Pfizer on Tuesday announced it reached a deal with the Medicines Patent Pool (MPP), a nonprofit backed by the United Nations, to allow its Covid-19 antiviral pill to be made inexpensively in 95 low-income countries.

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Details on the deal

As part of the deal, Pfizer will grant MPP a royalty-free license for the treatment, which is known by the brand name Paxlovid.

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Other drug manufacturers will then be able to take out a sublicense, receive the formula for Pfizer's drug, and sell the medication to 95 low-income countries once the World Health Organization (WHO) and other regulators authorize the medication in those countries.

A similar deal previously was reached between Merck and MPP for Merck's Covid-19 antiviral pill, molnupiravir.

"Pfizer will not receive royalties on sales in low-income countries and will further waive royalties on sales in all countries covered by the agreement" until the pandemic is no longer classified as a "public health emergency" by WHO, Pfizer said in a press release.

Pfizer said it plans to produce enough of its pill for 180,000 people by the end of the year. It will then increase manufacturing and expects to produce at least 50 million courses of the treatment in 2022, including at least 21 million in the first half of the year.

Charles Gore, executive director of MPP, said more than 20 companies already have contacted MPP expressing interest in manufacturing Pfizer's treatment, and that production could begin in the first quarter of 2022.

"We're not going to be handing out licenses to just anybody," Gore said. "At the same time, we want to make absolutely certain that there is enough supply."

Stephen Saad, CEO of the South African drugmaker Aspen Pharmacare, said his company likely will apply for a sublicense and will aim to sell a generic version of the treatment for $10 a course throughout Africa. However, Saad said he's unsure when the company will be able to start manufacturing the drug, as he doesn't yet know what's involved in making it or what raw ingredients are available.

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Reaction

According to Gore, the Pfizer deal will be "really important for low- and middle-income countries, because [the drug] is easy to take, just a short course of five days, and potentially relatively cheap to produce."

The treatment is especially needed in countries where few people have been vaccinated, the New York Times reports. Since the treatment can be taken at home, it can be distributed relatively easily even in countries with limited health care facilities.

"The fact that we now have two manufacturer-anywhere licenses for these two drugs is a big change, and it draws a big contrast with the restrictive licensing so far for vaccines," James Love, leader of Knowledge Ecology International, said.

Even so, some observers criticized the relatively limited scope of the deal. Pfizer's agreement excludes a number of low-income countries that have been hit hard by the coronavirus, including Cuba, Iraq, Libya, and Jamaica, the Times reports.

The deal also excludes China and Russia—two countries with a combined population of 1.5 billion people—as well as Brazil.

Felipe Carvalho, coordinator of Doctors Without Borders' access-to-medicines campaign in Brazil, criticized the exclusion of Brazil from the deal.

"It is outrageous that a high-burden country like Brazil is once again left behind on access to treatment," he said. While Brazil classifies as an upper-middle-income country, Carvalho said 75% of people in the country rely on its public health system, and few can afford expensive treatments. (Nolen/Robbins, New York Times, 11/16; Herman, Axios, 11/16; Hopkins, Wall Street Journal, 11/16)