GENEVA – Unitaid is working with partners and stakeholders to explore introduction of long -acting (LA) technologies – such as injectable drugs, patches and implants – to treat infectious diseases in low and middle-income counties (LMICs), according to a commentary co-authored by Unitaid’s Executive Director Lelio Marmora and published in the Lancet.

“To avoid the pitfalls of the past, when new medicines were introduced first in high-income countries and only much later in LMICs, we need to be thinking ahead about LA technologies for infectious diseases,” said the article, co-authored by Carmen Perez Casas, Ian Grubb, Craig McClure and Marmora.

A global technical consultation will be held in Geneva on 1-2 November to consider the science and market landscapes for LA technologies.

Scientific and technological advances may make it possible over the next decade for children to be protected from malaria for an entire season with a single injection of chemoprophylaxis, for example, or for women to protect themselves from being infected with HIV by taking capsules once a fortnight that slowly release antiretroviral medicine.

The article cited Cabotegravir, a new antiretroviral drug, that is being studied as a singular intramuscular injection every eight weeks for pre-exposure prophylaxis, as well as LA formulations in malaria that are being explored for chemoprophylaxis and vector control.

Apart from injectable drugs, once-weekly gastric resident capsules, various types of patches, implants and vaginal rings were also being developed to deliver long-acting medicines, the article said.

Long-acting technologies are likely to pose big challenges in low and middle-income countries and will require stronger health systems in managing supply chains and medical waste.

Difficult intellectual property and generic manufacturing issues will also have to be sorted out before the completion of clinical trials, if LA products are to be sourced from generic suppliers, as is the case with more than 90 percent of antiretroviral drugs supplied by funders such as the Global Fund and the US President’s Emergency Plan for AIDS Relief (PEPFAR), the article added.

“Above all, LA approaches in addition to being safe must be designed upfront for simplicity to minimize burden and increase convenience for patients, providers and health services.” Please click here to read the commentary in full.