The Bill & Melinda Gates Foundation has announced a commitment of up to $120 million to accelerate access for lower-income countries to the investigational antiviral drug molnupiravir.

To be allocated in consultation with partner organizations, the funding will support efforts to develop and manufacture generic versions of the drug, which is being developed by Merck & Co. in collaboration with Ridgeback Biotherapeutics. Initial data suggest that molnupiravir can cut the risk of serious disease and death from COVID-19 by half; authorization for its use is pending with regulatory agencies, including the World Health Organization and national governments. Molnupiravir would be the first oral outpatient drug authorized for use in treating COVID-19 patients with mild and moderate disease — a critical breakthrough to prevent hospitalizations and save lives in combination with increased vaccination coverage and existing treatments for severely and critically ill patients.

The commitment, which leverages the resources of the foundation's Strategic Investment Fund, is aimed at significantly reducing the time it takes for the new drug to reach low-income countries after it becomes available in high-income markets. The foundation already has provided expertise and funding to help strengthen generics manufacturers, including a $1.3 million grant to Medicines for All Institute and the University of Manchester to develop low-cost manufacturing processes that reduce the cost of raw materials and increase product yields, and grants totaling $2.4 million to expedite generics companies' readiness to apply for WHO prequalification and start manufacturing once approval is granted.

"To end this pandemic, we need to ensure that everyone, no matter where they live in the world, has access to lifesaving health products. The unjust reality, however, is that low-income countries have had to wait for everything from personal protective equipment to vaccines. That is unacceptable," said Gates Foundation co-chair Melinda French Gates. "Today's commitment will ensure that more people in more countries get access to the promising drug molnupiravir, but it's not the end of the story — we need other donors, including foundations and governments, to act."