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

New project will dramatically increase pediatric TB prevention, diagnosis, and treatment in Zimbabwe

Harare – The Zimbabwe government in partnership with Unitaid and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) today launched a four-year project to fight tuberculosis among children, a long-underserved group that bears the burden of TB illness and death worldwide. TB, a preventable, curable disease, is the second biggest killer of children in Zimbabwe. 

The project will scale up better diagnostic tests, easier to take, better-tasting medicines and new strategies for finding children with undiagnosed TB or in need of prevention. 

Funded by Unitaid and carried out by EGPAF, the project expects to double diagnosis of pediatric TB in Zimbabwe, and greatly increase the number of children who receive appropriate treatment and prevention. The project is called CaP TB, which stands for “Catalyzing Pediatric Tuberculosis Innovation.“

“CaP TB is an important contribution to our continued efforts to address childhood TB,” Zimbabwe Minister of Health and Child Care Dr. P. Parirenyatwa said. “Achieving our collective goal of zero TB deaths among children requires sustained advocacy, greater commitment, mobilization of increased resources and a joint effort by all stakeholders.” 

The burden of TB in children is much higher because many are undiagnosed.

“Every day, more than 200 children under the age of 15 die needlessly of TB worldwide,” Unitaid Executive Director Lelio Marmora said. “Unitaid is investing heavily in programs like CaP TB that integrate TB treatment into existing HIV and maternal and child health services. It’s a wise strategy for reaching more children with lifesaving treatment, and reaching them faster.”

Children with undiagnosed TB are often mistakenly treated for other ailments. Those exposed to TB are more likely than adults to develop the active form of the disease and to die from it. Other factors, such as age, HIV infection and malnutrition make TB more immediately life-threatening for children.

“As defenders of children’s health, we at the Elizabeth Glaser Pediatric AIDS Foundation are determined to help the MOHCC find and implement innovative solutions to the TB epidemic’s impact on children and their families,” Dr. Agnes Mahomva, Country Director for EGPAF in Zimbabwe said.

According to the World Health Organization, children should account for about 15 percent of reported TB cases in high-burden countries.  In Zimbabwe, children account for only eight percent of notifications, suggesting that half the children with active TB are not being diagnosed.

A strategy central to the project is to decentralize pediatric TB services and integrate them into the wider healthcare system, bringing care closer, and earlier, to the children who need it. The project will also train healthcare workers to collect samples from children and to perform clinical diagnosis when children cannot provide samples. 

CaP TB is being implemented in eight other sub-Saharan African countries and India.

EGPAF will establish services in 20 pilot sites in Zimbabwe during the first two years of the project, and 30 more sites in the last two years.

Global malaria diagnostic and artemisinin treatment commodities demand forecast: 2017 – 2021 Policy brief (May 2018)

Unitaid seeks to fund innovative projects against TB and drug-resistance

Unitaid today launched a call for proposals for projects that will fight tuberculosis and its drug-resistant strains through innovative diagnostics, wider use of the best new drugs for adults and children, and new technologies that remind patients to take their medicines on schedule.

To meet the challenge of quickly diagnosing drug-resistant TB, Unitaid is keen to fund projects that would widen access to targeted gene sequencing, a technique that finds genetic mutations in TB bacteria that are associated with drug resistance. Doctors can use targeted gene sequencing to evaluate the bacteria in a patient’s sample, quickly see which TB medicines are not likely to work, and choose the best combinations of available medicines for that patient.

Unitaid is also seeking to fund proposals that work toward:

  • boosting the use of quality-assured drugs to treat drug-resistant TB, ensuring a more stable supply, and collecting data to help shape treatment with a focus on vulnerable groups such as children.
  • showing the usefulness of technologies to help patients complete treatment . “Adherence technologies” can include, but are not limited to, devices like smart pillboxes that take note of when they are opened and pills are removed, electronic reminders, smartphone applications and other such inventions.

Through its calls for proposals, Unitaid finds smart new ideas to help relieve the burden of diseases such as HIV/AIDS, TB and malaria. A review committee of independent experts in global health helps Unitaid choose the best proposals to fund through a competitive selection process.

Drug-resistant tuberculosis is a global health crisis. In 2016, 600,000 people were believed to have the disease, but less than 22 percent of them were detected and enrolled in treatment. Of the treated patients, less than 12 percent were cured. TB is the most prevalent among diseases affected by antimicrobial resistance. Multidrug-resistant TB is responsible for a third of all deaths caused by antimicrobial resistance.

Although recent strides against TB have been significant—notably the introduction of the new drugs bedaquiline and delamanid and the expanded use of GeneXpert machines for diagnosis—the global health community is looking for further improvements to end the epidemic by the  target date of 2035 set by the UN.

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:

  1. our TB impact story
  2. our animation

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

Impact story: Childhood tuberculosis

Unitaid’s annual report shows innovation at work to end epidemics

GENEVA – Unitaid is pleased to present its 2016-2017 annual report, which describes a rewarding phase in the fight against the global epidemics of HIV/AIDS — including co-infections such as hepatitis C – and tuberculosis and malaria.

During the two years covered by the report, Unitaid launched a robust new operational strategy that supports the global push to end the three epidemics by 2030. At the same time, we  awarded a spectrum of forward-looking grants designed to deploy the world’s best new technologies at the heart of the epidemics.

As Executive Board Chair Celso Amorim has commented, “At Unitaid, we do not pursue innovation for its own sake, but rather as a way to change outcomes in the real world.”

Throughout, Unitaid pursued its flagship projects—from bringing the best new HIV drugs to  lower-resource countries to supporting the first new treatments for drug-resistant TB in nearly half a century.

The annual report also reflects our commitment to confront the threat posed by growing resistance to HIV, TB and malaria treatment, a phenomenon caused by misuse of medicines. Resistance threatens to undermine the extraordinary gains that have been made against the diseases over the past two decades. Unitaid has committed more than half its portfolio to projects to stop bacteria, viruses, fungi and parasites becoming resistant to antimicrobial drugs.

Read Full Report