10 Years of MPP – Message from Charles Gore, MPP’s Executive Director
11 December 2020
As we close in to end 2020, a year that will be engraved in our memories forever, we are bound to remember an unexpected and unprecedented pandemic and a world that has had to reinvent the way we live, work and communicate. Yet, despite the challenges, and to the best of our ability, we have tried to find ways to cope.
For us at the Medicines Patent Pool (MPP), it has been 10 years since we started. A decade on and the work of MPP is more relevant than ever. At the beginning of the year, we had high hopes of celebrating our achievements by physically bringing you together with all our partners who have contributed to our impact, but COVID-19 had other plans! The pandemic threatened lives and livelihoods, but I can proudly say that this did not deter us, in fact it gave us a bigger reason to come together through our joint mission of leaving no one behind in the access to treatment landscape. In a swift and agile move, MPP’s Board expanded the organisation’s mandate to COVID-19 shortly after the pandemic was declared. Since then, we have not only been exploring how MPP’s proven model of voluntary licensing can make a difference to the COVID-19 response, but also been making sure that our work in HIV, hepatitis C, TB and essential medicines is not disrupted owing to the pandemic. So, if you think a lot has happened this year, let me take you back 10 years and more to a time when MPP was just an idea.
Impossible is possible
As our first and founding Executive Director Ellen ‘t Hoen said, “10 years of MPP is a testimony of a crazy idea turned into real results. It was in 2002, a group of people attending the International AIDS Conference (IAS) first began to discuss a novel idea to save the lives of people living with HIV/AIDS.” At the time, patented life-saving antiretroviral medicines were often priced too high for the over 30 million people living in low- and middle-income countries (LMICs) to access them, and low-cost generic versions could not be supplied. “Inspired by an idea from the military airplane industry, where patented technologies were pooled by the US government to spur access to flight technology desperately needed for World War 1”, MPP was born in 2010.
As Unitaid Executive Director Philippe Duneton recalls, “When Unitaid founded MPP, many wondered whether the idea of a patent pool for medicines could work. But we all knew that the concept was novel and inspiring, and held tremendous potential to bring much-needed medicines to those in need. 10 years later, the impact is for all to see.” Unitaid has stood by MPP throughout our ten-year journey as our founder and funder, and in November 2020, they approved a further five-year grant, and we thank them for their confidence, trust and commitment to equitable access to better medicines.
Partnerships catalyse progress
Over the years, we have negotiated voluntary licences with some of the biggest innovators. The unprecedented collaboration brought unprecedented impact. The unique partnerships showed the global health world that voluntary licensing works and that it can transform millions of lives. It showed the originators that working with MPP is of mutual benefit. On one hand, it helped them complement and expand their geographic reach. On the other hand, it led MPP to advance its mission of making access to medicines a reality in LMICs. To date, MPP licensees have supplied over 15 billion doses of medicines across 141 countries – a gargantuan feat in itself.
A sustainable affordable pricing model supports scale up
Getting licences “for the people” is at the core of what we do. There are of course other models of access, but what is important with our model is that it allows for a healthy market that brings the cost of medicines down and is inherently sustainable. As ViiV’s CEO Deborah Waterhouse said “although there is no one-size-fits-all approach when it comes to access, we have seen that our work with MPP and others is an important and effective way of enabling affordable and sustainable access to the innovative new medicines for people living with HIV that are at the heart of what ViiV Healthcare brings to the global HIV response.” In 2017, 1.5 million packs of one month’s supply of generic dolutegravir (DTG) were supplied through our sublicensees to countries within the licence. In 2018, it was 35.3 million packs, in 2019, 88.4 million packs, and in the first six months of 2020 alone, 80.3 million packs reached those in need.
Nurturing relationships takes you further
A large part of this vision-turned-into-reality is thanks to the relationship we have nurtured, one sublicence at a time, with a trusted network of leading generic manufacturers from across continents. And this symbiotic relationship has been a win-win. As our partner Umesh K from Aurobindo put it “together, we have achieved a sustainable supply of affordable high-quality medicines in markets that would otherwise be impossible without licences”.
And as Anil Soni, former Head of Global Infectious Diseases, Viatris (formerly Mylan) said “working with innovators, MPP has streamlined the process by which manufacturers of generic medicines – such as Viatris (formerly Mylan) – can quickly access licences and develop low-cost and high-quality versions of these important (hepatitis C) treatments.” And just this month, yet again MPP’s generic manufacturing partners have joined forces and vested their trust in the organisation by signing an unprecedented open pledge to ensure access to COVID-19 treatments in LMICs.
Success has many faces – innovation, affordability, availability, quality, equity, speed, transparency, wide geographical coverage, bespoke licences
As Precious Matsoso, Former Director-General, National Department of Health in South Africa summarised, “MPP is a great success story from two important points of view, innovation and availability. MPP’s work has encouraged companies to innovate better fixed-dose combinations that contributed to decreasing the pill burden and increasing adherence to treatment, or paediatric formulations that are child-friendly and dose-adapted. Furthermore, through its voluntary licensing mechanism, MPP has facilitated the availability of quality antiretrovirals needed.” And as EGPAF’s CEO and President Chip Lyons added on “Ten years ago, the founding of MPP sparked new action towards closing the vast treatment gap between children and adults in the HIV treatment landscape.”
In our licences, transparency, wide geographical coverage, equity and quality has been at the helm of what we pushed for. Each of our licence is bespoke and every agreement is published online. As partner Jayasree Iyer from Access to Medicine Foundation points out “MPP’s commitment to transparency and access to healthcare is an important gold standard for how products can be affordable and brought to populations most in need around the world.” And as Wim Vandevelde, GNP+, Global TB Community Advisory Board added “MPP has been very instrumental, especially in the HIV and hepatitis C space, in ensuring that new drugs that become available in the global market also become accessible to people in LMICs with minimum delay.”
“For the people and with the people” is always the right approach
Public health impact, people’s health and human lives have always been the drivers for every move we made and every licence we signed. Key partners like civil society organisations and patient groups always kept us aligned with the needs on the ground. As Nelson Otwoma, CEO of NEPHAK said “Communities are a critical pillar to scale up Universal Health Coverage, working in partnership with organisations such as MPP, we are empowered to ensure that those living with the diseases equally have access to the treatments they need”.
Our achievements are a reflection of our values
If over 15 billion doses of treatment have been delivered in 10 years, it is a result of the collaboration of all our partners, including the Global Fund and the World Health Organization (WHO). None of this would have been possible without the strong commitment of a small group of highly dedicated professionals – the staff of MPP, an ever-committed Governance Board, an independent Expert Advisory Group and our recently formed Scientific Advisory Panel who ensure we are always making evidence-based decisions.
As Board Chair Marie-Paule Kieny said “Not only has MPP proved itself in delivering for people, it has also brought transparency by publishing its licences, board decisions and other important information online. Furthermore, the Board, advisory groups and staff are fully committed to MPP’s values ensuring efficient responsive decision-making while ensuring trust and accountability”.
Building a model that the community can rely on takes time
10 years on and our model is a gold standard for public health voluntary licensing. The mechanism has been tested across disease areas, medicines and countries, and what we have gained with all these years of finetuning is the trust and confidence of the global public health community, including the G7 and G20 health ministers. As stated in the latest declaration of the G20 Health Ministers’ Declaration, Riyadh Summit, Saudi Arabia: “We recognize the imperative of developing and ensuring equitable access (…) and the role that voluntary contributions and innovative mechanisms for international global health collaboration are playing in developing and deploying life-saving interventions. In this regard, we recognize the role that international partners dedicated to access to innovation such as Unitaid and the Medicines Patent Pool can play.”
WHO, and funders including Unitaid, the Swiss Agency for Development and Cooperation (SDC) and the Wellcome Trust have also publicly exhibited their trust in MPP. And now, what we are seeing is translation of this trust into a landscape where the public health community counts on us. We have been called upon to deliver in areas such as essential medicines, non-communicable diseases and COVID-19 and we have created value that will continue to yield impact in years to come.
Follow innovation and science and bring it to the world
The last few months have unveiled heroic victories for science – from several doses of good news on the COVID-19 vaccines to rising hopes on efficacious long-acting medicines that free people from the burden of hundreds of pills a year. Announced just this month, the development of berry-tasting sprinkles of WHO-recommended HIV medicines for children will be yet another game changer. As Dr Meg Doherty, Director of Global HIV, Hepatitis and STI Programmes at WHO said “Today we can finally guarantee that countries have rapid access to the appropriate formulations needed to fully implement WHO guidelines; so that no child is left behind. WHO welcomes the approval and commercialisation of the new paediatric DTG 10mg. Congratulations to all the partners involved for showing how quickly we can bring new formulations to market when we work together – clear proof that solidarity delivers results.” MPP with its paediatric licences for DTG will work to with the generic manufacturers so that children have access to this new treatment as soon as possible.
The innovation pipelines are brimming with hope, and as MPP marks its 10-year milestone, our true celebration will be in continuing to ensure these life-saving discoveries rapidly reach those in need. Because these innovations are only as powerful as they are accessible.
What we’ve built together is a strong foundation for the future
MPP has stood the test of time. Now, it’s the moment to aim higher – towards achieving supply of 30 billion doses of HIV treatments through MPP licences; ensuring that five million people have received MPP-licensed hepatitis C treatments; securing licences for all new patented medicines on the WHO Essential Medicines List for which licensing can contribute to improving access; demonstrating the usefulness of our model in non-communicable diseases; and much more.
The mission continues – bringing access to the top of the agenda and leaving no one behind.
Today, I thank each of you for partnering with us in every step we took. Here’s to 10 shining years of MPP and everything that is yet to come.
Charles Gore
We would love to hear your comments on the occasion of our 10-year anniversary!