À l’Assemblée générale des Nations Unies, Unitaid souligne le besoin urgent d’accélérer l’innovation pour mettre fin à la tuberculose

New York – As heads of state and leaders unveiled ambitious plans to fight tuberculosis at the first-ever United Nations High-Level Meeting on the disease, Unitaid has highlighted the special role it is playing to speed introduction of health innovations that are essential to end the disease.

“The road that leads from the laboratory to the final point of delivery of a health product in a clinic or village pharmacy is long and arduous,” said Unitaid Executive Director Lelio Marmora at a panel on TB on Wednesday afternoon. “It is vital to ensure we achieve the ultimate objective of our work of bringing an innovation to scale so it reaches the maximum number of people at the best possible price.”

Marmora said that one of the challenges in introducing innovative health solutions in low-income countries has often been the lack of a market big enough to attract pharmaceutical manufacturers. “This is precisely when well-targeted catalytic investments are called for.”

More than 80 countries are today using a child-friendly fixed-dose combination to treat TB, the result of a Unitaid partnership with the TB Alliance. Close to 700,000 children will get the treatment they need. “We now have a fixed dose combination for children that is used all over the world,” he said.

In an article published earlier today, Marmora and Partners In Health (PIH) co-founder Dr. Paul Farmer pointed out that new medications for multidrug-resistant TB (MDR-TB) are reaching only a tiny fraction of the people who need them, due in part to the exceptionally high cost of treatment. As a result, the number of new TB cases is falling very slowly—by less than 2 percent each year.

Marmora and Farmer said the UNGA’s decision to host the high-level meeting on TB is a sign that the tide could finally be turning. Funded by Unitaid, Partners In Health leads the endTB project, which is piloting the first new TB drugs in more than 40 years, bedaquiline and delamanid. EndTB’s shorter, less-toxic treatment regimens for MDR-TB, which are simpler to administer, have the potential to bring about major public health gains.

Unitaid’s approach makes it possible to introduce very expensive treatments at prices that are affordable in low-income countries. The organization’s experience with diverse partners has shown that medicines and other tools that may have cost large sums to develop can be made available on a very wide scale to those most in need.

Responding to a global TB crisis and the growing menace of drug-resistant forms of the disease, Unitaid expanded its funding for innovative TB projects from US$ 127 million in 2016 to US$ 215 million in 2018. Unitaid’s TB funding is on track to hit US$ 300 million in 2020.

Further investments are in development: new Unitaid projects will fight TB and its drug-resistant strains through innovative diagnostics, wider use of the best new drugs for adults and children, and new technologies to support people in taking their medicines.

In 2017, 10 million people fell ill with TB, according to the World Health Organization, and 1.6 million died from the disease. More than 95 percent of TB deaths occur in low- and middle-income countries. TB is a leading killer of HIV-positive people. In 2016, 40 percent of HIV deaths were caused by TB.

Unitaid classé parmi les principaux financeurs mondiaux de la R&D pour la tuberculose

Genève – Un classement récemment diffusé cite Unitaid comme le plus important bailleur de fonds multilatéral du monde en faveur de la recherche et du développement sur la tuberculose, et place l’organisation au quatrième rang des financeurs en général. Ce résultat est le reflet de l’intensification des investissements d’Unitaid dans la lutte contre la principale infection mortelle au monde. 

Établi chaque année par Treatment Action Group (TAG), ce classement montre qu’Unitaid est passé de la 9e à la 4e place parmi les principaux bailleurs de fonds en faveur de la recherche et du développement pour la tuberculose entre 2016 et 2017. 

Face à une crise mondiale de la tuberculose et à la menace grandissante que représentent les formes résistantes aux médicaments de la maladie, Unitaid a augmenté ses financements en faveur de projets innovants de lutte contre la tuberculose, passant de 127 millions de dollars en 2016 à 215 millions de dollars en 2017. Les financements d’Unitaid pour la tuberculose pourraient atteindre 300 millions de dollars en 2020. 

Les projets d’Unitaid s’appuient sur l’innovation pour améliorer le traitement préventif et le diagnostic, et favoriser de meilleurs traitements, à action plus rapide, en favorisant les conditions pour leur introduction à grande échelle par des partenaires financiers. Unitaid a annoncé aujourd’hui une extension majeure du projet endTB, un projet de recherche de 81 millions de dollars portant sur des schémas thérapeutiques améliorés, plus courts et moins toxiques contre la tuberculose multirésistante. Ce projet estpiloté par Partners in Health. 

Selon l’Organisation mondiale de la Santé, 10,4 millions de personnes sont tombées malades à cause de la tuberculose en 2016, et 1,7 million sont mortes de cette maladie. Plus de 95 % des décès dus à la tuberculose se produisent dans les pays à revenu faible et intermédiaire. La tuberculose est l’une des principales causes de mortalité chez les personnes vivant avec le VIH. En 2016, 40 % des décès liés au VIH ont été provoqués par la tuberculose. 

Le groupe TAG, basé à New York, étudie le financement mondial de la recherche et du développement pour la tuberculose depuis 2005, se basant sur des enquêtes électroniques auprès d’organisations publiques, privées, philanthropiques et multilatérales.

Unitaid étend ses principaux financements en faveur de la recherche dans le cadre d’une riposte forte contre la tuberculose

New York – Unitaid is intensifying its commitment to fighting tuberculosis with a US$ 21 million investment in extending endTB, a global research project that is improving treatment regimens for patients with multidrug-resistant tuberculosis (MDR-TB).

Led by Partners In Health, in partnership with Médecins sans Frontières and Interactive Research & Development, endTB has been piloting two new medicines, bedaquiline and delamanid, in 17 countries, that aim to make treatment for MDR-TB shorter, simpler, more effective, and with fewer side effects.

The ultimate goal of the endTB project is to provide countries and funding agencies, such as the Global Fund, with effective drugs that can be introduced on a massive scale to tackle MDR-TB, a virulent form of TB.

“Unitaid’s visionary investment is a brilliant and strategic approach to ‘double down’ on this critical work,” said Gary Gottlieb, CEO of Partners In Health. “An expanded and extended endTB will further pave the way to ending the scourge of multidrug-resistant tuberculosis and improving and saving the lives of countless deserving people.”

The endTB project’s original term was 2015-2019 and its budget US$ 60 million, but with the extension it will run through the end of 2022, with Unitaid support of up to US$ 81 million.

Unitaid’s growing, varied slate of TB investments makes it, as of 2018, the world’s largest multilateral actor to invest in TB research and development. Our active TB portfolio includes grants worth US$ 215 million that are designed to speed access to innovative solutions for latent, drug-resistant and childhood TB. And the TB grant portfolio is expected to reach US$ 300 million by 2020.

Long-used treatments for MDR-TB can take up to two years, succeed in only about half the cases, and can cause major side effects such as hearing loss and psychosis.

People with MDR-TB have a form of the illness that does not respond to multiple first-line TB drugs. With endTB’s extension, a new clinical trial will be added to develop a treatment regimen for patients with fluoroquinolone-resistant MDR-TB.

“We are proud to be deepening our commitment to endTB, a highly ambitious project with the potential to have a huge impact on the trajectory of drug-resistant forms of TB,” said Unitaid’s Executive Director, Lelio Marmora.

EndTB’s innovative treatment regimens have the potential to bring about significant public health gains. According to project estimates, the new treatments could cure 119,000 more patients, save 56,000 more lives and avert 239,000 drug-resistant infections from 2019 to 2027.

The endTB extension is among recent initiatives Unitaid has undertaken to fight back against TB, the world’s leading infectious killer. More than half a million people get MDR-TB every year and 200,000 die of it.

Further investments are in development: new Unitaid projects will fight TB and its drug-resistant strains through innovative diagnostics, wider use of the best new drugs for adults and children, and new technologies to support people in taking their medicines.

Impact story: Expanding access to next generation drug-resistant tuberculosis treatment

Impact story: Improving use of tuberculosis diagnostics

La baisse du prix d’un médicament permettra de préserver la santé d’un plus grand nombre de personnes vivant avec le VIH

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

Un nouveau projet va renforcer fortement les services de prévention, de diagnostic et de traitement de la tuberculose pédiatrique au 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.

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