Experts say that while the pill may seem promising, they are worried that some people will use it as an alternative to vaccines, which still provide better protection.
While low-income countries have been accused of hoarding doses by rich countries, they warn that last year’s vaccine catch could make Asia’s race see it again.
“(Molnupiravir) really has the power to change the game a little bit – it has the potential,” said Rachel Cohen, North American Managing Director for Nonprofit Drugs, an initiative for neglected diseases.
“We need to make sure we do not repeat history – we do not fall into the same patterns or repeat the same mistakes we saw in Govt vaccines.”
What is Molnupravir?
Molnupravir is considered a positive step because it provides a way to treat Govit-19 – patients do not need to be hospitalized.
The pill works like this: Once a patient is diagnosed with Covit-19, they can start the course of molnupravir. It consists of four 200 mg capsules, twice a day, for five days – a total of 40 tablets.
Sanjay Senanayake, an epidemiologist and medical associate professor at the Australian National University School of Medicine, said that unlike immunosuppressive vaccines, molnupravir disrupts the virus’ response. “In a way, the virus makes children unhealthy,” he said.
“Antiviral treatments that can be taken at home are very necessary to get those with Covit-19 out of the hospital,” he said.
Experts agree that the drug is promising. Instead of waiting to see if patients become seriously ill, Cohen said, from the Medicines initiative for neglected diseases that can be treated straight after the virus is diagnosed.
Unlike other Govit-19 treatments, Molnupravir can be taken at home and hospital resources can be released to the most ill patients.
“Getting the tablet is very simple,” Senanayake said. “This is a game changer.”
What does Govit mean for pill vaccines
But even in the Asia-Pacific, vaccination rates in many countries have improved after a slow start, with millions of people not yet vaccinated because they are not qualified, or they cannot access the footage.
And the tablet comes inside.
“There are many who can’t get vaccinated,” said Niall Weidt, an associate professor at the School of Pharmacy at the University of Sydney. “This drug will be a leading solution for the sick.”
But wheat and other experts are concerned that the pill may make it harder for some people to get vaccinated, which increases the vaccine reluctance found in many countries, including Australia.
Research shows that people prefer to swallow drugs rather than being injected, Weed said.
“If you had told me a year and a half ago that people would refuse a vaccine for a disease that would destroy this planet, I would have thought you were crazy,” he said. “People are always more likely to think that this drug is a better solution than vaccination.”
But experts say this pill is not a substitute for vaccines.
Senanayake says the approach is the same as how we treat the flu – there is a flu vaccine, but there are also antiviral drugs to treat those who are sick.
Cohen says the pill does not mean there is less urgency in increasing equivalent access to vaccines.
“Vaccine equality is the defining challenge of our time. But you can never fight an infectious disease with a single tool,” he said. “We really need a full arsenal of health technologies.”
Why Asia-Pacific countries buy Govit pill
According to Airfinity data, 10 countries or regions are in talks or have signed agreements for the tablet – eight of which are in Asia-Pacific.
“I think we need to make sure we are ahead of the game when it comes to these other new developments,” Senanayake said.
“There are a few middle-income countries out there that I think shouldn’t fall into the same trap they left when high-income countries hoarded all the vaccines,” Cohen added.
It is not clear how much each of these countries will pay for the pills.
Merck did not confirm whether those estimates were accurate, but said in a statement to CNN that the calculations did not take into account research and development.
“We have not yet established its price as Molnupravir is not approved for use,” the company said. “We have entered into an advance purchase agreement with the US Government, and that price is a substantial amount specified for Molnubra and does not represent a list price for the United States or any other country.”
Low-income countries may be at a disadvantage when using the pill.
Once a drug is approved for use, countries must decide whether to give it to anyone with symptoms or whether a positive test is needed before they receive it.
But it requires access to testing. In some countries it may be an issue, Cohen said. The interim results of the pill are for those given within five days of the onset of symptoms – and in some countries, getting a test sooner can be a problem.
First, the question is how they can access it.
Although the drug is simple to prepare, according to Lena Mengane, the South Asian head of the group’s access campaign, Merck controls the patent and can determine which countries should supply the drug at what price.
Cohen said health tools and technologies should be considered a common good – and the situation raised questions about how we can ensure that those benefits are shared equally.
“We are concerned that this will lead to a kind of therapeutic nationalism,” he said. “What we are most concerned about is that equal access to antivirals can be a challenge, especially in low- and middle-income countries.”
Senanayake once again said that rich countries run the risk of receiving more than their fair share.
“By Govt, you have to be selfless to be selfish,” he said. “Otherwise, if you protect your own small nest, your own small country, a new variant of the vaccine could develop if it occurs in other countries.”