Fair Treatment: The place of therapeutics in future pandemics

At the 74th World Health Assembly (WHA) to be held in Geneva, Switzerland 27 May – 1 June, the World Health Organization (WHO) has set itself a deadline for the negotiations to succeed around an inaugural Pandemic Accord.

Much of the conversation around the Accord text to date and within the broader debate around pandemic preparedness has been focused on equitable access to medicines, vaccines and other medical countermeasures, and waivers of intellectual property rights. A considerable portion of the “access” discussion has been attached to vaccines, with the need for therapeutics far less prominent. This mirrors, to a large extent, the scientific response to the COVID-19 pandemic. During the first 12 months of the COVID-19 pandemic, USD$91 billion was publicly invested globally in vaccines compared to just USD$4.6 billion in therapeutics.

The first COVID-19 vaccine was approved in July 2020 and delivered to people in December 2020. However, the therapeutic drug, Paxlovid, was only first administered in late 2021 and approved by the Federal Drug Administration in May 2023. If Paxlovid and Molnupiravir, or a similar therapeutic drug, had been available at scale in July 2020, in line with COVID-19 vaccine approval, millions of lives globally could have been prevented. Today these treatments still remain expensive and are largely only available in high income countries. Timely and accessible therapeutics, along with diagnostics and vaccines, are critical to any future pandemic response.

Meanwhile experts point out that although the rapid vaccine development and rollout for the COVID-19 pandemic was extraordinary, vaccine development for future new pandemics may prove more challenging, and that vaccines may not emerge in such a short space of time. Therapeutics, they argue, need to be an investment priority for future pandemic preparedness.

Ahead of the World Health Assembly, the Cumming Global Centre for Pandemic Therapeutics (Cumming Global Centre) at The Peter Doherty Institute for Infection and Immunity (Doherty Institute) in Melbourne, Australia, hosted a virtual panel of experts moderated by the UK’s Channel 4 Health and Social Care Editor, Victoria Macdonald. The panel broadly discussed the role of therapeutics and medical countermeasures in pandemic preparedness negotiations.

Who:

Victoria Macdonald, Health and Social Care Editor, Ch 4, London, UK (Moderator)

Michel Kazatchkine, Former member of The Independent Panel for Pandemic Preparedness and Response and Senior Fellow with the Global Health Centre of the Graduate Institute for International and Development Studies in Geneva, Geneva, Switzerland

Eloise Todd, Executive Director, Pandemic Action Network, Brussels, Belgium

Harjyot Khosa, Regional External Relations Director, International Planned Parenthood Federation & Long COVID Advocate, Delhi, India

Shingai Machingaidze, Co-Chair, The Science and Technology Expert Group (STEG), International Pandemic Preparedness Secretariat (IPPS), Addis Ababa, Ethiopia

Sharon Lewin, Director, The Peter Doherty Institute for Infection and Immunity and Director Cumming Global Centre for Pandemic Therapeutics, Melbourne, Australia