Gates Foundation to spend $120 million on access for Covid-19 pill

The Bill and Melinda Gates Foundation says it will spend $120 million to boost access to generic versions of drugmaker Merck's antiviral COVID-19 pill for lower income countries, if the drug gets approved by regulators.

The private foundation said in a statement released Wednesday it hasn't determined how it will allocate the money, but will use the funds to support the range of activities required to develop and manufacture generic versions of the drug, molnupiravir.

Merck has licensed its technology with generic drug manufacturers in India. Under the agreement, the company said it will provide licenses to manufacturers to supply the drug to India and more than 100 other lower and middle income countries. It's unclear how much of the generic drug could be available for use.

The Gates Foundation says its funding is also intended to help ready regulatory, delivery and other pathways in order to make the pill more accessible, if it becomes available.

The Food and Drug Administration hasn't authorized the pill, and its outside experts are expected to meet on Nov. 30 to scrutinize the drug. If cleared by regulators, the drug will be the first pill available to treat COVID-19.

Trevor Mundel, the president of the foundation's global health program, believes the generic manufacturers won't ramp up their manufacturing unless they know there will be demand, and are likely to wait until next year to begin production.

We want them not to wait, he said. So this money is about getting them active now."

Merck and its partner Ridgeback Biotherapeutics, have said early results for the pill showed high-risk patients who received it within five days of COVID-19 symptoms had about half the rate of hospitalization and deaths.

Mundel, of the Gates Foundation, says the studies need to be replicated in other countries so officials there can be more familiar with the drug. Otherwise, the health care workers and physicians are not going to have that pent up demand that will lead to immediate uptake, like it will in other place," he said.

The funding comes as many countries struggle to secure access to COVID-19 vaccines.

Lawrence Gostin, a professor of global health law at Georgetown University, says it's good more is being done to aid manufacturing abroad, but notes there might be more difficulties ahead. This is limited to just India, he said. So their ability to ramp up manufacturing quickly enough to supply middle and low income countries is going to be a really enormous challenge.