Safe and efficacious medicines are available for the prevention and treatment of major diseases, but their effectiveness can be compromised by poor treatment completion. Lack of adherence can worsen clinical outcomes, leading to increased mortality, persistent transmission and increased drug resistance in the case of antimicrobials and antivirals. Analyses of treatment and prevention of HIV, malaria, and TB within public health programs show wide disparities in rates of completion, especially among specific populations and regions.
Currently, most medicines in use require daily intake of oral tablets. Reasons for limited levels of adherence include: pill burden; duration of treatment (e.g., antiretrovirals (ART), maintenance phase for treatment of drug susceptible TB); stigma (e.g., treatment of TB, prophylaxis or treatment of HIV); discontinuation in access to health care for key populations (e.g. hepatitis C (HCV) treatment in people who inject drugs); and supply and programmatic issues. In addition, treatment interruptions are frequent in asymptomatic people (e.g., TB or malaria prophylaxis, HIV pre-exposure prophylaxis (PrEP) or ART).
Under this call, Unitaid is soliciting proposals to support development of long-acting products of medicines to treat and/or prevent diseases affecting LMICs, notably HIV, HIV coinfections/comorbidities, TB, and malaria, with broader consideration for management of antimicrobial resistance (AMR). Proposals should include the following elements:
- repurposing critical standard-of-care medicines into long-acting products, examples of such products may include injectables, implants, oral dosing technologies, or other;
- enabling sound commercialization to facilitate subsequent uptake and scale in LMICs for resulting products. Considerations include: capacity for adequate and quality-assured production; regulatory strategy for LMICs; licensure and pricing strategies that can facilitate introduction and broad access in LMICs. Proposals submitted should clearly demonstrate the fit with the objectives set out above, the expected impact and value for money, as well as, the complementarity to similar projects in this area.
Application Deadline: 23 April 2019