Third World Network (TWN) and the People’s Health Movement (PHM) hosted a webinar on ensuring fair access to Covid-19 diagnostics and therapeutics on Wednesday, October 6. One of the key issues raised was how rich countries’ unwillingness to support the proposal for waiver of Trade Related Aspects of Intellectual Property (TRIPS waiver) is not only having an effect on the distribution of available vaccines, but on tests and treatments too.
A recent release by Merck concerning molnupiravir, an antiviral therapy for Covid-19, has sparked the media’s interest. However, as pointed out by Brook Baker, professor at Northeastern University who has been following these developments closely, the discussion should move away from the highlights chosen by the PR office of the pharma company and focus on the aspects that will impact common people’s ability to actually access Covid-19 treatments.
“We should not conduct science through press releases,” stressed Michelle Childs, Director of Policy and Advocacy at the Drugs for Neglected Diseases initiative, a panelist at the event. One of the key steps we can take to overcome the pandemic, she argues, is making sure that scientists and producers engage in knowledge-sharing initiatives. According to Childs, the approach currently taken by Big Pharma is the exact opposite of this. Pharmaceutical producers are granting voluntary licenses to generic manufacturers. This helps them keep the know-how a secret and not share it in the public domain. Thus, they are able to avoid some of the key questions we should be asking in the context of the Covid-19 pandemic.
One of the most important among those questions is, of course, how affordable and adequate are the treatments for application in low-resource settings. The technical requirements for the administration of treatments used previously, like tocilizumab, make their delivery improbable in communities without access to the right medical technology.
This is additionally complicated by issues related to cost, as illustrated by Christa Cepuch, Pharmacist Coordinator at the MSF Access Campaign. Intellectual property rights (IPRs) and patents would mean that the price tag on many of the drugs could leave them out of reach for poor patients. Cepuch illustrated this with the example of baricitinib, a treatment on which manufacturer Eli Lily holds several patents, and which is priced by them at $44 per dose but costs only $0.54 in generic production.
“Molnupiravir is an excellent example of how extreme the price can become because of IPRs”, said Cepuch. A five-day treatment course has been priced by Merck at over $700, while an Indian generic manufacturer priced the same treatment at $13. Fighting against Big Pharma’s determination to profit at all costs is difficult if we don’t move forward from a country-to-country approach. In fact, all the panelists agreed that the TRIPS waiver is the best opportunity we have to make sure that Covid-19 drugs can be made available all over the world in the shortest possible time.
Reshma Ramachandran from the Yale National Clinician Scholar Program singled out another reason why rich countries should back the TRIPS waiver, and that is the amount of public resources used to support research and development of Covid-19 treatments. The US has invested $3 billion in this area of work through the program Operation Warp Speed alone, and more public funds are being allocated to the research of more than 450 types of treatment through programmes of the US Food and Drug Administration. “Molnupiravir itself was first developed in a public institution, and was only later on taken by Merck”, pointed out Ramachandran.
As more treatments for Covid-19 become available, it is becoming increasingly important to prevent Big Pharma from what it did in the case of vaccines — acquire monopoly rights which have left developing countries with very low access to vaccines. Products developed with public money should be accessible to everyone, and rich countries in particular should use that as leverage in their negotiations with manufacturers, the panelists pointed out. Like it has been said many times already, the pandemic can only be ended if everyone has access to all types of medical products, be it vaccines or treatments.
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