Nature Concern: The first oral anti-coronavirus drug Molnupiravir

Merck Pharmaceuticals announced in early October that the antiviral drug it is developing can halve the number of hospitalizations and deaths of COVID-19 patients

However, it is unclear whether the success of Molnupiravir will turn into a game changer in the global fight against the epidemic

Gilead Science's antiviral drug remdesivir and biotechnology company Regeneron's monoclonal antibody cocktail must be administered intravenously or by injection

COVID-19 is not the first disease caused by the coronavirus to seriously affect humans

The initial efforts to find a treatment for COVID-19 focused on drugs that have been approved by regulatory agencies, but only produced a winner: dexamethasone, a steroid designed to suppress excessive inflammation in the most severely ill people

DRIVE (Emory Drug Innovation Ventures at Emory), a non-profit company based at Emory University in Atlanta, initially used Molnupiravir as a possible treatment for the equine encephalitis virus in Venezuela

Painter also recruited his collaborator Plemper to test the drug against influenza and respiratory syncytial virus

Dozens of coronavirus drugs are being developed - what will happen next?

Like Remdesivir, Molnupiravir is a nucleoside analogue, which means it mimics some of the building blocks of RNA

However, some researchers say that the compound's mutagenic potential in human cells-it may bind to DNA-does raise safety concerns

Other antiviral drugs are also under development

Atea Pharmaceuticals, a biotechnology company based in Boston, Massachusetts, is also developing an antiviral drug

Pfizer, headquartered in New York City, is also one step ahead

The United States has agreed to purchase 1.
7 million courses of Molnupiravir for US$1.
2 billion, which is equivalent to approximately US$700 per 5-day course of treatment
.
This is much lower than the price of remdesivir or monoclonal antibodies, but it is still too expensive for many parts of the world
.
Merck, which co-developed the compound with Ridgeback, has reached licensing agreements with five Indian generic drug manufacturers
.
These agreements allow manufacturers to set their own prices in India and 100 other low-income and lower-middle-income countries
.

However, even if poorer countries can afford the drug, they may not have the diagnostic capacity to use the drug correctly
.
If it is necessary to take Molnupiravir within the first 5 days after the onset of symptoms, "this requires us to be able to diagnose patients really quickly
.
" For many developing countries-even some wealthy countries-"this is actually a huge challenge
.
"