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[e-drug] New medicines available for low- & middle-income countries as new UNITAID grants

E-DRUG: New medicines available for low- & middle-income countries as new 
UNITAID grants 
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Breakthrough new medicines for hepatitis C and drug-resistant TB and 
largest-yet global programme for seasonal malaria chemoprevention to be made 
available for low- and middle-income countries as part of $160 million of new 
grants funded by UNITAID

Geneva 6 May 2014 - The UNITAID Executive Board committed $160 million in new 
grants, including investments to ensure low- and middle-income populations have 
access to new high performing treatments for hepatitis C and drug-resistant 
tuberculosis, and the largest-yet global programme for seasonal malaria 
chemoprevention. These innovative investments will reduce prices, overcome 
market barriers to access for patients, and generate crucial data on new 
products to speed up their introduction for those most in need.

A grant has been made to Médecins Sans Frontières (MSF) for the first major 
global scale-up for low- and middle-income countries of the new 
highly-anticipated hepatitis C medicines. It is one of two initial investments 
for UNITAID in this viral disease, and will lead to substantially larger 
hepatitis C cure rates for people living with HIV through reducing medicine 
prices to $500-1000 per patient. The current cost of one particular new and 
extremely effective hepatitis C treatment in the United States is $84,000 per 
patient. (more details below)

"Until recently, the only treatment for hepatitis C involved an expensive 
combination of injections and tablets that lasted a year with limited 
efficacy," said Dr Philippe Douste-Blazy, Chairman of the UNITAID Executive 
Board. "Treatments which have recently been made available can cure the disease 
in weeks but currently have a heavy price tag. Our investment will lower the 
prices of these treatments and therefore increase access, and is a decision the 
public health community has been waiting months for."

Meanwhile, a grant to Partners In Health will accelerate access to new 
treatments for multidrug-resistant tuberculosis (MDR-TB), including the first 
new tuberculosis drug to be approved in 40 years by the United States Food and 
Drug Administration (FDA) and the European Medicines Agency (EMA). This project 
will push availability of these promising new medicines and help transform the 
heavily fragmented treatment market for MDR-TB to enable cost-efficiencies, 
simpler treatments, and reduced prices to increase the cure rate from 48% to 
70% and increase the number of cases averted ten-fold. (more details below)

"The currently-used treatment for MDR-TB is expensive, has serious side 
effects, and only about half of those who finish the two-year course are 
cured," said Dr Philippe Duneton, UNITAID's Executive Director a.i.. "UNITAID's 
investment will help make MDR-TB treatment simpler, shorter, more affordable 
and more effective, thereby improving cure rates and helping to halt the 
disease's spread."

"We're grateful for this support from UNITAID, and particularly for their 
partnership, with which we're hoping to make diagnosis and treatment of 
drug-resistant tuberculosis more effective and more tolerable for patients, as 
well as more readily accessible and lower-cost" said Dr Paul Farmer, Chief 
Strategist and Co-founder of Partners in Health.  "UNITAID has given us a way 
to use the power of markets to serve the poor, driving down the cost of 
essential commodities and helping to deliver them to the people who need them 
most."

Other new grants, described below, are equally as revolutionary, including the 
world's largest-yet programme to roll-out malaria prevention treatment to 
children in the Sahel region of Africa which will save an estimated 50,000 
lives.

More Details on All the Grants Approved by UNITAID's Executive Board this week:

(from above) Up to $15 million to Médecins Sans Frontières (MSF) to reduce 
barriers in product markets to enable improved treatment of hepatitis C in low- 
and middle-income countries. Patients will be screened, diagnosed and treated 
in India, Iran, Kenya, Mozambique, Myanmar, and Ukraine to catalyse demand for 
newly-available medicines. MSF anticipates that this will help to reduce the 
price to $500-1000 per treatment course by the end of the intervention through 
negotiations and entry of new generic manufacturers. An estimated 150-180 
million people worldwide are infected with HCV and up to 500,000 die every 
year. Approximately 16% of the HIV-infected population (over 5 million people) 
is co-infected with HCV.  Those co-infected with HIV and HCV are much more 
likely to develop liver illnesses than those with only HCV.

(from above) Up to $60.4 million to Partners in Health (PIH) to radically 
change the MDR-TB medicines market and accelerate uptake of newly released 
MDR-TB medicines (bedaquiline and delamanid) in 17 countries. Over the course 
of four years, PIH will enrol 3200 patients on treatment involving new TB 
medicines and devise a more user-friendly and effective treatment regimen. 
Currently the small and fragmented MDR-TB medicines market features many 
medicine buyers and a large number of possible drug combinations. High-burden 
MDR-TB countries are currently estimated to use upwards of 40 or 50 unique 
MDR-TB regimens, leading to inefficiencies in ordering and manufacture and 
unnecessarily high prices. Today only an estimated 17% of MDR-TB patients 
receive treatment.  The investment will consolidate the market for MDR-TB 
drugs, and expand access to new, effective, and user-friendly treatment 
regimens for patients with MDR-TB. MDR-TB spreads through the air, especially 
in confined living conditions, and caused an estimated 170,000 deaths in 2012.

Up to $67.4 million to the Malaria Consortium to implement the largest-yet 
global programme to increase seasonal malaria chemoprevention (SMC) - the use 
of anti-malarials during the rainy season to prevent malaria.  By giving 
children prophylactics at monthly intervals during this high-risk period, drug 
levels are maintained in the blood to prevent malaria.  WHO has recommended SMC 
since 2012 and estimates that it can prevent 75% of cases, but in 2013, only 3% 
of eligible children received treatment. This grant will increase capacity and 
reduce prices for SMC products in Burkina Faso, Chad, Guinea, Mali, Niger, 
Nigeria and Gambia. The project will supply an estimated 30 million treatments 
every year to protect 7.5 million children, the population segment most at risk 
of dying from this disease. It is estimated that 50,000 deaths will be 
prevented.

Up to $3.7 million to the Northwestern Global Health Foundation (NWGHF) to 
support the market entry of a best-in-class early infant diagnostic (EID) test 
for HIV.  The test can be used in remote settings by community health care 
workers and gives results while patients wait. There are still 1.4 million 
infants born with HIV each year.  Fewer than an third receive a test and of 
those who test positive, over half never receive their results.  Infants retain 
maternal antibodies against HIV for over a year after birth, hence highly 
sensitive molecular testing for babies is essential for accurate diagnosis. 
Currently-available tests are complicated to use, require sophisticated 
infrastructure, and skilled technicians to operate them. NWGHF's new technology 
is less expensive and is simple enough to be used at the point-of-care. 
UNITAID's grant will facilitate more widespread adoption of this technology and 
lower the cost of testing in 29 countries where over 90% of HIV-positive 
infants are born.  This will help to increase the number of children on 
treatment.  Studies show that EID and prompt treatment can reduce infant 
mortality by 76%.

Up to $5.2 million to Coalition Internationale Sida to work with partners in 
Brazil, China, Ecuador, Egypt, Georgia, Indonesia, Malaysia, Morocco, South 
Africa, Thailand and Ukraine to advance access to new treatments for hepatitis 
C for HIV co-infected patients.   The project will develop an alliance between 
the countries to pool efforts to negotiate lower prices.  This is the second of 
two UNITAID grants to support hepatitis C projects.

Up to $6 million to the Tides Centre/International Treatment Preparedness 
Coalition<http://www.itpcglobal.org/> to remove barriers to generic competition 
for second- and third-line HIV antiretrovirals in middle-income countries 
outside Sub-Saharan Africa where 20% of the HIV burden exists. By removing 
these barriers, this investment aims to lower prices in four countries 
(Argentina, Brazil, Thailand and Ukraine) and expand the overall market for new 
antiretrovirals thereby increasing access for an additional 130,000 people and 
generating annual cost savings of $150 million. Patent barriers mean prices 
remain high for non-generic HIV medicines.

Clare COURTNEY | Communications Manager | UNITAID
courtneyc@unitaid.who.int

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