A study carried out by Harvard university estimated that molnupiravir could cost about US$20 if produced by generic drugmakers, with the price potentially going down to US$7.7 under an optimised production.
The ACT-A document says that its target is to reach a deal by the end of November to secure the supply of an “oral outpatient drug”, which it aims to be available from the first quarter of next year.
The money raised would initially be used to “support procurement of up to 28 million treatment courses for highest risk mild/moderate patients over the next 12 months, depending on product availability, clinical guidance, and volumes changing with evolution of needs,” the document says, noting this volume would be secured under an advance purchase agreement.
Larger additional amounts of new oral antivirals to treat mild patients are also expected to be procured at a later stage, the document says.
Another 4.3 million courses of repurposed COVID-19 pills to treat critical patients are also expected to be purchased at a price of US$28 per course, the document says, without naming any specific drug.
The ACT-A also intends to address essential medical oxygen needs of 6-8 million severe and critical patients by September 2022.
In addition, the programme plans to invest massively in COVID-19 diagnostics in order to at least double the number of tests carried out in poorer nations, defined as low income and low-middle income countries.
Of the US$22.8 billion, the ACT-A plans to raise in the next 12 months, about one third and the largest share is to be spent on diagnostics, the document says.
Currently poor countries conduct on average about 50 tests per 100,000 people every day, against 750 tests in richer nations. The ACT-A wants to bring testing rates to a minimum of 100 tests per 100,000 in poorer states.
That means delivering around 1 billion tests in the next 12 months, around 10 times more than the ACT-A has procured so far, the document shows.
The largest share of diagnostics would be rapid antigen tests at a price of around US$3, and only 15 per cent would be spent to procure molecular tests, which are more accurate but take more time to deliver results and are estimated to cost around US$17, including delivery costs, the document shows.
The push on tests is meant to narrow the gap between the rich and the poor, as only 0.4 per cent of the about 3 billion tests reported across the world have been conducted in poor nations, the document says.
It would also help spot earlier possible new variants, which tend to proliferate when infections are widespread, and therefore are more likely in the countries with lower vaccination rates.
The document underlines that “vaccine access is highly inequitable with coverage ranging from 1 per cent to over 70 per cent, depending largely on a country’s wealth.”
The programme aims to vaccinate at least 70 per cent of the eligible population in all countries by the middle of next year, in line with the WHO’s goals.