Unitaid invests in revolutionary long-acting medicines Unitaid News – 31 January 2020


1. Unitaid forms new partnerships to develop long-acting formulations of medicines

2. Two billion bed nets and counting

3. In brief: pneumonia, cervical cancer and more

Unitaid enters the race to develop long-acting medicines

Unitaid has invested heavily in improving the drugs used to fight world epidemics. With two grants signed this week, Unitaid is taking that work a step further by making key medicines much easier for patients to take and for clinicians to administer.

The initiatives with the University of Liverpool and the University of Washington are not creating new medicines, but rather transforming treatments that already exist in pill form into long-acting injectable formulations that need to be taken far less often.

Long-acting technologies hold the potential for greatly improving patients’ adherence to medicines, which should lead to a greater number of successful treatments, less spread of diseases and fewer preventable deaths, global health experts say.

“Also, from a supply-chain perspective, it’s super exciting,” Unitaid Program Manager Kate Hencher said. “In cases where treatment is required for life, or where administering drugs is particularly complex, these new products could offer a wonderful solution. Instead of needing truckloads of pills, treatment or prevention could be effective for months after a single injection. That’s where this is going. That’s how big it is.”

University of Liverpool’s LONGEVITY project, funded by a US$ 32 million Unitaid grant, will develop long-acting formulations to prevent malaria and TB, and to cure hepatitis C. University of Washington’s GLAD project, with about US$ 7 million in Unitaid support, is repurposing oral HIV treatment into a long-acting injectable.

Principal investigator for the LONGEVITY project is Andrew Owen, professor of pharmacology at the University of Liverpool. He answered some questions about long-acting medicines:

Andrew Owen, professor of pharmacology at the University of Liverpool

Q: How do long-acting injections work compared with pills?

A: Instead of giving the drug orally you inject it into the muscle or into the subcutaneous tissue between the skin and the muscle. The formulation then gradually releases the drug into the bloodstream over a period of between one and six months.

Q: Can you tell us about the history of long-acting medicines?

A: The concept has been around for a long time. Surprisingly, the first publication about a long-acting injectable was back in 1953. Since the early 2000s there have been major advances for long-acting injectable contraception and treatments for schizophrenia. Just about ten years ago, in 2009, there were reports of long-acting injectable formulations for HIV, which is where the concept got introduced to infectious diseases in a big way. Our project aims to develop long-acting medicines for other infectious diseases that have a major burden in low- and middle-income countries.

Click here to read the full interview

Two billion bed nets and counting

Unitaid joined the global malaria community this month to mark the distribution of the two-billionth insecticidal mosquito net, highlighting one of the most effective tools for preventing malaria. Insecticide-treated mosquito nets placed around beds are credited with saving more than 7 million lives and preventing more than 1 billion cases of malaria from 2000 to the present. The commemoration also drew attention to the need for investment in innovative tools and methods—a core Unitaid activity--to end the world malaria epidemic by a 2030 global target.

Unitaid and the Global Fund are jointly funding the US$ 66 million New Nets Project (2018-2022), implemented by the Innovative Vector Control Consortium, which is putting new versions of insecticide-treated nets to the test. The project hopes to demonstrate that the new nets can protect against mosquitos that have grown resistant to older insecticides.

“We know that the scale-up of long-lasting insecticidal nets has been a key factor in the progress we have made against malaria since 2000,” said Ali Cameron, senior technical manager on Unitaid’s strategy team. “To have reached such widespread distribution is an incredible achievement, one worth celebrating. Going forward we need to continue to pursue maximum coverage of those in need, while also thinking about innovations in nets that can address major challenges such as insecticide resistance.”

Two recent studies, one by the World Health Organization and another by The Lancet, cited innovation, research and development as indispensable factors for eliminating malaria.

Unitaid is investing in other promising vector-control tools, including new insecticides for indoor spraying, spatial repellents that drive mosquitoes from populated areas, and antiparasitic drugs that kill mosquitoes after they bite humans or livestock treated with the drug. Unitaid is also supporting the new RTS,S malaria vaccine and investing to break down barriers to better medicines for severe malaria. In December, Unitaid issued a call for proposals to increase malaria prevention for infants in the wake of its highly successful ACCESS-SMC project.

Unitaid is gearing up to launch projects that will develop long-acting medicines against malaria and bring single-dose treatment to the fight against Plasmodium vivax, the parasite that causes the second most common type of the disease.

Watch the video on the two-billionth bed net:

In brief:

Pneumonia: Unitaid is co-sponsoring the first Global Forum on Childhood Pneumonia this week in Barcelona. Pneumonia is the single biggest infectious killer of children, claiming more than 800,000 lives every year, and the conference aims to find practical pathways that governments and their partners can use to combat it. On Wednesday, Unitaid launched two initiatives to provide easy-to-use pulse oximeters to frontline health workers in Asia and Africa. The devices are small, portable, and can detect low oxygen in the blood, a sign of life-threatening illness. The new projects, with partners ALIMA and PATH, will pilot the use of pulse oximeters that can address childhood mortality from multiple causes--pneumonia, diarrhea and malaria among them.

Cervical cancer: Unitaid launched its newest screen-and-treat initiative to fight cervical cancer at a December event in Abidjan, Côte d'Ivoire. The SUCCESS project will be implemented by Expertise France in Burkina Faso, Côte d'Ivoire, Guatemala and the Philippines. The official signing by Unitaid Board Chair Marisol Touraine and Deputy Executive Director Philippe Duneton with Expertise France Director-General Jérémie Pellet, in the presence of French Health Minister Agnès Buzyn and representatives of the Côte d'Ivoire Ministry of Health, coincided with French President Emmanuel Macron’s visit to the country. SUCCESS brings Unitaid’s recent investments in cervical cancer to US$ 60 million. The disease disproportionately affects women in lower-resource settings and women living with HIV. Unitaid’s projects are focused on detecting cervical lesions caused by the human papillomavirus and treating them before they can turn into life-threatening cancer.

Special visitors: A delegation from Norway including Development Minister Dag Inge Ulstein and Ambassador to the United Nations Hans Brattskar visited the Global Health campus to meet with Unitaid, the Global Fund and Gavi. Talks with Unitaid focused on fever management, cervical cancer, tuberculosis, equity and access to medicines, as well as reproductive, maternal, newborn and child health.

Future projects: Deadlines are approaching for two calls for proposals that were issued by Unitaid late last year. Project proposals to help eliminate congenital Chagas disease infection are due by 27 Feb., and proposals to expand malaria chemoprevention for infants are due by 11 March.