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UNITAID

UNITAID. IAS 2014. Overview of paediatric antiretroviral market : is market in shape to enable achieving targets?. . Carmen Pérez Casas. Melbourne, Australia 2014. Access to ART for children still limited. Children represent 10% of total HIV burden,

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UNITAID

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  1. UNITAID • IAS 2014 Overview of paediatric antiretroviral market : is market in shape to enable achieving targets?  Carmen Pérez Casas Melbourne, Australia 2014

  2. Access to ART for children still limited • Children represent 10% of total HIV burden, • 3.4 million children live with HIV • Global ART coverage is currently 23% (36% for adults) • Less than 1 in 4 children in need of ART receive it • 792,000 on treatment Newtargets (90*90*90) seek to multiply almost by3,5the number of children receiving ART… Or up to 4,3 times more on ART if we target for them all!

  3. Identified barriers to scale-up paediatric treatment • Inadequate political commitment • Insufficient financial resources • Policy challenges • Insufficient innovation: • in diagnostic technologies • in paediatric HIV medicines • in paediatric treatment delivery • Stigma and discrimination

  4. A small and fragmented market Donor-funded sales by stock keeping unit, 1 July 2012 – 1 July 2013 $1,009M $45M … and confined to poor nations

  5. With multiple options ... Preferred 1st-line regimen for children implies at least 2 or 3 formulations per day, and multiple options are available in the market  not yet a full-regimen FDC.

  6. … with multiple options, Donor-funded sales by pediatric product, 1 July 2012 – 1 July 2013 Five products make up 76% of sales value 3TC/ZDV/NVP 30/60/50mg accounted for 41% sales value

  7. .. and very concentrated from supply side Donor-funded sales by pediatric product, 1 July 2012 – 1 July 2013 top 12 * HerfindahlHirshman index is a commonly used measure of market concentration. When assessing mergers and anti-trust issues, US Department of Justice considers a market with an HHI > 2500 to be highly concentrated

  8. .. and very concentrated from supply side Donor-funded sales by pediatric product, 1 July 2012 – 1 July 2013 top products

  9. What prompts timely development and production of most adequate products? • Knowledge on which products and formulations are preferred • Adequate technical know-how and enabling IP landscape to produce and sell • Clear regulatory pathways to follow for timely approval • Possibility of making an adequate return in a competitive market • A forecast of future demand to plan manufacturing

  10. Great need but … No incentives Collaboration Great challenges

  11. Partnership of funders, procurers & technical bodies collaborating to improve the supply of paediatric ARVs Procurers Funders Egypt Mauritania Mali Niger C.A.R. Cameroon Observers Uganda Kenya Congo D.R.C. Tanzania Procurement Consortium Paediatric ARV Procurement Working Group

  12. Partnership to accelerate the development of adequate formulations for all children Egypt C.A.R. Cameroon Uganda Kenya Congo D.R.C. Tanzania Angola All stakeholders

  13. Thank you! Particular thanks to Patrick Aylward, UNITAID consultant

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