7 million courses of the treatment.
However, a study carried out by Harvard university estimated that molnupiravir could cost about $20 dollars if produced by generic drugmakers, with the price potentially going down to $7.7 under an optimized production.
Merck & Co. has licensing deals with eight Indian generic drugmakers.
The ACT-A document says that its target is to reach a deal by the end of November to secure the supply of an "oral outpatient drug", which it aims to be available from the first quarter of next year.
The money raised would initially be used to "support procurement of up to 28 million treatment courses for highest risk mild/moderate patients over the next 12 months, depending on product availability, clinical guidance, and volumes changing with evolution of needs," the document says, noting this volume would be secured under an advance purchase agreement.
Larger additional amounts of new oral antivirals to treat mild patients are also expected to be procured at a later stage, the document says.
Another 4.3 million courses of repurposed Covid-19 pills to treat critical patients are also expected to be purchased at a price of $28 per course, the document says, without naming any specific drug.
The ACT-A also intends to address essential medical oxygen needs of 6-8 million severe and critical patients by September 2022.