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COVID-19 ISO Insights

Poor Countries Struggle to Acquire Covid-19 Vaccines and Treatments

November 8, 2021

By Travis Decaminada

Key Takeaway: Although a Covid-19 vaccine is reportedly widely available in most affluent countries, this is not the case for the billions of people living in the world’s poorest countries – some of which currently have a vaccination rate of only one percent. Poor countries are also struggling to acquire treatments like remdesivir or Merck’s new antiviral drug molnupiravir, despite efforts to make these drugs more available to them and supplies actually often being hindered by wealthy countries pre-ordering massive quantities of the drugs.

Poor countries around the world have been battling the Covid-19 pandemic with limited resources since the virus first appeared. One incredibly valuable action that wealthier nations can take to help is by donating vaccines. Several wealthy countries have pledged to donate vaccines, reports The Guardian, however, out of the 1.8 billion promised vaccine doses, only 261 million have actually been delivered to developing countries thus far (~14% of the total pledge). As noted by The Guardian:

  • The U.K. pledged to donate 100 million vaccine doses but has delivered less than 10 million to date. (~10% of their pledge)
  • The U.S. vowed to donate a staggering 1.1 billion doses but has only delivered 177 million thus far. (~16% of their pledge)
  • Canada vowed to donate 40 million doses but has only delivered 3.2 million as of yet. (~8% of their pledge.)
  • Covax, a consortium of the worlds largest pharmaceutical companies including Pfizer, Moderna, AstraZeneca, and Johnson & Jonson, promised to donate 994 million vaccine doses, but have only delivered 120 million doses so far. (~12% of their pledge).

In the world’s poorest countries, reportedly, only 1.3% of people are fully vaccinated. The World Health Organization (WHO) is imploring wealthy nations to deliver their promised vaccine doses by year’s end, asserting that any delay will lead to unnecessary deaths.

Further, some health experts argue that the only way to truly end the pandemic is to share the technology and knowledge necessary to manufacture vaccines with developing countries, allowing them to produce the vaccines they need independently. For this reason and others, at least 100 nations have petitioned the World Trade Organization (WTO) to suspend their enforcement of patents for Covid-19 vaccines.

Supply and Demand

A related article from the New York Times describes some of the challenges that developing countries are facing, or will face, when trying to acquire Covid-19 treatments. The article uses a new pill being developed by Merck called molnupiravir as an example, a drug which can reportedly prevent severe Covid-19 symptoms including death, upon onset of infection. Even though Merck has reportedly entered into agreements with 100 developing nations to allow them to manufacture generic versions of the pill, experts are still concerned that simply sharing the formula will not be enough. From the New York Times:

Drug-access advocates say the Merck licensing deal is an encouraging start but only a small step toward equity. Merck has begun production of the drug, but it is unclear how much of the generic product will be available next year. The agreements leave out many undervaccinated nations, such as Ukraine, that have been hit hard by Covid. And an antiviral must be combined with reliable, affordable [COVID] testing, which is also limited in many places.

Because of its limited availability and the additional costs molnupiravir may end up largely being used in wealthy countries, regardless of the aforementioned deals. Additionally, from The Times “[h]alf of all the coronavirus infections reported in low- and middle-income nations in the first six months of 2021 occurred in 32 countries excluded from the Merck license.”

What’s more, wealthy countries have already begun to pre-order tremendous quantities of molnupiravir, in a similar fashion as they did the antiviral drug remdesivir at the beginning of the pandemic. Should molnupiravir receive emergency use authorization, the U.S. has already agreed to purchase 1.7 million courses of the drug from Merck at a price tag of $1.2 billion. 1.7 million courses of molnupiravir would reportedly equal about 20% of what Merck can manufacture in a given year. Moreover, other countries including Australia, South Korea and New Zealand also have pre-ordered significant quantities of the drug. Ultimately, this likely means that poorer nations will be unable to afford to buy a meaningful amount of molnupiravir in the coming year.

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