PHM-Exch> HAI ASIA PACIFIC (INCLUDES ARTICLE ON AFRICA)

[Claudio Schuftan]

Information sharing

- World Health Day 2022 April 7: Well-being, Equity and Sustainable
Development.

- Access to molnupiravir in Thailand

- NEJM editorial – Vaccine inequity

- Pharmaceutical crime in Africa: arrests and seizures



World Health Day 2022

This year the theme is Well-being, Equity and Sustainable Development. (It
had earlier been announced

as Universal Health Coverage.)

WHO has issued a manifesto – the way ahead.
https://www.who.int/campaigns/world-health-day/2022

A campaign Tool Kit is available
https://www.who.int/campaigns/world-health-day/2022/campaign-toolkit



Access to molnupiravir in Thailand: MSD threatens Thailand if they
rightfully manufacture or import

affordable generic molnupiravir.

Molnupiravir, an antiviral drug that has been approved for use (with
certain specifications) for treatment of

COVID-19 infection was researched and developed by Emory University in the
United States with a budget

supported by the US government, from US citizens’ taxes. After development
the research right was sold to

MNC Merck. Merck sells the drug at a price of USD 700 per treatment.

It has been offered at a ‘reduced priced’ of USD 300 per treatment to
Thailand while the total cost of

production including profits and taxes should not exceed USD 20 per
treatment (approx. THB 600).

In October 2020, Merck had issued the voluntary licensing measure through
the international organization,

‘Medicine Patent Pool’ (MPP). With this measure, Merck allowed eight
generic pharmaceutical companies in

India to produce and market the generic versions of molnupiravir at lower
price to the 105 low- and middleincome

countries without being deemed as patent infringement. However, it does not
include Thailand and

https://www.haiasiapacific.org

Haiasiapacific at gmail.com

2

many other developing countries that are encountering the critical crisis
of no or insufficient COVID-19

medicines.

Merck did not file for a patent for molnupiravir in Thailand. In December
2021, Thai civil society organizations

sent a letter to the Minister of Public Health to inform them that
molnupiravir does not have any patent

application filed in Thailand, therefore Thailand can import or manufacture
generic molnupiravir without it

being considered an infringement of the patent.

On March 10, 2022 a Thai Civil Society organisation received information
that a person who claimed to be

working for Merck, had called a local pharmaceutical manufacturer,
threatening to file a lawsuit against them

if they produced or imported generic molnupiravir by claiming that it
infringed Merck’s intellectual property

rights of molnupiravir.

This development reflects the threatening tactics frequently used to
intimidate governments that attempt to

rightfully manufacture or access affordable generic medicines. An example
was the threat of sanctions against

the Thai government for their intention to rightfully manufacture
didanosine for HIV treatment in 2004.

An open letter from Thai Civil Society organisations to MSD regarding their
threat to local manufacturer and

preventing Thailand from importing generic molnupiravir was released on 16
March. Read the whole letter

here:

https://www.haiasiapacific.org/wp-content/uploads/2022/03/Open-Lettwer-MOL-MSD-Eng-FINAL.pdf



NEJM – Vaccine inequity - a very nice editorial acknowledges the gross
inequity of COVID-19 vaccine

distribution. But will there be any change? Attached and available here

https://www.nejm.org/doi/pdf/10.1056/NEJMe2202547?articleTools=true



Pharmaceutical crime:

First INTERPOL-AFRIPOL front-line operation sees arrests and seizures
across Africa

https://www.interpol.int/News-and-Events/News/2022/Pharmaceutical-crime-first-INTERPOL-AFRIPOL-frontline-

operation-sees-arrests-and-seizures-across-Africa

[Following the publication of this information on E-drug, Richard Laing
asked

‘Were NRA's involved? In the past when these multi country actions were
taken, the National Medicines

Regulatory Agencies were not involved and sometimes were not even informed.
I wonder if they were

this time?’

Although it is mentioned in the report that ‘law enforcement and drug
regulatory agencies from 20 African

countries were involved’, there has been no further response about their
involvement.]

COVID-19 crisis heightens threat of global trade in counterfeit
pharmaceutical products.

A pan-African police operation jointly coordinated by INTERPOL and AFRIPOL
has identified hundreds of

suspects and resulted in seizures of more than 12 million illicit health
products. Operation Flash-IPPA saw the

identification of hundreds of suspects across 20 African countries.The
pan-African police operation seizures

included a wide range of COVID-19 related medical merchandise.

Frontline officers conducted inspections at roadblocks, open markets,
pharmacies, warehouses and other

locations suspected of producing, smuggling, storing or distributing fake
pharmaceuticals. Flash-IPPA’s most

commonly seized illicit medicines included antibiotics,
anti-inflammatories, analgesics and medication used to

correct erectile dysfunction, rheumatism and epilepsy.

With the pandemic creating unique crime opportunities for organized crime
networks to introduce fake

medical products into legal markets, officers were on the lookout in
particular for COVID-related vaccines,

medicines and medical devices. West African operations revealed the use of
counterfeit COVID-19 vaccination

certificates in several countries, whilst East African operations saw the
use of unregulated and unlawful

distribution and sale of genuine COVID-19 vaccines.



FLASH-IPPA participating countries included Algeria, Benin, Botswana,
Central African Republic, Congo, Eritrea,

Ethiopia, Gabon, Ghana, Libya, Kenya, Mauritius, Namibia, Niger, Rwanda,
Sudan, Togo, Uganda, South Africa

and Zimbabwe.

(Prof. Kris Weerasuriya commented ‘Note that it is Counterfeit that is used
rather than the WHO Phrase of "Falsified and Substandard Medicines". While
the action on Counterfeit Medicines is to be commended, the lack of
involvement of the National Medicines Regulatory Authorities is troubling.
The WHO is too rigid to handle this as they have to play by all the rules.
However, they have a Rapid Alert which keeps the issue bubbling away on the
surface. The issue is a real "Tar Baby" but needs to be tackled. You can
see that Flash-IPPA does not use the generic names of the medicines so it
is not possible to check what the medicines are’).



The WHO Rapid Alerts are available here

https://
www.who.int/teams/regulation-prequalification/incidents-and-SF/full-list-of-whomedicalproductalerts

.

For further information write to rapidalert at who.int

Also

Systematic Reviews Open Access. Those interested in reading further will
find then useful.

https://gh.bmj.com/content/5/8/e002393

A systematic review of substandard, falsified, unlicensed and unregistered
medicine sampling studies: a focus

on context, prevalence, and quality

http://dx.doi.org/10.1136/bmjgh-2020-002393

What has happened since to these activities?

Are there current actions addressing COVID-19 –related drug crime?

If anyone has information we could share that would be wonderful.

https://www.haiasiapacific.org

Haiasiapacific at gmail.com
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