COVID-19 Therapy & Vaccine Trends in Middle East & Northern Africa Region (MENA)

COVID-19 Therapy & Vaccine Trends in Middle East & Northern Africa Region (MENA)

Known as the MENA region, the Middle East and Northern Africa, Arabian Business recently elaborated on the various COVID-19 therapies and vaccine deals in lace in MENA nations. The most prominent vaccine approved and purchased in the region is the BNT162b2 vaccine developed originally by BioNTech and now in partnership with the German company’s global partner Pfizer. Next on the vaccine front comes Sinopharm in terms of total number of deals in MENA. Common therapies still include Hydroxychloroquine and favipiravir for mild to moderate early onset cases but some of these nations have rejected these controversial treatments for remdesivir or even dexamethasone for more severe cases. Every nation has its own set of rules and norms, and what is in use in the region broadly categorized as MENA is as diverse as the nearly 580 million people living here.

MENA Key Nation & COVID Acceptable Therapy & Vaccine Situation

NationTreatmentsVaccine Selected
AlgeriaHydroxychloroquine, Antibiotics & Cortisone (prednisolone or dexamethasone) & AnticoagulantsNot selected yet
BahrainHydroxychloroquine; plasma therapySinopharm’s vaccine approved for frontline health workersPfizer-BioNTech vaccine
EgyptAzithromycin, paracetamol, cortisone & oral anticoagulantsSinopharm (100K doses)Ordered another 20m dosesMass vaccine campaign may not start till July
IranRemdesivir (producing locally)Pre-ordered about 16.8m doses of vaccine via COVAXImpacted by sanctionsDeveloping its own vaccineIn discussions with vaccine sources in Russia, China & India
IraqMild cases: Favipiravir & Plasma therapySevere cases: remdesivir, plasma therapy; tocilizumabStill in various talks; joined GAVI (COVAX)Negotiating with Pfizer
IsraelSteroids & remdesivir; plasma in some casesCountry has ordered 14 million doses for 7 million residents—2 doses per person required from both Pfizer & ModernaBNT162b2 rolled out recently
JordanSteroids (dexamethasone or hydrocortisone) as well as immunosuppressant prednisone. Remdesivir or favipiravir used as well as plasma therapy in some casesPfizer/BioNTech vaccine approved—available by Feb 2021
KuwaitDexamethasone (serous cases)Remdesivir; blood plasma but then stopped due to lack of efficacyPfizer/BioNTech—the country should receive supply late Dec
LebanonDexamethasone (considered due to price and findings of efficacy via RECOVERY); A few hospitals use remdesivir & chloroquine; little use of plasmaPfizer/BioNTech ($18m for 1.5m vaccines with shipment expected in Feb).Participating in COVAX (2.2m vaccines to be delivered Q32021
LibyaBlood plasmaAstraZeneca (AZD1222) 2.7m doses for $10m—have enough supply for 1.25m people (20% of pop); arrival of supplies hoped for March 2021
MoroccoHydroxychloroquine; azithromycinSinopharm—country acquired 10m doses
OmanPlasma therapyPfizer/BioNTech vaccine approved—importation in the works
Saudi ArabiaHydroxychloroquine for moderate to mild cases; Dexamethasone for patients on ventilatorSaudi Arabia has rejected remdesivir due to “little to no effect” on severe casesPfizer-BioNTech approved—first jab of Health Minister Tawfiq Al-Rabiah last Thursday
SudanAntibiotics & Steroids (dexamethasone & anticoagulants)The nation has ordered 8.4m doses but actual product not disclosed
SyriaDexamethasone, oxygen & ventilators for severe casesMild cases: chloroquine (six labs in Syria can product); azithromycin and interferonNo decisions yet but WHO together with the UN children’s agency UNICEF and GAVI—targeting 3% of the population aiming for 20% in 2021
TunisiaAzithromycin, paracetamol and anticoagulants as well as oxygenPfizer/BioNTech via COVAX initiativeVaccine should arrive Q2 2021—enough for vaccination of 1 million people
United Arab EmiratesHydroxychloroquine  in simple and moderate cases; blood plasma on 240 patientsSinopharm rollout approved and underwayReports 86% effective based on study with “no serious safety concerns”Two other vaccines include another one in Phase 3 from Sinopharm as well as Russia’s Sputnik V
YemenNo treatments—nation in dire humanitarian scenario based on civil war—a tragic situation.Some clinics managed by international NGOs opened in select locations—but responses focused on testing, surveillance & case management. No deals yet.

Responses

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  1. In India, 39 pharma companies manufacture favipiravir:
    Abbott (Fapvir), Aeon (COFA), Alkem (Alfluenza), Aprazer (Favikast), Avra (generic), BDR (BDFAVI), Biocon (Araflu), Biophore (generic), Blue Cross (FaviBlu), Brinton (Faviton), Cipla (Ciplenza), Converge (Vergiflu), Covalent (Favimax), Divi’s (generic), Dr. Reddy’s (Avigan), FDC (PiFLU and Favenza), Fusion (Xaravir), Glenmark (Fabiflu), Healing Pharma (Fapivir), Hetero (Favivir), Hikal (generic), Indoco Remedies (Fevindo), J.B.Chemicals (Favipill), Jenburkt (Favivent), Lasa (generic), Lee (Faravir), Lupin (Covihalt), Macleods (generic), Micro (Actavir), MSN (Favilow), Mylan (Favtris), Novagen (generic), Optimus (Favicovid), Raghava (generic), Sun (FluGuard), Strides (generic), Tagoor (generic), Vivimed (Favulous), Zenara (Favizen)

    In Bangladesh, 8 pharma companies manufacture favipiravir:
    Beacon (Favipira), Beximco (Viraflu), Biopharma (Biofavi), Eskayef (Favipir), UniMed UniHealth (Unifav), NIPRO JMI (Fluvigan), Square (Favinil), Veritas (Verigan)

    In Turkey, 8 pharma companies manufacture favipiravir:
    Atabay (Favicovir), Awamedica (Fabivir), Koçak Farma (Raviran), Istanbul Pharma (generic), Neutec Pharma (Favimol), Novelfarma (Favira), Santa Farma (Convolyn), World Medicine İlaç (Loqular)

    In China, 5 pharma companies manufacture favipiravir:
    APICMO (generic), Hunan Huateng (generic), Shouyuan Chemical (generic), Sihuan (generic), Zhejiang Hisun (Favilavir)

    In Egypt, 4 pharma companies manufacture favipiravir:
    EIPICO (Epifluver), Eva (Avipiravir), Rameda (Anviziram), Sabaa (generic)

    In Russia, 3 pharma companies manufacture favipiravir:
    Chromis, which is RDIF plus ChemRar (Avifavir), Promomed and Solyur-pharm (Areplivir), R-Pharm (Coronavir)

    In Bolivia, Sigma Pharma manufactures Avifavir (favipiravir)
    In Costa Rica, the University of Costa Rica manufactures their own favipiravir
    In Hungary, the Hungarian Academy of Sciences and the University of Pécs had been manufacturing favipiravir but now, Egis Pharma manufactures favipiravir
    In Indonesia, PT Kimia Farma manufactures the favipiravir API for PT Beta Pharmacon, which manufactures the Avigan (favipiravir) tablets
    In Iran, Shahid Beheshti Medical University manufactures their own favipiravir
    In Japan, Fujifilm Toyama Chemical manufactures Avigan (favipiravir)
    In Jordan, Sana Pharma manufactures Sancovir (favipiravir)
    In Kazakhstan, a pharma company in Almaty manufactures their own favipiravir
    In Nepal, Deurali-Janta Pharma manufactures Favir (favipiravir)
    In Pakistan, India-based PharmAlliance manufactures favipiravir for Pakistan
    In the Philippines, Biocare manufactures their own favipiravir
    In Romania, Terapia (Sun Pharma Therapy Cluj) manufactures FluGuard (favipiravir)
    In Taiwan, the Development Center for Biotechnology manufactured their own favipiravir long before COVID-19 first started
    In Thailand, the Government Pharmaceutical Organization (GPO) manufactures their own favipiravir
    In the Ukraine, Microkhim Pharma manufactures Favipiravir-Microkhim (favipiravir)

    In addition, numerous other nations have imported favipiravir for treating COVID-19 but have not manufactured it

  2. An interesting summary. Hydroxychloroquin (HCQ) is mentioned in a few countries, sometimes combined with Azithromycin (AZ) to form the “Raoult” cocktail. Zinc is not mentioned; it has a strong synergistic effect if combined with HCQ or Raoult (=the Zelenko cocktail). This is why studies designed to disprove the effectiveness of Zelenko, leave out the zinc.
    It would be interesting to know, which countries include zinc in their therapies; I believe Senegal and Uganda do. Those that use HCQ without zinc should be informed that Zelenko is more effective. Early intervention is critical.