Could Merck’s Covid Pill be the Magic Bullet for Low-Income Countries?

October 11, 2021

Merck & Co have created a new treatment for COVID-19 in the form of an experimental pill that is flying through the regulatory red tape due to resounding success in their clinical trials. Merck & Co. have created the pill with the hopes of distributing it to lower income nations that have disproportionately low vaccination rates as a result of inequities in technology.

Merck & Co have created molnupiravir, an antiviral treatment that is the first of its kind. Molnupiravir stands alone, as all other authorized Covid therapies in the United States require an IV or an injection. In contrast, molnupiravir is designed to be administered orally which effectively eliminates a substantial amount of the dependencies on technology for dissemination of the current Covid treatments. 

There is a strong correlation between less developed countries with limited access to technology and low vaccination rates. The COVID-19 pandemic has once again illuminated the “longstanding systemic disparities in technology [as well as] access and [technology] literacy”. Even in the U.S., access to technology was a massive piece of the puzzle in attempting to “flatten the curve” by facilitating social distancing. For those privileged enough to have access to technology and jobs conducive to operating remotely utilizing said technology, some could continue to work safely without risking exposure while trying to provide for their families.  Although access to technology is one important hurdle, there are additional problems surrounding technology literacy in locating Covid therapies such as the vaccine and scheduling an appointment to receive it.

These technology inequities in lower income nations result in their people being unprotected against the raging virus. Approximately nine months after the approval of the Covid vaccine, more than 55 countries had not vaccinated even 10% of their populations. Further, “more than two dozen nations have vaccination rates below 2%”. The technology barriers stand in the way of less developed countries having the ability to adequately protect their citizens from COVID-19.

Merck & Co. report, “Investigational Oral Antiviral Molnupiravir Reduced the Risk of Hospitalization or Death by Approximately 50 Percent Compared to Placebo for Patients with Mild or Moderate COVID-19.”

Merck & Co seek to address these inequities head on and as soon as possible. Taken orally, the pill “works by interfering with an enzyme the coronavirus uses to copy its genetic code and reproduce itself”. In the clinical trials, the pill was administered to patients with Covid like symptoms within five days. Molnupiravir, was so successful the medical experts monitoring the trials and the U.S. Food and Drug Administration abruptly stopped the trials “so more people might benefit”. A report released by Merck & Co. is titled, “Investigational Oral Antiviral Molnupiravir Reduced the Risk of Hospitalization or Death by Approximately 50 Percent Compared to Placebo for Patients with Mild or Moderate COVID-19”.

Molnupiravir has begun the process of gaining regulatory clearance in the United States with plans to submit their data to other regulators worldwide. Once they have received clearance or emergency authorization, Merck and Co. have already signed agreements with generic manufactures in India to enhance their ability to distribute molnupiravir to low and middle income countries as quickly as possible upon the pills proper local authorizations.      

“A safe, affordable and effective oral antiviral would be a huge advance in the fight against Covid,” Dr. Peter Horby, a professor of emerging infectious diseases at the University of Oxford in the United Kingdom

In furtherance of their goal of targeting low-income countries with their experimental course of treatment, Merck & Co. also strive to keep the cost of molnupiravir low. The pill is relatively cheap to manufacture and Merck & Co. are confident that they can make a quality product at an affordable price by effectively marketing generics. “A safe, affordable, and effective oral antiviral would be a huge advance in the fight against Covid,” Dr. Peter Horby, a professor of emerging infectious diseases at the University of Oxford in the United Kingdom.

The medical community is desperate for a pill like molnupiravir to be cleared and rapidly distributed. For instance, contingent upon the proper authorization by the FDA, the U.S. government has already committed to purchase 1.7 million doses of molnupiravir based on the pill’s exceptional promise. The pill is also drawing global attention as “The global health agency Unitaid and its partners hope to reach an agreement as soon as next week to secure the first supplies of the antiviral treatment for lower- and middle-income nations, Philippe Duneton, its executive director, said in an interview.”

Merck & Co, as well as the medical community as a whole, hope that this is the very pill needed to assist in the global fight against COVID-19. Molnupiravir could be the “convenient pill” Anthony Fauci was calling for to function the same way that Tamiflu does in relation to the flu. Molnupiravir, with such promising results, could very well be the magic bullet to bridge the gap in protection against COVID-19 created by the inequities in technology in lower income nations.

Allison Gray

Allison Gray is a graduate of Davidson College where she majored in Philosophy and also played Division I Women’s Soccer. In law school, Allison is a staff writer for JOLT and is also vice president of Carolina Health Law Organization. After law school, Allison hopes to practice litigation and focus her pro bono efforts on the mental health of incarcerated individuals.

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