The World Health Organization said yesterday that it "strongly recommends" Pfizer Paxlovid's antiviral pill against Covid-19 for patients with milder forms of the disease who are still at high risk of hospitalization.

However, the UN agency warned that it was "extremely concerned" that the inequality of access observed with Covid vaccines would again leave low- and middle-income countries "pushed out of the queue".

The combination of nirmatrelvir and ritonavir by US pharmaceutical giant Pfizer is the "better choice" of treatment for unvaccinated, elderly or immunocompromised people with coronavirus, according to WHO experts in the medical journal BMJ.

For the same patients, the WHO also made a "conditional recommendation" for the antiviral drug remdezivir, manufactured by the American biotechnology company Gilead - which it had previously recommended not to take.

Oral treatment with the Pfizer tablet prevents hospitalization more than "available alternatives, has fewer concerns about the harms of molnupiravir and is easier to administer than intravenous remdezivir," WHO experts said.

The new recommendation is based on the results of two studies involving almost 3,100 patients, which showed that Paxlovid reduced the risk of hospitalization after covid infection by 85%.

The studies also "did not suggest a significant difference in mortality" and "little or no risk of side effects leading to discontinuation of treatment".

"The drug can be used only while the disease is at an early stage," said WHO experts.

This means that patients must quickly pass a positive test and have the medicine prescribed by a doctor - all of which can be an obstacle for low- and middle-income countries, the WHO said.

Patients should start taking Paxlovid tablets within five days of the onset of symptoms - then the course lasts for five days.

Lisa Hedman, senior WHO adviser on access to medicines, said to NPR radio that the full course of Paxlovid treatment cost 0 in the United States. Another source, unconfirmed by the WHO, gives a price of 0 in a high-income country.

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