A pile of Merck's antiviral pills. | Merck & Co. via AP
FAIR SHARE— “The future is already here,” the science-fiction writer William Gibson said. “It’s just not very evenly distributed.” You could say the same for the coronavirus vaccine and its effects on the Covid pandemic.
The vaccines were not and are still not equitably distributed around the world. Rich countries have a lot of vaccines — poor countries, not so much.
Yet Merck says its promising new Covid pill, molnupiravir, will be different. The drug doesn’t prevent Covid; vaccination is still the gold-standard defense. But the medicine does halve the risk of hospitalization and death for people who take it soon after testing positive for the disease.
Paul Schaper, Merck’s executive director of global pharmaceutical public policy, understands your skepticism about global drug equity, given the industry’s spotty record, during the pandemic and before. Rich countries got better access to life-saving medications for diseases like HIV and hepatitis, even when the need was great elsewhere.
But Merck, Schaper told Nightly, started working on how to distribute its Covid-19 pill around the world even before the company even knew if the drug would work. By the time Merck announced its promising results, it had already licensed the drug to five Indian-based generic makers, which were screened for their track records on past international distribution and their ability to move fast when regulators give the OK.
Merck’s agreements with the generic makers call for broad distribution to both low- and middle-income countries. And the company has been in touch with numerous governments, as well as philanthropies and global coalitions, that will make some of the decisions about where and how to spread Covid therapeutics.
“We’re trying to make sure that we will have timely and accelerated access for patients globally and not just access for this product in higher-income countries,” Schaper said.
Even some critics of the big pharmaceutical companies, like Doctors Without Borders, see the potential here — with ample caveats, given the industry’s overall history.
Merck is already known for one of the exceptions to that history. For years, it has donated loads of a drug called Mectizan to treat a dreadful ailment called River Blindness in Africa, Latin America and Yemen. Perhaps you know the drug by another name: ivermectin. On River Blindness, it works.
Assuming that Merck’s molnupiravir data holds up to review by the FDA and its foreign counterparts, the medicine is a Big Deal. It’s a pill that doesn’t have to be injected or infused at a hospital or clinic or kept in super-cold freezers. It’s relatively easy to ship, distribute and store in poor nations.
One downside: The patient needs to start taking the drug within five days of symptoms. That requires quick and affordable testing. In many countries, including the U.S., that’s still a heavy lift.
The prompt generic licensing is a “very positive step,” said Rachel Vreeman, chair of the department of global health and the director of the Arnhold Institute for Global Health at Mount Sinai’s med school, in an email to Nightly.
But “the resource and access questions do not end when a generic drug is produced — even if the price for the medicine is low,” she added. Getting the drug to the right patients at the right time will require spending money to improve testing access, too.
Doctors without Borders’ Leena Menghaney, who is based in India, told us she worries less about getting the drug to really poor countries in Africa and elsewhere than she does about getting it to the middle-income countries, places like Brazil or Thailand.
You can think of the middle-income countries as the donut hole of global drug pricing. These countries are too rich to get a ton of help — but too poor to pay their way to the table where the U.S. and E.U. countries are placing their bids for a limited supply. The U.S., for instance, has already put in a $1.2 billion order for 1.7 million treatment courses — out of the 10 million Merck aims to have ready by year’s end.
That middle-income squeeze is one reason Doctors without Borders is among those advocating for a waiver of intellectual property rules for Covid (and beyond) — to open up generic production and access in those nations, both for acquiring raw materials to make the drugs and to get the finished products. Most of this IP debate (and the Biden administration’s surprise endorsement of the idea) centers on IP waivers for vaccines.
The Merck drug, Menghaney said, underscores that the rules of the game need to be changed for drugs as well.
Nightly contributor Joanne Kenen, POLITICO’s former health editor, is the Commonwealth journalist-in-residence at Johns Hopkins School of Public Health.
Welcome to POLITICO Nightly.Reach out with news, tips and ideas for us at nightly@politico.com. Or contact tonight’s author on Twitter at @JoanneKenen.
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WHAT'D I MISS?
— U.S. to reopen to international travelers on Nov. 8: The U.S. will reopen its border to fully vaccinated foreign travelers on Nov. 8 . White House assistant press secretary Kevin Munoz announced today the new U.S. travel policy, which applies “to both international air travel and land travel.” “This policy is guided by public health, stringent, and consistent,” Munoz wrote on Twitter. The U.S. border has been closed to discretionary travel since March 2020.
— Capitol Police officer charged with obstructing Jan. 6 investigation:A Capitol Police officer has been charged with helping a participant in the Jan. 6 Capitol attack attempt to obstruct justice by deleting incriminating social media posts, federal prosecutors announced today. In the two-count indictment, prosecutors say the officer, Michael Riley, expressed support for the unnamed rioter’s political views and contacted him on Jan. 7. Riley encouraged him to remove incriminating evidence that he was inside the building on Jan. 6. The rioter, identified only as “person 1,” was subsequently arrested.
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— Justice Department to ask Supreme Court to block Texas abortion ban:Texas’ first-of-its-kind abortion ban appears headed back to the nation’s highest court. The Biden administration today confirmed it will petition the Supreme Court to block the law after a federal appeals court extended an order on Thursday night that kept it in place. The law bans abortions once cardiac activity is detected, usually around six weeks, and delegates enforcement to private citizens rather than government officials.
— FDA panel endorses broad use of Johnson & Johnson booster shot:Americans who received Johnson & Johnson’s Covid-19 vaccine should be able to receive a second shot of the vaccine two months after their first dose under an emergency authorization, FDA vaccine advisory committee members said in a 19-0 vote. The independent vaccine experts’ vote came after an hourslong discussion of the underlying data J&J submitted to the FDA. The company had proposed a booster after two months for people at high risk, such as the elderly, and after six months for most people.
NIGHTLY NUMBER
6 years
The amount of time the post of Pentagon inspector general has been either vacant or filled by an acting official. Nine months into the Biden administration, there are still 12 IG vacancies that require presidential nomination. (h/t National Security Daily)
AROUND THE WORLD
MP KILLING RAISES SAFETY CONCERNS —The killing of British MP David Amess has raised immediate questions about the safety of MPs . The long-serving Conservative representative for Southend West was stabbed at a drop-in meeting in his constituency today, Esther Webber writes.
These so-called surgeries are commonplace in Britain, and see MPs open their doors to hear voters’ concerns. Usually, they are accompanied only by their office staff.
It is not the first time a parliamentarian has been attacked while carrying out this part of their duties. Labour MP Jo Cox was murdered in Batley and Spen by a far-right extremist during the 2016 Brexit campaign. In 2010, Labour’s Stephen Timms survived after being stabbed twice during a surgery in West Ham. And in 2000, Andy Pennington died after being stabbed trying to protect his boss, the Liberal Democrat MP Nigel Jones.
Amess himself had lamented the need for extra security in the wake of Cox’s death, writing in his memoir: “These increasing attacks have rather spoilt the great British tradition of the people openly meeting their elected politicians.”
Home Secretary Priti Patel said questions are “rightly being asked” about the safety of MPs following Amess’ death and vowed to “provide updates in due course.”
PUNCHLINES
BETTER BUILD BACK — The Biden agenda is having a rough time, and political satire and cartoons have taken notice, as you’ll see in the latest Weekend Wrap hosted by Brooke Minters . Other top worries: Christmas shopping delays and grocery store shortages.
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PARTING WORDS
Former Virginia Gov. Terry McAuliffe, Democratic gubernatorial candidate for Virginia for a second term, accompanied by his wife Dorothy (L), addresses supporters as he arrives to cast his ballot during early voting at the Fairfax County Government Center in Virginia. | Win McNamee/Getty Images
Democrats are sending their biggest guns to back up former Gov. Terry McAuliffe: First lady Jill Biden is in the Richmond area tonight. Former President Barack Obama will be here next weekend. It’s a reflection of how the suburbs that ring the city’s history-laden downtown have become critical in a state that has trended blue but is still no guaranteed win for Democrats.
“So goes Henrico County, so goes the commonwealth of Virginia,” Richmond Mayor Levar Stoney, a Democrat, said at a fish fry on his city's border earlier this week.
Both McAuliffe and Republican Glenn Youngkin have homed in on Richmond and Central Virginia, bombarding the area with on-the-ground visits and TV advertising. Unlike the Washington suburbs in Northern Virginia, a voter-rich area where McAuliffe is expected to dominate, and the state’s south and southwest, which are strong for Youngkin, public polling shows the two candidates are essentially tied in the Richmond market.
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A Capitol Police officer has been charged with helping a Jan. 6 rioter attempt to obstruct justice by encouraging him to delete incriminating social media posts, federal prosecutors announced Friday.
In the two countindictment, prosecutors say the officer, Michael Riley, expressed support for the unnamed rioter’s political views and contacted him on Jan. 7 via Facebook direct message. Riley encouraged him to remove incriminating evidence that he was inside the Capitol on Jan. 6. The rioter, identified only as “person 1,” was subsequently arrested.
Riley, a 25-year veteran of the Capitol Police force, faces two counts of obstruction and is expected to appear in court Friday afternoon. He was on duty on Jan. 6 as part of a K-9 unit, but did not enter the Capitol building during the melee, according to the indictment. He was among the officers who responded to explosive devices placed near the Democratic National Committee and Republican National Committee offices.
“Obstruction of Justice is a very serious allegation. The Department was notified about this investigation several weeks ago,” said U.S. Capitol Police Chief Thomas Manger. “Upon his arrest, the officer was placed on administrative leave pending the completion of the case. The USCP’s Office of Professional Responsibility will then open an administrative investigation.”
In the aftermath of the attack on the Capitol, the U.S. Capitol Police revealed that three dozen officers had been investigated for potential misconduct, and six had been suspended. But most of the cases were ultimately deemed to be unsubstantiated.
But Riley’s arrest adds a new and troubling element to the ongoing probes of the Capitol Police response to the riot. Some Democrats had long suspected that some Capitol Police officers may have sympathized with the rioters, pointing to selfies some were seen taking as the crowd milled about the Capitol. But those charges had not been substantiated. Riley’s case is the first concrete example.
The charging documents also suggest that the FBI was aware of the officer’s contact with “Person 1” in January. But Manger revealed that he didn’t learn about the case until recent weeks, and the officer continued to work in the department until his arrest. It’s unclear why there was a delay in communicating this evidence, which allowed Riley to continue working on the Capitol Police force for more than nine months after Jan. 6.
Riley made his initial appearance in federal court on Friday afternoon before Magistrate Judge Michael Harvey. He's slated to appear again on Oct. 26 before Judge Amy Berman Jackson.
Gus Papathanasiou, the chair of the Capitol Police union, urged people to wait for more facts to emerge — as well as Riley's defense — before passing judgment on Riley.
"In this country, there is a presumption of innocence. All I ask is that everyone respect the process and let it proceed before rendering a judgment on this officer," he said in a statement.
According to prosecutors, Riley had never met the rioter he later communicated with but the two shared a love of fishing and were both in the same fishing-related Facebook groups. Riley, according to the indictment, viewed the alleged rioter’s Facebook posts attesting to being inside the Capitol and decided to make contact on Jan. 7.
“im a capitol police officer who agrees with your political stance,” Riley wrote, according to the indictment. “Take down the part about being in the building they are currently investigating and everyone who was in the building is going to be charged. Just looking out!”
Prosecutors say the pair exchanged dozens of messages after that until the alleged rioter’s arrest on Jan. 19.
Riley subsequently deleted all of his contacts with “person 1” and sent a scolding message on Jan. 21 criticizing him for smoking inside the Capitol.
While Riley did note in a message to the unnamed riot suspect that the Capitol Police had “over 50 officers hurt, some pretty bad,” about 10 days after the riot, Riley invited the person to join him at his home in the future and to return to the Capitol, the indictment returned by a grand jury in Washington Thursday alleges.
“Next time you want to come to DC just call me, you can stay at my house on shore for free and bring your daughter to the museums,” Riley wrote, according to the indictment. “If you want to see the capitol building, lets do it legally next time….I know a guy who can get you a tour...lol.”
Despite the U.S. attorney's decision not to name "Person 1," the details of the case align closely with those of Jan. 6 defendant Jacob Hiles. Hiles was arrested on Jan. 19 and is a Virginia Beach-based boat captain who is known for a love of fishing. The statement of facts in his case notes that he smoked an "unidentified substance" inside the Capitol on Jan. 6. Hiles pleaded guilty to a misdemeanor offense related to his Jan. 6 conduct last month. He's set to be sentenced in December.
Hiles' attorney did not immediately respond to a request for comment.
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