The booster injections revealed the inequality of the vaccines. Will COVID treatments be distributed evenly?

Tedros Adhanom, the head of WHO, said he was “appalled“after being informed by a major pharmaceutical association that” vaccine supplies are high enough to allow both booster shots for people in well-supplied countries and the first vaccines in poorer countries facing shortages His comment comes at a time when, despite countless commitments, the world’s poorest countries are unlikely to receive a significant number of doses of vaccine until 2023.

The insistence of some wealthy countries to start administering a third dose of the vaccine against advice World Health Organization is further undermining vaccine supplies to the poorest countries of the Third World. As a number of promising non-vaccine treatments for COVID begin to emerge, efforts must be made to ensure their equitable distribution around the world, with particular emphasis on poor countries with low vaccination rates.

The third dose and the third world

After one of the largest public health mobilizations in history, a total of 5.6 billion vaccines doses have been administered around the world. But the way in which these doses have been distributed is far from fair. About 82% of the total number of vaccines used so far have gone into the arms of people living in high- and upper-middle-income countries, while only 1.4% of the population in low-income countries has received the jab.

The situation has become so serious in some parts of the world, especially in Africa, that the authorities are forced to consider what is called “dose saving” strategies, using jabs with only half or a third of the usual vaccine dose, in order to expand their extremely limited vaccine supplies to a larger percentage of the population. With most of the rich countries already heavily vaccinated, the gap between the rich countries and the developing world was expected to begin to narrow. But the decision by many wealthy states to go ahead with the so-called “booster shot,” a third dose of the vaccine, has fueled fears that it will continue. shortages in the developing world.

Israel became the first country in the world to offer the booster, making it available to people over 60 before quickly expanding eligibility. In early September, more than 2.5 million Israelis received the third blow, as the country’s health minister has already instruct the population to prepare for a fourth dose. Earlier this month, France became the first major country to start distributing booster shots to people over 65, with plans to reach up to 18 million people by next year.

Many experts reacted to such plans with anger and disbelief. In the United States, two senior officials of the United States Food and Drug Administration resigned to protest the government’s plans to introduce booster injections, while Tulio de Oliveira, a prominent biologist who works in South Africa, describe the plans as “potentially criminal”. WHO recommends the third shot in the case of vulnerable groups but has called on Western health authorities to put a moratorium on its widespread use until more doses of the vaccine can reach impoverished countries.

Treat the disease

As poor countries are thus left particularly vulnerable, the question of the use of new treatments for those who contract COVID arises. Not only would effective treatments help coronavirus patients in rich and poor countries, but by making the coronavirus less threatening to vaccinated and unvaccinated populations, they could reduce the demand for booster doses in richer countries and free up vaccine stocks for the developing world. Fortunately, several treatments are on the radar.

One of these drugs is Rigel’s fostamatinib, marketed under the name Tavalisse, which was shown to be so effective in early trials that Rigel has received $ 16.5 million in funding from the US Department of Defense to support Phase III trials of the potential treatment. The drug, which is administered orally, has been show halve the risk of serious adverse reactions in hospitalized COVID patients and significantly reduce the number of deaths.

Most importantly, the multicenter, double-blind, placebo-controlled phase II trial, the results of which were recently reported in the journal Clinical Infectious Diseases proved that Tavalisse met the primary endpoint of security. The subjects of the trial treated with Tavalisse saw their stay in intensive care reduced to three days on average, compared to seven in the placebo group. In addition, the three deaths that occurred during the trial were in the placebo group, none in the fostamatinib-treated segment.

Approved for medical use in the United States since 2018, fostamatinib has previously been used successfully to treat chronic immune thrombocytopenia, a disease characterized by abnormally low blood levels platelets. In early 2020, he was also approved in the European Union. Hopes are high that the drug can now be used to treat COVID as well – Rigel is currently conducting a phase III trial in 308 patients with plans for the trial to be completed by the end of the year, while the drug is also examined in the National Institutes of Health ACTIV-4 trial.

AstraZeneca is also developing a processing which appears to be effective, reducing the risk of developing symptoms by 77% in an advanced-stage trial – a much-needed victory for the company after reliance on its coronavirus vaccine tumbled following reports of rare blood clots. If approved, the antibody cocktail that is currently known as AZD7442 would become the first long-acting drug that is not a vaccine that demonstrated disease prevention. According to the Anglo-Swedish company, preliminary cell studies have shown that the cocktail neutralizes emerging viral variants, including the Delta variant.

Lessons learned?

In many parts of the world, often underreported, the pandemic is raging. In India, even the staggering official figures are pale compared to estimates which puts the number of COVID deaths in the country between 3 and 4.7 million. The world can’t stand idly by while another disaster tied with the second wave hits the country.

Given the way developing countries were neglected in the race for vaccination, it should be obvious that they must be given priority in the distribution of treatment for the coronavirus. Life-saving drugs like Tavalisse or AZD7442 should not be subjected to the same pressure that allows rich countries to store vaccines, often to the point of spoiling itself, while the rest of the world suffers.

At the end of the day, there is no way to pass COVID treatments, for both rich and poor countries. But until developing countries close the immunization gap, they should be a priority for the distribution of treatment.

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