WHO doubles down on antibodies and steroids; shuns remdesivir

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A World Health Organization-led scheme to supply COVID-19 drugs to poor countries is betting on experimental monoclonal antibody treatments and steroids but shunning remdesivir therapy, an internal document accessed by Reuters shows.

TheWHO draft document says priorities are to secure monoclonal antibodies in a tight market and to boost distribution of cheap steroid dexamethasone, of which it has already booked nearly 3 million courses of treatment for poorer countries. Monoclonal antibodies are manufactured copies of antibodies created by the body to fight an infection, and drugmakers including Roche and Novartis confirmed initial contact with the WHO scheme.

The paper does not cite remdesivir among priority drugs – a significant omission as the antiviral is the only other medication alongside dexamethasone approved across the world for treating COVID-19. Gilead Science said the WHO scheme had not funded its COVID-19 trials and had never approached the firm for the possible inclusion of remdesivir in its portfolio.

The drug-supply scheme is one of the four pillars of the so-called ACT Accelerator, a WHO-led project which also seeks to secure COVID-19 vaccines, diagnostics and protective gear for poorer countries by raising more than $38 billion by the beginning of 2022.

The scheme, co-led by the Wellcome Trust, a charity, and Unitaid, a health partnership hosted by the WHO, urgently needs $6.1 billion, $750 million of which by February, out of a total ask of $7.2 billion.

Apart from monoclonal antibodies and dexamethasone, it is also eyeing other experimental drugs, including new antivirals and repurposed drugs.

The scheme would spend another $100 million to seal deals with unspecified drugmakers from mid-2021, the document says, and next year plans to invest another $4.4 billion on drugs that succeed in clinical trials.

The Unitaid spokeswoman said dexamethasone and its alternative, hydrocortisone, were the most promising among repurposed drugs.

Unitaid confirmed the scheme had not procured or funded remdesivir, which was initially trialled against Ebola. It did not comment on why remdesivir did not appear among priority treatments in the document.

Remdesivir has been authorised in multiple countries to treat COVID-19. However, preliminary findings of a WHO-sponsored trial conluded the antiviral had little or no benefit, contradicting previous positive trials.

Governments however continue to buy it, with Germany this week announcing a 150,000-plus dose purchase.

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