Developing Countries: The Forgotten Victims Of COVID-19

On Thursday, Britain made the first global move to authorize the use of an antiviral pill to tackle COVID-19 symptoms. The drug, known as molnupiravir and sold by the pharmaceutical company Merck, was shown in clinical trials to reduce the risk of hospitalization and death in high-risk COVID patients by fifty percent. The take-at-home drug is expected to reach more people than treatments like monoclonal antibodies, typically administered intravenously in hospitals. Demand, predictably, is extraordinarily high, and Britain has already ordered pills for 480,000 people. Other wealthy countries have also raced to lock up supplies, including the United States, Australia, South Korea, New Zealand, Serbia, and Singapore. Last week, Merck granted a royalty-free license for the pill to a United Nations-backed non-profit, allowing the drug to be manufactured and sold cheaply in developing countries, whilst continuing to produce and sell molnupiravir in wealthy nations and many middle-income ones at significantly higher prices.

Sajid Javid, the British health secretary, described the pill’s authorization as a “historic day”, saying that “this will be a game-changer for the most vulnerable and the immunosuppressed.” Charles Gore, director of the Medicines Patent Pool, commended the new agreement with Merck as the first transparent public health license for a COVID medicine, stressing that the license would be critically important as a precedent in establishing access to COVID treatment, hoping that this would “start a landslide of people coming to the Medicines Patent Pool […] because there’s no question that access has been the problem.”

Other groups have also expressed support for the patent pool license. In South Africa, Sibongile Tshabalala, chairwoman of the Treatment Action Campaign, stated that “We have lost so many lives to the blocking of licensing.” During the HIV outbreak, Tshabalala and the TAC lobbied global drug companies for affordable treatment, and, in recent months, have been campaigning for COVID vaccine access. Global supplies of the treatment, however, are expected to be limited at first, with Merck saying it can only produce enough supply of the drug for 10 million people this year.

Promises regarding access are not uncommon, however, and whilst we may be hopeful, we must also remain wary of the devastating effects, which are all-too-easily exacerbated by the greed and doomsday hoarding of the wealthy, of COVID-19 on developing countries. Covax, the initiative set up to avoid vaccine nationalism, was created to ensure every country in the world had access to doses for 20% of its population in 2021, regardless of ability to pay. The outcome? Only around 0.8% of all COVID vaccines distributed in the world have gone to poor countries. It seems that the idea became a means for wealthy countries to boast self-righteousness without any substantive intervention or aid. Moreover, in the UK, GPs are being forced to bin excess vaccines because they have exceeded their expiration date, something the British Medical Association described as “extremely concerning, absolutely unacceptable and morally wrong.”

For developing countries, the lack of domestic financial resources, high debt levels, and fragile health systems may mean that COVID has yet more far-reaching impacts on education, human rights, food security, and economic development in the future. These multi-faceted consequences may appear subtle at first, but quickly begin to limit the fiscal space to respond to the pandemic and to recover in a manner that does not leave developing countries even further behind. It has also been revealed that the patent pool agreement for molnupiravir excludes middle-income countries and most nations in Latin America.

If the inability to share COVID treatments continues, disenfranchised countries may potentially use this as a reason to renege on their climate promises, or it may even rouse anger amongst terrorist organizations who hope to exert vengeance by disrupting the lives of citizens in wealthier nations. Only time will tell if promises to help those developing countries remain empty, or whether we might finally extend overseas the fundamental social responsibility that the pandemic has reminded us to share with our home-country neighbors.