By Francesco Guarascio

BRUSSELS, (Reuters) – A World Health Organization-led program to make sure poorer countries have fair access to COVID-19 vaccinations, tests, and treatments aims at ensuring that patients suffering from mild symptoms can get antiviral medications for as low as $10 each course. This draft document was seen by Reuters.

Merck & Co’s experimental pill molnupiravir is likely to be one of the drugs, and other drugs to treat mild patients are being developed.

This document outlines the Access to COVID-19 Tools Accelerator’s (ACT-A), which aims to provide about 1 Billion COVID-19 test results to countries that are poorer and to procure drugs to help 120 Million patients worldwide. It also estimates it will receive approximately 200 M new cases in the next twelve months.

Plans show that the WHO is trying to boost supplies of drug and test supplies at a low price, after losing out on the vaccine race to wealthy countries which snatched a significant share of the global supply. The plan leaves those in need of few shots.

A spokesperson from the ACT-A stated that the Oct. 13 document was still in draft and is being consulted. He declined to comment on the content of the finalized document. This document will be also sent to the global leaders in advance of the G20 summit, scheduled for Rome at month’s end.

The ACT-A requests $22.8 billion in additional funding from the G20 and all other donors between September 2022 and February 2019. This will help to purchase and distribute drugs, vaccines and testing to the poorer countries and reduce the large supply gaps between the more advanced and wealthy. So far, $18.5 million has been pledged by donors to this programme.

Financial requests will be based on estimates of the costs of medicines, tests and treatments. These are the largest expenses for the program, as well as the cost of vaccine distribution.

Although the ACT A document does not specifically mention molnupiravir it expects that $10 per course will be paid for “novel oral antibiotics for mild/moderate patient”.

Although there are other drugs that can be used to treat mild conditions, molnupiravir remains the most effective. The ACT-A is in talks with Merck & Co and generics producers to buy the drug.

The cost is extremely low when compared to $700 for each course of treatment that the United States will pay.

Harvard University found out that the cost of molnupiravir, which is a generic version of the drug, could be as high as $20, with a potential drop in price to $7.7 for optimised production.

Merck & Co. has licensing deals with eight Indian generic drugmakers.

According to ACT-A, the company’s goal is to strike a deal before November 31 to ensure the supply of “oral outpatient drugs”. It aims to have the drug available in the first quarter next year.

According to the document, the money would first be used for “support procurement up to 28 millions treatment courses for high risk mild/moderate patients in the next twelve months” depending on availability of products, clinical guidance and volume changes with the evolution of need.

The document states that additional oral antivirals for mild cases will be obtained in larger quantities at a later stage.

Additional 4.3 Million courses of COVID-19 pills repurposed for critical patient treatment are expected to also be sold at $28 per course. The document does not name any drug.

The ACT-A will also address the essential medical oxygen requirements of six to eight million patients who are severely and critically ill by September 2022.

TEST

The program also intends to massively invest in COVID-19 Diagnostics, in an effort to double the number tests performed in the poorer countries, which are low-income and low-middle-income nations.

The document states that of $22.8 billion that ACT-A will raise within the next 12 month, approximately one-third and largest portion is expected to be used for diagnostics.

Poor countries currently conduct about 50 blood tests for every 100,000 inhabitants per day, compared to 750 in the richer countries. The ACT-A aims at reducing testing rates in less developed countries to a minimum level of 100 for every 100,000.

This means that around one billion test will be delivered in the next twelve months. That’s around 10 times the amount of tests the ACTA has purchased so far.

It is estimated that rapid antigen testing would account for the majority of diagnostics, at an average cost of $3. Molecular tests can be ordered, but they are much more expensive and take longer. They are expected to cost about $17 plus delivery costs.

According to the document, 0.4% of all the 3 billion global tests have been performed in poor countries. This is why the push for tests was intended to reduce the disparity between rich and poor.

This would help to spot newer variants earlier, as they tend to multiply when there are many infections. Therefore, it is more common in countries that have lower vaccination rates.

This document demonstrates that vaccine access is extremely inequitable, with coverage levels ranging between 1% and over 70% depending on the country’s wealth.

In line with WHO goals, the programme will aim to vaccine at least 70% of eligible populations in all countries before the middle of next years.