New Unitaid report: World’s leading HIV drug proven to have reduced global CO2 emissions by 26 million tons

• The transition from efavirenz to dolutegravir (DTG) in HIV treatment is estimated to reduce total carbon emissions by 26 million tons of CO2 equivalent by 2027 thanks to the shift to a treatment formulation that requires less active ingredient.
• The adoption of DTG reduced the health sector’s overall carbon footprint in low- and middle-income countries by approximately 0.3-0.4%, a magnitude of reduction – from one single drug – that surpasses many hard-won climate mitigation achievements in both health and other sectors.
• The report also shows how the global health sector could reduce the carbon emissions of DTG even further at low or little additional cost – a blueprint for developing climate- smart medicines that could be followed for other health products.
• Following Unitaid’s “From milligrams to megatons” report last year, the new research provides further evidence that new health technologies can and must be developed in a climate-smart way.

Geneva – A new report released today by Unitaid reveals that the lifesaving HIV treatment dolutegravir (DTG) has unexpectedly contributed to a significant reduction in carbon emissions when compared to the previous standard of care, efavirenz. These findings come just days ahead of the International AIDS Society (IAS) Conference – the premier global event on HIV research and policy.

The report, “The untold story of dolutegravir: When climate impact goes hand-in-hand with access to better treatments,” highlights how DTG, now the preferred treatment for HIV taken by more than 24 million people in low- and middle-income countries, is beneficial for both global health and the environment. Building on Unitaid’s “From milligrams to megatons” report last year – which analyzed the climate and nature assessment of 10 key health products – this report is the first of its kind to analyze the environmental impacts of a single widely used medicine compared to its alternative. It also includes a foreword from the Green Climate Fund emphasizing the necessity of integrating climate considerations into health interventions.

The report estimates that the transition to DTG will have prevented over 26 million tons of CO2 equivalent from entering the atmosphere from 2017 to 2027. This is in comparison to what would have been emitted had the world continued using efavirenz as a first-and second-line antiretroviral therapy for HIV during the same period. This emissions reduction is comparable to eliminating 10 years’ worth of carbon emissions of the entire city of Geneva, Switzerland.

DTG, the most effective and lowest cost antiretroviral drug ever, was rapidly scaled up across low- and middle-income countries starting in 2017, thanks to a concerted global effort by Unitaid, manufacturers, governments, global health organizations and affected communities. DTG is now the standard of care in over 110 low- and middle-income countries.

Understanding the environmental impact of health treatments is crucial for making informed decisions that benefit both people and the planet. This report demonstrates that we can achieve significant health improvements while also making strides in reducing carbon emissions. By adopting innovative practices and prioritizing sustainability, we can ensure that medicines like DTG are not only effective but also environmentally responsible."

Vincent Bretin

Director of Unitaid’s Results and Climate Team

It was found that compared to efavirenz-based treatment, DTG requires a smaller quantity of active pharmaceutical ingredients which naturally lowers emissions during the production process. Optimized supply chains, supported by coordinated efforts to improve distribution and production processes, further enhance environmental efficiency.

While DTG’s carbon footprint is significantly lower than its predecessor, it remains very high. The report also outlines several measures that can be taken to reduce emissions from DTG even further, with the potential for application to other commonly used drugs. For example, up to 40% of these emissions could be abated through cost-saving measures such as process optimization to improve energy and material efficiency, and another 50% could be reduced by adopting green energy and materials.

With its unique market-shaping role, Unitaid is committed to advancing the insights from this report. By working with climate and health partners, Unitaid aims to introduce, promote, and ensure equitable access to health products that are both less carbon-intensive and more resilient to climate change.

Unitaid continues to call on the global health industry, policymakers, governments, research institutions and major buyers of pharmaceutical products to take action now to ensure key health products remain accessible and fit-for-purpose as the climate changes.

• Read the full report: The untold story of dolutegravir: When climate impact goes hand-in-hand with access to better treatments (en anglais seulement)

About Unitaid

We save lives by making new health products available and affordable for people in low- and middle-income countries. We work with partners to identify innovative treatments, tests and tools, help tackle the market barriers that are holding them back, and get them to the people who need them most – fast.

Since we were created in 2006, we have unlocked access to more than 100 groundbreaking health products to help address the world’s biggest health challenges, including HIV, TB, and malaria; women’s and children’s health; and pandemic prevention, preparedness and response. Every year, more than 300 million people benefit from the products we’ve helped roll out.

About dolutegravir and efavirenz

In 2014, the innovative new HIV drug, dolutegravir (DTG) was approved; it was faster working, had fewer side effects and had the potential to be less expensive than the existing first-line antiretroviral therapy (ART) at the time, efavirenz. Unitaid brought together partners, including the Medicines Patent Pool, manufacturers, researchers, communities and scale-up partners like the Global Fund to Fight AIDS, Tuberculosis and Malaria to make DTG affordable and accessible for people with HIV in low- and middle-income countries. DTG replaced efavirenz as the leading first-line ART for people with HIV and is now taken by more than 24 million people in low- and middle-income countries.