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Improving access and innovation in HIV treatment: the Medicines Patent Pool and other approaches

Improving access and innovation in HIV treatment: the Medicines Patent Pool and other approaches IAC –25 July 2012. Different mechanisms to address IP challenges. Mariângela Simão Rights, Gender and Community Mobilization Department UNAIDS.

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Improving access and innovation in HIV treatment: the Medicines Patent Pool and other approaches

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  1. Improving access and innovation in HIV treatment: the Medicines Patent Pool and other approaches IAC –25 July 2012 Different mechanisms to address IP challenges Mariângela Simão Rights, Gender and Community Mobilization Department UNAIDS

  2. People receiving antiretroviral therapy versus the 2015 target and the number of AIDS-related deaths, low- and middle-income countries, 2003–2011 AIDS-related deaths Estimated range of AIDS-related deaths People receiving antiretroviral therapy 2015 Target

  3. Eligibility for antiretroviral therapy versus coverage, low- and middle-income countries, by region, 2011 The area of the larger circle represents the number of people eligible for antiretroviral therapy. The shaded circle and percentage represent coverage in 2011.

  4. Prices of first-line and second-line ARV regimens for adults in low-income countries, 2008–2011 FIRST-LINE REGIMENS SECOND-LINE REGIMENS Source: Global Price Reporting Mechanism, World Health Organization, 2012.

  5. Value for money: price reductions Prices of first-line regimens in low-income countries 700 2008 2011 -60% Median transaction price (US$/ppy) - 57% - 53% - 41% - 15% 0 TDF+FTC+NVP TDF+3TC+EFV ZDV+3TC+EFV 3TC+NVP+ZDV TDF+FTC+EFV Source: Global Price Monitoring Mechanisms, WHO 2012

  6. The vast majority of people living with HIV will be in middle income countries Proportion of people living with HIV by countries’ income level category Source: IMF (DATE), UNAIDS (DATE)

  7. So we need diverse approaches so that... • “No one is left behind” • How to increase coverage – upper middle income countries; key populations, etc • No double standards • Simpler to use, less toxic, heat stable drugs are good for patients no matter where they live • People live long and better lives • Early diagnosis. Earlier treatment initiation(?) • Better drugs and monitoring kits • …………..

  8. Addressing innovation and access to innnovation • Improve effectiveness, tolerability and resilience of 1st line regimens • Better tools to assess regimen switch needs: PoC VL • New drugs in the pipeline: accelerating entry into market • Ensuring competition for innovative products: licensing mechanisms and technology transfer • Global R&D convention?

  9. Strategies and initiatives that can be utilized to reduce costs of treatment • Role for the UN supporting countries on the use of TRIPS flexibilities, access principles – guidelines, policy papers, issues briefs - avoid TRIPS + measures in FTAs • UNITAID, CHAI, PEPFAR, GF,…. • Local production and regulatory harmonization • Upcoming – consultation on pricing in upper middle income countries

  10. What strategies could be utilized to reduce costs of treatment? IP related issues and access • Voluntary licensing mechanisms - MPP • Other initiatives (?) • Compulsory licenses • Patent opposition (TDF in Brazil)

  11. What strategies could be utilized to reduce costs of treatment? IP related issues and access • Transfer of technology • Analysis of patent requests • Public Health lens to avoid granting patents for applications that don’t fulfil TRIPS requirements (novelty, inventive step and industrial application) – WHO’s guidance • “prior consent” mechanisms

  12. Successful country initiatives to cut the costs of ARV Note: (i) At an exchange rate of 7.40 ZAR/USD, the savings amounted to R 4.7 billion. Sources: (ii) Massive reduction in ARV prices. Johannesburg, Government of South Africa, 2010 (www.info.gov.za/speech/DynamicAction?pageid=461&sid=15423&tid=26211, accessed 15 June 2012); (iii) Mutabaazi I.I. Scaling up antiretroviral treatment using the same dollar: cost efficiency and effectiveness of TASO Uganda Pharmacy Management System of CDC-PEPFAR funded program. XIX International AIDS Conference, Washington, DC, 22–27 July 2012. Note: the content of poster discussion abstracts and poster exhibition abstracts for the XIX International AIDS Conference is embargoed until 15:00 (U.S. Eastern Standard Time) on Sunday, 22 July 2012; (iv) ViegasNeves da Silva F, Hallal R, Guimaraes A. Compulsory licence and access to medicines: economic savings of efavirenz in Brazil. XIX International AIDS Conference, Washington, DC, 22–27 July 2012. Note: the content of poster discussion abstracts and poster exhibition abstracts for the XIX International AIDS Conference is embargoed until 15:00 (U.S. Eastern Standard Time) on Sunday, 22 July2012.

  13. Bridging the gap?

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