Assessing the Impact of Alternative Patent Systems on the Cost of Health Care: The TPPA and HIV Treatment in Vietnam. Moir H V J, Tenni B, Gleeson D and Lopert R. (2014)

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In the Trans Pacific partnership Agreement (TPPA) negotiations, the United States has proposed expanded patent protections that will likely impact the affordability of medicines in TPPA partners. This includes antiretroviral (ARV) medicines used in the treatment of HIV/AIDS. Vietnam has the lowest GDP per capita of the 12 countries participating in the TPPA negotiations. Using the current Vietnamese patent regime as our base case, we analyse the potential impact of alternative patent regimes on access to ARVs in Vietnam. The two other scenarios investigated are a patent regime making full use of TRIPS flexibilities, and a regime based on the US proposals in the 2014 leaked draft of the TPPA intellectual property chapter. Using World Health Organization (WHO) treatment guidelines, we identified the most commonly used chemical entities and combinations used in the treatment of HIV. We examined patent data sets to discover patents that had been registered for these medicines and used information from examination of these patents to identify which might be granted under alternative patent regimes. We then drew on the empirical literature to estimate prices under the three patent scenarios. The current ARV budget was used as a constraint, with the consequence that the results focus on the impact of alternative patent regimes on access to treatment. Our results indicate 82% of the HIV population eligible for treatment would receive ARVs under a full TRIPS flexibility scenario, while only 30% of Vietnam's eligible HIV patients would have access to ARVs under the US 2014 TPPA proposals – more than halving the proportion treated compared to the current 68% receiving treatment. Similar price impacts can be expected for other countries participating in the TPPA, though these are less economically vulnerable than Vietnam.

 


Keywords: TPPA, patent policy, trade policy, access to medicines, Vietnam

 

 

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Challenges and Potential Barriers to the Uptake of Antiretroviral-based Prevention in Asia and the Pacific Region. Lo YR, Kato M, Phanuphak N, et al (2014)

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Evidence has emerged over the past few years on the effectiveness of antiretroviral-based prevention technologies to prevent (i) HIV transmission while decreasing morbidity and mortality in HIV-infected persons, and (ii) HIV acquisition in HIV-uninfected individuals through pre-exposure prophylaxis (PrEP). Only few of the planned studies on treatment as prevention (TasP) are conducted in Asia. TasP might be more feasible and effective in concentrated rather than in generalised epidemics, as resources for HIV testing and antiretroviral treatment could focus on confined and much smaller populations than in the generalised epidemics observed in sub-Saharan Africa. Several countries such as Cambodia, China, Thailand and Vietnam, are now paving the way to success. Similar challenges arise for both TasP and PrEP. However, the operational issues for PrEP are amplified by the need for frequent retesting and ensuring adherence. This paper describes challenges for the implementation of antiretroviral-based prevention and makes the case that TasP and PrEP implementation research in Asia is much needed to provide insights into the feasibility of these interventions in populations where firm evidence of 'real world' effectiveness is still lacking. 

 

Keywords: Cambodia, China, pre-exposure prophylaxis, Thailand, treatment as prevention, Vietnam

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Ambitious Treatment Targets: Writing the Final Chapter of the AIDS Epidemic. UNAIDS. (2014)

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By 2020, 90% of all people living with HIV will know their HIV status. By 2020, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy. By 2020, 90% of all people receiving antiretroviral therapy will have durable viral suppression. When these targets are achieved, at least 73% of all people living with HIV worldwide will be virally suppressed—a three-fold increase over current estimates of viral suppression. Modelling demonstrates that achieving these targets by 2020 will enable us to end the AIDS epidemic by 2030.

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A Review of the AZD5847 Patent Landscape: A Scoping Report. Amin T. (2014)

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AZD5847 belongs to the oxazolidinone class of compounds, which function as protein synthesis inhibitors and were first discovered in the mid- 1980s. Linezolid was the first compound of the oxazolidinone class to be approved for marketing and is most commonly used to treat drug-resistant TB. However, the use of linezolid has been limited by toxicity concerns, particularly haematological effects after periods of treatment over 14 days.

AZD5847 (previously referred to as AZD2563, generic name posizolid) is a modified analogue of the linezolid compound. AZD5847 was originally designed for treatment of gram-positive infections but was subsequently repurposed as an anti-TB agent. Like linezolid, AZD5847 has a bactericidal effect against mycobacterium TB in macrophages as well as in murine models of acute and chronic TB infection.


Keywords: HIV, TB, treatment, drugs

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Diagnostics Access Initiative to Achieve Final HIV Treatment Targets. UNAIDS, WHO, the Clinton Health Access Initiative, et al. (2014)

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The world is uniting around a final set of treatment targets to lay the groundwork to end the AIDS epidemic as a public health threat by 2030. Through national, regional and global-level consultations, diverse stakeholders are pledging to ensure that by 2020.

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A Review of the Bedaquiline Patent Landscape: A Scoping Report. Amin T. (2014)

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The patent landscape in Annex I of this report sets out the key patents and patent applications for bedaquiline, including their geographical patent coverage, as of June 2011. While every effort has been made to obtain comprehensive and accurate information on the status and geographical scope of the patents covering bedaquiline, in many countries patent information is not readily available to the public or not updated on a regular basis. In addition, some patent applications may have been published only after the searches were conducted. As such, there may be other relevant patents which have subsequently been published and which are not included in this landscape. Accordingly, the information provided herein is subject to the above disclaimers.

 

Keywords: HIV, TB, drugs, treatment, coverage

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Hepatitis B Vaccination. Department of Health, Hong Kong. (2014)

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Hepatitis B is a potentially life-threatening liver disease caused by hepatitis B virus (HBV). HBV is found in blood and body fluids of carriers. 

 

It has an incubation period of 6 weeks to 6 months. During the acute infection phase, most people do not have any symptoms. If symptoms occur, they may include yellowing of the skin and eyes (jaundice), mild fever, tiredness, nausea, vomiting and abdominal pain. Approximately 5-10% of adults and 70%-90% of infants infected are unable to clear the virus, thus becoming chronic carriers. About a quarter of the chronic carriers might develop chronic liver damage including cirrhosis and liver cancer.


Keywords: Hong Kong, hepatitis B, prevention, vaccine

 

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An Ambitious Treatment Target to Help End the AIDS Epidemic. UNAIDS. (2014)

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HIV treatment is a unique tool in the AIDS response, preventing illness and death, averting new infections and saving money. As hopes for ending the AIDS epidemic depend  in large measure on the world’s ability to provide HIV treatment to all who need it, in a rights-based approach, final targets for universal treatment access are critical.

 

Keywords: HIV, coverage, testing, antiretroviral therapy (ART), antiretroviral drugs (ARV), key populations, 90-90-90

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A Review of the Delamanid Patent Landscape: A Scoping Report. Amin T. (2014)

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Delamanid was discovered via a screening programme carried out by Otsuka. The compound belongs to the nitroimidazole class of compounds and is a derivative of compound CGI-17341 whose anti-TB activity was already reported in 1993.4 Indeed, various 5- and 2-nitroimidazoles and 5-nitrofurans were already known to be effective against a variety of protozoan and bacterial infections in humans and animals. For example, the published international patent application WO 97/01562 previously disclosed a 6-nitro- 1,2,3,4-tetrahydro[2,1-b]-imidazopyran compound with bactericidal action in vitro to mycobacterium TB.

 

Keywords: HIV, TB, pediatric, testing, drugs, treatment

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Hepatitis C Silent Killer Behind HIV. Department of Health, Hong Kong. (2014)

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In Hong Kong, the estimated HCV prevalence in general population is around 0.3%.

 

In the last decade, there have been increasing overseas reports of acute HCV infections via sexual transmission in men who have sex with men (MSM), especially those who were HIV positive. Locally, the prevalence of HCV in the HIV infected MSM seen at the Department of Health (DH) was found to be 1.3% for the years 2000-2012, which is 4 times that of the general population. In addition, rising trend of the infection among local HIV infected MSM has been observed in recent years. In 2013, a case series of sexually transmitted HCV infections among HIV infected MSM was found by DH.


Keywords: HIV, HCV, sexual transmission, diagnosis

 

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