When I joined the Medicines Patent Pool (MPP) at the beginning of July this year, I knew I was doing so at an exciting and challenging time. The day before the governing board appointed me they had decided, following a feasibility study, to expand the remit of the organisation to include other patented essential medicines. Having started with the aim of making HIV medicines affordable in low- and middle-income countries (LMICs) through intellectual property licences, the MPP expanded its remit in 2016 to include hepatitis C and tuberculosis but is now looking at doing the same thing for new essential medicines that are urgently needed in LMICs. At the same meeting the board also adopted a five-year strategy and my job is to deliver on it.
Given the breadth of the new remit our first task is to prioritise the drugs we would like to license. To do that we are creating a framework that will help us address three broad questions: is there a public health need for a given drug in LMICs, what are the barriers to access and can the MPP significantly help to make them accessible and affordable? The MPP has always been about addressing public health need and that will continue to be our focus.
This is not public health need as defined by me personally, or even by the MPP; rather it is what the global public health community sees as the need, just as our expansion has happened in response to a request from that community. We are therefore consulting widely. We are having ongoing discussions with the World Health Organization (WHO), manufacturers, both originators and generics, and civil society. Last week, we held a very informative formal consultation with our 23-member Expert Advisory Group and in January will be consulting with countries. So, as you read this, please feel free to let us know your opinionon where we should be concentrating our efforts.
Because this expansion will take us into areas beyond Unitaid’s remit, we need to find other funders for this and I am delighted that the Swiss Government and the Wellcome Trust have agreed to support our initial expansion work.
I do want to stress that our expansion will not mean that we lessen our efforts in our core areas of HIV, hepatitis C and tuberculosis. In November I was especially pleased, as someone with the lived experience of hepatitis C and a personal commitment to ensuring access to hepatitis treatment, that thanks to the efforts of the MPP team and the originator company, AbbVie, we signed a licence to expand access to akey HCV treatment, glecaprevir/pibrentasvir. This collaboration will ensure quality, affordable hepatitis C treatment options in 99 LMICs and territories. It was welcomed by our partners, including the WHO, Unitaid, the World Hepatitis Alliance and the Government of Pakistan, a country with a significant global HCV burden, affecting over eight million people, who said, “This agreement will considerably aid our efforts and, ultimately, accelerate the permanent elimination of the HCV virus.”
I am also thrilled that in the third quarter of this year we passed an important milestone in hepatitis C. More than one million people have been treated with daclatasvir produced by our licensees. There is of course a long way to go to eliminate hepatitis C by 2030 but the MPP is now playing an increasingly important role.
The MPP’s achievements to date – millions of people with HIV or hepatitis C treated with quality-assured, affordable drugs – should be more widely understood and appreciated. So we will be significantly stepping up our communications activities in 2019 because highlighting our past will be crucial in ensuring broad support for our expansion in the future.
Nothing in my first six months has lessened the excitement I felt when I was offered this job. Indeed, the more I have learned, the more I see the opportunity for the MPP to continue making a real difference but across the much broader field of essential medicines. I am extremely grateful to have been given the chance to be part of that.
I wish you all a restful holiday period and a successful, meaningful year ahead, and I want to thank Unitaid, for their continuing support; the organisations who partner with us to deliver our unique model; and of course the MPP’s committed staff, Governance Board and members of our Expert Advisory Group.