The health ministry is silent on whether the Narendra Modi government plans to order in advance, as several other countries have done, the oral anti-Covid-19 drugs from Merck and Pfizer that dramatically reduce the risk of hospitalisation and death.
The US companies have independently announced steps to make available their drugs — Merck’s molnupiravir and Pfizer’s Paxlovid — through licenced local manufacture in India but, experts say, how patients in India could access them remains unclear for now.
The lack of advance agreements with foreign vaccine makers had delayed the rollout of the Covid inoculation drive in India.
The UK earlier this month became the first country to approve the restricted use of molnupiravir that has been shown through trials to reduce Covid-19 hospitalisation or death by 50 per cent. Regulatory approval is pending in other countries, including India.
Pfizer had announced earlier this month that its novel drug Paxlovid, co-administered with a small dose of another anti-viral called ritonavir, can reduce risk of hospitalisation or death by 89 per cent. Paxlovid too is yet to receive regulatory approval.
But both treatments need to be given early after onset of symptoms which, public health experts say, would require a streamlined drug-distribution mechanism to enable patients to receive the medicines.
Several countries have signed or are negotiating advance purchase pacts with Merck and Pfizer.
The US government had in June announced a $1.2 billion purchase agreement for 1.7 million five-day treatment courses of molnupiravir to be procured if the country’s drug regulatory authority approves the drug. The UK has ordered 480,000 courses of molnupiravir and Japan has ordered 1.6 million.
Pfizer has also entered into advance purchase agreements with multiple countries and is in negotiations with several others, the company said earlier this month. “We cannot share the specifics of any future agreements as discussions are ongoing,” a Pfizer spokesperson told this newspaper.
Merck had earlier this year announced licencing pacts with five Indian companies — Cipla, Dr Reddy’s Laboratories, Emcure Pharmaceuticals, Sun Pharmaceuticals and Torrent Pharmaceuticals — to produce molnupiravir for India and low and middle-income countries.
Pfizer has said Paxlovid would be available at low cost in 95 countries, including India.
But neither the health ministry nor the companies have disclosed whether the Indian government has initiated discussions on procurement of these drugs with either Merck or Pfizer.
A query sent by this newspaper to the health ministry asking if the Indian government had, like the other countries, sought from either company any quantum of either drug has not evoked a response.
A spokesperson for Cipla said regulatory processes were currently in progress. “The regulators have sought more trial data to evaluate before any approval,” the spokesperson said, but did not respond to a query asking whether the Indian government had initiated discussions on supply of the drug if it is approved.
A senior physician who is not connected with the government said if and when the drugs become available, they would “almost certainly” be regulated, administered only to those who need them. India had regulated the antiviral oseltamivir during the H1N1 influenza pandemic in 2009-10.
“But drug procurement can also be done by states,” the physician said.
A senior government scientist who is advising the Centre on Covid-19 said he was not aware of any plans to procure the drugs.
“I think there is a feeling that Covid is gone.… This government works with ad-hoc thinking and short memory,” the scientist said, requesting anonymity. “Thankfully, our private sector will be making both the drugs and they will thus be available at reasonable cost.”
