Unitaid Official Explains How ‘Breakthrough’ HIV Medicine Pricing Deal Brings Best To The Neediest

NEW YORK — In the midst of the high-level meetings of the annual United Nations General Assembly last week, health officials from the UN and foundations announced what they called a breakthrough pricing agreement that will speed the availability of “the first affordable, generic, single-pill HIV treatment regimen containing [the key compound] dolutegravir to public sector purchasers in low- and middle-income countries at around $75 per person, per year.” A senior official at Unitaid, the drug purchasing mechanism that helped reach the deal, explained to Intellectual Property Watch how it came about and why this is significant.

The pricing agreement was announced at a press conference on 21 September, during the UN General Assembly. Speaking at the press conference was Michel Sidibé, executive director of UNAIDS, Aaron Motsoaledi, minister of health of South Africa, and Lelio Marmora, executive director of Unitaid. They were joined by Dame Sally Davies, the chief medical officer of the United Kingdom.

In a related development, UNAIDS on the same day issued a call to quicken the pace of action to end AIDS. “The Fast-Track approach is saving more and more lives,” it said. “In 2016, 19.5 million people—more than half the 36.7 million people living with HIV—were accessing life-saving treatment. The number of people who died from AIDS-related illnesses has been reduced by nearly half since 2005, and the global number of new HIV infections has been reduced by 11% since 2010.” Still, the pace is not enough to end AIDS as a public health threat by the UN goal of 2030, the release said. The event concept note is here [pdf].

On the dolutegravir deal, a press release was issued listing the many partners involved in bringing the deal about, including: the governments of South Africa and Kenya, together with the Joint United Nations Programme on HIV/AIDS (UNAIDS), the Clinton Health Access Initiative (CHAI), the Bill & Melinda Gates Foundation (BMGF), Unitaid, the United Kingdom’s Department for International Development (DFID), the United States President’s Emergency Plan for AIDS Relief (PEPFAR), the US Agency for International Development (USAID), and the Global Fund to Fight AIDS, Tuberculosis and Malaria, with Mylan Laboratories Limited and Aurobindo Pharma,

The release said the agreement “takes an important step toward ensuring the availability of worldwide high-quality treatment for HIV.”

The Gates Foundation, with the support of CHAI, “recently completed ceiling price agreements with Mylan and Aurobindo with the goal of accelerating the availability of the new fixed-dose combination to the public sector in over 90 LMICs at reduced pricing,” the release said. “The agreements, which set an upper price limit for TLD, are by some estimates expected to save public sector purchasers over US$1 billion over the next six years.”

BMGF CEO Sue Desmond-Hellmann said: “This unprecedented new partnership – the largest of its kind ever seen in global health – will transform millions of lives by making a highly-effective drug more affordable to countries with the largest numbers of people living with HIV. The Bill & Melinda Gates Foundation is uniquely placed to help in this endeavor….”

A Question of Volume

In an interview with Intellectual Property Watch after the press conference, Unitaid‘s Philippe Duneton explained in detail how the agreement came into being and why it is so important.

“ARVs and the fight against AIDS is always about innovation,” he said. “It has taken a lot of time … to reach the best regimen. This one is the best of the best because it’s easy to take [one per day combination] … less side effects … has a resilience against genetic barriers so there is less risk of developing resistance … and the people if they forget one time, they will continue to be protected, plus it’s much more powerful.”

The best drug available for HIV is available only 3 years after registration, compared with 12 years to reach Africa for the previous treatment, he said. ViiV should be praised for understanding the responsibility to make it available not just to patients in the global North, and for working with Unitaid and the others to reach a deal, said Duneton. He also broke down how they made it worthwhile for ViiV and arrived at the price.

Listen to the 7 minute interview here:

 

Image Credits: UNAIDS, William New