China’s Approval of Pfizer Pill Opens Door to Ending COVID Zero

China’s surprising decision to buy Pfizer Inc.’s coronavirus pill to release for use offers rare insight into how Beijing may plan to move beyond its COVID Zero strategy, leaving it increasingly isolated.

Paxlovid’s conditional approval over the weekend makes it the first foreign pharmaceutical to be approved by China for COVID-19, with the country sticking steadfastly to domestically developed vaccines and therapies so far, even withholding approval for the highly potent mRNA injection co-produced by Pfizer and BioNTech SE.

Pfizer’s pill will serve a strategic purpose, Zeng Guang, a former chief scientist at China’s Center for Disease Control and Prevention who advised Beijing on COVID control, told investors in a briefing hosted by Sealand Securities Co. on Saturday, hours after the approval was announced. The move could lay the groundwork for China’s COVID containment regime to gradually give way to a more flexible approach, he suggested, according to a transcript seen by Bloomberg News and confirmed by Sealand.
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“China will not isolate itself from the rest of the world and has several measures at its disposal to turn things around,” Zeng said at the event. “Strategy precedes action.”

Zeng’s takeaway was shared by experts and analysts familiar with China’s virus approach.

The country is the last major economy still trying to eliminate COVID, a task that is becoming increasingly difficult in the face of more transferable variants such as Omicron and Delta. The lower efficacy of China’s homegrown vaccines is seen as a major reason behind the ongoing strategy, and having an effective antiviral in its arsenal could mitigate that drawback if the virus could circulate more freely.

“Hopefully it shows that they are preparing to not get zero cases,” said Sophia Archuleta, chief of infectious diseases at National University Hospital in Singapore and associate professor at Yong Loo Lin School of Medicine. “If and when COVID becomes widespread in the community, they have an effective drug to deploy.”

pharmaceutical nationalism

The conditional approval is an important milestone in the fight against COVID-19 and reflects the government’s efforts to increase access to innovative medicines in China, Pfizer said in a statement Monday.

Paxlovid’s approval also allays concerns that China, the world’s second-largest pharmaceutical market, was actively avoiding foreign treatments when it came to COVID. The Pfizer-BioNTech vaccine, licensed to Shanghai Fosun Pharmaceutical Group Co. in China, has yet to be stamped for use there, months after an application is made. Nearly 90% of the country is now fully vaccinated and many more are getting a boost with the less potent domestic vaccines.

“A foreign pill for COVID is much less radioactive than approving a foreign vaccine because vaccines have been at the heart of the soft-power race and such a point of national pride,” said Michael Shoebridge, director of defense, strategy and national defense. safety. program at the Australian Strategic Policy Institute, a think tank in Canberra.

Statistical models by Chinese experts suggest the country could see more than 600,000 infections a day if the current set of restrictions were lifted, a view difficult to reconcile in a place that has seen fewer than 5,000 COVID deaths since the suppression of the first major outbreak in Wuhan. But such a prospect underscores China’s need for the Pfizer Pill, which has been shown to reduce the risk of hospitalization and death by nearly 90% and would likely put less strain on China’s largely untested hospital system.

‘Unnecessary delay’

As with the vaccines, China has several domestic COVID antiviral candidates in the final stages of development, but progress has been slow. The increasing vaccination coverage worldwide, coupled with the reduced virulence of Omicron, makes it more difficult to prove that they can prevent hospitalization and death. One of China’s most advanced COVID pills, from Suzhou-based Kintor Pharmaceutical Ltd, had to conduct a second late-stage trial in several countries after a first in the US failed to yield meaningful results amid very low hospital admissions.

“This approval is likely that China calculates that relying on its own antivirals to end its zero-COVID policy would cause an unnecessary delay, compared to opening up the rest of the world,” said Brad Loncar, CEO of Loncar Investments, which closely follows developments. Chinese biotechnology industry. “It is positive to see China prioritize rejoining the global network rather than adopting a more nationalistic stance.”

Still, domestic antiviral candidates could still get a boost from Pfizer’s decision, as the US company is unlikely to be able to meet all of China’s treatment needs on its own, said Zhang Jialin, head of China healthcare research at Nomura Holdings Inc. said Paxlovid’s global supply is only 120 million courses of treatment by 2022.

Executives of Shanghai Junshi Biosciences Co, which is in the final stages of testing an antiviral drug in China and abroad, told investors this weekend that China’s approval of Paxlovid’s approval reflects Beijing’s recognition that pills are a role in ending the pandemic, according to a company spokesperson. Junshi shares rose more than 5% in Hong Kong on Monday.

“It creates favorable conditions for a return to normalcy in mainland China, including exchanges with the rest of the world,” Nomura’s Zhang said. “But more details need to be learned.”

—With the help of Dong Cao.

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