Access to COVID-19 Antivirals and Future Outbreak Medical Counter-Measures

In December 2021, two treatments for COVID-19—Paxlovid, developed by Pfizer, and Lageviro, developed by Merck—received emergency use authorization in the US. One year later, access remains concentrated in wealthier countries and demand in lower-income countries is extremely low. Pfizer and Merck signed voluntary licensing agreements with select manufacturers to produce generic versions at more affordable prices, but these products are not expected to be available until 2023. Even then, insufficient deployment infrastructure may hamper patient access.

As COVID-19 evolves into an endemic disease and macroeconomic challenges squeeze health budgets, we need a more realistic strategy. Governments and donor partners must advance a more strategic approach with targeted goals for oral antiviral access. In the near-term, efforts to stabilize demand, speed up the production of high-quality generics, and lay the infrastructure for delivery will serve as an important insurance policy if—or when—a dangerous new variant emerges, especially in settings where vaccination coverage is low. In the longer-term, the global community must learn from this experience to accelerate access to oral antivirals and other medical countermeasures to combat future disease outbreaks.

A new body of CGD research examines the current state of play on COVID-19 antivirals. They provide a deep dive into key cross-cutting areas—demand, voluntary licensing for generic supply, and deployment—and offer policy actions for 2023 and beyond.

More from the Series

CGD NOTE
Developing an Omni-Channel Deployment Strategy for COVID-19 Oral Antivirals
December 14, 2022
Ensuring rapid and equitable access to effective oral COVID-19 therapies is essential to reducing health disparities from COVID-19 and building a better response system for future epidemics and pandemics. A multipronged strategy for medical countermeasures must include antivirals, monoclonal antibod...
CGD NOTE
Lessons from Expanding Access to COVID-19 Treatments in LMICs through Voluntary Licensing
December 14, 2022
Voluntary licensing agreements can be a powerful tool to facilitate global access to essential medicines—but without careful attention to their features, their impact on access in LMICs will be too little, too late.
Blog Post
Do COVID-19 Oral Antivirals Represent Good Value for Money for African Countries?
December 14, 2022
It’s clear that COVID-19 oral antivirals are effective, and recent deals have made them even cheaper for African countries. But should these countries be investing in these medicines? Or would spending on alternative health services be better value for money? Unfortunately, there is very little avai...
CGD NOTE
Oral Antiviral Treatments for COVID-19: Time to Revisit?
December 14, 2022
Almost a year after two oral antiviral treatments received emergency use authorization, demand is extremely low. In this note, we argue that governments and their donor partners should use data and evidence to consider the economic and clinical rationale for registering, financing, purchasing, and d...