Article by Andrew Jack in Financial Times (15 December 2009)

Nine western pharmaceutical companies face fresh pressure to ease control over their HIV medicines following the establishment of an international mechanism designed to increase treatment access in the developing world.

The board of Unitaid, the French-backed health funding agency, voted on Tuesday to create a “patent pool” to increase the freedom of rival companies to combine and sell almost 20 antiretroviral drugs to provide greater help to patients in poor countries.

Philippe Douste-Blazy, chairman of Unitaid’s executive board, said: “This is an historic day. Unitaid has now put in place a mechanism that will make medical advances work for the poor while compensating companies for sharing their technology.”

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UNITAID EXECUTIVE BOARD APPROVES BREAKTHROUGH PLAN TO MAKE AIDS TREATMENT MORE WIDELY AVAILABLE AT LOWER COST

PATENT POOL COULD SAVE OVER ONE BILLION DOLLARS A YEAR

Geneva, 14 December 2009 — Today UNITAID’s Executive Board made a landmark decision to establish a Patent Pool for AIDS medicines.  The pool, scheduled to start operating in mid-2010, aims to make newer medicines available in patient-adapted form, at lower prices, for low- and middle-income countries.  UNITAID has committed to provide start-up funds of up to US$ 4 million over the next year.  Expected savings exceed one billion dollars a year, which will make more medicines available for more people.

“This is an historic day,” said Philippe Douste-Blazy, Chair of UNITAID’s Executive Board.

“UNITAID has now put in place a mechanism that will make medical advances work for the poor, while compensating companies for sharing their technology.”

The Patent Pool will allow generic companies to make lower cost versions of widely patented new medicines by creating a common space for patent holders to license their technology in exchange for royalties.

This will spur competition and further bring down the price of vital new and effective medicines, giving hope to millions of patients.

Companies with which UNITAID has had consultations include Gilead, Tibotec, Merck and Sequoia.

UNITAID has identified 19 products from nine companies for potential inclusion into the pool.

The pool will facilitate the development of fixed-dose combinations (FDCs).

For some years now clinical evidence has revealed that these combinations are the best way for patients to access safe, effective treatment.

Until now, patents have created barriers to developing FDCs combining newer and more effective drugs from different companies.

Today, with the first concrete step in the realisation of the Patent Pool, the door is open for new FDCs to enter the market.

“FDCs are especially important in the treatment of children, who make up 10% of current treatment needs,” said Jorge Bermudez, UNITAID Executive Secretary.

“The Patent Pool will greatly help us accomplish our mission of scaling up treatment access, particularly for specific target groups otherwise neglected by the market – that is, children and people who fail on older therapies.”

The idea of a Patent Pool has been in discussion for a number of years.

In 2006, Knowledge Ecology International and Médecins Sans Frontières proposed it to UNITAID.

Today UNITAID has become the first international body to translate this idea into reality.

“Today is a good day for people living with HIV/AIDS in developing countries,” said Nelson Otwoma, the HIV/AIDS community representative on UNITAID’s Executive Board.

“When my son was a baby we had to break pieces of adult tablets for him – treating him was guess work.

The Pool gives me hope that we’ll have better medicines to treat children in the future.”

“We’ve had enormous interest from companies and political support from numerous constituencies around the globe,” said Ellen ‘t Hoen, in charge of the Patent Pool for UNITAID.

“We’re now ready to move to the next phase – reaching agreements with companies to get the drugs out.”

A Memorandum of Understanding is being signed today at the Ministry of Foreign Affairs between Cyprus and UNITAID, said the government today.

The Memorandum was signed at 11am by Permanent Secretary of the Ministry, Ambassador Nicholas Emiliou, on behalf of the Minister of Foreign Affairs and the Chairman of the Executive Board of UNITAID, former Minister of Foreign Affairs of France Mr Philippe Douste-Blazy as well as by the Executive Secretary of UNITAID Mr Jorge Bermudez.

By signing the Memorandum, Cyprus will be actively participating in UNITAID with a contribution of 2,5 million euros, or 400,000 euros per year over a six year period.

UNITAID is an international innovative financing mechanism, set up to accelerate the treatment of HIV/AIDS, malaria and tuberculosis in developing countries. Founded in 2006 by the Governments of Brazil, Chile, France, Norway and the United Kingdom, it aims at creating ‘healthy markets for medicines’ which will facilitate access to drugs and treatments in developing countries.

By joining UNITAID the Republic of Cyprus reiterates its commitment to the Millennium Development Goals and actively contributes to international efforts to address current global development challenges, it said.

STATEMENT ON PATENT POOL SCOPE BY UNITAID CHAIR

PHILIPPE DOUSTE-BLAZY

To fulfil its mission of scaling up access to medicines in developing countries, UNITAID has elaborated an implementation plan for an HIV/AIDS medicines patent pool. That plan will be discussed for approval at UNITAID’s Executive Board meeting next week, on 14 December. In developing the plan, UNITAID has consulted widely with a variety of stakeholders, spanning from communities living with the disease to public health and intellectual property experts and pharmaceutical companies.

Given that UNITAID’s mandate is to ensure that medicines are made available according to public health needs, and particularly in countries where the disease is widespread, the Patent Pool plan aims to enable both low- and middle-income countries to benefit from the work of the Patent Pool.

In keeping with UNITAID’s constitution, the Patent Pool in no way means to replace or override other provisions contained in the Trade Related Aspects of Intellectual Property Rights (TRIPS) Agreement or the Doha Declaration on TRIPS and Public Health. The Patent Pool represents an additional tool to increase access to HIV treatment, and an opportunity for patent holders to voluntarily contribute to the attainment of crucial health-related goals endorsed by the international community.

Travelers’ Fee Can Help Fight Diseases

A United Nations program that has raised $1.2 billion over the past three years for the treatment of H.I.V./AIDS, malaria and tuberculosis through a small fee added to airline tickets sold in 15 countries is going global.

Starting in January, travelers in the United States and other countries buying airline tickets through some of the world’s largest booking companies — including Travelocity, Orbitz and other companies owned or served by Sabre, Travelport and Amadeus — will have the option of adding $2 to their cost to support the fund-raising efforts of Unitaid, which fights life-threatening diseases in poor countries.

Philippe Douste-Blazy, chairman of the organization and the under secretary general at the United Nations charged with developing new financing mechanisms for development projects, said he expected the extended program to add hundreds of millions of dollars to Unitaid’s coffers each year.

In 2006, when Mr. Douste-Blazy was the French foreign minister, he and Jacques Chirac, who was then the French president, and President Luiz Inácio Lula da Silva of Brazil conceived the idea of taxing airline tickets and subsequently persuaded 16 countries to participate — one has not yet had a chance to contribute. He said the tax currently applies to 7 percent to 10 percent of airline tickets sold and accounts for three-quarters of Unitaid’s financing. “This new program will be the first global voluntary citizen contribution system, and it comes at a very important time,” Mr. Douste-Blazy said.

He noted that government support for development aid is decreasing because of the economic crisis, which will make United Nations targets known as the Millennium Development Goals harder to achieve. The eight goals — which include reducing extreme poverty by half and providing universal primary education — were adopted in 2000 at a meeting of world leaders, but they are looking more and more elusive as the 2015 deadline approaches.

A United Nations report released last week found that donations have fallen $35 billion short of the pledges made by the Group of Eight industrialized countries in 2005. Similarly, aid to Africa has fallen $20 billion short of the total pledged.

“The consequences for developing countries are devastating, particularly for health care,” Mr. Douste-Blazy said.

The program, to be unveiled Wednesday at the United Nations under the name Massive Good, will work through various channels that people use to buy airline tickets. At the point of purchase, customers will be asked to indicate their willingness to make the contribution, while corporate travel departments will be asked to agree to add the donation to each ticket they buy for employees’ travel. Countries that have already agreed to the tax will continue to pay it.

Unitaid uses the money it raises to do what Daniel Altman, president of the consulting firm North Yard Economics, calls “innovative spending.” For instance, the partners it supports were able to use its buying power to coax drug companies to create pediatric doses of anti-retroviral medicines so parents would not have to break pills originally intended for adults.

Because Unitaid finances drugs for three-quarters of the children in the world receiving anti-retrovirals, it could guarantee a market for those drugs. Mr. Altman, who is writing a book about new types of development programs with Mr. Douste-Blazy, said, “The financing has led to much higher quality of treatments for these diseases.”

A version of this article appeared in print on September 23, 2009, on page A23 of the New York edition.

Find this article at: http://www.nytimes.com/2009/09/23/world/23surcharge.html?_r=1&scp=1&sq=unitaid&st=cse