BIDEN TO EMPHASIZE ‘GLOBAL TEST TO TREAT’ PLAN

As poor nations seek COVID pills, officials fear repeat of AIDS

A devastating virus was laying waste to nations that lacked medicines available to Americans. The pills were patented and pricey. Poor countries lacked refrigeration to store them, the thinking went, and patients would not be able to follow the complex dosing regimen.

The year was 2002, the virus was HIV, and the president, George W. Bush, secretly sent his top health advisers to Africa to investigate what activists were calling “medical apartheid.”

In the 20 years since, the United States has led the way in building a global infrastructure for HIV testing and treatment, saving an estimated 21 million lives.

Now, with that history in mind, global health agencies and the Biden administration are working to bring coronavirus tests and expensive antiviral pills to low- and middle-income nations.

This week, President Joe Biden will emphasize “global test to treat” at his second international COVID-19 summit, a virtual gathering of world leaders aimed at injecting new energy into the international pandemic response.

Until now, the response has been focused largely on vaccinations, which remain a high priority.

But Biden will also use the summit to call on wealthy nations to donate $2 billion to purchase COVID treatments and $1 billion to purchase oxygen supplies for low- and middle-income countries, according to a senior administration official involved with the planning.

In the United States, where antiviral pills to combat COVID-19 are widely available, Biden’s “test to treat” initiative lets many patients go to pharmacies, get tested for the coronavirus and receive a free prescription on the spot if they test positive.

In low- and middle-income nations, such efforts will most likely be much more limited until generic pills arrive, probably in 2023.

But the global effort faces some of the same obstacles and inequities that existed two decades ago.

Rich nations, including the United States, have gobbled up much of the supply. Global health agencies do not have the money to buy the antivirals or tests, which are crucial because the medication needs to be started early in the course of infection.

Drug companies, trying to protect their patents, are limiting the supply of generic alternatives in many middle-income countries, including an entire swath of Latin America.

All of this is playing out against the infectious disease equivalent of a ticking time bomb.

“We all expect a major new surge from Omicron or a new variant in the global south from June to September, and if that happens, we are not going to be ready with test and treat,” said Dr. Bill Rodriguez, who runs the testing arm of the ACT Accelerator, the Geneva-based consortium coordinating the global response. “It feels extremely similar — painfully, ironically, tragically similar — to what happened with HIV.”

Today, ahead of the summit, the consortium, which is backed by the World Health Organization, is set to convene a discussion of global health experts and declare access to testing and treatment an “equity issue,” officials said.

Biden may well show up at his own summit emptyhanded.

The White House has asked Congress for an additional $22.5 billion in emergency coronavirus aid, including $5 billion for the global response, but Senate Republicans are refusing to authorize any funding unless it is offset by cuts to other programs.

A $10 billion compromise proposal includes no money for the global response, and it is unclear when or whether that plan will come up for a vote.