Efforts to bring the fight against COVID-19 to lower-income nations received a significant boost after a deal was struck between the United Nations and a global consortium of drugmakers.

The U.N.-led global public health alliance Medicines Patent Pool (MPP) signed agreements on Thursday with 27 generic drug manufacturing companies to produce Merck's COVID-19 antiviral pill known as molnupiravir. The partnerships were made with manufacturers across Asia and Africa to raise supply levels of the pill in 105 low- and middle-income nations.

Charles Gore, MPP's executive director, described the licensing deal as a "critical step" to expand global access to more treatments for COVID-19.

“We are encouraged by the large number of new and existing partners that have moved quickly to secure a sublicence for molnupiravir through MPP," said Gore in a statement.

Under terms of the deal, the manufacturers sign onto non-exclusive sublicenses that allow them to produce the raw ingredients for molnupiravir or the finished drug. MPP explained that each of the companies that were offered the sublicence successfully demonstrated their ability to meet its requirements, including production capacity and an ability to meet international standards for medicine quality.

There is also a clear division of labor attached to the deal. Five companies will focus on producing the raw ingredients, 13 companies will produce both raw ingredients and the finished drug, and nine companies will produce only the finished drug.

The parties behind the pill, including Merck, its partner Ridgeback Pharmaceuticals and Emory University in the U.S., are not entitled to any royalties, so long as COVID-19 remains classified as a Public Health Emergency of International Concern by the World Health Organization (WHO).

The Merck antiviral pill is not the same as the COVID-19 vaccine, but rather a treatment for those who have been diagnosed with the virus. For the U.N. and WHO, the bid to acquire more antiviral pills represents at least a means to treat those infected and prevent more deaths.

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