Transcript MPTs for Repo Health

Multipurpose Prevention Technologies (MPTs)
for Sexual & Reproductive Health
Session Objectives
This session is designed to help you:
 Define multipurpose prevention technologies (MPTs)
 Describe 3 benefits of MPTs for women
 Describe 2 existing MPTs in use globally
 Describe at least 3 delivery systems in development
 Describe 2 major challenges for MPTs development
 Describe the general MPTs development timeline
Multipurpose Prevention Technologies
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Prevent at least 2 of the
following: unintended pregnancy,
STIs, HIV/AIDS
Should be safe & easily
available
Are designed with key input
from women for their specific
needs & preferences
Global need, regional priorities
Case Study #1: HIV in Women
• Age 33, married
• Already has 6 children
• Husband spends a significant
amount of time out of the village
and she accepts he is unfaithful
• Husband will not wear a condom
Every 60 seconds a young woman is
infected with HIV.
Global Need…
 Each year 1.7 million people die from AIDS
and 2.5 million become infected.
 1 million people contract a sexually
transmitted infection every day.
 222 million women have an unmet need
for modern contraception.
 Each day, close to 800 women in
developing countries die from complications
related to pregnancy and childbirth.
Case Study #2: Unintended Pregnancy
• Age 30, married
• Has delivered 2 children in 3
years
• Husband wants more children
• Sister died birthing her 5th baby in
7 years
222 million women have an unmet need for
modern contraception.
In the United States
 Nearly half of all pregnancies
among American women are
unintended.
 STIs are the most commonly
reported communicable diseases
in the US.
 There are18.9 million new cases
of STIs each year in the US.
14
Case Study #3: STIs
• Age 27
• Not in a committed relationship
• Currently taking oral
contraception
• Doesn’t always use a condom
1 million people contract a sexually transmitted
infection everyday.
MPTs: Historical Precedents
H2O + flouride
The pill + iron
Grains + folic acid
Currently Available MPTs
Male Condom
Female Condom
ADVANTAGES:
Available now
DISADVANTAGE: Use rates are low, difficult to negotiate
Complex Factors = Many Possibilities
Conditions
Pregnancy, HSV, HPV, HIV, BV,
Chlamydia, Gonorrhea, Syphilis,
Candida, Trich
Product Types
Vaginal film, Vaginal tablet, Oral
tablet, Vaginal ring, Non-IVR device,
Vaginal gel, Injectable, Implantable
MPT Product
Possibilities
Delivery
Methods
Topical daily, Topical pericoital,
Systemic sustained, Topical
sustained, Oral daily, Oral pericoital
Actions
HC, Non-HC, Barrier, Pro-biotic,
Antimicrobial, Antifungal, Antiviral
Why do women need MPTs?
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Healthy timing & spacing of intended pregnancies
Protection against HIV
Protection against other STIs
On-Demand Products:
Tenofovir Gel (CONRAD)
1st proof-of-concept vaginal
microbicide
 Coitally-dependent
 Confirmation trial underway
for 2014

Electrospun Nanofibers
Novel formulation of active
drugs in thin film-type
configuration
 Combination via film layering
 Vaginally administered w/o
applicator

Sustained Release Devices:
Combination Intravaginal Rings
60-day Dapivirine + LNG (IPM)
DPV + LNG
 Early development underway,
clinical studies 2015?
 Pregnancy, HIV

Nuvaring Type MPT Technology
Novel polymer/co-extrusion IVR
 Multiple API delivery
 Established scale-up
manufacturing system
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Long Acting Injectables:
TMC278LA (rilpivirine; PATH)
Injectable nano-suspension of
approved NNRTI
 Long acting: 2-3 mos (?)
 Multiple trials:
 P1 dose ranging PK;
SD/MD PK/PD
 P2 planning

GSK ‘744 (II; ViiV)
Experimental integrase inhibitor
 Dose ranging human safety P1
 NHP model efficacy studies
complete
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MPTs in the Pipeline

Small Organic
Molecules
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Broad Spectrum
Natural Products
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Proteins/Peptides
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Non-Hormonal
Contraceptives
Single & Multipurpose Vaccines
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Today: Single purpose vaccines
(HPV & HBV)
20 years: Multivalent vaccines
(HSV, HIV, Gonorrhea, Chlamydia,
Trichomonas, other STIs)
Contraceptive vaccines are not
likely
MPT Product Profile:
Working Group Recommendations
MPT PRODUCTS
HIV/STI Prevention
Unintended Pregnancy
MPT Product Development Timeline
PRE-CLINICAL
CLINICAL
MPTs roadmap is not linear
Collaboration, advocacy, & research to advance MPTs
Initiative for Multipurpose Prevention Technologies
Barriers to progress on MPTs
The time for MPTs is now
What you can do?
 SHARE – Spread the news about life saving MPTs with your
colleagues and networks.
 COLLABORATE – If you work in a related field, join the IMPT
and move research, policy, funding and education efforts forward
to save lives.
 CONTRIBUTE – Your financial and in-kind support can accelerate
MPT education, research and introduction.
 TELL YOUR STORY- Make the case for MPTs with your stories,
experiences and anecdotes by emailing [email protected].
Learn more about MPTs…
www.MPTs101.org
Questions?
Thank you!
Support for this project is made possible by the generous support of the American people through the
United States Agency for International Development (USAID) under the terms of the HealthTech
Cooperative Agreement #AID-OAA-A-11-00051, managed by PATH. The contents are the
responsibility of CAMI/PHI and its partners and do not necessarily reflect the views of USAID or the US
Government.