{"id":44559,"date":"2022-12-01T07:30:18","date_gmt":"2022-12-01T07:30:18","guid":{"rendered":"https:\/\/i-base.info\/htb\/?p=44559"},"modified":"2023-01-26T13:33:30","modified_gmt":"2023-01-26T13:33:30","slug":"chai-2022-report-on-global-access-to-art","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/44559","title":{"rendered":"CHAI 2022 report on global access to ART"},"content":{"rendered":"<p><b>Simon Collins, HIV i-Base<\/b><\/p>\n<p><b><img loading=\"lazy\" decoding=\"async\" class=\" wp-image-44561 alignright\" src=\"https:\/\/i-base.info\/htb\/wp-content\/uploads\/2022\/12\/CHAI-cover-208x300.png\" alt=\"\" width=\"155\" height=\"220\" \/>On 13 November 2022, Clinton Health Access Initiative (CHAI) published their annual global HIV market report, with UNITAID and the Bill &amp; Melinda Gates Foundation.<\/b><\/p>\n<p>These organisations continue to play a leading role in global access by using economies of scale and bulk purchasing agreements to negotiate lower prices for better HIV medicines in lower and middle-income countries (LMICs).<\/p>\n<p>Globally, 95:95:95 targets by 2025 are currently at 88:90:92, with COVID-19 leading to fewer HIV tests for 2019 and 2020.<\/p>\n<p>Key highlights include:<\/p>\n<ul>\n<li>Only 52% of children are on ART (880,000\/1.7 million) compared to 76% adults in LMICs.<\/li>\n<li>Only 40% on ART have undetectable viral load<\/li>\n<li>There are still 160,000 new paediatric infections each year<\/li>\n<li>Only 30% of children in LMICs access early infant diagnosis (EID) &#8211; and many children with positive results are lost to care within the next year..<\/li>\n<li>98,000 children died of HIV-related causes.<\/li>\n<li>Undiagnosed syphilis during pregnancy still causes 200,000 preventable<span class=\"Apple-converted-space\">\u00a0 <\/span>stillbirths or newborn deaths.<\/li>\n<li>Deaths from advanced HIV (AHD) are not dropping quickly enough. Although 650,000 people (11% children) died of AHD in 2021, this is only 6% per each year compared to the 20% annual drop needed to reach the 2025 target of 200,000.<\/li>\n<li>One-third of deaths are related to TB<span class=\"Apple-converted-space\">\u00a0 <\/span>(incluiding 11% of children).<\/li>\n<li>COVID-19 disproportionally affects people living with HIV, but by July 2022, only 21% of people in Africa had completed a primary course of vaccines (and coverage wanes after 6 months). CHAI and partners negotiated for a course of Paxlovid to be available for high risk patients at $25.<\/li>\n<li>Continued investment is still needed to enable access to latest and upcoming HIV drugs. Most people globally are treated with generic medicines which has a market of US$1.2 billion.<\/li>\n<li>Generic TLD (tenofovir D\/lamivudine\/dolutegravir) is now available for less than US$ 50 per year using 6-monthly 180-pack cartonless packs. (By comparison, people living in the US are often still restricted to having to get a new prescription every month).<\/li>\n<li>80% of people in LMICs now use DTG-based ART, although differentiation between first\/second-line and adult\/paediatric data are unclear, making monitoring difficult.<\/li>\n<li>Generic darunavir\/ritonavir (400\/50 mg) is now US$ 17.50 per month. This is less than lopinavir\/r although WHO still lists LPV\/r as a second-line option). This is WHO approved but not available for PEPFAR because it is expected to be FDA prequalified until 2024.<\/li>\n<li>Generic paediatric dolutegravir is<span class=\"Apple-converted-space\">\u00a0 <\/span>US$ 4.50 for 90-pill pack.<\/li>\n<li>HIV self-testing now US$ 1.00 per test for public purchasing in 140 LMICs including a dual HIV\/syphilis test.<\/li>\n<li>Generic TDF\/FTC for oral PrEP is US$ 4.00 a month.<\/li>\n<li>Point-of-care CD4 test to diagnose advanced HIV (Visitect, with a 350 c\/mm3 threshold)<span class=\"Apple-converted-space\">\u00a0 <\/span>is &lt; US$ 4.00 and available for public purchasing in 130 LMICs.<\/li>\n<li>Low pricing agreements have also been negotiated for TB preventative treatment preventive therapy three\u2010month weekly rifapentine and isoniazid (3HP) and one\u2010month daily rifapentine and isoniazid (1HP).<\/li>\n<li>Access programmes for liposomal amphotericin B (L-AmB) for cryptococcal meningitis are also being developed. This includes the important example of an FDA-approved generic biosimilar formulation of a liposomal nanomedicine.<\/li>\n<\/ul>\n<p>Information is also included on long-acting cabotegravir and rilpivirine. Also for lenacapavir and islatravir, although neither compound has been included in a generic access option.<\/p>\n<p>The report also highlights increases in global uptake of PrEP and developments for access to injectable PrEP.<\/p>\n<p>References<\/p>\n<p>CHAI 2022 HIV Market Report: The state of the HIV market in low- and middle-income countries<br \/>\n<a href=\"https:\/\/www.clintonhealthaccess.org\/webinar\/2022-hiv-market-report\">https:\/\/www.clintonhealthaccess.org\/webinar\/2022-hiv-market-report<\/a> (report )<\/p>\n<p>CHAI. Highlighting the latest updates in HIV treatment, prevention, and diagnostics<br \/>\n<a href=\"https:\/\/www.youtube.com\/watch?v=GKay_ifczWE&amp;t=70s\">https:\/\/www.youtube.com\/watch?v=GKay_ifczWE&amp;t=70s<\/a> (webinar)<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Simon Collins, HIV i-Base On 13 November 2022, Clinton Health Access Initiative (CHAI) published their annual global HIV market report, with UNITAID and the Bill &amp; Melinda Gates Foundation. These organisations continue to play a leading role in global access &hellip;<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[38],"tags":[],"class_list":["post-44559","post","type-post","status-publish","format-standard","hentry","category-treatment-access"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/44559","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=44559"}],"version-history":[{"count":12,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/44559\/revisions"}],"predecessor-version":[{"id":44684,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/44559\/revisions\/44684"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=44559"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=44559"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=44559"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}