LONDON, Sept 26 (Reuters) - Pfizer ( PFE ) has so far signed up

less than a quarter of the countries targeted under a plan to

make its medicines available to the world's poorest nations at

not-for-profit prices, just over two years after it launched.

The programme, which Pfizer ( PFE ) called "An Accord for a

Healthier World," launched in 2022 and was expanded to cover

more products in 2023. It aims to provide 45 low-income

countries affordable access to Pfizer's ( PFE ) entire portfolio of

drugs and vaccines, including bestsellers like blood thinner

Eliquis and cancer drug Ibrance, as well as new products.

The company had been criticized for its rollout of its

COVID-19 vaccine, with some poorer countries waiting for months

compared with wealthier ones.

Pfizer ( PFE ) chief executive Albert Bourla said in an interview

the progress was slower than he had hoped because "few countries

are really mobilising themselves to bring the products in". Ten

countries have signed up so far, Pfizer ( PFE ) said.

"It is extremely challenging in terms of bureaucracy,"

Bourla said. "They need to change the process of how they're

going to procure and they need to register the products, and

those are the bottlenecks."

Many of the countries initially listed, from South Sudan to

Myanmar, face significant competing challenges, including

conflict, natural disaster and disease outbreaks.

Five countries - Rwanda, Ghana, Malawi, Senegal and Uganda -

committed to joining the accord in 2022. Rwanda received the

first shipment of 1,500 treatment courses for infectious

diseases, inflammatory diseases and some cancers in September of

that year, but there have been no further details on drugs or

vaccines delivered since.

A Rwandan health official said it had expanded the number of

products it could buy from Pfizer ( PFE ) from eight to 20, and was

working with the company on accessing more.

"Rwanda has moved quickly," said Julien Mahoro Niyingabira,

a spokesperson for Rwanda's Ministry of Health.

Pfizer ( PFE ) is also in talks with ten more countries to join the

programme, but Bourla acknowledged the company had not spoken

directly to all of the countries it hoped would join, relying

instead in some cases on countries showcasing the program to

their neighbours.

"We are actively working with nearly half of the 45

accord-eligible countries," a spokesperson added by email. They

said the accord had the potential to reach one million patients

this year, based on doses delivered and product orders.

Bourla said many countries are most interested in Pfizer's ( PFE )

off-patent products, like sterile injectables - products used

regularly in hospitals, including basic tools like saline

drips.

"It's not a question of price," Bourla said, adding that

Pfizer's ( PFE ) pricing under the accord for many its off-patent drugs

is competitive with generics in the countries.

"It is, of course, the quality (that matters) in countries

where they have suffered a lot from counterfeits."

Bourla said the uptake of innovative drugs has been slower,

and the company is working with physicians in the countries on

improving access to diagnosis and managing the drugs.