President Donald Trump wants Remdesivir, all Remdesivir. The American administration announced, Tuesday, June 30, having bought from the American pharmaceutical group Gilead almost all of the production of the next three months of this promising drug in the fight against Covid-19. A new application in times of health crisis of the Trumpet doctrine of "America First" which leaves the rest of the world on the shelf.
Remdesivir, originally developed to treat people infected with the Ebola virus, is the first drug to have shown encouraging results when it is administered to patients seriously affected by Covid-19. A study conducted at the end of April in the United States showed that this drug could improve the remission time of hospitalized persons, which pushed the American administration to give the green light to the large-scale production of Remdesevir. Even the European Medicines Agency (EMA) has recommended its use in hospitals.
For a few crumbs of Remdesivir
Access to this molecule has therefore become a public health issue worldwide. All the more so "if new studies confirm the first encouraging results", specifies Barbara Mintzes, specialist in pharmaceutical laboratory strategies at the Pharmacology Center of the University of Sydney.
Donald Trump's greed for Remdesivir can be understood. “It should not be forgotten that the United States is the country most affected by the pandemic, with a number of new cases increasing rapidly every day and a high proportion of elderly people - therefore at risk and who may need this drug - in large urban centers particularly exposed to coronavirus ”, summarizes Penny Ward, specialist in pharmaceutical medicine at King's College London.
Read also on France 24: Covid-19: remdesivir, an antiviral treatment called desire?
But it was the decision to leave only a few meager crumbs to the others that sparked an outcry. The United States has, in fact, ensured the exclusivity of the entire production of Remdesivir for the month of July, and 90% of what can be produced in August and September. “I have never seen anything like it. It is both very strange and disturbing in behavior, ”reacted Thomas Senderovitz, director of the Danish Medicines Agency.
The German and British authorities hurried to specify that they already had sufficient stocks to spend the summer. In France, the National Agency for Health and Medicines did not answer France 24's questions on possible stocks of Remdesivir or on the authorities' willingness to use this drug to treat patients most seriously affected by Covid-19.
The use of compulsory licenses
The American decision also illustrates, in the eyes of his critics, the competitive rather than cooperative approach adopted by Donald Trump since the start of the health crisis. It is, in fact, “not the first time that Washington has acted in this way,” recalls Farasat Bokhari, specialist in health economics at the University of East Anglia in Norwich, contacted by France 24. The American president had almost obtained, in May, that the French laboratory Sanofi reserves a possible future vaccine in priority in the United States. It had taken the intervention of the French authorities so that the tricolor group did not give in to Washington's advances. Donald Trump has also banned the export of certain medical equipment to reserve it only for national use.
"Again, the rest of the world is left behind," said Andrew Hill, a researcher in the pharmacology department at the University of Liverpool, interviewed by the British daily The Guardian.
It is not entirely fair. First, Gilead authorized developing countries to develop generics of its Remdesivir to meet their national needs. They can then export them to other states that cannot afford to do the same.
Then, "countries that join the World Trade Organization (WTO) can use the compulsory licensing mechanism to order national laboratories to produce generics," said Farasat Bokhari. This procedure allows to bypass international patent law in times of crisis or medical emergency. During the pandemic, a French laboratory could, on the orders of the government, make a “Remdesivir made in France” without having to ask Gilead for authorization. The Dutch government is, therefore, thinking about using this method.
But “it is a procedure which is not easy to implement and which can take time”, specifies Farasat Bokhari. One of the major obstacles lies in the fact that Gilead is entitled to remuneration for the use of its molecule, specifies the rules of the WTO. The American laboratory may be tempted to demand a large sum to punish the country which has thus decided to ignore its patent.
The price of R emdesivir criticized
It can also decide to grant to other laboratories what is called free licenses, that is to say that Gilead gives up claiming remuneration in the event of the development of generics. It all depends, therefore, on the attitude of the American laboratory, which is itself the target of criticism.
The main one concerns the price at which Gilead wishes to sell its Remdesivir. In the United States, a patient will have to pay $ 3,120 for a standard six-day treatment, while globally, the drug will be sold for $ 390 per dose, or $ 2,340 for six days. An independent study has shown that “Gilead can break even by selling each dose between $ 1 and $ 60. This shows that pharmaceutical companies cannot be trusted to act in the best interest of all in times of crisis, ”said Deborah Gleeson, specialist in public health issues at the Australian University of La Trobe.
A reproach that Farasat Bokhari finds in part unjustified. “If you want others to develop drugs to fight Covid-19 - and that's really what we need now - we have to show that innovation pays off. As such, a price of $ 390 per dose does not seem excessive to me, ”he says. Especially in countries where medical cover reimburses only part of these treatments. For others, the important thing, "and this is what Gilead started to do in Pakistan, or even in Bangladesh", is that licenses to develop generics are free. In any case, this is the test of whether Gilead will be more cooperative with the international community than Donald Trump.
The France 24 week summary invites you to come back to the news that marked the week
I subscribeTake international news everywhere with you! Download the France 24 app
google-play-badge_FR