There are 37.9 million people living with HIV worldwide, but only 24.5 million currently receive antiretroviral therapy. HIV paediatric care is improving, but still only one in two children living with the virus has access to treatment[1].
Affordable, effective HIV medicines are imperative, especially for those living in low- and middle-income countries where HIV is most prevalent. Medicines must also be available in the right formulations. Fixed-dose combinations increase adherence. Special treatments for children, appropriate for different ages and weights, improve care.
Since 2010, we have worked with leading HIV drug manufacturers, governments, international organisations and civil society to improve access to World Health Organization’s priority and new medicines for people living with HIV in developing countries.
[1] UNAIDS: Global HIV & AIDS statistics — 2019 fact sheet (last accessed on 3 Dec. 2019)
VIRAL HEPATITIS
International Goals
Eliminate viral hepatitis as a major public health threat by 2030. Reduce infections to less than one million and deaths to 500,000 in the same time period.
MPP’s Contribution
Promote access to direct-acting antivirals with the potential of working across all strains of the virus.
Hepatitis C
Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). 58 million are estimated to be living with the virus[1], with 62% residing in low- and middle-income countries[2].
New direct-acting antivirals (DAA) that are effective across all major HCV strains can cure millions. Yet, approximately 84% of the people infected with HCV are not receiving treatment[3].
The Medicines Patent Pool works with generic partners to speed the development and distribution of these new treatments that can eliminate the virus through a short course of oral therapy in regions with a high HCV burden.
MPP signed licence agreements for three hepatitis C treatments: daclatasvir (DAC) in 2015, ravidasvir (RAV) in 2017 and glecaprevir/pibrentasvir (G/P) in 2018.
Hepatitis B
MPP’s licences from Gilead Sciences, covering tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide (TAF), benefit people living with HIV as well as people living with chronic hepatitis B, a disease affecting 296 million globally[4]. The majority of people with hepatitis B live in low- and middle-income countries.
[1] World Health Organization, Global report on HIV, viral hepatitis and sexually transmitted infections, 2021
[2] World Health Organization, Progress report on access to hepatitis C treatment – key messages (last accessed on 9 March 2020)
[3] World Health Organization, Global report on HIV, viral hepatitis and sexually transmitted infections, 2021
[4] World Health Organization, Global report on HIV, viral hepatitis and sexually transmitted infections, 2021
Tuberculosis (TB) is a global pandemic affecting around 10 million people worldwide. In 2018, the disease caused 1.5 million deaths, and it is the leading killer of people living with HIV. Almost 90% of TB deaths occur in low- and middle-income countries[1].
The World Health Organization’s post-2015 Global TB Strategy sets ambitious targets aimed at reducing TB deaths by 95% between 2015 and 2035, and to end TB. To meet these targets, faster acting, better therapies to treat TB are urgent, particularly for multidrug-resistant TB (MDR-TB).
We work to improve access to new treatments for MDR-TB and drug-susceptible tuberculosis. We also facilitate the development of new regimens by licensing TB drugs that are still under development. In early 2017, MPP signed its first agreement with the Johns Hopkins University. This agreement was to facilitate the clinical development of sutezolid, a promising investigational treatment for tuberculosis. It was followed by a second agreement with Pfizer in October 2019 to access Pfizer’s preclinical, phase I and phase IIa clinical study data and results on sutezolid. The agreement’s aim was to further study, develop and make available this potential important component of new TB regimens.
[1] World Health Organization, Global Tuberculosis Report 2019 (last accessed on 9 March 2020)
While there has been tremendous progress in new technologies to treat cancer, major challenges persist in many low- and middle-income countries (LMICs) that face inequity in access to new-generation cancer medicines which could allow patients to live better and longer. Advances in treatment, such as nilotinib, have contributed to a greatly improved prognosis for people diagnosed with CML.
Nilotinib is the first licence that MPP has signed for a cancer treatment, and the first time a company is licensing a patented cancer medicine through a public health-oriented voluntary licensing mechanism.
“Access to high-quality cancer medicines is a crucial component of the global health response to the cancer burden, therefore I am delighted to be signing our first licence agreement with Novartis for a much-needed cancer treatment in LMICs. Although the remaining patent life is relatively short, this voluntary licence in the non-communicable disease space sets a vital precedent that I hope other companies will follow.” said Charles Gore, MPP Executive Director, October 2022.
OTHER DISEASE AREAS
For too many, health is inaccessible, unaffordable or unavailable. 100 million people each year, worldwide, are driven into poverty because healthcare costs are too high[1]. In most countries of the world, there is no universal health coverage or even individual access to new treatments.
In 2018, MPP conducted a feasibility study. This explored the expansion of our mandate to include other patented priority essential medicines beyond HIV, hepatitis C and tuberculosis. The study was funded by the Swiss Agency for Development and Cooperation (SDC). It included a series of illustrative case studies on access to essential medicines in the fields of cancer, diabetes and cardiovascular diseases (CVDs).
Approximately 70% of deaths from cancer occur in low- and middle-income countries[2]. Diabetes prevalence has been rising more rapidly in low- and middle-income countries[3]. And more than three quarters of CVD deaths take place in low- and middle-income countries.[4]
The study highlighted the expected public health value of providing generic access to patented products on the WHO Essential Medicines List (EML). It also showed the products that the WHO EML Committee recognize as having potential for future inclusion on the List.
The organisation’s remit now covers patented essential medicines included in the WHO EML and those with strong potential for future inclusion. The current focus is on small molecules, while the applicability of the model to biologics is under consideration.
In 2019, MPP published a prioritisation framework that outlines a precise methodology for assessing candidate medicines. These candidate medicines could play a major role in the expanded mandate.
Related content
MPP’s publications:
> Framework for Prioritisation of Candidate Medicines for In-Licensing under an MPP Expanded Mandate
> Peer-reviewed article on the WHO bulletin: Patent pooling to increase access to essential medicines
Related publications:
> Essential medicines for patients with multiple sclerosis – The Lancet Neurology
> Improving affordability of new Essential Cancer Medicines – The Lancet Oncology
MedsPaL:
> MedsPaL’s update on Essential Medicines
[1] https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc)
[2] https://www.who.int/news-room/fact-sheets/detail/cancer
[3] https://www.who.int/news-room/fact-sheets/detail/diabetes
[4] https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)