While reaffirming its work in core areas – HIV, hepatitis C and tuberculosis – MPP has now expanded its mandate to new disease areas including cancer, cardiovascular disease, diabetes and COVID-19.
To expand treatment to reach 30 million people living with HIV by 2025. End AIDS by 20301.
Accelerating development and access to affordable, quality-assured generic versions of prioritised HIV prevention and treatment medicines and formulations in optimal formulations.
View MPP’s Licences for HIV
In 2024, 40.8 million people were living with Human Immunodeficiency Virus (HIV) worldwide, with 31.6 million people accessing antiretroviral therapy[1]. HIV paediatric care is stalling, with only 55% of children living with the virus accessing treatment, compared to 78% of adults living with HIV. With 1.3 million people acquiring HIV annually, prevention remains key to tackle the transmission. Although pre-exposure prophylaxis (PrEP) has proven effective in preventing HIV infection, its uptake remains insufficient to meet global targets.
These persistent gaps highlight the need for affordable, effective HIV medicines, especially for people living with HIV (PLHIV) in low- and middle-income countries (LMICs) where HIV is most prevalent. Medicines must also be available in the right formulations. Fixed-dose combinations and long-acting formulations can help to improve adherence, while age-appropriate treatments for children, adapted to different weights and developmental stages, are essential to improve care.
Since 2010, we have worked with leading HIV drug manufacturers, governments, international organisations, civil society, and affected communities[2] to improve access to World Health Organization (WHO) prioritised and recommended medicines for PLHIV in LMICs. As of December 2025, MPP licensees have supplied 53 billion doses of DTG-based regimens in 129 countries. The cumulative volumes supplied until December 2025 are equivalent to treating 142 million PLHIV with DTG-based regimens for a year. It is estimated that in 2025 there were 26 million PLHIV on DTG-based treatments[3].
Alongside HIV treatment access, MPP has worked to increase access to HIV prevention tools and supported the diversification of prevention options. In 2022, MPP signed a voluntary licensing agreement with ViiV Healthcare for cabotegravir long-acting (LA) for HIV PrEP[4], which was complemented in 2025 with the addition of the treatment indication, perfectly aligning with updated WHO guidelines for HIV[5]. This marked an important step in accelerating affordable and equitable access to the first approved injectable long-acting PrEP and treatment options recommended by WHO in up to 142 countries[6].
These efforts reflect broader interest in long-acting therapeutics for both PrEP and HIV treatment, given their potential benefits in terms of efficacy (including through support of improved adherence), and user experience (including convenience and discretion)[7]. At the same time, 2025 saw an unprecedented disruption in HIV services as a consequence of international funding cuts[8]. This underscores the need for more effective HIV programmes in LMICs, and for continued efforts to develop and roll out HIV prevention and treatment innovations, including long-acting and ARV-sparing regimens, to reach more people and manage increasingly scarce resources more effectively.
[1] UNAIDS: Global HIV & AIDS statistics – 2025 Fact Sheet. https://www.unaids.org/en/resources/fact-sheet
[2] Launch of MPP’s Community Advisory Panel (CAP)
[3] Access to Medicines Tracker – MPP
[4] MPP Press Release – CABOTEGRAVIR LONG-ACTING (LA) FOR HIV PRE-EXPOSURE PROPHYLAXIS (PrEP)
[5] WHO updated recommendations on HIV clinical management: recommendations for a public health approach. Geneva: World Health Organization; 2025. Licence: CC BY-NC-SA 3.0 IGO.
[6] There are 90 countries nominally listed in the MPP-ViiV CAB for PrEP voluntary licence + 47 countries that appear not to have patents on CAB-LA and where generic supply may be possible + 5 additional countries post 2026/2027
[7] Arens Y, Gulick RM. Future options for long-acting HIV treatment and prevention. Curr Opin HIV AIDS. 2025 Jan 1;20(1):39-47. doi: 10.1097/COH.0000000000000901. Epub 2024 Nov 7. PMID: 39560965.
[8] UNAIDS Global AIDS Update 2025: AIDS, Crisis and the Power to Transform. https://www.unaids.org/en/UNAIDS-global-AIDS-update-2025
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.
Promoting access to WHO-recommended quality -assured direct-acting antivirals (DAAs) with the potential of working across all HCV genotypes.
View MPP’s Licences for Viral Hepatitis
In 2022, viral hepatitis claimed approximately 1.3 million lives, of which 83% were attributed to hepatitis B and 17% to hepatitis C. New infections decreased from 3 million in 2019 to 2.2 million in 2022 (1.2 million hepatitis B, 1.0 million hepatitis C)[1]. Despite this progress, the global burden remains substantial with 304 million people living with viral hepatitis in 2022 (254 million with hepatitis B, 50 million with hepatitis C)[2].
Children represent 12% of the hepatitis burden, primarily affecting those with hepatitis B. Significant regional disparities persist, with the WHO African Region accounting for 63% of new hepatitis B infections, yet only 18% of newborns in this region receive the hepatitis B birth-dose vaccine. The Western Pacific Region reports 47% of hepatitis B deaths, with inadequate treatment coverage.
Each form of viral hepatitis (B, C and D) presents distinct clinical unmet needs and disease-specific considerations that are important to take into account when assessing product relevance and access pathways for LMICs. At the same time, the three diseases are linked by common access challenges, particularly underdiagnosis, limited screening, and the difficulty of delivering affordable care at scale.
Although hepatitis C is curable, there is an urgent need for well-tolerated, highly effective pangenotypic cure regimens requiring less frequent administration. The identification of populations living with the virus remains challenging due to limited awareness and screening programs. High-cost diagnostic tools and the requirement for confirmatory molecular diagnostics represent key barriers to treatment access.
Hepatitis B, while preventable through vaccination, maintains high prevalence rates. Beyond improved diagnostics, treatments that could provide a functional cure for hepatitis B are essential to reduce long-term disease burden, management costs, and complications. Expanded prevention, screening, and treatment initiatives are critical to address the global hepatitis crisis. Currently, few LMICs have committed to hepatitis elimination goals, and additional funding for effective diagnostic and care implementation is urgently needed[3].
This is even more critical for hepatitis D, which remains an area of high unmet medical need, with very limited treatment options and a substantial risk of severe liver outcomes, including cirrhosis and liver cancer. Occurring only in people living with hepatitis B, hepatitis D is associated with a two- to six-fold higher risk of liver cancer compared with hepatitis B alone. However, despite encouraging progress, future treatment approaches will still face several important challenges, notably ease of administration, long-term efficacy, and persistent diagnostic barriers, which may further complicate implementation, especially in LMICs.
Based on the specific clinical gaps identified across the different hepatitis infections, MPP monitors the evolving pipelines for hepatitis B, C, and D, and outlines below the rationale for the prioritisation and watchlist inclusion of the following products.
[1] WHO – Global hepatitis report 2024: action for access in low- and middle-income countries
[2] World Health Organization – Elimination of hepatitis by 2030
[3] El-Kassas M, Shousha H, Johannessen A et al. Africa must not be left out of the hepatitis B cure era. The Lancet Gastroenterology & Hepatology, 2026
End the global tuberculosis epidemic by 2035 through a reduction in TB deaths by 95%, and in TB incidence by 90%6.
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.
View MPP’s Licences for TB
An estimated 10.7 million people fell ill with tuberculosis (TB) in 2024, most of them in LMICs[1]. TB remains among the top 10 causes of death worldwide and the leading cause of death from a single infectious agent. In 2024, an estimated 1.23 million people died from TB globally. TB is also the leading cause of death among PLHIV and a major contributor to antimicrobial resistance.
Globally, there were an estimated 390 000 people who developed rifampicin-resistant TB (RR-TB) in 2024, of whom 164 545 received treatment, representing about 42% of those in need of treatment.
The End TB Strategy sets ambitious targets to reduce TB deaths by 95% between 2015 and 2035 and end the global TB epidemic. However, despite important advances, progress remains insufficient: between 2015 and 2024 TB deaths declined by 29% and the TB incidence rate fell by 12%, far short of the interim milestones[2].
To meet these targets, better TB products for both treatment and prevention are still urgently needed, particularly for drug-resistant TB. Current regimens still fall short on several fronts. They need to be shorter, safer, better tolerated, more resilient to resistance, and compatible with HIV co-treatment. They also need to be better adapted to children and other populations that remain poorly served by current TB programmes. In the future, long-acting approaches could also help simplify treatment, improve adherence, and expand prevention options.
MPP therefore continues to monitor this space to support affordable access to new products, and outlines below the rationale for the prioritisation and watchlist inclusion of the following products.
[1] WHO – Global tuberculosis report 2024
[2] WHO – The end TB strategy
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.
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.
Read more
View MPP’s Licences for COVID-19
The COVID-19 pandemic exposed how weak global mechanisms still are for ensuring timely, equitable access to medical countermeasures during health emergencies, especially in LMICs[1]. In its 2026–2030 strategy, MPP therefore includes pandemic preparedness and response as a core strategic goal, with a focus on licensing, technology transfer and geographically diversified manufacturing to support both equitable access and security of supply[2].
Alongside Unitaid, MPP is also participating in broader global efforts to strengthen preparedness for future outbreaks, including collaboration with WHO and organisations involved in the Therapeutics Development Coalition, so that access considerations are addressed early in the product development pathway[3].
Influenza is a particularly relevant area within this agenda. It combines a substantial and recurring public health burden (seasonal influenza) with well-recognised pandemic potential. WHO estimates that seasonal influenza causes around 3 to 5 million cases of severe illness and 290,000 to 650,000 respiratory deaths each year worldwide[4]. In parallel, MPP’s strategy explicitly identifies influenza viruses with pandemic potential as an area of focus, including work with WHO to assess manufacturing capacity for influenza antivirals and exploration of licensing opportunities for approved or investigational treatments.
Given this strategic alignment, pandemic preparedness has been included as a main pillar in MPP’s strategy, with influenza as a particularly relevant entry point because it combines concrete access needs in LMICs today for seasonal influenza with clear relevance for preparedness against a future influenza pandemic.
[1] Intellectual property licensing of therapeutics during the COVID-19 crisis: lessons learnt for pandemic preparedness and response
[2] MPP ON PANDEMIC PREPAREDNESS AND RESPONSE
[3] Machingaidze S, Pérez Casas C, Mburu S, Draghia-Akli R, Mowbray C, Rosen J, et al. (2024) The case for a global therapeutics development coalition: Building a therapeutics pipeline for pandemic and endemic diseases. PLOS Glob Public Health 4(8): e0003654.
[4] WHO Influenza fact-sheet
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.
Securing licence agreements with originator and generic manufacturers and working with partners for improved access to priority cancer medicines in LMICs.
View MPP’s Licences for Cancer
Cancer is a leading cause of death worldwide, accounting for nearly 10 million deaths in 2020, or nearly one in six deaths1. Among the prevalent cancer types, breast, lung, colon and rectum, prostate, stomach, liver, cervix uteri and skin cancers stood out as the most frequently encountered. Many cancers can be cured if detected early and treated effectively. Many health systems in low- and middle-income countries remain ill-equipped to cope with this growing health crisis. Consequently, a significant portion of cancer patients worldwide continues to face significant barriers to accessing timely and high-quality diagnosis and treatment.
Lung cancer arises from the rapid and unregulated proliferation of abnormal cells in the lungs, posing a significant threat to health and carrying a high risk of fatality. The two most common forms of lung cancer are: non-small cell lung carcinoma (NSCLC), which is prevalent and tends to develop at a gradual pace, and small cell lung carcinoma (SCLC), which is rarer but usually exhibits a rapid growth rate. In low- and middle-income countries (LMICs), there were 1.2 million incident cases of non-small cell lung cancer (NSCLC) in 20202. Unfortunately, around 70% of NSCLC cases are diagnosed in advanced stages, such as locally advanced or metastatic.
Breast cancer is the most commonly occurring cancer in women and the most common cancer overall. There were more than 2.26 million new cases of breast cancer in women in 20203. There are four main female breast cancer subtypes, including the following in order of prevalence: HR+/HER2-, HR-/HER2-, HR+/HER2+, HR-/HER2+. HR stands for hormone receptor. HR+ means that tumour cells have receptors for the hormones estrogen or progesterone, which can promote the growth of HR+ tumours. HER2 stands for human epidermal growth factor receptor 2. HER2+ means that tumour cells make high levels of a protein called HER2/neu, which has been shown to be associated with certain aggressive types of breast cancer4.
Chronic Lymphocytic Leukaemia (CLL) is the most common form of leukaemia, accounting for 25% to 30% of all leukaemia cases in Western countries5. In 2019, CLL resulted in 44,612 deaths worldwide. Regarding incidence rates in 2019, CLL affected 1.34 individuals per 100,000 in the global population, with rates of 1.13 in high-income countries, 0.45 in middle-income countries, and 0.28 in low-income countries6. CLL predominantly occurs in older individuals, peaking in the elderly population, with a median age at diagnosis of 71 years in Europe7. Furthermore, the incidence of CLL is approximately twice as high in males compared to females8.
Prostate cancer made up 7.3% of all new cancer cases in 2020, accounting for 14.1% of all new male cancer diagnoses9. Notably, cancer incidence rates have been on the rise in various Sub-Saharan African populations10. Men of African descent face nearly double the risk of being diagnosed with prostate cancer before the age of 45 compared to Caucasian men11. Additionally, research indicates that men with greater overall and central body fat have a heightened risk of prostate cancer-related mortality12.
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.
Securing licence agreements with originator and generic manufacturers and working with partners for improved access to priority diabetes medicines in LMICs.
In 2021, 537 million adults (10.5% of the global population) are grappling with diabetes. Projections indicate that this number will climb to 643 million by 2030. Approximately 240 million individuals worldwide live with undiagnosed diabetes. Notably, 90% of these undiagnosed cases are concentrated in LMICs. Type 1 diabetes (T1DM) affects over 1.2 million children and adolescents, with 54% of them under the age of 15. Type 2 diabetes (T2DM) is the most common type of diabetes, accounting for over 90% of all diabetes worldwide. Globally, the prevalence of type 2 diabetes is high and rising across all regions and has also become a concern in children and young people as a result of an increasing prevalence of obesity.
In 2022, one in eight people worldwide were living with obesity. Obesity and type 2 diabetes are closely linked, driving cardiometabolic conditions such as cardiovascular and kidney diseases, which present major health challenges, particularly in LMICs. By 2035, 79% of individuals living with obesity are expected to be in LMICs. Obesity trends and metabolic dysregulation are also rising among people living with HIV. With increased life expectancy, this population faces a growing burden of NCDs, including CVDs and diabetes. In South Africa, a recent study found that 63% of people living with HIV were overweight or obese, and 6% had diabetes. Ensuring accessibility and affordability of effective treatments is crucial, as the high cost of current medications poses significant barriers, particularly in LMICs with a high HIV burden.
Cardiovascular diseases (CVDs) stand as the leading global cause of death, accounting for 32% of all deaths in 2019, with an estimated 17.9 million lives lost. Over three-quarters of CVD deaths occur in low- and middle-income countries. These diseases were responsible for 38% of the 17 million premature deaths (those under 70 years old) attributed to noncommunicable diseases in 2019. Early detection of cardiovascular disease is paramount to initiate timely management through counselling and medication2. Despite high-quality scientific evidence of the benefits of different classes of drugs in preventing and controlling cardiovascular disease, their current use remains low.
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.
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.
View MPP’s Licences for Maternal Health
As part of our commitment to improving children’s health, MPP is focusing on medicines for childhood-onset diseases—conditions that begin early in life and continue into adulthood, or are high in the public health agenda in relation to young ages. In most disease areas MPP works in, children often face delays in access to essential medicines compared to adults. Many important therapeutics are not yet available in child-friendly formulations. Since its creation, MPP has worked to close this gap by partnering with manufacturers to develop and accelerate access to paediatric formulations. This work increasingly takes place through our role in the Global Accelerator for Paediatric Formulations Network (GAP-f), a WHO-led initiative that MPP co-founded. Within GAP-f, we help prioritise and support the development of the most-needed paediatric medicines, with the goal of getting them to children faster.
Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory infections in children and severe respiratory disease in the elderly. Each year, RSV leads to over 3.6 million hospitalisations and around 100,000 deaths in children under 5, with 97% of paediatric deaths occurring in low- and middle-income countries (LMICs) due to limited medical care. While most young children have mild symptoms, some, especially those with their first infection or underlying health conditions, develop severe diseases like pneumonia and bronchiolitis. Two passive immunisation options are available for infants: a monoclonal antibody (mAb) and a maternal vaccine. Three vaccines also prevent severe RSV in elderly adults with certain health conditions. The under-recognition of RSV’s impact in LMICs has delayed access to these potentially life-saving interventions in the countries where they are most needed. MPP has prioritised RSV mAbs for in-licensing, building on its work on mechanisms to expand access to biologics (including mAbs) in LMICs.
Malaria incidence reached nearly 263 million cases globally in 2023, including close to 600,000 malaria-related deaths, with children under five years old accounting for 80% of casualties in sub-Saharan Africa. Significant efforts are being made to further prevent new infections, including through the development and approval of malaria vaccines and antibody therapies. It is crucial to continue improving the safety and efficacy of malaria treatments and prevention products while also enhancing the palatability of paediatric formulations to ensure rapid and widespread uptake of malaria medicines among children.1
Low-grade gliomas (LGGs) are primary brain tumours that develop from glial cells, which support and protect neurons. They are the most common brain tumours in children and young adults, accounting for around 30% of all paediatric central nervous system tumours. In approximately 15–20% of LGGs, a BRAF V600E mutation is found. This mutation activates a key signalling pathway that drives tumour growth and affects response to chemotherapy. 1
LGGs are one of six focus cancer types of the WHO Global Initiative for Childhood Cancer (GICC) 2. The GICC selected these common, highly curable cancers to improve access to quality care for children worldwide and potentially save a million lives by 2030.
Cystic fibrosis is a rare, progressive, life-threatening disease, caused by mutations in the Cystic Fibrosis Transmembrane conductance Regulator (CFTR) gene that results in the formation of thick mucus that builds up in the lungs, digestive tract, and other parts of the body. Cystic fibrosis leads to severe respiratory and digestive problems as well as other complications including diabetes, meningitis, osteomyelitis as well as skin and soft tissues infections. There is currently no cure for the condition and people with cystic fibrosis need daily treatments depending on the severity of their symptoms. There are no global annual deaths estimates for cystic fibrosis and related life expectancy, but it is generally assumed that in the absence of CFTR modulators, which remain not accessible in low- and middle-income countries, the median life expectancy for cystic fibrosis may be around 25 years (compared to 46 in presence of CFTR modulators).
There has been important progress preventing peri- and post-natal HIV transmission through HIV treatment for pregnant and lactating people coupled with antiretroviral-based post-natal prophylaxis for infants. Despite this, there were still 120,000 new infant infections in 2023, due to complex social and structural barriers, including adherence challenges. Although still in the early stages of development, broadly-neutralising antibodies demonstrate significant potential for use in HIV post-natal prophylaxis (PNP), due to their favourable safety profile. Their long-acting characteristics may offer protection during most of the breastfeeding period, helping make these prevention tools both effective and convenient.