Community Call to Action on Equitable Access to Long-Acting Therapies

CONTACT: Joelle Dountio Ofimboudem, TAG Acting HCV Director, jdountio@treatmentactiongroup.org

February 1, 2023 — The growing pipeline for long-acting therapies and their potential to accelerate various national and global disease elimination goals warrants global community mobilization to ensure equitable access to these therapies.

As communities representing vast civil society networks, and people living with and affected by various infectious and non-infectious diseases, particularly diseases requiring daily tablet/pill or injection intake across the world, we welcome the efforts leading to the development of long-acting therapies given their potential to accelerate global disease elimination goals by addressing tablet/pill fatigue, and providing choice.

We equally welcome initiatives to address current inequities in access to long-acting therapies such as cabotegravir/rilpivirine (Cabenuva) for HIV treatment, and Cabotegravir long-acting (CAB-LA) for PrEP, which are currently only available to a select few in high-income countries, through public funding to develop long-acting therapies in high volumes and at lower prices for global equitable access.

To ensure that long-acting therapies currently being developed with public funding are available to all on an equitable basis, we call on policy makers to:

Engage with communities to raise awareness about this ongoing research and development, build capacity among health advocates and activists about long-acting therapies, the options they provide to communities, and their pros and cons taking into consideration the lived experience of communities;
Adopt policies to address existing patent barriers for long-acting technologies to ensure access at affordable prices such as through the use of all necessary public health TRIPS flexibilities and the inclusion of all low-, middle- and upper-middle- income countries to benefit from licensing agreements and no restriction on the number of generic manufacturers that can join the licensing agreements;
Ensure that national laws and policies respect principles of self-determination, keep various prevention and treatment options available for communities and beneficiaries, including people in incarceration, people who use and inject drugs, men who have sex with men and other key populations, to enable them to make informed-decisions free from coercion, harassment from the police, and mandatory preconditions for prevention and treatment;
Engage with health service providers and communities to address stigma and build trust between communities and health care providers;
Begin discussions with national stakeholders, including communities, health providers and national regulators about potential regulatory changes that long-acting technologies would require so that these changes can be effectively integrated in health systems and services in a timely manner. This might include the reinstatement of previously existing delivery methods like injectables, and increased engagement between health providers and people who opt for long-acting treatment options.

We call on funding agencies and researchers to:

Address questions relating to equitable access to long-acting therapies in high-burden low- and middle-income countries at the beginning stages of the research and development process, and to encourage the use of all public health Trade Related aspects of Intellectual Property Rights Agreement (TRIPS) flexibilities such as research exemption, which allow researchers to further the development of patented technologies during the term of the patent;
Engage with clinical trial researchers to ensure the prioritization of critical, often marginalized groups, such as women, pregnant people, people with comorbidities, people with unsuppressed HIV viral loads, children and adolescents, to ensure the availability of clinical trials data for all population groups when long-acting therapies are approved and rolled-out.

We call on health advocates, communities and civil society organizations to:

Monitor patent filings and patents granted to assess possible access hurdles they may impose, and to raise awareness about their implications for the research and access to long-acting therapies;
Engage with partner organizations to develop advocacy messaging and materials on long-acting therapies to ensure that communities are aware of these options and can make informed decisions based on their preferences, needs and contexts;
Build synergies and coalitions to advocate for access to long-acting therapies at affordable prices, including developing strategies for the use of public health TRIPS flexibilities and generating demand.