E-DRUG: The Lancet - UK MPs support the UNITAID Patent Pool Initiative
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Dear All,
Please find below a Lancet article on the UK MPs All Party Parliamentary
Group on AIDS (APPG) report on long-term access to HIV medicines in the
developing world, supporting the UNITAID Patent Pool Initiative.
Volume 9, Issue 10 (October 2009) of The Lancet Infectious Diseases can be
found here:
http://www.thelancet.com/journals/laninf/issue/vol9no10/PIIS1473-3099(09)X7010-6
The full text of the below article can be found here:
http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(09)70244-0/fulltext
The APPG full report, The Treatment Timebomb can be found here:
http://www.aidsportal.org/repos/APPGTimebomb091.pdf
The Lancet Infectious Diseases, Volume 9, Issue
10<http://www.thelancet.com/journals/laninf/issue/vol9no10/PIIS1473-3099(09)X7010-6>,
Page 593, October 2009
Urgent action needed to defuse HIV treatment timebomb
Original Text
[Copied as fair use]
Kelly Morris<http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=Kelly+Morris>
1 year before the G8 target of universal access to antiretrovirals (ARVs),
only a third of those in need are receiving medication. With the HIV
pandemic continuing to spread dramatically, an inquiry by the UK all-party
parliamentary group on AIDS “shows that
we are sitting on a treatment timebomb”. Action is needed now,
to avert crisis later, says the report, which predicts that over 50 million
people worldwide could need ARVs by 2030.
The International AIDS Society has applauded The Treatment Timebomb report.
Society president Julio Montaner explains that suppression of viral load
reduces transmission rates of both HIV and tuberculosis to the wider
community. “The more you treat, the more lives are saved, the more families
are protected, the more people can go back to work”, he says. But, universal
access to ARVs “is not just the humanitarian, ethical, or cost-effective
thing to do”, he continues. “It is cost-averting”, and vital especially in
times of fiscal crisis. Most importantly, he stresses, universal ARV
coverage is an essential part of the solution to control and reduce the
spread of HIV, which is a millenium development goal for 2015.
The UK International Development Minister Mike Foster told TLID that “we
must think ahead when it comes to HIV treatment. The number of people
needing treatment, and more complex and expensive treatments, will continue
to rise. The price of those treatments is an issue now, and will only grow
bigger in the future.” The report notes that, in some countries, access to
therapies to prevent vertical transmission is particularly poor, whereas
treatment for adults and children is often started late on the basis of
symptoms, because of the lack of CD4 count testing. Revised WHO guidelines
due to be released later this year are expected to raise the CD4 count at
which to begin treatment, which will mean more people will be immediately
eligible for ARVs. Effective treatment will increase lifespan, and thus more
people will need drugs for longer, but effective treatment is a key part of
the strategy to eliminate HIV, says Montaner. “We need to get policy makers
to understand this”, he urges.
The UK all-party parliamentary group is calling for immediate action and
long-term plans by countries and donors, including secure financial
commitments to ensure continued ARV supplies and bulk ordering to reduce
costs. Stakeholders need to work together to decide the optimum balance of
spending between treatment and other prevention efforts, the report
recommends. Cheap CD4 tests are also urgently needed to guide treatment.
Poor adherence, interrupted drug supplies, and counterfeit drugs increase
the likelihood of resistance, which necessitates newer ARV regimens.
Notably, adherence and cost-savings can be substantially improved by use of
generic fixed-dose combinations. However, the World Trade Organization is
tightening rules on patenting and so reducing new generic drug production.
Foster points out that the UK Department for International Development is
working with manufacturers to lower the price of drugs, and supports the
initiative by UNITAID to develop an ARV patent pool. In principle, companies
will pool their patents, which are then available for license—eg, to generic
manufacturers—in return for a royalty payment. Voluntary licensing schemes
already exist but via individual companies, whereas the UNITAID patent pool
would be a “one stop shop”. Ellen 't Hoen, UNITAID, Geneva, Switzerland
advises that the patent pool will overcome many obstacles, especially to
rapidly produce new fixed-dose combinations and urgently needed paediatric
formulations. Unless such an approach is taken, generic drug companies
cannot continue to produce new innovative products for developing countries,
she warns.
UNITAID is talking to major stakeholders—from patent holders to potential
licensees—and hopes to have the patent pool established by the end of the
year. “Everyone recognises that something needs to be done”, but although
some parties are very positive others are more hesitant, says 't Hoen.
However, “it's an unbelievable opportunity to get something right and will
become increasingly important for the future”, she says.
The Treatment Timebomb concludes with a call for political activism, but
noting that all parties must be involved and pharmaceutical companies need
not be cast as the enemy. What is needed most now is political leadership,
says Veronica Oakeshott, the parliamentary group's policy advisor. Montaner
points out that at the 2005 G8, the UK played a key part in developing the
universal access goal for ARVs. But, current G8 head Stephen Harper, the
Canadian Prime Minister, is not prioritising HIV at the summit. “People of
the G8 countries need to know that we are walking away from promises”, says
Montaner. He is urging the UK government to use the report to demand that
action on HIV be put at the top of the agenda for the 2010 G8 summit. “The
consequences of not doing so will be devastating for us and for generations
to come.”
UNITAID - Medicines Patent Pool Initiative
20 Avenue Appia // 1211 Geneva 27 // Switzerland
Tel +41 22 791 3778 // Fax +41 22 791 4890
utdmppi@gmail.com // borolim@who.int // www.unitaid.eu
What is a Patent Pool?
http://www.youtube.com/watch?v=Vj0dbFgjoh4