2023 End of Year Message from MPP Executive Director – Equitable Access, Universal Health Coverage and Pandemic Preparedness
12 December 2023
2023 has been another busy year for MPP. In the troubling geopolitical environment, we have worked with our many partner organisations to try to keep health, and specifically equitable access to it, as a key priority for world leaders. Our role is to bring down prices of health products to affordable levels in LMICs and ensure they are available through licensing and technology transfer.
A new strategy for MPP.
So, 2023 began with the launch of our 2023-25 strategy, with its ambitious targets of 10 new licences in the three-year period, together with five new products developed by our generic licensees and available for procurement in LMICs. This included one new formulation for children, and an initial mRNA vaccine technology package transferred to 10 LMIC manufacturers. Our aim is to continue our licensing in infectious diseases while expanding further into non-communicable diseases and facilitating the development of novel technologies. We also want to use our model to help prepare for the next pandemic and to support more diversified sustainable manufacturing across LMICs.
New licences and sublicences signed in 2023.
How are we doing with our targets? In 2023, we received three new licences through WHO’s Covid Technology Access Pool and we had three new products developed and available. They include molnupiravir and nirmatrelvir for the treatment of COVID-19 and an HIV fixed-dose combination treatment for children – paediatric ALD (abacavir, lamivudine, dolutegravir). Although we have not transferred any full mRNA vaccine technology packages, we have transferred ten initial sections of those packages. We also signed three sublicences for ViiV’s long-acting cabotegravir, a potentially game-changing drug for HIV prevention; four sublicences for Novartis’s nilotinib, our first licensed cancer drug; and seven sublicences for ensitrelvir, Shionogi’s COVID-19 antiviral.
We have also strengthened our work for children and our engagement with communities. When people talk of leaving no one behind, they usually think about disadvantaged or vulnerable communities, such as indigenous peoples, migrants, oppressed minorities, people who use drugs, and LGBTQ+ people. Rarely do they think about children. Yet kids are almost always left behind. Therapeutic formulations that are appropriate for them, of the right strength, and in palatable form often appear only years after the adult versions, if at all. From the beginning, we have been strong supporters of the WHO Global Accelerator for Paediatric Formulations (GAP-f) and have increased our commitment to it this year by taking on the role of co-chair. Leaving kids behind is just not acceptable.
Let Communities Lead!
This year, we also established our own Community Advisory Panel (CAP) to ensure we hear more regularly and more systematically from the communities for whom we work and the people who need the medical products that we license. The Panel provides us with ad-hoc advice from the user perspective on a range of issues. These include the products we are considering licensing, and once we have agreed the terms of a licence, members of the CAP also sit on our Expert Advisory Group that advises our Governance Board on whether we should sign the licence, looking at amongst other things as to whether it significantly improves public health.
Working with governments and global initiatives.
We have also engaged extensively with the governments of India and Japan, who held the presidencies of G20 and G7, respectively. During their presidencies, both countries highlighted the importance of Universal Health Coverage (UHC) and Pandemic Preparedness and Response (PPR). In both, we believe MPP has a potentially important role to play: UHC is simply not attainable unless key medical products are affordable, and we are looking at ways to significantly speed up the availability of licensed products for the next pandemic. And, of course, our mRNA Technology Transfer Programme that we co-lead with WHO is intended to ensure that LMICs have the needed vaccine manufacturing capacity for the next pandemic, at least for mRNA vaccines.
Update on the mRNA Technology Transfer Programme.
The mRNA Technology Transfer Programme has broadened its focus this year. While the development of the platform continues apace at Afrigen with a series of successful pre-clinical trials in animals, because of the waning of COVID-19 incidence, there is much more interest from the partner organisations on what other vaccines can be developed with mRNA technology to ensure the sustainability of the facilities. Partner meetings in Cape Town in April and Bangkok in October discussed the creation of R&D consortia with different partners, with the results to be shared amongst all partners through MPP’s unique agreements with each partner. The agreements include provisions on the sharing of intellectual property. These meetings were further supported by the 2nd and 3rd Scientific Colloquia at Afrigen, as well as MPP’s mRNA Scientific Advisory Committee, which includes many of the world’s mRNA experts, including Drew Wiseman, the co-winner of this year’s Nobel Prize for medicine.
Health For All: Time For Action
Despite our successes this year, there is still so much to do. Equitable access, like universal health coverage, is a widely accepted goal, but we are still far from achieving it. The fine words, the bold commitments, the unprecedented focus – they are wonderful. But what we need is to turn them into concrete results that see billions more people really reaping the benefits. We have supplied over 34 billion doses of treatment, and in HIV, more than 20 million people on antiretroviral treatment are taking medicines supplied by MPP licensees.
The last few years have seen an unprecedented pandemic, unexpected wars, a climate crisis affecting more and more people, particularly in LMICs. We live in an increasingly divided world and 2023 has been no exception, a year that has threatened to turn attention and funding away from health, undoing so many of the gains of the recent past. There is every reason to expect these unanticipated crises will continue to appear. What is critical is that we do not let them undermine our commitment to equitable access, to universal health coverage and to pandemic preparedness. As COVID-19 has shown us, everything else is at risk if we don’t have health. Equitable access to health, like education, is a fundamental building block of the world we want to see, and I would like to take this opportunity to thank all our partners in industry, civil society, governments and health agencies as well as our funders for their support in allowing us to concentrate on ensuring much broader access to key health technologies and hence healthier, longer and more productive lives for people living in LMICs.