A World Health Organization-led programme 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 programme 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.
There is precedent for lower prices of critical medicines for low-income countries during the pandemic.
AstraZeneca has pledged to sell its COVID-19 vaccines at cost of around $4 per dose during the pandemic and Pfizer is charging the U.S. government at cost – around $7 a dose – for 1 billion doses for the country’s donations to the ACT-A’s vaccine programme called COVAX.
Still its COVID-19 vaccine will be a big revenue driver for the U.S. drugmaker – it charged wealthy countries around $20 for billions of doses in initial supply deals and will make an expected $33 billion in revenue from the shot this year.
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 finalised. 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 programme.
The financial requests are based on detailed estimates about the price of drugs, treatments and tests, which will account for the programme’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.
But Merck has said it is committed to providing timely access to its drug globally with plans for tiered pricing according to a country’s ability to pay. It also has licensing deals with eight Indian generic drugmakers.
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 optimised production.
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.
TESTS
In addition, the programme plans to invest massively in COVID-19 diagnostics in order to at least double the number of tests carried out in poorer nations, defined as low income and low-middle income countries.
Of the $22.8 billion, the ACT-A plans to raise in the next 12 months, about one third and the largest share is to be spent on diagnostics, the document says.
Currently poor countries conduct on average about 50 tests per 100,000 people every day, against 750 tests in richer nations. The ACT-A wants to bring testing rates to a minimum of 100 tests per 100,000 in poorer states.
That means delivering around 1 billion tests in the next 12 months, around 10 times more than the ACT-A has procured so far, the document shows.
The largest share of diagnostics would be rapid antigen tests at a price of around $3, and only 15% would be spent to procure molecular tests, which are more accurate but take more time to deliver results and are estimated to cost around $17, including delivery costs, the document shows.
The push on tests is meant to narrow the gap between the rich and the poor, as only 0.4% of the about 3 billion tests reported across the world have been conducted in poor nations, the document says.
It would also help spot earlier possible new variants, which tend to proliferate when infections are widespread, and therefore are more likely in the countries with lower vaccination rates.
The document underlines that “vaccine access is highly inequitable with coverage ranging from 1% to over 70%, depending largely on a country’s wealth.”
The programme aims to vaccinate at least 70% of the eligible population in all countries by the middle of next year, in line with the WHO’s goals.
(Reporting by Francesco Guarascio @fraguarascio; Additional reporting by Michael Erman in New JerseyEditing by Susan Fenton)
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
