For much of the last two-plus years of COVID-19, health authorities have relied heavily on vaccination to slow the disease and prevent serious illness and death. Unfortunately, vaccination hasn’t been a panacea. The shots don’t prevent all illness, protection doesn’t last forever, new variants emerge, and, of course, not everyone is willing or able to be vaccinated.
For low- and middle-income countries, as has been widely discussed here and in other media, vaccination efforts have met what can only be called mixed success, with many of these less-wealthy countries vaccinated at low rates, even into the current year. So it’s pretty clear that additional public health tools beyond vaccination are needed to contain the pandemic.
Recognition of the limits of vaccination has led to the creation of a multi-sector consortium involving philanthropy, NGOs and diagnostics manufacturers to launch a “test-and-treat” program for low- and middle-income countries. The idea is to identify and immediately treat people at high risk of developing severe disease using recently developed COVID antiviral medicines.
Partners in the collaboration are Open Society Foundations and NGOs including the Clinton Health Access Initiative and the COVID Global Accountability Platform. They’ll work with developers of diagnostics and pharmaceuticals to ensure sufficient supplies of low-cost COVID tests and antiviral medicines. They’ll also work with governments, multilateral agencies such as the ACT Accelerator, and bilateral donors. The program will launch in four to-be-determined countries, intended eventually to scale up to as many as 20.
For those in philanthropy, one thing that’s worth highlighting in this announcement is that the partnership reaches across sectors, involving philanthropic funders, but also NGOs and businesses. Sure, many of society’s needs and problems are multifaceted, but a global pandemic is among the largest of large-scale, complex challenges.
“All of us in philanthropy have cast about as to how best to make a difference in this pandemic, but the scale of investment needed to contain COVID is not foundation territory, it’s government territory — not millions, but billions,” said Mark Malloch Brown, president of Open Society Foundations. OSF has made significant investments to bring more vaccines to underserved countries, but Brown says OSF and other global health entities recognize that vaccination can’t be the only arrow in the quiver. Widespread test-and-treat programs must be mounted as a part of the public health mission to contain the pandemic.
Members of the coalition are talking with drug manufacturers about donating COVID antivirals or selling them at cost. These pharma companies include Pfizer, which recently introduced its COVID-19 treatment Paxlovid. Studies have suggested the drug is about 90% successful at preventing cases of COVID illness from advancing to the point that the patient needs hospitalization.
OSF will cover the in-country costs of the program. The Clinton Health Access Initiative (CHAI) has worked on the ground in low- and middle-income countries, and has developed relationships with government health agencies and healthcare facilities in countries around the world to deliver vaccines and care for HIV, malaria, tuberculosis, maternal and child health, and other healthcare needs.
“We’ll look for similar working models here,” said Sean Regan, director of COVID Therapeutics for CHAI. They’ll have to clear a number of hurdles to implement the test-and-treat procedures, such as regulatory approval of the COVID medicines in each country, updating monitoring and evaluation protocols and managing the healthcare workforce, among other needs.
As mentioned, the program will roll out in phases, first in four countries, then to others. But as COVID surely will not be the last global pandemic, philanthropic organizations that aim to address health threats of this scale will need to continue to improve their ability to form novel coalitions everywhere.