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Co-creating a collaborative resource to guide the development of long-acting therapeutics for low- and middle- income countries

This project is a collaboration between CELT Global Health, Liverpool School of Tropical Medicine and LVCT Health Kenya. Together, we aim to support the development of practical, person-centred long-acting treatments for chronic infectious diseases in low- and middle- income countries (LMICs). The project is funded by global health agency Unitaid, with the goal to co-create a resource developed with country partners, experts, and end users, that helps developers apply implementation science in designing and delivering long-acting formulations for diseases such as tuberculosis (TB) and hepatitis C virus (HCV). Systematic and grey literature review will inform our understanding of current knowledge and resources available. This will guide and shape qualitative and participatory research, which will explore the perceptions of communities and health workers and assess health system readiness to adopt these innovations, in order to co-create a practical resource for product developers to support them to design and deliver long acting therapeutics in LMICs.

Project overview

Health conditions that require ongoing treatment remain a significant public health challenge in LMICs, where healthcare systems often face resource constraints. These conditions, ranging from infectious diseases, such as malaria, tuberculosis (TB) and hepatitis C virus (HCV) to non-communicable diseases disproportionately affect children, poor and marginalized communities, people who use drugs, and individuals living with HIV. In many cases, LMICs bear the overwhelming majority of global disease burden, with 95% of TB cases and 75% percent of HCV cases occurring in these settings (Unitaid).

Treatment adherence is a critical determinant of health outcomes. Inconsistent or incorrect use of medicines undermines treatment effectiveness, resulting in continued illness, disease transmission and increased mortality. Poor adherence also fosters drug resistance, which is a major impediment to global efforts to control epidemics such as malaria, TB and HIV/AIDS (Unitaid).  In response, long-acting therapeutics, administered through injections, patches, or implants, offer sustained drug release over weeks or months, potentially improving adherence, reducing treatment failure, and easing the operational and financial pressures on healthcare systems (Sabaté, Gupta et al.; Scarsi et al.).

Despite the potential advantages of long-acting therapeutics, their acceptability and feasibility in LMIC settings are not well understood (Chaudri). Factors such as healthcare infrastructure, patient preferences, cultural beliefs, and logistical challenges may affect the successful implementation of long-acting therapeutics in these regions (Reach). Assessing the perceptions of both healthcare providers and patients is critical for understanding the barriers and facilitators to the adoption of long-acting therapeutics.

Therefore, this study aims to better understand community and health workforce perceptions of long-acting therapeutics for managing chronic infectious diseases in LMICs, through a qualitative systematic review and a series of qualitative and participatory methods. These findings will then be used to co-create a toolkit to be able to conduct a readiness assessment of LMIC health systems to implement long-acting therapeutics for chronic infectious diseases of poverty.

Objectives

  • Understand the existing resources and tools available to support product developers in developing suitable long-acting therapeutics for use within LMIC settings, and what additional resources or guidance would be necessary to support the product development 
  • Understand the existing evidence base regarding the acceptability and feasibility of using long-acting therapeutics for the management of conditions in LMICs from the perspective of health workers and patients, through a qualitative systematic review
  • Assess health system, provider, and community understanding and readiness for the adoption and delivery of long-acting therapeutics for infectious diseases of poverty in Kenya through qualitative and participatory methods
  • To develop a practical resource for product developers to be informed by implementation science approaches, to support them in designing and delivering usable long-acting therapeutics for chronic infectious diseases of poverty in LMIC settings.

Awarding body

The Unitaid logo is the organisation name written above the words

 

 

 

 

(2020-38-LONGEVITY)