Promoting fair and equitable access to medicines

Professor Anthony Green of the Manchester Institute of Biotechnology (MIB) explores an open-source model of drug production, making life-saving treatments more sustainable, practical and affordable to produce.

Most of us in the UK don’t worry about medical care; we know that it’s there for us, including all the drugs and therapies that accompany treatment. The NHS – free at the point of care – is a service we’re fortunate to have, but this luxury isn’t afforded to many in the world.

Imagine, then, what it is like in developing countries where medicines are expensive, certain treatment options are not available, and hospitals and medical centres are few and far between. It is a problem faced by many countries and we have a responsibility to help change this. We need to support fair access to medicine – this starts with making drugs more practical to produce, administer and more affordable for the end user. This is what our recent work on the COVID-19 antiviral therapy, molnupiravir, aimed to do.

Sustainable and low-cost solutions for life-saving drugs

Molnupiravir was used to treat influenza, but studies now show that it offers approximately a 30% reduction in both hospitalisations and deaths from COVID-19 (for mild to moderate disease) in unvaccinated patients with at least one comorbidity. If you can reduce the amount of people with mild disease requiring medical care, you can ensure resources are available for those who are most in need. In countries where healthcare systems are stretched, this could be a lifeline they didn’t have before.

Knowing that molnupiravir could help turn the tide on COVID-19 in developing countries, my colleagues Professor Nicholas Turner, Dr Sarah Lovelock, Dr Ashleigh Burke, and I worked in conjunction with a philanthropic organisation, Prozomix Ltd. and Sterling Pharma Solutions to develop an efficient biocatalytic process to manufacture molnupiravir. This new method is scalable, low-cost, environmentally sustainable and is freely available for companies to use.

This last point, that it is freely available, is crucial to ensuring fairer access to the drug and was a key stipulation for our work. Now that it is available in the public domain, anyone can make use of it.

Our process has been carried out on a kilo-scale by industrial partners to demonstrate scalability and the key engineered enzyme, developed in our labs, has also been commercialised by Prozomix Ltd. Free samples are available to pharmaceutical manufacturing companies interested in adopting our process. This open source approach allows them to test out and apply the process, which should, in turn, reduce production costs by introducing competition.

Collaborative research opening doors to healthier futures

When faced with a health threat like COVID-19, it is key to have potentially life-saving drugs available to treat the global population. Increasing the efficiency, scalability and sustainability of manufacturing is one important piece of the jigsaw in ensuring fair and equitable access to medicines.

The open and collaborative approach to research we adopted – drawing on skills and expertise from academia, industry, charities and philanthropic organisations – provides a valuable model for new low-cost routes to essential medicines. Pfizer recently launched Accord for a Healthier World, an initiative where patented drugs are released to a group of countries on a not-for-profit basis. This recognition of the need for health equity from a global pharmaceutical giant is an important step forward. We hope that our work and this model of drug production will pave the way for many more to approach other global health challenges in a similar way.