UNITAID approves grants of $160 million

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 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.

Source: UNITAID