Strap design for the test of America First doctrine

On Tuesday, the US government decided to take over almost all of the upcoming production of Remdesivir, the first drug to show encouraging results in the treatment of covid-19 patients. An attitude condemned on the international stage as an illustration of the deleterious effects of the “America First” doctrine advocated by Donald Trump.

US President Donald Trump wants Remdesivir, all Remdesivir. On Tuesday, June 30, the US administration announced that it has purchased from nearly $ 3,000 of the American drug group Gilead over the next three months of this promising drug in the fight against Covid-19. A new application in times of health crisis in the Trumpet doctrine of “America First” leaving the rest of the world on the shelf.

Originally developed to treat people infected with ebola virus, LeRemdesivir is the first drug to provide encouraging results when administered to patients severely affected by Covid-19. A study conducted in late April in the United States showed that this drug could improve the remission time for people in hospitals, prompting the US administration to give green light to the large-scale production of Remdesevir. Even the European Medicines Agency (EMA) has recommended use in hospitals.

For some crumbs of Remdesivir

Access to this molecule has therefore become a public health issue worldwide. All the more “if new studies confirm the first encouraging results”, specifies Barbara Mintzes, specialist in pharmaceutical laboratory strategies at the Pharmacology Center at 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 growing rapidly every day and a high proportion of older people – therefore at risk and who may need this medicine – in large urban centers particularly vulnerable to coronavirus ”, summarizes Penny Ward, a specialist in pharmaceutical medicine at King’s College London.

Also read in France 24: Covid-19: remdesivir, an antiviral treatment called desire?

But it was the decision to leave only a few crumbs to the others that led to a scream. Indeed, the United States has ensured exclusivity for the entire production of Remdesivir during the month of July and 90% of what can be produced in August and September. “I’ve never seen anything like it. It is both very strange and disturbing behavior, ”replied Thomas Senderovitz, director of the Danish Medicines Agency.

The German and British authorities rushed to specify that they already had enough stock to spend the summer. In France, the National Health and Medicines Agency did not respond to questions from France 24 about possible stock of Remdesivir or the authorities’ willingness to use this drug to treat patients severely affected by Covid-19.

Use of compulsory licenses

The US decision also illustrates, in the view of his critics, the competitive rather than cooperative strategy that Donald Trump has adopted since the beginning of the health crisis. It’s actually “not the first time Washington acts this way,” recalls Farasat Bokhari, a health economics specialist at the University of East Anglia in Norwich, contacted by France 24. In May, the US president had almost received that the French laboratory Sanofi is reserving a possible future vaccines prioritized in the United States. It had taken the French authorities’ intervention so that the tricolor group did not give in to Washington’s progress. Donald Trump has also banned the export of certain medical equipment to reserve it for national use only.

“Again, the rest of the world finds itself left out,” said Andrew Hill, a researcher at the Department of Pharmacology 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 from their 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 mandatory licensing mechanismordering national laboratories to produce generics, says Farasat Bokhari. This procedure makes it possible to circumvent international patent law in crisis or medical crises. During the pandemic, a French laboratory under government orders could make a “Remdesivir made in France” without having to ask Gilead for permission. Therefore, the Dutch government is Remember to use this method.

But “it is a procedure that is not easy to perform and that can take time,” Farasat Bokhari specifies. One of the major obstacles lies in the fact that Gilead is entitled to compensation for the use of its molecule, states WTO rules. The US laboratory may be tempted to demand a large sum to punish the country which has thus decided to ignore its patent.

Priced byRemdesivir criticized

It may also decide to grant other laboratories what are known as free licenses, that is, Gilead refrains from claiming compensation in the event of generic development. So it depends on the attitude of the American laboratory, which itself is the target of criticism.

The most important is about the price at which Gilead wants to sell its Remdesivir. In the US, 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 $ 2340 for six days. ONE independent studyshowed that “Gilead could break even by selling every dose between $ 1 and $ 60. This shows that we cannot rely on pharmaceutical companies to act in all interests in times of crisis. ” deplores Deborah Gleeson, public health specialist at the Australian University of La Trobe.

A blame that Farasat Bokhari partly finds unjustified. “If we 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 doesn’t seem too much to me, he says. Especially in countries where medical coverage means you can only replace some of these treatments. For others, it is important, “and this is what Gilead started doing in Pakistan, or even Bangladesh,” that generic development licenses are free. In any case, this is the test of whether Gilead will be more collaborative with the international community than Donald Trump.