HIV
VIRAL HEPATITIS
TUBERCULOSIS
COVID-19
CANCER
DIABETES
MATERNAL HEALTH
OTHER DISEASE AREASHIV
International Goals
To expand treatment to reach 30 million people living with HIV by 2025. End AIDS by 20301.
MPP’s Contribution
Accelerating development and access to affordable, quality-assured generic versions of prioritised HIV prevention and treatment medicines and formulations in optimal formulations.
There are 38.4 million people living with HIV worldwide, but only 28.7 million currently receive antiretroviral therapy. HIV paediatric care is improving, but still only one in two children living with the virus has access to treatment2.HIV prevention is also key to tackle the transmission of the disease. Pre-Exposure Prophylaxis (PrEP) has proven efficient in preventing infections for people at risk, however uptake has been very low.
Affordable, effective HIV medicines are imperative, especially for people living with HIV in low- and middle-income countries (LMICs) 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, civil society, and affected communities3 to improve access to World Health Organization prioritised and recommended medicines for people living with HIV in LMICs. We have also worked to increase access to HIV prevention tools and support the diversification of prevention options. In 2022, MPP signed a voluntary licensing agreement with ViiV Healthcare for cabotegravir long-acting (LA) for HIV pre-exposure prophylaxis (PrEP). This is an important step in accelerating affordable and equitable access to long-acting PrEP in over 90 countries4.
1 https://www.un.org/en/academic-impact/countries-commit-action-end-aids-2030
2 UNAIDS: Global HIV & AIDS statistics — 2021 fact sheet (last accessed on 4 April 2023)
3 In the framework of MPP’s work with communities, MPP relies on its Community Advisory Panel, a group of experts with lived experience that support MPP in the implantation of our activities.
4 MPP will be collaboratively working with the LA PrEP Coalition https://www.avac.org/resource/coalition-accelerate-access-long-acting-prep
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 period5.
MPP’s Contribution
Promoting access to WHO-recommended quality -assured direct-acting antivirals (DAAs) with the potential of working across all HCV genotypes.
Hepatitis C
Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). 58 million are estimated to be living with the virus1, with 62% residing in low- and middle-income countries2 .
New direct-acting antivirals (DAA) that are effective across all major HCV genotypes can cure more than 95% of the people treated, generally in 3 months or less. Yet, approximately 84% of the people infected with HCV are not receiving treatment1.
The Medicines Patent Pool works with a wide range of partners including governments, WHO, civil society and communities, procurement agencies, originator and generic companies and others to expand and accelerate the development and distribution of these new treatments that can eliminate the virus through a short course of oral therapy in LMICs 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. DAC 60mg sales have occurred in 37 countries where MPP licensees have supplied more than 1.3 million treatments in which 55.5% of PLHCV reside in the licensed territory.
Hepatitis B
Chronic hepatitis B is a disease affecting 296 million globally1. The majority of people with hepatitis B live in LMICs.
MPP holds licences from Gilead Sciences, covering tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide (TAF), the medicines for treating HIV as well as chronic hepatitis B.
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)
5 https://www.who.int/health-topics/hepatitis/elimination-of-hepatitis-by-2030#tab=tab_1
TUBERCULOSIS
International Goals
End the global tuberculosis epidemic by 2035 through a reduction in TB deaths by 95%, and in TB incidence by 90%6.
MPP’s Contribution
Licensing new treatments and contributing to their sustainable use in developing countries with the highest TB burden. Facilitating the development of and access to improved TB regimens1.
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 urgently needed, particularly for multidrug-resistant TB (MDR-TB).Since 2020, there is a PAN-TB, Project to Accelerate New Treatments for Tuberculosis (both DS-TB and MDR-TB) aiming at developing new drug regimens to transform the care of patients with tuberculosis.
We work to improve access to new treatments for TB. We also facilitate the development of new regimens by licensing TB drugs that are still under development. In 2019, MPP signed an agreement with Pfizer on facilitating access to Pfizer’s preclinical, phase I and phase IIa clinical study data and results on sutezolid. A sublicence was issued to the Gates Medical Research Institute and the drug is now being studied as part of the Project to Accelerate New Treatments for Tuberculosis (PAN-TB)]
1 World Health Organization, Global Tuberculosis Report 2022 (last accessed on 4 April 2023)
6 https://www.who.int/teams/global-tuberculosis-programme/the-end-tb-strategy
COVID-19 and Pandemic Preparedness, Prevention and Response (PPPR)
International Goals
The coronavirus pandemic presents an opportunity for the world to act in solidarity and turn the crisis into an impetus to achieve the UN Sustainable Development Goals.
MPP’s contributions:
Contributing to equitable access to countermeasures for COVID-19 and other public health emergencies of international concern.
From the outset of the COVID-19 outbreak, MPP realised that equitable access to treatments would be essential in the fight against this global threat. MPP issued a statement on 5 February 2020 offering its expertise to support access to treatment through its voluntary licensing mechanism in low- and middle- income countries.
On 31 March 2020, MPP’s Board decided to expand MPP’s mandate to include any health technology that could contribute to the global response to COVID-19 and where licensing could facilitate innovation and accelerate access.
CANCER
International Goals
SDG Target 3.4 Reduce by one-third premature mortality from non-communicable diseases through prevention and treatment8.
NCD Global Monitoring Framework: 80% availability of the affordable basic technologies and essential medicines, including generics required to treat major NCDs in both public and private facilities9.
MPP’s Contribution
Securing licence agreements with originator and generic manufacturers and working with partners for improved access to priority cancer medicines in LMICs.
Noncommunicable diseases (NCDs) kill 41 million people each year, equivalent to 71% of all deaths globally. Each year, more than 15 million people die from a NCD between the ages of 30 and 69 years; 85% of these “premature” deaths occur in low- and middle-income countries. Cardiovascular diseases account for most NCD deaths, or 17.9 million people annually, followed by cancers (9.3 million), respiratory diseases (4.1 million), and diabetes (1.5 million)1.
In 2018, MPP expanded its mandate to work on patented essential medicines across all disease areas, with a focus on medicines already included in the WHO EML and those that have strong potential for future inclusion. 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.
In 2022 signed the first-ever public health-oriented voluntary license agreement for a cancer medicine with Novartis. The licensed product, nilotinib, was included in the EML in 2017 for the treatment of Chronic Myeloid Leukaemia in adults and in 2019 in the EML for children.
While working to ensure the successful uptake of nilotinib, MPP is also maintaining its effort to identify and prioritize cancer products where an MPP intervention could have the greatest impact.
Given the multiple diagnostics, health systems, and other challenges in access to NCD medicines in LMICs and MPP’s specific mandate and expertise, the organisation seeks to contribute to partnerships that aim to address the multiple dimensions of access in a holistic manner. The recently launched Access to Oncology Medicines (ATOM) consortium is an example of that approach.
1 World Health Organization, Global report on HIV, viral hepatitis and sexually transmitted infections, 2021
8 https://www.who.int/data/gho/data/themes/topics/sdg-target-3_4-noncommunicable-diseases-and-mental-health#:~:text=SDG%20Target%203.4%20Reduce%20by,71%25%20of%20all%20deaths%20globally.
9 https://www.who.int/publications/m/item/who-ncd-accountability-framework-for-ncd-implementation-roadmap
DIABETES
International Goals
SDG Target 3.4 Reduce by one-third premature mortality from non-communicable diseases through prevention and treatment10.
NCD Global Monitoring Framework: 80% availability of the affordable basic technologies and essential medicines, including generics required to treat major NCDs in both public and private facilities11.
MPP’s Contribution
Securing licence agreements with originator and generic manufacturers and working with partners for improved access to priority diabetes medicines in LMICs.
Noncommunicable diseases (NCDs) kill 41 million people each year, equivalent to 71% of all deaths globally. Each year, more than 15 million people die from a NCD between the ages of 30 and 69 years; 85% of these “premature” deaths occur in low- and middle-income countries. Cardiovascular diseases account for most NCD deaths, or 17.9 million people annually, followed by cancers (9.3 million), respiratory diseases (4.1 million), and diabetes (1.5 million)1.
In 2018, MPP expanded its mandate to work on patented essential medicines across all disease areas, with a focus on medicines already included in the WHO EML and those that have strong potential for future inclusion and, in 2021, the mandate was further expanded to includes also biotherapeutics.
Given the multiple diagnostics, health systems, and other challenges in access to diabetes medicines in LMICs and MPP’s specific mandate and expertise, we seek to build partnerships with relevant organizations in the field to address access in a holistic manner.
MPP signed a Memorandum of Understanding with the International Diabetes Federation in 2020 and, since its inception in 2021, is part of the WHO Global Diabetes Compact Forum.
1 World Health Organization, Global report on HIV, viral hepatitis and sexually transmitted infections, 2021
10 https://www.who.int/data/gho/data/themes/topics/sdg-target-3_4-noncommunicable-diseases-and-mental-health#:~:text=SDG%20Target%203.4%20Reduce%20by,71%25%20of%20all%20deaths%20globally.
11 https://www.who.int/publications/m/item/who-ncd-accountability-framework-for-ncd-implementation-roadmap
MATERNAL HEALTH
International Goals
Reduce the global maternal mortality ratio to less than 70 per 100,000 live births and end preventable deaths of newborns and children under 5 years of age by 2030 1.
MPP’s Contribution
Exploring licences for approved products to support maternal and new-born health, such as for the prevention or treatment of post-natal hemorrhage, identifying other upstream maternal health products through MPP’s prioritisation framework and approaching patent holders to explore licensing.
According to WHO, 295,000 women die every year during and following pregnancy and childbirth. Most of these deaths (94%) occur in low-resource settings, and most could have been prevented. This includes approximately 72,000 women who die every year of post-partum haemorrhage (PPH), 99% of whom are in LMICs.
To date, MPP’s work on maternal health has been limited, and has mainly focused on facilitating access to HIV medicines that could be used by women living with HIV during pregnancy, contributing to women’s health and reducing vertical HIV transmission. Going forward, with the targeted support of Unitaid, MPP will explore additional opportunities to contribute to supporting maternal health.
1 https://www.unwomen.org/en/news/in-focus/women-and-the-sdgs/sdg-3-good-health-well-being#:~:text=By%202030%2C%20reduce%20the%20global,into%20national%20strategies%20and%20programmes.
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 high1. 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).
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.Approximately 70% of deaths from cancer occur in low- and middle-income countries2. Diabetes prevalence has been rising more rapidly in low- and middle-income countries3. And more than three quarters of CVD deaths take place in low- and middle-income countries.4
MPP is consolidating its recent expansions in areas like non-communicable diseases (NCDs), maternal health, mRNA vaccines, and biologics, proving that its model can be adapted to new disease areas and more complex technologies.
To carry out this work and better serve the people that need essential medicines the most, MPP has created a Community Advisory Panel to get firsthand advice from experts with lived experiences in each disease area we cover.
1 https://www.un.org/en/academic-impact/countries-commit-action-end-aids-2030
2 UNAIDS: Global HIV & AIDS statistics — 2021 fact sheet (last accessed on 4 April. 2023)
3 In the framework of MPP’s work with communities, MPP relies on its Community Advisory Panel, a group of experts with lived experience that support MPP in the implantation of our activities.
4 MPP will be collaboratively working with the LA PrEP Coalition https://www.avac.org/resource/coalition-accelerate-access-long-acting-prep