Oral Antiviral Access Critical to Saving Lives, Controlling COVID-19 Outbreaks

Oral Antiviral Access Critical to Saving Lives, Controlling COVID-19 Outbreaks

This virus is here to stay. It is still killing, and it’s still changing. The risk remains of new variants emerging that cause new surges in cases and deaths. The worst thing any country could do now is to… let down its guard, to dismantle the systems it has built, or to send the message to its people that COVID-19 is nothing to worry about.—World Health Organization Director-General Tedros Adhanom Ghebreyesus, May 5, 2023

Recent actions by the World Health Organization and the United States to remove the designation of COVID-19 as a public health emergency follow similar moves by almost all countries, deprioritizing COVID-19 responses. Yet the disease remains a serious threat, claiming thousands of lives each week, particularly targeting older individuals and those with underlying heath issues. As COVID-19 transmission continues around the globe, active disease management involving rapid, equitable access to the full range of mitigation tools, including oral antivirals, remains essential to protect the most vulnerable, build more resilient health systems, and contain future waves of infection.

While nirmatrelvir/ritonavir and other antivirals have been available in many high-income countries since late 2021, access remains limited in many low- and middle-income countries and particularly in sub-Saharan Africa. When administered within five days after symptom onset, oral antivirals have been proven to moderate illness and reduce hospitalizations.

The COVID Treatment QuickStart Consortium is working in partnership with ten countries to urgently establish test-and-treat programs for high-risk populations as part of integrated, essential health services. Such programs are essential not only to improve individual health outcomes but also to protect fragile health systems, especially during potential surges.

So far, QuickStart has provided oral antivirals through pilot programs in five countries, four in sub-Saharan Africa and one in Asia, thanks to financial support from the Open Society Foundations, Conrad N. Hilton Foundation, and Pfizer, along with a donation by Pfizer of 100,000 total courses of PAXLOVID™. Over the next 18 months, the consortium will facilitate sustained access to COVID-19 testing and oral antibiotics as part of resilient primary health care systems.

While countries are juggling a number of pressing priorities, including other diseases such as HIV and TB, developing systems for managing COVID-19 alongside other respiratory infections is critical to protecting the most vulnerable and controlling outbreaks. Effective and decentralized test-and-treat capacity, integrated into primary care, contributes toward more prepared health systems that can respond to ongoing and future threats.