Children are one of the most vulnerable yet neglected population in terms of access to optimal medicines in adapted formulations. Consequently, paediatric therapies often remain limited and sub-optimal. To address this issue, MPP and partners are accelerating the development and uptake of child-friendly formulations.
Across most disease areas in which MPP has worked, access to medicines for children lags behind that for adults, and in many cases important medicines are not available in formulations that can be taken easily by young children.
Since its inception, MPP has prioritised working with manufacturers on bringing needed paediatric formulations to market, including accelerating their development and facilitating uptake. This contribution has increasingly taken place in partnership with other key stakeholders in the paediatric field.
For example, throughout its interactions with manufacturers, MPP highlights the demand for recommended and priority paediatric medicine formulations listed in WHO guidelines and PADO priority lists, while exploring with patent holders practical ways to further expand access to optimal formulations for paediatric populations across disease areas.
In addition, and as committed at the Vatican in December 2022, MPP has expanded its quarterly reported information on the progress of priority paediatric HIV drug formulations, in particular dolutegravir (DTG) based medicines. This detailed country-by-country quarter-by-quarter information on regulatory filing plans, reviews, and approvals, as well as supplies of medicines is available here (with more context available further below on this webpage):
Click Here to Access MPP’s Reporting on Paediatric DTG Products
Moving forward, and as outlined in MPP’s strategy 2023-2025, MPP will continue to place particular focus on addressing the needs of children across all disease areas in which it operates. Its contribution in paediatrics will be framed in alignment with the Global Accelerator for Paediatric Formulations (GAP-f) WHO network, of which MPP is a founding member, to ensure that the most-needed, optimal paediatric formulations are prioritised, developed, and made available to children in an accelerated manner. MPP will also take a more prominent leadership role within GAP-f by acting as the Vice Chair of its Strategy and Coordination Committee for the period from mid-2023 until end of 2024.
As part of high-level dialogues convened by the Vatican to accelerate research, development, registration, introduction and uptake of HIV and TB diagnostics and medicines for children living with HIV and/or TB, as well as medicines for pregnant and lactating women, with the ultimate objective of reducing morbidity and mortality among these high vulnerable groups , MPP made the following commitments:
In the HIV space, MPP has signed licenses for all the drugs already developed for paediatric use that are included in WHO guidelines. In addition, MPP licences exist for a number of drugs that are still being studied for use in children or that could potentially be important for the paediatric population.
There are four royalty-free MPP licensing agreements specifically for paediatric HIV medicines. These licences allow generic supply in countries where the vast majority of children living with HIV in low- and middle-income countries reside:
Other MPP licences in the HIV space allow sublicensees to manufacture treatments for paediatric use without any royalties on paediatric sales:
In TB, MPP has signed a collaborative agreement with Otsuka with the goal of making delamanid more available to children infected with multidrug-resistant TB. In addition, MPP signed a memorandum of understanding with TB Alliance committing both parties to explore potential avenues of collaboration to ensure that appropriate and affordable TB drug formulations reach children in need. Moreover, MPP licences in the TB space are royalty-free (including for paediatrics):
MPP licences in the hepatitis C space are either royalty-free or allow sublicensees to manufacture treatments for paediatric use without any royalties on paediatric sales:
As part of MPP’s strategy 2023-2025, MPP will collaborate with GAP-f to ensure the identification of relevant drug formulation gaps for children and, where appropriate, contribute to supporting development of and/or affordable access to needed paediatric formulations.
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[1] UNAIDS 2021. Children living with HIV lagging behind adults in access to treatment [2] WHO Global TB Report 2018. [3] WHO Guidelines for the care and treatment of persons diagnosed with chronic hepatitis C virus infection 2018. [4] Rome Action Plan on Paediatric HIV, Online tracker.
Strategy, Policy and Market Access
Agreements with Innovators
The Medicines Patent Pool (MPP) is a United Nations-backed public health organisation working to increase access to and facilitate the development of life-saving medicines for low- and middle-income countries. Through its innovative business model, MPP partners with civil society, governments, international organisations, industry, patient groups, and other stakeholders to prioritise and license needed medicines and pool intellectual property to encourage generic manufacture and the development of new formulations.
To date, MPP has signed agreements with 22 patent holders for 13 HIV antiretrovirals, one HIV technology platform, three hepatitis C direct-acting antivirals, a tuberculosis treatment, a cancer treatment, four long-acting technologies, a post-partum haemorrhage medicine, three oral antiviral treatments for COVID-19 and 16 COVID-19 technologies.
MPP was founded by Unitaid, which continues to be MPP’s main funder. MPP’s work on access to essential medicines is also funded by the Swiss Agency for Development and Cooperation (SDC), Government of Canada, the World Intellectual Property Organization (WIPO) and the Government of Flanders. MPP’s activities in COVID-19 are undertaken with the financial support of the Japanese Government, the French Ministry for Europe and Foreign Affairs, the German Agency for International Cooperation, and SDC.