* ACT-A wants to raise $22.8 bln to buy vaccines, drugs,
* Sees "at risk" deal for 28 mln courses of COVID pill by
* Wants to enable access to new COVID drugs for 120 mln
* Programme to buy pills for critical patients, oxygen
* It wants to procure 1 bln tests for poorer nations
BRUSSELS, Oct 19 (Reuters) - 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
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
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 countrys 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
The ACT-A also intends to address essential medical oxygen
needs of 6-8 million severe and critical patients by September
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
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 Jersey
Editing by Susan Fenton)