By Wallace Mawire
As the latest subvariant of COVID-19 continues to spread, a new test-and-treat consortium announced that it is moving quickly to support Ministries of Health in 10 low- and middle-income countries to provide oral antiviral treatments immediately to high-risk patients and scale up wider access through 2023.
The COVID Treatment Quick Start Consortium brings together 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. The consortium will support governments to introduce and scale up access to new and effective COVID-19 oral antiviral therapies in high-risk populations and expects patients to start receiving treatment in select countries in September. Partner countries include Ghana, Kenya, Laos, Malawi, Nigeria, Rwanda, South Africa, Uganda, Zambia, and Zimbabwe.
“We are eager to continue the fight against the COVID-19 pandemic and make sure it does not become entrenched in our society,” said Prof Claude Muvunyi, Director General, Rwanda Biomedical Center. “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. Like so many other diseases, COVID-19 won’t go away if you just ignore it.”
The project will kick-start programs through a donation by Pfizer of 100,000 courses of PAXLOVID™ (nirmatrelvir/ritonavir), for which the World Health Organization (WHO) issued a strong recommendation for use in high-risk individuals with mild to moderate COVID-19, administered within five days of symptom onset. These test-and-treat programs will shift to using quality assured, low-cost generics when they become available to facilitate wider adoption throughout low- and middle-income countries.
“Having oral antivirals for COVID is something we have always looked forward to, and we are thus excited to be part of an initiative accelerating PAXLOVIDTM for use for COVID management,” said Professor Lloyd B. Mulenga, Director of Infectious Diseases for the Ministry of Health, Zambia. “With this new milestone, we expect less admissions and also fewer COVID related deaths leading to a reduced burden on our health system.” In addition to donating PAXLOVID™, Pfizer will provide financial support to help further the activities and objectives of the consortium but will not participate in project design or have access to country-level data generated through operational research.
“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.”
This effort to close gaps in access to new COVID-19 medicines comes as the subvariant Omicron BA.5 has become a primary source of COVID-19 infections this summer, according to the WHO. The virus has remained a Public Health Emergency of International Concern since January 20, 2020.
“The program will provide governments with catalytic access to the drugs and technical assistance needed to quickly scale up testing and treatment to reach those who need it most. CHAI and our Quick Start partners are deeply committed to correcting the injustice of essential, lifesaving COVID-19 tools disproportionately available to those lucky enough to live in high-income markets,” said Dr. Neil Buddy Shah, Chief Executive Officer of CHAI. “But this goal cannot be met by Quick Start alone, and we welcome additional partners to join our consortium’s efforts.”
“In addition to identifying the most effective pathways for new product introduction and implementation of test-and-treat, our consortium will establish a learning network – open to all – across countries and sites,” said Gary Edson, President of COVID Collaborative. “By developing and sharing learnings in near-real time, we hope to catalyze and inform additional country programs and population-level scale-up.”
“Over the past two and a half years, we have seen the COVID-19 pandemic impact the health of hundreds of millions of people and claim more than six million lives,” said Christine Squires, President and CEO of Americares, one of the world’s leading nonprofit providers of donated medicine and medical supplies. “By expanding access to testing and treatment in low- and middle-income countries, we will be taking a more equitable approach to reduce hospitalizations and severe disease and, ultimately, save lives.”
“COVID-19 has exposed the massive inequities in our global health system of who can access vaccines, tests, and treatments,” said Mark Malloch-Brown, President of the Open Society Foundations. “The Open Society Foundations is proud to support the first program to address the urgent gap in test and treatment availability for COVID-19, and which aims to demonstrate that enhancing timely access to diagnostics and low-cost antivirals can be a viable long-term solution to help end this pandemic.”
Over the past two and a half years, the COVID-19 pandemic has revealed significant global disparities in the availability of therapeutics, vaccines, testing, and other medical interventions that could limit the range and impact of the disease. In contrast, approximately hundreds of millions of HIV and malaria rapid tests are performed annually, largely in low- and middle-income countries, with treatment provided soon thereafter, highlighting the feasibility of test-and-treat approaches.
Access to treatment has become another urgent need to tackle alongside persistently low primary vaccination and booster rates in many countries. New antiviral medicines, such as PAXLOVID™ and molnupiravir, have been available in high-income countries since late 2021 but are not yet widely available in low- and middle-income countries, where self-testing must be scaled in parallel.
“The pandemic has proven that supply is only one step towards enabling greater access of COVID-19 treatments and bringing an end to the pandemic for everyone everywhere,” said Caroline Roan, Senior Vice President, Global Health & Social Impact, and Chief Sustainability Officer for Pfizer. “Broad and sustainable systems for rapid testing and diagnosis must be in place to help ensure that treatment courses can reach high-risk patients in need. We are committed to working with the global health community to address barriers to access and are proud to provide our oral treatment and financial support to further the objectives of the consortium.”
“We are proud to join our partners in the COVID Treatment Quick Start Consortium to improve access to life-saving treatments in Africa,” said Peter Laugharn, President & CEO of the Conrad N. Hilton Foundation. “The Quick Start program will center the experiences of local communities to help save lives immediately. Looking ahead, this program will lay the groundwork for equitable access to COVID testing and treatment continent-wide.”
The next step for the COVID Treatment Quick Start Consortium will be to work with Ministries of Health to begin introducing PAXLOVID™ into countries. The consortium will combine this introduction with operational research to inform how best to deploy and scale up COVID-19 test-and-treat programs in low- and middle-income countries. The initial product introduction and research will pave the way for quality assured, low-cost generic equivalent drugs, which will be critical to the sustainability of programs in partner countries.