Unequal access to vaccines harm recovery

It’s now two years since the World 健康 Organization began calling the COVID-19 outbreak a p和emic. 但是,世界各地获得疫苗的机会仍然极不均衡.

两年前是这样的 unclear whether it would even be possible 研发新型冠状病毒有效疫苗或治疗方法. In the interim, we’ve seen enormous scientific advances made in record time将一种而不是一种疫苗和一系列治疗方法推向市场.

但是,世界各地获得疫苗的机会仍然极不均衡. 现在,由于不公平地获得COVID-19治疗,也出现了类似的问题.

与此同时, 世界贸易组织(WTO)全球十大赌钱软件App放弃COVID-19健康产品和技术知识产权的谈判, underway for almost 18 months, are still in a state of paralysis. 而且在世贸组织达成的任何协议都有可能只适用于疫苗, 导致全球约一半人口无法获得或负担不起治疗.

Access to vaccines is still vastly unequal

全球已使用近110亿剂COVID-19疫苗, 但是世界上三分之一以上的人口仍然没有接种疫苗 13.7% of people in low-income countries have yet received one or more doses.

到2021年底, more boosters had been administered 高收入国家的总剂量高于低收入国家.

虽然通过covid - 19疫苗获取渠道的供应在过去几个月一直在增加, there is still a long way to go to reach the 他的目标 到2022年6月底为每个国家70%的人口接种疫苗.

And with effective 治疗 now entering the market, 全球十大赌钱软件App很可能看到类似的不平等模式,除非全球十大赌钱软件App解决阻碍公平获取的动力.

Antiviral 治疗 have become increasingly important

比如辉瑞公司生产的口服抗病毒药Paxlovid和默克夏普公司生产的Lagevrio & Dohme with Ridgeback Biotherapeutics, 是防治这一大流行病工具箱中日益重要的一部分吗.

辉瑞的Paxlovid是一种名为nirmatrelvir的新化学实体的组合, ,例如, an older drug used to treat HIV. Paxlovid作品 与酶结合 that is needed for viral replication. 辉瑞公司报道 临床试验参与者在症状出现3天内接受药物治疗,住院或死亡的风险降低了89%.

默克公司的molnupiravir(品牌名Lagevrio)也可以防止病毒复制, but in this case by incorporating itself into the viral RNA, disabling its ability to reproduce. Molnupiravir reduces the risk of hospitalisation 在30%左右.

而 both drugs have limitations, 它们已被证明可以降低风险较高的成年人患严重疾病的风险, 与其他类型的治疗相比,它们的优势在于可以在家里进行. This is particularly important for countries without strong health systems, 和 where vaccination coverage is less than ideal.

Patents on 治疗 enable high prices 和 profits

辉瑞 has signalled it has filed, or intends to file, patent applications covering Paxlovid 在至少61个国家以及一些区域专利局.

Multiple patent applications 还申请了吗 molnupiravir 在许多高收入国家和一些中等收入国家,如印度和巴西.

其中一些专利申请要么被拒绝,要么被批准,可能需要数年时间, 但是这种不确定性使得仿制药公司很难进入市场.

默克公司正在向美国等高收入国家销售一疗程的莫仑匹利亚韦 712美元(970美元), around 40 times the cost of production. 辉瑞公司是 收费530美元(A722美元) 一个疗程的帕克斯洛维德.

虽然两 辉瑞 和 默克公司 have offered tiered pricing based on a country’s income level, 目前尚不清楚价格将如何设定,以及人们是否负担得起. 分级定价已经 criticised for failing to lower prices sufficiently for middle-income countries in the past.

Paxlovid是辉瑞公司的另一个巨大的摇钱树 US$22 billion (A$30 billion) in revenue from sales of the drug in 2022. And 默克公司’s 2022 revenue forecast for Lagevrio is 5 - 6美元 (6 - 8美元).

针对低收入国家的非专利抗病毒药物,但中等收入国家却没有

辉瑞和默克已经与药品专利池达成自愿许可协议,这将使世界上任何地方的仿制药公司能够为某些低收入国家生产更便宜的仿制药.

But these license agreements are tightly restricted. 默克的 agreement with the Medicines Patent Pool permits supply of the generic copies to only 105 countries. 辉瑞’s  license agreement for Paxlovid restricts its supply even more tightly, 95个低收入和中等收入国家,仅占全球人口的53%.

这些许可协议都不包括泰国等中等收入国家, 中国, 以及墨西哥——在这些国家,专利产品的价格有可能使他们买不起.

High income countries have pre-purchased large quantities

Making the situation even worse, 富裕国家正在抢购专利产品的有限供应, 就像疫苗一样.

辉瑞 expects to manufacture 120 million courses of Paxlovid this year. At least 30 million of the treatment courses have already been pre-purchased 包括2000万份与美国签订的合同. 与此形成鲜明对比的是, 辉瑞公司承诺只向低收入国家提供1000万剂疫苗, 与疾病负担相比,这个数字非常不足.

默克公司 plans to make 20 million courses of Lagevrio in 2022, 3.1 million of which have been promised to the US government, 和 默克公司 has also entered into deals with “加拿大、韩国、澳大利亚、日本、泰国、乌克兰等全球30多个市场”.

Australia’s 健康 Minister 宣布 advance purchase agreements for 500,00 doses of Paxlovid 和 300,000 courses of molnupiravir in October 2021.

世贸组织陷入僵局

不幸的是, 投入在创造新产品上的努力并没有与公平分享这些产品的努力相匹配.

一项放弃要求各国提供COVID-19健康产品和技术专利和其他知识产权的世贸组织规则的提议, first made by India 和 South Africa in October 2020, 现在是 co-sponsored by 63 of the WTO’s 164 countries 和 supported by more than 100.

Adoption of this proposal, known as the 放弃旅行, 能让制造商进入市场,而不用担心侵犯知识产权的诉讼吗. 这将为更广泛地生产COVID-19疫苗扫清道路, 治疗, diagnostic tests 和 other technologies to fight the p和emic.

But the 放弃旅行 proposal is still languishing due to opposition by the EU, UK 和 Switzerl和 -总部强大的制药公司-和 pharmaceutical industry has been lobbying against it.

The EU is pushing a separate proposal, which 依赖于允许强制许可的世贸组织现有规则. 然而, 这是一个繁重而漫长的过程,无法在全球范围内提供快速访问.

而美国是 only supporting a waiver for vaccines. 这是一种有限的方法,将使许多中等收入国家无法负担专利药品或购买仿制药品.

Two years into the p和emic, 早该制定全球解决方案,提供世界管理COVID-19所需的所有产品和技术.

This article originally appeared in 谈话.