21 July, 2016 DURBAN - The Drugs for Neglected Diseases initiative (DNDi) announced a new and better treatment for children living with HIV, which could be available by the end of 2018. The new 4-in-1 formulation, in the form of pellets, is more tolerable, better tasting, safer for children to use and does not require refrigeration. It will replace a liquid formulation being used to treat children living with HIV that had high alcohol content, and tasted bitter.
GENEVA, 20 July, 2016 - A report by Médecins Sans Frontières (MSF) provides invaluable guidance to countries seeking to make viral load testing routine for those on antiretroviral treatment, according to UNITAID Executive Director Lelio Marmora.
“Making Viral Load Routine” is based on lessons learned over the past four years in the course of a UNITAID-funded project, implemented by MSF, which established the feasibility of viral load testing in challenging environments. A toolkit [PDF] emerging from the project can be used by implementing countries to expand viral load testing.
A viral load test quickly detects exactly how much HIV is in the blood. If treatment is not working, the virus will replicate. By monitoring how well antiretroviral therapy is controlling the virus, a viral load test can help prevent a treatment failure and avert a switch to more expensive and toxic second-line treatment regimens.
UNAIDS’ 90-90-90 targets call, among other things, for 90 per cent of all people receiving antiretroviral therapy (ART) by 2020 to have viral suppression, meaning that they have no detectable HIV in the blood. UNAIDS estimated in December 2015 that more than 17 million people are accessing ART – but less than 30 per cent of them have ever had a viral load test.
“[Though] viral load testing is the most important tool that we have to determine whether HIV treatment is having the desired effect […] it is not widely available,” writes Marmora in the foreword to the report.
In 2012, UNITAID funded its first grant with MSF to demonstrate the feasibility of monitoring HIV treatment using viral load testing. Almost four years on, this detailed report provides guidance on how we can make viral load testing routine for all those on antiretroviral therapy.
A key finding is that viral load diagnostic tools and approaches need to be adapted to the setting they will be used in. Another major factor contributing to success is to work with clinicians, health workers and people living with HIV in order to create awareness and stimulate demand.
UNITAID has invested more than US$180 million in the last three years in a range of projects that address the diagnostic needs of countries, assess innovative and adapted solutions, and generate essential evidence to inform countries and global stakeholders on how to invest more effectively in this vital area of the HIV response.
Read the report: "Making Viral Load Routine"
Download the toolkit for implementers [PDF]
MSF will officially launch this report on Wednesday 20 July 2016 at the 21st international AIDS conference in Durban, South Africa. Follow the launch using #undetectable on Twitter.
For more on UNITAID’s HIV response, check out our HIV grant portfolio.
PUBLIC RECOGNITION AWARD
Highlighting Exceptional Efforts to Increase Access to Children’s HIV/AIDS Treatment
29 June 2016
PARIS - UNITAID has committed up to US $2.45 million to support a trial of the new-generation anti-HIV drug dolutegravir as a first-line treatment for HIV in low-income settings. The trial, which will take place in Cameroon, aims to gather evidence on the potential benefits of dolutegravir in a low-income setting.
The NAMSAL trial – sponsored and co-funded by ANRS "France REcherche Nord & Sud Sida-hiv Hepatites" and implemented by the Institut Bouisson Bertrand (IBB) and the Institut de Recherche pour le Développement (IRD) – aims to determine the potential clinical and economic benefits of a dolutegravir-based regimen in an African setting, representative of real-world conditions with constrained resources.
Dolutegravir is an antiretroviral medicine – a drug that prevents HIV from replicating in a patient’s body. To reach the 90-90-90 targets set by UNAIDS in 2014, some 22 million more people need access to life-long antiretroviral therapy with simpler, less expensive and more robust treatment options.
The UNAIDS targets call, by 2020, for 90 per cent of all people living with HIV to know their HIV status; 90 per cent of all people diagnosed with HIV infection to receive sustained antiretroviral therapy and 90 per cent of all people on antiretroviral therapy to have viral suppression.
Dolutegravir-based regimens are recommended as a first-line HIV treatment option in high-income countries. The drug is safe, effective and more tolerable to patients. The dolutegravir regimen may be available as a single pill to be taken once a day. In addition, the relatively low manufacturing cost makes dolutegravir an affordable alternative to other antiretrovirals such as efavirenz.
However, more evidence is needed to inform use of dolutegravir-based regimens in real-world conditions. The drug has yet to be tested in resource-constrained settings where viral load monitoring is limited, where HIV often affects pregnant women or where people are co-infected with tuberculosis, for example.
UNITAID will purchase study drugs for the duration of the 48-week NAMSAL trial, and for up to three years for post-trial access. UNITAID will also support two studies nested within the trial, which are expected to complement its efficacy and safety assessments.
“We see this initiative as key to accelerate the availability of simpler and better HIV treatment in low and middle-income countries – in particular addressing gaps in our understanding of how dolutegravir should be used in low-income settings,” said Lelio Marmora, Executive Director of UNITAID, who attended a signing ceremony at the ANRS office in Paris. Professor Jean François Delfraissy of ANRS said he was "very happy to start his new chapter of collaboration with UNITAID," citing the OPP-ERA project as an example of a previous successful partnership.
HIV projects make up the majority of UNITAID’s grant portfolio. UNITAID is also supporting initiatives to improve market conditions for dolutegravir, including voluntary licences, support for development of fixed-dose combinations, and ways to decrease the price, such as addressing potential barriers for future scale-up in resource-limited settings.
Lelio Marmora, Executive Director of UNITAID, signs an agreement with Professor Jean François Delfraissy of ANRS "France REcherche Nord & Sud Sida-hiv Hepatites" to commit US $2.45 million to trial the antiretroviral drug dolutegravir as a first-line HIV treatment in a low income setting. (Image: Marina Hue/UNITAID).
Geneva, 3 June 2016. Ministers of Health from more than 30 countries gathered with national ambassadors and UNITAID partners in Geneva, Switzerland, on 22 May 2016 to celebrate 10 years of UNITAID’s work. They discussed the organisation’s successes as well as challenges for the future. The ministers also shared ideas about their national policies for HIV, malaria and tuberculosis.
Health ministers and diplomats gathered at Hotel President Wilson in Geneva to celebrate UNITAID’s 10 years of innovation in global health (Video: François Glatz for UNITAID):
Dr Raymonde Goudou Coffie, the Ivorian Minister of Health and the Fight against HIV/AIDS, congratulated UNITAID on work that has helped West Africa, praised its innovative financing model, and
urged the organisation to continue to innovate to beat the three diseases. “Now is the time to act, to research and to put vaccines in place,” she said. “The fight continues.” Ivory Coast is using mobile technology to deliver health services, setting a good example for many African countries.
Dr Peter Kumpalume, the Minister for Health of Malawi, listed the top innovations that he would like to see for healthcare in his country. “If we could find a means of eliminating malaria quickly and cheaply, that would be number one,” he said. “Number two would be a test-kit for tuberculosis which is as quick as the Rapid Diagnostic Tests for malaria we currently have.” Kumpalume added that innovation was needed for shorter TB treatments.
Jim O'Neill of the Review on Antimicrobial Resistance called for the reform of our use of antibiotics, warning against using them "like sweets". He called for banning the use of antibiotics in agriculture, reminding us that 70 % of antibiotics prescribed in the US are for animals. Lord O'Neill also said that the world needs state-of-the-art diagnostics to prevent unnecessary use of antibiotics.
After O'Neill's presentation on Antimicrobial Resistance, UNITAID chair Philippe Douste-Blazy took the stage to speak of UNITAID's success over 10 years.
Brazilian minister Celso Amorim, who will soon take over as UNITAID chair from Philippe Douste-Blazy, was there.
GENEVA, 22 March 2016 – Today UNITAID published an updated “disease narrative” for tuberculosis – a rigorous analysis of the context surrounding the disease – to help guide its investments.
A primary goal of UNITAID is to identify how it can best contribute to the global response with carefully targeted investments that help, for example, to overcome specific obstacles such as high prices for medicines that show promise.
These “areas for intervention”, pinpointing where UNITAID’s investments can most effectively help advance global health goals to end tuberculosis, are the building blocks of our work. They also enable our partners to achieve more with scarce resources.
Geneva, 27 November 2015: UNITAID today released its 2015 HIV/AIDS Diagnostics Technology Landscape that summarizes the latest products and technologies to detect, stage and monitor HIV infection. The Landscape covers technologies including instruments for laboratories, multi-purpose platforms and innovations at points of care to diagnose infants and to monitor viral load and CD4.
26 February 2015 - Global health partners met in Geneva to begin the process of building a new approach to better determine health needs and constraints and addressing them in countries.
The new framework, the Equitable Access Initiative, aims to better inform international decision making processes on health and development, particularly where they rely on traditional gross-national-income classification as a measure of where to invest global health resources.
UNITAID signs grant with MSF to spur action
Geneva. 12 February 2015 - UNITAID’s newly published analysis on the rapidly changing medicines market for hepatitis C [PDF, 2 MB] indicates four routes by which recently developed but currently prohibitively expensive medicines can be made affordable and available for widespread use. There are up to 150 million infected worldwide with this curable disease, and up to 700,000 deaths each year from related liver disease. The new medicines could be game-changers for the fight against the disease if made widely available. UNITAID has already started working with Médecins Sans Frontières (MSF) to demonstrate the feasibility of treating hepatitis C with these new medicines in resource limited settings, including through reducing prices.
Diagnosis and screening currently too complex and expensive, but new options emerging
Geneva – January 2014. UNITAID’s review of testing technologies for hepatitis C (HCV) published today, finds that although current diagnosis and screening options for the disease remain too complex and expensive for widespread scale up, there are some emerging technologies which could change this situation. The new report, Hepatitis C Diagnostics Technology Landscape [PDF, 4 MB], follows an initial scoping report released in 2013 that explored the many issues and challenges related to HCV treatment and diagnosis. The new landscape report identifies several simpler tests which will enable diagnosis and monitoring closer to the point-of-care with the patient. Some of these are expected to reach the market later this year.
- New Vector Control Products Urgently Needed to Combat Insecticide Resistance, UNITAID Report Warns
- UNITAID Finds Affordability, Availability and Demand Slow Access to HIV Prevention Products
- UNITAID’s EXPAND-TB and TBXpert MTB-RIF Projects Detect Over A Quarter of all MDR-TB Cases
- Support Builds For Japan’s Adoption of the Air Ticket Levy at the Terashima Commission
- UNITAID Tuberculosis Medicines Technology and Market Landscape (Second Edition)