In the search for pills for Covid, poor nations fear a recurrence of the AIDS crisis

Paxlovid’s cost to UNICEF – including Pfizer’s insistence that UNICEF keep secret how much it pays – remains a key point, said Dr Philippe Duneton, who leads the therapeutic part of the WHO consortium. Announcing its “strong recommendation” for Paxlovid, the WHO has taken a very unusual step by publicly reprimanding Pfizer for its “lack of transparency”, making it difficult to know which countries have the drug and what they are paying for.

“We need to have better visibility in terms of price,” Dr. Duneton said.

Manufacturers often prefer to keep the details of their sales contracts secret so as not to weaken their hands with other potential buyers. Pfizer CEO Albert Bourla reported last week that Paxlovid was a “key driver of growth” for the company, which uses a “tiered pricing approach” in which low- and low-middle-income countries will get Paxlovid at the lowest cost. -profit price.

In response to a query from The New York Times, Pfizer issued a statement saying it was “deeply disappointed with the feelings expressed by our partners,” adding, “We have heard and responded to many of their concerns in good faith.”

Both Pfizer and Merck have also taken steps to make cheap generic versions of their tablets available, signing licensing agreements with the Pool of Patent Medicines, created during the global AIDS crisis to bring medicines to low- and middle-income countries at low cost. . It took years and bitter struggles between activists and companies to reach such agreements on HIV drugs.

But agreements on antiviral drugs against Covid do not apply to many middle-income countries, including much of Latin America and parts of North Africa and Asia. The result, experts say, is that both poor and rich countries will have access, but middle countries will have to negotiate with companies – or force drug manufacturers to surrender their intellectual property.

So far, 36 companies from 12 countries have applied to produce generic Paxlovid. Companies in India already produce generic versions of both Paxlovid and molnupyvir. Both drugs are expected to eventually be available in about 100 low- and middle-income countries, covering about half of the world’s population. Companies will not receive royalties from the sale until the WHO declares the pandemic a global health emergency still in effect.

“Given the severity of the pandemic and the fact that vaccines have had very uneven penetration rates, we felt this was a very important contribution that the company could make,” said Paul Schaper, executive director of global public policy at Merck.

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