NEW YORK/GENEVA, MARCH 18, 2022—The Medicines Patent Pool’s (MPP) decision to sign agreements with 35 manufacturers in 12 countries to produce and supply more affordably priced nirmatrelvir/ritonavir, marketed as Paxlovid, is a positive step towards addressing the ongoing access challenges for this COVID-19 treatment. However, the limitations of the deal remain concerning as it will not increase the generic supply enough to meet the global treatment needs, said the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF).
Nirmatrelvir/ritonavir is thought to be the most promising oral, easy-to-administer drug available to treat people at high risk of developing severe and critical COVID-19. Yet, the limited global supply of this drug—produced by US-based Pfizer—has so far largely been bought up by a number of high-income countries, including the US. Meanwhile, the company is blocking wide generic production.
Pfizer signed a voluntary license deal with the MPP in November 2021, leading to these agreements with the 35 manufacturers. However, this deal excludes some key regions and middle-income countries with manufacturing capacity, several of which have suffered a high burden of COVID-19. These are also countries where nirmatrelvir/ritonavir is already patented, or patent claims are pending.
Felipe de Carvalho, MSF Access Campaign coordinator in Brazil, said of the announcement:
“The agreements signed between the MPP and 35 manufacturers to produce and supply nirmatrelvir/ritonavir are a welcome step, but the deal only covers 53 percent of the world’s population and excludes millions of people in middle-income countries.
“Most Latin American countries, including Brazil, are left out of this deal, as well as other middle-income countries, such as China, Malaysia, and Thailand. While a company in Brazil, for example, that signed this agreement will be able to produce the medicine for export, it will not be able to supply Brazil itself to meet local needs.
“This agreement underscores why countries need to take immediate steps to remove barriers for generics supply for this important COVID-19 treatment. This means overriding patents with ‘compulsory licenses,’ and not enforcing any patents or rejecting patent applications held by Pfizer. The better solution would be for WTO members to endorse a TRIPS waiver that includes all countries and covers treatments and not just vaccines. Otherwise the countries excluded from this deal will be left with limited options other than to buy high-priced treatments directly from Pfizer.”