Plan to deliver 1 billion Covid - 19 tests to poorer nations

Merck Co's mild drug molnupiravir is likely to be one of the drugs, and experimental drugs to treat experimental 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 global, 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 who scooped up a huge share of global supplies leaving the world's poorest countries with few shots.

A spokesperson for the ACT-A said the document, dated 13 October 2007, was still in process of consultation and declined to comment on its content until it has been finalized. The document will also be sent to global leaders ahead of a G20 summit at the end of this month in Rome. 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 between rich and less advanced countries. So far, donors pledged $18.5 billion to the program.

The financial request is based on detailed estimates about the price of drugs, treatments and tests that will account for the program's biggest expenditure along with the cost of distributing vaccines. Although it does not explicitly mention molnupiravir, the ACT-A documents expects to pay $10 dollar per course for novel oral antivirals for mild moderate patients. Other pills to treat late patients are being developed but molnupiravir is the only drug that has shown positive results in mild stages trials. The ACT-A is in discussions with Merck Co and generics producers to buy the drug. The price is very low if compared to 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. Indian drug companies have taken licensing deals with Merck Co. to identify eight generic drugmakers in India. Countries in Asia are placing orders for a new drug to treat coronavirus. Poorer nations could miss out once more The ACT-A document says that its goal 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 which change 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 at a later stage, the document says. Other 4.3 million courses of non-specifically repurposed Covid - 19 pills are expected to be purchased at a price of $28 per course, the document states, without naming any critical medicine. The ACT-A also plans to address critical oxygen needs of 6 – 8 million severe and critical patients by September 2022. In addition, the program plans to invest massively in Covid-19 diagnostics in order to at least double the number of tests carried out in low income nations defined as poorer countries. Of the $22.8 billion ACT-A will spend in the next 12 months, about one third and the largest share will be for diagnostics, the document says. Currently the rich countries conduct about 50 tests every day against 750 tests in poor nations. The ACT-A wants to bring the 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, approximately 10 times more than the ACT-A has yet procured, 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 that 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 intended to narrow the gap between the rich and poor, as only 0.4% of the about 3 billion tests reported across the world have been conducted in poor nations, according to the document. It would also help spot possible new variants, which tend to proliferate when infections become more prevalent and therefore are more likely in countries with lower vaccination rates. The program aims to vaccinate at least 70% of the eligible population in all countries by the middle of next year, in line with WHO's policies.