A new initiative to introduce COVID-19 oral antivirals and national test-and-treat programmes in 10 countries in Africa and Southeast Asia was launched on Wednesday by the COVID Treatment Quick Start Consortium.

The consortium will support governments to introduce and scale up access to antivirals, starting with Pfizer’s Paxlovid, in high-risk populations in Ghana, Kenya, Laos, Malawi, Nigeria, Rwanda, South Africa, Uganda, Zambia, and Zimbabwe. 

In Africa just over 20% of the population is fully vaccinated and vulnerable people, particularly the elderly and immune-compromised, are at risk of developing severe illness or dying from COVID-19.

Paxlovid has been shown to reduce deaths in elderly people by over 80% if it is taken within five days of infection, which is why early COVID-19 testing is particularly important.

However, access to Paxlovid is presently limited and it is largely available in high-income countries only. In addition, of three billion COVID-19 tests administered worldwide since the pandemic, only 0.4% took place in a low-income country.

Operational research on test-and-treat

The initiative will combine the antiviral roll-out with operational research on how best to develop and scale up COVID-19 test-and-treat programmes in low- and middle-income countries.

Pfizer will donate 100,000 courses of Paxlovid to start, but the programme will shift to using low-cost generics as soon as they become available, according to the consortium.

The consortium is made up of Duke University, the Clinton Health Access Initiative (CHAI), COVID Collaborative, and Americares as implementing partners, with support from the Open Society Foundations, Pfizer and the Conrad N. Hilton Foundation.

“We have seen throughout the global COVID-19 response that new life-saving interventions like vaccines and treatments are not quickly reaching those most in need around the world,” said Dr Krishna Udayakumar, founding director of the Duke Global Health Innovation Center.

“The Quick Start Consortium is partnering with governments to bring urgently needed medicines to high-risk populations in countries that do not have easy access to such innovations.” 

COVID Collaborative president Gary Edson described the 18-month programme as “the first concerted effort to bring new highly effective COVID oral antiviral treatments to low and middle income countries”, adding that it will complement the efforts of the US government and multilateral organisations with whom we’ve been closely coordinating

Professor Lloyd Mulenga, director of infectious diseases for the Zambian Ministry of Health, said that his government had wanted access to oral antivirals to treat those with COVID-19 “and we are thus excited to be part of an initiative accelerating Paxlovid for use for COVID management”.

“With this new milestone, we expect less [hospital] admissions and also fewer COVID-related deaths leading to a reduced burden on our health system,” added Mulenga.

“The Quick Start Consortium will help us to continue to build and strengthen a resilient healthcare system, quickly find the patients who need treatment, and make sure they get needed medicines, regardless of socio-economic status,” said Professor Claude Muvunyi, Director General of Rwanda Biomedical Center. “Like so many other diseases, COVID-19 won’t go away if you just ignore it.” 

Correct injustice of access

CHAI CEO Dr Neil Buddy Shah said that the programme aimed to correct the injustice of disproportionate access to life-saving COVID-19 tools, but added that this goal could not be met by Quick Start alone.

“We welcome additional partners to join our consortium’s efforts,” said Shah. CHAI has been instrumental in assisting African countries to get access to cheaper antiretroviral medication to treat HIV.

Meanwhile, Christine Squires, President and CEO of Americares, one of the world’s leading non-profit providers of donated medicine and medical supplies, said that the COVID-19 pandemic had claimed over six million lives and impacted the health of hundreds of millions of people over the past two and a half years.

“By expanding access to testing and treatment in low- and middle-income countries, we will be taking a more equitable approach to reduce hospitalisations and severe disease and, ultimately, save lives,” she stressed.

Image Credits: Pfizer .