US move to buy global supply of remdesivir sets 'dangerous precedent' for pandemic response, experts warn

The Trump administration’s move to purchase virtually all remdesivir stocks for the next three months has set a “dangerous precedent” and undermines global efforts to tackle the pandemic, experts have warned.

The drug, produced by Gilead Sciences, has been shown to cut recovery time for Covid-19 patients by four days and is one of only two that is currently proven to work against the virus.

But the US has purchased more than 500,000 doses of remdesivir - which equates to all of Gilead’s projected production for July and 90 per cent of the company’s capacity for August and September.

Alex Azar, secretary of the Department of Health and Human Services, said the US had “struck an amazing deal” to ensure Americans have access. A statement added that the cost is roughly $3,200 (£2,500) per treatment of six doses.

The announcement has brought into sharper focus Donald Trump’s “America first” attitude throughout the pandemic, but is not unexpected - the President has already attempted to skip the queue on medical supplies.

The administration put pressure on French manufacturer Sanofi and the German biotech CureVac to prioritise the US any potential vaccine earlier this year.

But the latest developments have strengthened concerns about potential bidding wars for supplies, where wealthy countries push their way to the front of the line or put pressure on domestic companies to prioritise their own country.

“This definitely sets a dangerous precedent,” Professor Devi Sridhar, chair of global public health at Edinburgh University and advisor to the Scottish Government on Covid-19, told The Telegraph. “It sends a sign about solidarity and that, actually, the US is going to go it alone.”

She said that such an approach made it harder for other governments to commit to global agreements to ensure potential vaccines, drugs and diagnostics are distributed equitably.

“All you need is one government not to cooperate… to misbehave and not play by the rules of the game, and it becomes very hard for everyone else too.”

The UK’s business minister, Nadhim Zahawi, added that competition for medical supplies serves to “undermine all of our strategies”, while Dr Ohid Yaqub, a senior lecturer at the University of Sussex, said the US decision is disappointing “because it so clearly signals an unwillingness to cooperate with other countries.”

Concerns that the UK would be left facing shortages of remdesivir were quashed on Wednesday, when the Department of Health and Social Care insisted that the Government has already secured enough doses to treat every NHS patient who needs it. Australia and Germany made similar announcements.

The broad spectrum antiviral, which was first developed roughly a decade ago, is one of only two drugs licensed for use in the NHS. The other is dexamethasone, a 60-year-old steroid that has been shown to dramatically reduce the risk of death among the most severely ill patients. Shortages are unlikely as this drug is cheap, easy to manufacture and widely available.

But a scarcity of remdesivir is probable while Gilead works to ramp up production. Any shortages are likely to be felt most keenly in developed countries.

In May Gilead signed deals with five generic drug companies in India and Pakistan, which allow them to manufacture a non-branded version of remdesivir and distribute it to 127 low and middle income countries.

The same month Beximco Pharmaceuticals in Bangladesh became the first to sell a generic version of the antiviral. The company manufactured the drug under World Trade Organisation ‘TRIPS’ provisions, which allow authorities in the least developed countries to issue compulsory licences in certain scenarios.

Dr Penny Ward, a visiting professor in pharmaceutical medicine at King’s College London, said that Gilead has been clear that “manufacturing capacity is limited” and laid out the steps they have taken to meet demand. “It would be unfair to the company to blame Gilead for President Trump’s actions,” she said.

But Peter Horby, an Oxford University professor who chairs the UK government’s new and emerging respiratory virus threats advisory group (Nervtag), told BBC Radio Four that as an American company, Gilead would be under “certain political pressures locally” to supply the US first.

Prof Horby added that such issues will become even more contentious once a vaccine, considered the ultimate “exit strategy”, has been proven effective.

“I think once the vaccine is produced countries are not going to play nice,” added Prof Sridhar.

She also said that while the World Health Organization and other international bodies, including the European Union, have pushed for global agreements to prevent this sort of nationalistic response, so far they were largely rhethorical, not binding.

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