Studies have shown that Pfizer’s new oral COVID-19 pill looks promising, but one of the several lingering questions has been who’ll get access once the antiviral medicine is approved. Today, the drugmaker surprised people with an answer, announcing it has signed a licensing agreement that will allow generic versions of the pill to be produced around the world. The partner in the deal is a UN-backed organization called the Medicines Patent Pool that was started during the HIV/AIDS epidemic; it exists to negotiate these specific kinds of generic deals in order to make high-quality drugs widely available. The Pfizer deal gives other drug companies permission to manufacture its COVID pill for use in 95 different countries that collectively have about 53% of the world’s population.
The license agreement shows which countries got access, but the equation for determining them was somewhat arbitrary, as Pfizer’s own explanation of the list shows:
This includes all low- and lower-middle-income countries and some upper-middle-income countries in sub-Saharan Africa as well as countries that have transitioned from lower-middle to upper-middle-income status in the past five years.
Under the terms, Pfizer says it’s waiving royalties on sales until WHO stops classifying COVID-19 as a public health emergency, and will never take royalties on sales in low-income countries.
Since the pandemic began, scientists have been hustling to create a pill that will easily treat COVID-19 at home—ease its symptoms, hasten the recovery, and just generally help hospitals from filling up. For people with mild or moderate infections, Pfizer says its pill cuts the risk of hospitalization and death by 89%. So this development is heartening news both for poorer countries and for the pandemic as the whole. At this point, no pharmaceutical company—Pfizer included—has agreed to release its COVID-19 vaccine for wider production like this. (The AP says, for instance, that fewer than 1% of the Pfizer-BioNTech shots have gone to poorer countries.)
Still, the deal does exclude some big countries that have been devastated by outbreaks. A generic pill won’t be available for use in Brazil, for example, where the National Congress is threatening to charge President Jair Bolsonaro with “crimes against humanity” for his mishandling of the pandemic. Doctors Without Borders says it is “disheartened” that Pfizer didn’t make the drug available to the whole world, noting the deal technically barely includes more people than it excludes—among them, the populations of China, Russia, and Thailand.