Review Covid drug policy

Covid-19 cases have been surging over the past few weeks including a rise in the number of new cases which is likely to last until early next year. The Public Health Ministry said new cases rose over 12% last week over the previous week. The actual amount of cases is expected to be much higher than that reported; some health experts estimate new cases currently reach 13,000 daily.

It is surprising to see such an abrupt rebound of Covid. Most countries in the world, including Thailand, have opened their borders to welcome international travellers. Everyone wants to see business activity return to normal.

In the wake of the new wave of Covid-19 cases, the government, despite almost three years grappling with Covid, still cannot deliver efficient Covid treatment.

Many Covid patients choose not to see doctors at hospitals and still stick to herbal concoctions or basic paracetamol to deal with Covid-induced fever.

That is because the Ministry of Public Health only permits patients with seven proven medical conditions, or those in high-risk groups, to receive the antiviral drugs molnupiravir, paxlovid or remdesivir.

This guideline results in many patients being rejected from the most efficient treatment. They have to depend on herbal medicines or basic medicines and some go back into society even while they are able to transmit the virus.

The government insists there is no shortage of antiviral medicines, particularly molnupiravir, and lets private hospitals import the medicines. But some evidence suggests patients are being forced to look elsewhere.

Policies hindering access to the medicines have forced people to find the drugs under the counter or from aboard.

Recently, the authorities cracked down on illegal imports of molnupiravir from India.

After the border reopened, many Thai tourists flocked to neighbouring countries and one of things they want to buy is not a souvenir but locally-made molnupiravir (some neigbouring countries have been granted a production licence).

Currently doctors avoid prescribing antiviral medicines for mild and moderate patients, particularly for patients under the state universal healthcare and social security schemes.

Yet when Deputy Prime Minister and Public Health Minister Anutin Charnvirakul caught Covid-19 recently, he was treated with molnupiravir immediately, raising public questions about why he was able to get access to the antiviral medicine when he had only mild Covid symptoms.

The ministry’s senior officials said the minister has an “obesity” problem which is one of underlying diseases designated for getting a prescription.

Without exact data to support that, the public can only imagine why many Covid-19 patients with bigger weight problems or a higher body mass index than the deputy prime minister failed to receive the drugs.

Thais must be equally entitled to receive the best efficient treatment without discrimination and regardless of economic status.

The US FDA issued an Emergency Use Authorisation for molnupiravir for adults with mild to moderate Covid-19 symptoms who are considered at risk of progressing to severe disease.

Likewise, the Public Health Ministry should review its guidelines for antiviral medicines prescriptions to allow people to have easier access.