Letter Urges Pfizer CEO to Ramp Up Paxlovid Supply Agreements with Developing Countries

In a letter sent today to Pfizer Chairman and CEO Albert Bourla, Public Citizen warned that the company is poised to repeat the same mistakes it made with the inequitable rollout of its vaccine with the global distribution of its new antiviral treatment, Paxlovid.

"We are gravely concerned that inequalities in access to COVID-19 treatments will soon resemble, if not exceed, gaps in vaccine access seen around the world," says the letter.

According to one estimate, more than half of the global population at increased risk of severe COVID-19 live in Africa, Asia, Latin America, and the Caribbean. But Pfizer has entered into Paxlovid supply agreements almost exclusively with countries based in North America and Europe, notes the letter. No African country has yet to purchase the treatment at all.

Paxlovid shortages are acute and may remain so through 2022. Pfizer plans to produce enough Paxlovid for just 120 million people this year. Yet Pfizer has estimated that the "addressable patient population" - the number of people that may need Paxlovid - is more than twice that number, or 250 million people in 2022. Of these, 95 million patients would be in countries supplied by Medicine Patent Pool-licensed generics. However, according to a Pfizer investor document, this generics supply, intended to help meet need in many developing countries, may "come on board" only in 2023, suggesting a delay of at least a year. "This is unacceptable," says the letter.

The letter asks that Pfizer set aside at least two-thirds of its 2022 supply for developing countries at a reasonable price, and make transparent its allocation criteria, pricing, and delivery schedules. Second, it notes that the company should accelerate the entry of generic manufacturers licensed under the Medicines Patent Pool by providing deeper technical assistance and sharing regulatory information. Finally, Pfizer should expand the scope of the Medicines Patent Pool license to allow the generics producers to supply many more countries.

The letter concludes, "We urge Pfizer to help end the pandemic this year around the world--not just in a handful of rich countries."

"Pfizer is not prepared to meet global need," says Peter Maybarduk, director of the Access to Medicines program at Public Citizen. "Millions of people in developing countries are likely to suffer through a COVID treatment shortage that mirrors the gross vaccine inequity of the past year. Generics can make a major difference, but not for many months yet, and Pfizer is erecting patent barriers in middle-income countries that have suffered terrible pandemics. Pfizer and wealthy countries should dedicate two-thirds of supply to low- and middle-income countries to prevent needless deaths, ease the pain of medical apartheid and shorten the pandemic."