Our Commitment to Eliminating Visceral Leishmaniasis and Deaths from Cryptococcal Meningitis
Gilead’s work to address neglected tropical diseases (NTDs) began over three decades ago when we launched our partnership with the World Health Organization (WHO) provide our therapy for the treatment of visceral leishmaniasis at a no-profit price in low- and middle-income countries where it is highly endemic. Moreover, in 2022 the WHO published guidelines that strongly recommend this medicine as part of the preferred regimen for the treatment of HIV-related cryptococcal meningitis. As a result, we expanded our global access program to include treatment of HIV-related cryptococcal meningitis as well.
What is VL?
Visceral leishmaniasis (VL), or kala-azar, is one of the most dangerous NTDs globally. If left untreated, it is fatal in more than 95% of cases. Between 200,000 and 400,000 new cases of VL are diagnosed every year and it is most prevalent in low- and middle-income countries (LMICs). In 2020, more than 90% of new cases reported to the WHO occurred in Brazil, China, Ethiopia, Eritrea, India, Kenya, Somalia, South Sudan, Sudan and Yemen. VL is particularly dangerous for people living with HIV, as co-infections have been linked to accelerated HIV replication and higher mortality rates.[1]
What is CM?
Cryptococcal meningitis (CM) is an opportunistic fungal infection that is a leading cause of death in HIV-infected adults, accounting for 19% of global HIV-associated mortality. More than 214,000 new cases are diagnosed each year, primarily in sub-Saharan Africa. The estimated one-year mortality of people living with HIV who are treated for CM is 70% in low-income countries, compared to 20% to 30% in high-income countries.
Our Role
Access Pricing
Since 1992, we have partnered with the WHO and other groups to make our treatment available at discounted prices in LMICs. Gilead also works with Médecins Sans Frontières and Unitaid to build capacity to prevent, diagnose and treat VL. As an original signatory of the 2012 London Declaration on NTDs, Gilead has been working alongside international health organizations, patient groups and other private-sector partners to eliminate NTDs. In 2022, we reaffirmed our commitment to these efforts by signing the Kigali Declaration, an important milestone in the WHO’s 2030 roadmap for the prevention, control and elimination of NTDs.
Donations of Medicine to Treat Visceral Leishmaniasis
We work with the WHO to connect individuals in areas with heavy burden of VL to access to medicine. Between 2011 and 2021, Gilead donated more than 825,000 vials of our medicine and contributed more than $50 million in funding to eliminate VL in endemic countries. Through this partnership, nearly 2,000 health workers have been trained to treat VL in 28 countries.
In 2023, we signed another agreement with the WHO to donate more than 300,000 vials of our medicine. The renewed collaboration, estimated at a value of $11.3 million, also includes financial assistance that will support improved coverage and access to screening in countries such as Bangladesh, Ethiopia, Eritrea, India, Kenya, Nepal, Somalia, South Sudan, Sudan, Uganda and Yemen.
Progress to Date
Our three decades of collaboration with the WHO’s VL program has enabled previously endemic regions in India, Nepal and Bangladesh to make significant progress toward elimination. As a result of the partnership with the WHO, VL morbidity in Southeast Asia has been reduced by more than 82% and case fatality has decreased by 95%.
Expanding Efforts to Help Eliminate Cryptococcal Meningitis
We’re committed to partnering with international health organizations to develop frameworks that will help countries eliminate CM. For example, Gilead intends to work alongside the Eswatini Ministry of Health, the Mycotic Diseases Branch in the U.S. Centers for Disease Control and Prevention, Integral Global Consulting and Georgetown University Center for Global Health Practice and Impact to treat CM as part of routine, government-led HIV programming and reduce CM deaths in Eswatini.
References
[1] HIV AIDS (Auckl). 2018; 10: 193–201. Published online 2018 Oct 15. doi: 10.2147/HIV.S143929