Impact story: Early-infant diagnosis of HIV using point-of-care technologies
Global malaria diagnostic and artemisinin treatment commodities demand forecast: 2017 – 2021 Policy brief (May 2018)
Price cut on medicine will help preserve the health of more people living with HIV
Geneva — Unitaid and Indian drug manufacturer Cipla Ltd. struck a landmark agreement today that will lower the price of the first combination therapy (containing co-trimoxazole, isoniazid and vitamin B6) that prevents opportunistic infections in people living with HIV.
The HIV virus can weaken the immune system, increasing the risk of dangerous infection by bacteria and viruses.
Under this agreement, Cipla will reduce the ceiling price of the medicine by more than 30% from US$ 3 to US$ 1.99 per person, per month, for all public-sector procurers in low- and middle-income countries. The price of the product is expected to come down more as governments and international funding bodies procure larger quantities for their HIV treatment programmes.
“Unitaid-funded projects are putting more people on improved HIV treatment, but we continue to see high rates of opportunistic infections,” Unitaid Executive Director Lelio Marmora said. “By preventing these deadly infections, more people living with HIV will lead healthier lives.“
Additional manufacturers of this product are expected to enter the market in due course, bringing competition and greater supply to meet patient demand. Unitaid, meanwhile, will continue working with governments, international funding bodies, and its implementing partners to speed the introduction of the new therapy into countries’ HIV treatment programmes.
The drug, known as Q-TIB, has been on the market since 2017, but its high price has put it out of reach of countries’ health budgets.
“Despite great progress in the global response to HIV, up to one third of people living with HIV seek care only when they have advanced disease. They often present with a range of serious opportunistic infections,” said Dr Gottfried Hirnschall, director of WHO’s HIV Department. “Providing access to new combination therapies in the form of a single pill daily will make it easier and more affordable to prevent these common infections and help save lives.”
In 2016, about one million people died of AIDS-related illnesses, according to WHO, most of them from TB, bacterial and fungal infections.
“We very much welcome this initiative,” said Dr. Osamu Kunii, head of the Global Fund’s Strategy, Investment and Impact Division. “This single combination of medicines in one tablet has several critical advantages over separate tablets. By reducing the number of pills people need to take, we will see better medication adherence resulting in improved health outcomes.”
The collaboration is part of Unitaid’s broader effort to expand access to a package of essential products for screening, preventing and treating the most prevalent opportunistic infections in people living with HIV.
The combination therapy is a once-daily pill that protects in three ways: against TB, the leading cause of death among people with HIV; and against other life-threatening bacterial and protozoan infections. The new combination is expected to be particularly effective in reducing TB, because it will increase the use of isoniazid, the TB-fighting component whose availability has been inconsistent.
Q-TIB was prequalified by WHO in 2017, which authorizes it to be procured and distributed by international funding bodies, such as the Global Fund and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).
MEDIA CONTACTS:
Andrew Hurst, Unitaid, Geneva – tel. +41 22 791 3859, hursta@unitaid.who.int
Dominique De Santis, Unitaid, Geneva – tel. +41 78 911 5327, desantisd@unitaid.who.int
Unitaid launches call for proposals to help eliminate cervical cancer
Geneva – Unitaid is seeking to fund smart, innovative projects that will help eliminate cervical cancer, a leading cause of death in low- and middle-income countries, particularly among women with HIV.
One woman dies of cervical cancer every two minutes, with about 90 percent of the deaths occurring in less affluent countries. Cervical cancer is caused by certain types of human papillomavirus (HPV), an extremely common group of viruses.
The HPV projects that Unitaid will fund would improve and expand screening and treatment for cervical cancer, with special attention given to women living with HIV. They are particularly vulnerable given that HIV/HPV co-infection progresses more quickly to cervical cancer.
“Unitaid is committed to promote innovative technologies that will empower women to screen for cervical cancer and access treatment more quickly and easily,“ said Lelio Marmora, Unitaid Executive Director. “Too often we hear tragic stories of women in low-income countries who travel long distances to access a health clinic only to discover they have late-stage cervical cancer.“
With this call for proposals, Unitaid aims to contribute to eliminating cervical cancer as a public health problem, an objective set by the World Health Organization at this year’s World Health Assembly meeting in Geneva.
“Through cost-effective, evidence-based interventions, including HPV vaccination of girls, screening and treatment of pre-cancerous lesions, and improving access to diagnosis and treatment of invasive cancers, we can eliminate cervical cancer as a public health problem and make it a disease of the past,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
This HPV call seeks projects that would:
- Create a market for the best available tools to screen HPV and treat women at risk of developing cervical cancer in low- and middle-income countries, including point of care molecular tests and treatment devices.
- Remove market barriers that stand in the way of these emerging tools being put to use.
- Help to efficiently and economically integrate these tools into countries, setting them up for large-scale expansion in the future.
In high-income countries, strategies that identify women at risk of cervical cancer and provide them with early treatment have dramatically reduced illness and death. In most low- and middle-income countries, screening and treatment are very limited.
Through its calls, Unitaid finds new ideas to help alleviate the burden of diseases such as HIV/AIDS, tuberculosis and malaria. A review committee of independent experts in global health helps Unitaid choose the best proposals to fund through a competitive selection process.
Unitaid encourages further safety reviews of HIV drug
Unitaid supports further investigation of findings from an independent study, released by the World Health Organization (WHO) on May 18, that identifies a potential link between use of HIV drug dolutegravir (DTG) and birth defects.
The study, funded by the US National Institutes of Health in Botswana, found a rate of neural tube defects in newborns higher than expected in women who became pregnant while taking dolutegravir.
Unitaid is working closely with WHO and partners to ensure that the proper steps are taken to avoid potential exposure to dolutegravir of women who might become pregnant.
Dolutegravir was approved in 2013 by the U.S. Food and Drug Administration to treat HIV in combination regimens. It has since become the drug of choice for people living with HIV in many countries because it is more easily tolerated and less susceptible to resistance than previous regimens.
Unitaid is supporting a number of projects to evaluate use of dolutegravir in low and middle-income countries. The aim of the programs is to help WHO in its efforts to draw up guidelines and to facilitate adoption by countries of the best available antiretroviral regimens.
WHO’s statement: https://bit.ly/2Le1i7w
Unitaid’s investments support global drive to end TB
Geneva — On the occasion of World TB Day, Unitaid wishes to reassert its commitment to ending tuberculosis, with special consideration for the estimated 1 million children who are among the most vulnerable and neglected victims of this curable disease.
Since its inception, Unitaid has funded more than US$ 460 million in innovative TB grants. In the last quarter of 2017, Unitaid turned decisively toward providing more help for children, with $117 million in new grants that include paediatric TB prevention, diagnosis and treatment.
“We are not standing still in our response,” Unitaid Executive Director Lelio Marmora said. “We’re increasing our investments and confronting tuberculosis and its drug-resistant strains on every front—prevention, testing and treatment.”
One of Unitaid’s highest priorities is investing in innovative grants to keep drugs effective in the face of a world crisis of resistant bugs, including strains of bacteria that cause TB. About half of Unitaid’s US$ 1 billion grant portfolio is invested in projects that fight antimicrobial resistance.
Unitaid has invested US $26 million in TB Xpert, an innovative machine that quickly diagnoses TB and its drug-resistant forms, and US $60 million in the EndTB project to improve treatment for multidrug-resistant TB.
Unitaid is an important contributor to the massive global effort to end the world’s TB epidemic by 2030. The World Health Organization’s End TB Strategy is a blueprint for bringing about an 80 percent drop in new infections, a 90 percent drop in deaths and 100 percent protection for families from catastrophic TB-related costs by the year 2035.
Unitaid’s active TB portfolio provides nearly US$ 180 million for developing innovative drugs, diagnostics and strategies to fight latent, childhood and drug-resistant TB. At the same time, Unitaid funding for the Medicines Patent Pool is being used to bring the best new TB medicines to low-resource countries, as quickly as possible, and at affordable prices. The World Health Organization’s prequalification programme, also supported by Unitaid, approved two child-friendly TB medicines in late 2017.
Our four newest TB grants include:
- US $ 58 million to expand short-course preventive TB therapy for HIV-positive people and children exposed to TB in Africa, Asia and South America.
- US $36.3 million to improve the treatment services and market for paediatric TB medicines and incorporate TB control into HIV, maternal and child health services in India and nine African countries.
- US $14.6 million to widen the availability of childhood TB diagnosis, using fast tests that can be done even in small local clinics. The project is taking place in six African countries and Cambodia.
- US $7.4 million to collaborate with the World Health Organization’s Global TB Program on diagnosis and treatment of paediatric, latent and multidrug-resistant TB in high-burden countries.
Download here:
Unitaid and South Africa partner to accelerate HIV and TB prevention and treatment
Pretoria – Unitaid and South Africa’s National Department of Health have launched a partnership to accelerate the country’s efforts to prevent and treat HIV and tuberculosis. South Africa is home to the world’s biggest HIV/AIDS epidemic, as well as one of the highest TB burdens.
The joint endeavour will introduce HIV self-screening, expand access to prevention for adolescent girls and young women at high risk of HIV infection, and to TB preventive therapy for people living with HIV and children under the age of five. It will also support the development of better first-line HIV treatment, and efforts to find better and shorter treatment for multidrug-resistant TB.
“We are very excited to partner with the South African government to accelerate the introduction of health innovations to prevent, diagnose and treat HIV and TB,” Unitaid Executive Director Lelio Marmora said. “Through this partnership we hope to boost HIV testing, particularly among adolescent girls, young women, and men, and ensure they have access to treatment.”
South Africa is at the forefront of the global AIDS response and has made significant progress in getting people to test for HIV in recent years. Although South Africa has the world’s largest HIV treatment programme, the country still faces challenges in preventing new infections and reaching the one million people living with HIV who do not know their status.
HIV self-screening is a new, cost-effective way of testing hard-to-reach populations, including young people, men, female sex workers and men who have sex with men. Through its HIV Self-Testing Africa (STAR) project, Unitaid is helping to close the testing gap in six countries in eastern and southern Africa, including South Africa. It is working with the health department and its implementing partners—Society for Family Health, the Clinton Health Access Initiative, the Wits Reproductive Health and HIV Institute and Population Services International—to ensure that HIV self-screening is included in the national HIV programme.
In 2017, the South African government began offering pre-exposure prophylaxis (PrEP)—a highly effective daily pill to prevent HIV—to adolescent girls and young women. Unitaid is working closely with the health department and the Wits Reproductive Health and HIV Institute to generate data on how to best deliver PrEP.
TB is the leading infectious disease killer globally and the leading cause of death in South Africa. An estimated 80% of South Africans are infected with TB bacteria, the vast majority of whom have latent TB rather than active TB disease. People living with HIV are 20 to 30 times more likely to develop active TB disease than people not infected with HIV.
People with latent TB have Mycobacterium tuberculosis in their body, but it is inactive; a normal immune system prevents it from causing illness or becoming contagious. However, latent TB bacteria can ‘wake up’, even many years after their arrival in the body, and cause illness. People with weakened immune systems are particularly susceptible to developing active TB.
As South Africa works to end TB, its highest priorities are treating people with multidrug-resistant TB and providing preventive therapy to high-risk populations, including people living with HIV.
With Unitaid funding, The Aurum Institute is scaling up access to affordable short-course preventive therapy for TB, known as 3HP, for people living with HIV and children under age five. The project seeks to establish 3HP as an affordable, less-toxic therapy suitable for wide introduction in 12 countries most affected by TB, including South Africa.
The endTB project, implemented by Partners in Health, Médecins Sans Frontières and Interactive Research and Development, supports the introduction of the first new medicines for drug-resistant TB in nearly half a century in 17 countries, including South Africa.
“These new HIV and TB prevention technologies could have a major impact on the trajectory of the HIV and TB epidemics in South Africa,” said South Africa Minister of Health Aaron Motsoaledi. “We are delighted to be working with Unitaid as we aim to reach the Sustainable Development Goal targets of ending TB and HIV by 2030.”
The partnership announcement was made on the eve of World TB Day during a partners meeting organized by Unitaid on innovations to prevent, diagnose and treat HIV and TB in South Africa.
Unitaid has committed more than US$ 50 million to this multi-year partnership.
Media contacts
Unitaid : Dominique De Santis (in Pretoria), desantisd@unitaid.who.int, cell. +41 78 911 5327
National Department of Health : Popo Maja, popo.maja@health.gov.za, cell. +27 82 373 1169