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$6bn planned for worldwide distribution of Covid-19 drug treatments

Credit: Roche

Unitaid, Wellcome Trust and other global health partners are working with WHO to create a system for equitable distribution of lifesaving treatments - parallel to the COVAX vaccine initiative.

While the successful results of Pfizer’s Covid-19 vaccine trial, announced just this week, has raised both expectations that a vaccine rollout could begin early next year - and fears about how equitably they will be distributed - getting available Covid-19 drugs to people that need them right away is an equally momentous challenge.

A new World Health Organization (WHO) co-sponsored partnership is laying the groundwork for a worldwide distribution plan of the most effective Covid-19 drugs to ensure that high-income countries do not snap up all available new therapies as they arrive on the market.

The proposed basket of medicines would be procured under the auspices of the World Health Organization’s (WHO) co-sponsored ACT Accelerator: a collaboration with seven other UN and global health agencies and philanthropies, including Unitaid and The Wellcome Trust, to provide equitable access to Covid-19 drugs.

The ACT Accelerator is also sponsoring the better-known COVAX Facility, which 186 countries have joined. Backed by some  $15bn in World Bank loans and country donations, COVAX aims to support equitable, world-wide rollout of new vaccines to the highest-risk groups around the world, like health care workers, older people and people with chronic diseases, as soon as they become available.

The parallel ACT drug scheme requires more than $ 6bn, its sponsors say. Some $ 750m would be required by February 2021 to begin making pre-orders of drugs from pharma companies, according to the plan. Due to be released in the coming week, the plan is currently under review by the ACT Accelerator's Facilitation Council, co-chaired by Norway and South Africa, representing both donor countries as well as low- and middle-income countries (LMICs) that would benefit from reduced prices and drug reserves.

The new procurement scheme is being supported by Bill and Melinda Gates Foundation and Mastercard Impact Fund - which banded together with Wellcome Trust in a Covid-19 Therapeutics Accelerator to provide funding and support for the drug procurement effort.

Monoclonal antibodies in, Remdesivir out. More than half of this investment would go to procuring and distributing monoclonal antibodies, as part of the so-called Therapeutics Pillar - one of four pillars of the Accelerator scheme, alongside vaccines, diagnostics and health systems.

Monoclonal antibodies appear to be a promising treatment. These artificial antibodies are manufactured copies of those created by the body to fight invading viruses. The emerging treatment would join key approved treatments - like the steroid dexamethasone - in the medicine basket.

However, the Remdesivir would not be included in the plan - even though the drug was recently approved by the United States Food and Drug Administration. That is because a larger WHO study showed a lack of proven benefit - a study that the Gilead, the drug's developers ignored in their FDA submission.

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