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The quest for COVID-19 treatments Unitaid News - Summer 2020

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In this issue:

1. What you need to know about the quest for COVID-19 treatments

2. How new insecticides are boosting the fight against malaria-carrying mosquitoes

3. Procurement in times of COVID-19: Insights from Husain Mohd Afifi

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What you need to know about the quest for COVID-19 treatments

And how the ACT-Accelerator is expanding access to a life-saving medicine for severe cases

Exiting the COVID-19 crisis calls for one of the greatest public health collaborations in history. The world urgently needs treatments to confront the pandemic now and to prepare for potential new waves in the coming months. In the frame of the the Access to COVID-19 Tools Accelerator (ACT-A), Wellcome and Unitaid are co-leading global efforts to find, produce and deliver 245 million treatment courses in low- and middle-income countries by mid-2021.Read on to learn why therapeutics are vital to change the course of the pandemic and how the ACT-A Therapeutics Partnership is already making a difference:

A first breakthrough into tackling COVID-19 infection

There is currently a lack of approved therapeutics for COVID-19. Members of the ACT-A Therapeutics Partnership are rapidly assessing how existing medicines can be repurposed to confront the virus, and researching new treatments with emphasis on products that can be easily deployed on a large scale.

The first results of this global effort are recent findings on the potential of dexamethasone to reduce deaths among critically ill patients who are on ventilators or receiving oxygen therapy. Working with Wellcome and other partners, Unitaid and the Unicef Supply division have agreed on an initial purchase to expand access to dexamethasone in low- and middle-income countries.

Products to prevent and treat

The world urgently needs therapeutics for all stages of the COVID-19 infection. Therapeutics could protect people from infection and prevent those who are already have the virus from developing symptoms and passing it onto other people. They could also make the difference between mild and severe symptoms, short and long hospitals stays and life-long health effects, and even life and death.

The need for therapeutics —now and when a vaccine becomes available

The global roll-out of one or more vaccines will take time and may not reach full protection. This means the world will still need to test and to treat those who continue to fall ill. Research is ongoing, but accelerating the quest for medicines to prevent and treat COVID-19 requires additional resources.

Making COVID-19 therapeutics a reality

Speeding up the development of medicines, tests and vaccines for COVID-19 is a health and economic imperative, the alternative being a total global cost in the region of US$30 trillion. On the therapeutics front, the international community must provide at least US$7.2 billion in the next 12 months, of which US$3.8 billion are needed immediately, while domestic contributions should amount to at least US$4.4 billion. The investment will be channelled through 3 work streams: Unitaid will lead the work on market preparedness, costing and financing, while Wellcome and the Bill and Melinda Gates Foundation will oversee the rapid evidence assessment of candidates and The Global Fund will oversee the deployment of treatments.

Ensuring access for everybody, everywhere

In the face of pandemics, nobody is safe until everybody is safe. The package of essential products against COVID-19 must be adapted to low- and middle-income countries, and respond to the needs of people with other diseases such as HIV, TB and malaria. Equitable access to medicines, tests and vaccines could contribute to saving millions of lives and limiting the economic ravages of the pandemic.

NgenIRS: How new insecticides are boosting the fight against malaria

In only four years, the Unitaid-supported Next Generation Indoor Residual Spraying (NgenIRS) initiative with UK-based Innovative Vector Control Consortium (IVCC) has succeeded in reinvigorating the fight against malaria-carrying mosquitoes —particularly, those that have developed resistance to the most commonly used insecticides.

Alongside treated bed nets, the spraying of walls with insecticides that last for months has been instrumental in reducing malaria cases. But by 2016, the use of indoor residual spraying (IRS) had dropped by 40 percent. Mosquitos had become resistant to pyrethroid-based products and the only new insecticide in the market was expensive and did not allow for rotation, which is essential to slow down the development of resistance.

In response, the NgenIRS initiative led by the IVCC in collaboration with the US President’s Malaria Initiative, The Global Fund, Abt Associates and PATH, has paved the way for a marked increase in the use of 3rd Generation Indoor Residual Spraying (3GIRS) products, saving lives, countering resistance and easing the pressure on health systems. Here is how:

NgenIRS has reversed the downward trend in IRS use, bringing forth a significant public health impact, savings in commodity costs, and new evidence showing the cost-effectiveness of 3GIRS.
The investment is part of Unitaid's work to accelerate progress towards the global malaria goals. It also supports the commitment of 53 nations to halve cases in the Commonwealth by 2023, as announced in the Malaria Summit London in 2018.

Procurement in times of COVID-19: insights from Husain Mohd Afifi

When he graduated in Construction Contracts in Malaysia, little did Husain Mohd Afifi know what he would be helping to build were not skyscrapers but stronger health systems. A procurement specialist with WHO's Global Service Centre in Kuala Lumpur, Afifi has finished a five-month stint with Unitaid. "I got to see things from the users perspective," he says. "I now have a much better understanding of the needs and challenges users face, and of the hard work that goes behind each requisition." Especially, in times of COVID-19.

The pandemic calls for more agile and flexible procurement arrangements. Also, there is a much higher demand for certain services and goods, making supplies and expert resources harder to come by. It is the job of professionals like Afifi to make things happen, no matter what.

"Procurement officers must ensure sufficient and timely supply of the things organizations such as Unitaid and WHO need to fulfill their missions and save lives. And that —well, that is gratifying."

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