USA – Pfizer has reached an agreement to supply up to six million courses of its COVID-19 antiviral Paxlovid to the Global Fund to get treatment to low and middle-income countries.

This supply agreement was made as part of the Global Fund’s COVID-19 Response Mechanism (C19RM), Pfizer said in a statement.

“The C19RM has been the primary channel for providing grant support to low- and middle-income countries to purchase COVID-19 tests, treatments, personal protective equipment, and critical elements of health systems strengthening,” Pfizer said.

“PAXLOVID treatment courses will be available for procurement through this mechanism, subject to local regulatory approval or authorization, by the 132 grant-eligible countries determined by Global Fund based on income classification and disease burden.”

The company said it expects the supply of Paxlovid to become available sometime this year. Paxlovid was the first oral antiviral treatment for Covid-19 granted emergency use by the Food and Drug Administration in December 2021.

Paxlovid is made up of two separate medications: two doses of nirmatrelvir and one dose of ritonavir.

Nirmatrelvir stops a key enzyme that causes the coronavirus to replicate, and ritonavir – once used to treat HIV/AIDS – is used to boost levels of nirmatrelvir so that it stays in the body’s system longer. Patients take three pills twice a day for five days.

The Paxlovid courses will be sold according to Pfizer’s tiered pricing model, with low-income countries paying not-for-profit prices and upper-middle-income countries paying according to the tiered approach.

Access to coronavirus therapeutics like Paxlovid, which must be administered within five days of symptom-onset, has been limited for poorer countries. Efforts to provide access to these treatments to poorer countries have been since authorized.

Facilitating equitable access to Covid treatments

Pfizer said the supply agreement is part of its strategy to facilitate equitable access to oral COVID-19 treatments.

Though Paxlovid is readily available in the US and Europe, Pfizer has received criticism for limited access to the drug elsewhere.

In April, the World Health Organization condemned the US$246 billion market cap company for limited distribution and lack of price transparency for Paxlovid.

WHO expressed its concern that “low- and middle-income countries will again be pushed to the end of the queue when it comes to accessing this treatment.”

This agreement with Global Fund is a part of Pfizer’s plan to address these criticisms by distributing Paxlovid worldwide.

To that end, Pfizer is also working with UNICEF to supply 95 low-and-middle-income countries with four million courses of Paxlovid.

Earlier this month, Pfizer donated 100,000 courses of Paxlovid to the Covid Treatment Quick Start Consortium, a newer organization created with the goal of helping countries set up test-and-treat programs.

The company has made a deal with several generic drugmakers to produce its treatment at a lower price for developing countries.

The company has also signed a licensing agreement with Medicines Patent Pool, a United Nations-backed public health organization, to assist in the creation and distribution of generic versions of Paxlovid.

Expected to be ready by the end of the year, these generics will be available in 95 low- and lower-middle-income countries.

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