A year since Paxlovid was launched and The Medicines Patent Pool licensed Pfizer’s nirmatrelvir, we look at a few likely reasons for authorized generics of Paxlovid not turning up and what lies ahead in 2023, as Hetero’s version becomes the first with WHO prequalification while two Chinese and a Korean company wait in the wings.

R&D-based companies have denounced what they see as a dangerous and unjustified attack on intellectual property after the World Trade Organization’s ministerial conference finally adopted a decision on an IP waiver for COVID-19 vaccines. NGOs, by contrast, say the decision amounts to little more than a limited exception to existing rules on the compulsory licensing of medicines.

The “Accord for a Healthier World” pledges to provide patent-protected medicines on a not-for-profit basis in 45 lower-income nations. Pfizer, which profited most from the COVID-19 pandemic, sees the pandemic experience as a way to advance health equity.