Geneva, 16 August 2022 – Unitaid is pleased to announce new investments aimed at averting deaths during childbirth. With its partners, Unitaid will advance a package of care for preventing and treating postpartum haemorrhage that is better suited to needs in low- and lower-middle income countries where nearly 94% of all maternal deaths occur.
Defined as severe bleeding after childbirth, postpartum haemorrhage is the leading cause of maternal mortality worldwide, with stark disparities in survival rates between women in high- versus lower-income countries. Each year, approximately 14 million women experience postpartum haemorrhage, resulting in 70,000 lives lost.
“One in five deaths during childbirth are caused by excessive bleeding. Despite being largely avoidable with access to appropriate tools, each year millions of women suffer the trauma of postpartum haemorrhage. More than 70,000 women die as a result – almost all of them in low- and middle-income countries. Unitaid’s investments aim to reduce this inexcusable gap in care, ensuring critical medicines are available and adapted to use where they are needed most,” said Dr Philippe Duneton, Executive Director of Unitaid.
Oxytocin, the most used medicine for preventing and treating postpartum haemorrhage, requires cold chain storage to remain effective. Because this is difficult to maintain in many resource-limited settings, the quality of the medicine can suffer. Three underutilized drugs recommended by the World Health Organization (WHO) hold great potential to improve the control of postpartum haemorrhage, but several barriers limit their wide scale access and use.
With US$45 million invested across three complementary initiatives, Unitaid will fund research needed to optimize use and enable broader access to products that, when implemented at scale, could save tens of thousands of women’s lives.
A clinical trial, coordinated by the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (Human Reproduction Program), will evaluate the safety and efficacy of using heat-stable carbetocin for treating postpartum haemorrhage. This drug, which is already recommended for preventing excessive bleeding during childbirth, represents a high-quality alternative to oxytocin as it does not require cold chain storage.
The London School of Hygiene & Tropical Medicine (LSHTM) will lead a second project aimed at improving access to tranexamic acid (TXA), a treatment recommended by the WHO that is proven to reduce the risk of death from severe bleeding by 30%. Currently, TXA can only be administered intravenously, which makes it inaccessible in facilities that lack the necessary staff capacity and infrastructure. A clinical trial will evaluate the safety and efficacy of intramuscular administration of TXA compared to intravenous administration. If intramuscular TXA proves to be as effective, this lifesaving treatment could be made much more widely available, particularly at lower levels of the health system where it is needed most.
Lastly, Jhpiego will lead a large-scale demonstration project to inform optimal deployment and scale-up of a critical set of new and newly recommended postpartum haemorrhage drugs in LMICs. This will include heat-stable carbetocin and TXA, as well as misoprostol, a medicine in tablet form that is recommended by the WHO for self-administration to prevent haemorrhage when giving birth at home or in the absence of skilled health personnel.
“We are delighted to be working with Unitaid and others towards a common goal of reducing severe bleeding after childbirth and saving the lives of mothers world-wide. All mothers should have access to lifesaving treatments wherever they give birth. There is an urgent need for alternative routes of administration to allow task shifting of TXA treatment to community health workers, nurses, and midwives. Evidence that intramuscular TXA is safe and effective will greatly expand equitable access, preventing many women from dying unnecessarily,” said Amy Brenner, Epidemiologist and TRANSFORM Project Lead at LSHTM.
“It is a tragedy that so many women die unnecessarily due to the lack of access to available drugs proven to prevent bleeding after childbirth. These deaths shine a light on continued inequities brought by geography and economy. This important funding announcement from Unitaid along with our collaboration will potentially lift those barriers and go some way to reducing the 70,000 preventable deaths we see from postpartum haemorrhage every year,” said Dr Soumya Swaminathan, Chief Scientist at the World Health Organization (WHO).
“One life lost to postpartum hemorrhage is one life too many. Through Unitaid’s commitment to expand access to lifesaving drugs and our partnership with Ministries of Health, FIGO and PATH, we can prevent the deaths of thousands of women who experience severe bleeding after birth. We are honored to lead this project and use our decades-long experience in managing complications at birth to propel catalytic change across Africa and Asia and significantly reduce maternal deaths,” said Elaine Roman, Project Lead at Jhpiego.
Unitaid is a global health agency engaged in finding innovative solutions to prevent, diagnose, and treat diseases more quickly, cheaply, and effectively, in low- and middle-income countries. Its work includes funding initiatives to address major diseases such as HIV, malaria, and tuberculosis, as well as HIV co-infections and co-morbidities including advanced HIV disease, cervical cancer, and hepatitis C, and cross-cutting areas, such as fever management. Unitaid is now applying its expertise to address challenges in advancing new therapies and diagnostics for the COVID-19 pandemic, serving as a key member of the Access to COVID-19 Tools (ACT) Accelerator, co-leading with Wellcome the Therapeutics Pillar and participating in the Diagnostics Pillar. Unitaid is hosted by the World Health Organization.
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