The World Health Organization (WHO) has strongly recommended nirmatrelvir and ritonavir (Paxlovid), as well as remdesivir, for COVID-19 treatment. WHO emphasized that these medicines should be made accessible to low- and middle-income countries.
WHO made, in their words, “a strong recommendation for nirmatrelvir and ritonavir, sold under the name Paxlovid, for mild and moderate COVID-19 patients at highest risk of hospital admission, calling it the best therapeutic choice for high-risk patients to date.”
Paxlovid is now strongly recommended for patients with non-severe COVID-19 who are at high risk of severe disease and hospitalization. The therapy is intended for people who may devolve into severe disease due to being older, unvaccinated, or immunosuppressed.
Phase 2/3 clinical trial data showed oral nirmatrelvir, the active protease inhibitor in Paxlovid, to reduce the risk of hospitalization and death by 89% in high-risk, non-hospitalized adults with COVID-19 infection.
Paxlovid is an oral antiviral drug developed by Pfizer. In their recommendation, WHO asked Pfizer to be more transparent with their pricing and bilateral deals. Additionally, WHO emphasized Pfizer should enlarge the geographical scope of its license with the Medicines Patent Pool, enabling more generic manufacturers to produce Paxlovid quickly and affordably. The current licensing agreement between Pfizer and the Medicines Patent Pool limits the countries that benefit from Paxlovid’s generic production.
When Paxlovid was issued Emergency Use Authorization (EUA) by the US Food and Drug Administration (FDA), Pfizer agreed to philanthropic measures, such as providing 4 million treatment regiments to UNICEF for equitable global distribution. “WHO is extremely concerned that—as occurred with COVID-19 vaccines —low- and middle-income countries will again be pushed to the end of the queue when it comes to accessing this treatment,” the organization said in their statement.
Alongside WHO’s recommendation of Paxlovid for global distribution came a reversal of their stance against remdesivir. Remdesivir was previously not recommended by WHO, due to clinical trial data suggesting the treatment offered inadequate protection against COVID-19 mortality. Now, in light of recent hospital data, WHO says the drug should be used in mild or moderate COVID-19 patients at high risk of hospitalization. WHO is still determining whether to recommend remdesivir for severe or critical COVID-19.