The World Health Organisation (WHO) has recommended the use of a Pfizer oral antiviral drug for the treatment of mild and moderate Covid-19 patients who are at highest risk of developing severe disease or being hospitalized.

According to the international health body, the use of nirmatrelvir and ritonavir, which are sold under the name Paxlovid, has been the best therapeutic choice for high-risk patients till date.

This recommendation follows randomised controlled trials among some 3,078 Covid-19 patients.

After treating the patients with the drug, the risk of hospitalisation reduced by 85%. It means in a high-risk group with over 10% risk of hospitalisation, there were 84 fewer hospitalisations per 1,000 patients.

A press statement released by the WHO on April 22 explained that non-severe Covid-19 patients such as ones who are unavaccinated, older or immunosuppressed can be treated with the drug.

“One obstacle for low- and middle-income countries is that the medicine can only be administered while the disease is at its early stages; prompt and accurate testing is, therefore, essential for a successful outcome with this therapy.

“Data collected by FIND show that the average daily testing rate in low-income countries is as low as one-eightieth the rate in high-income countries. Improving access to early testing and diagnosis in primary health care settings will be key for the global rollout of this treatment,” the statement highlighted.

The WHO, however, called for a wide distribution and transparency from the originator.

It expressed concern that the lack of price transparency in bilateral deals made by the producer and the need for prompt and accurate testing before administering the medicine may turn “this life-saving medicine into a major challenge for low- and middle-income countries.”

“WHO is extremely concerned that – as occurred with COVID-19 vaccines – low- and middle-income countries will again be pushed to the end of the queue when it comes to accessing this treatment.

“WHO, therefore, strongly recommends that Pfizer make its pricing and deals more transparent and that it enlarge the geographical scope of its licence with the Medicines Patent Pool so that more generic manufacturers may start to produce the medicine and make it available faster at affordable prices,” the statement urged.

WHO updates recommendations on remdesivir

Along with the strong recommendation for the use of nirmatrelvir and ritonavir, the WHO has also updated its recommendation on remdesivir, another antiviral medicine.

Previously, WHO had suggested against its use in all Covid-19 patients regardless of disease severity, due to the totality of the evidence at that time showing little or no effect on mortality.

But “following publication of new data from a clinical trial looking at the outcome of admission to hospital, WHO has updated its recommendation.

“WHO now suggests the use of remdesivir in mild or moderate COVID-19 patients who are at high risk of hospitalisation.”

“The recommendation for use of remdesivir in patients with severe or critical Covid-19 is currently under review,” it stated.