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Multipurpose prevention technologies: Strategy recommendations to guide the most promising products from the lab to hands of women

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BACKGROUND: Multipurpose prevention technologies (MPTs) are products designed to prevent a combination of HIV, other sexually transmitted infections (STIs), and/or pregnancy. Recent results from long acting HIV prevention trials in parallel with the MPTs in the pipeline herald an exciting time for the MPT field. However, given finite resources and technical challenges to advance products from preclinical through clinical evaluation, objective benchmark criteria would be useful to identify and guide the most promising pre-clinical MPT candidates through the pipeline. This presentation describes MPTs in development and a strategy for bridging funding and development gaps.
METHODS: The Initiative for MPTs conducted the annual update of the MPT Product Development Database between February - June 2020 using the following benchmarks: availability of preclinical or clinical test results suggestive of efficacy for two or more indications (contraception, or prevention of HIV and/or other STIs). Resources used to update the database included: published peer-reviewed literature, relevant scientific conferences, product developer updates, and publicly available funding data. To guide the advancement of the most promising candidates we convened a group of experts to outline a process for establishing benchmark criteria to move promising candidates forward.
RESULTS: As of June 2020, of the 25 MPT candidates in the searchable database, most are in pre-clinical development (17/25) and combine contraception and HIV prevention (14/25). Two candidates are in late clinical stages (III or IV) of development. Several non-hormonal contraceptive MPTs are in development (7/25) as well as some with non-HIV anti-infective indications (e.g. HSV-2, chlamydia) (16/25). Delivery methods include: intravaginal rings (IRVs); dissolving inserts; vaginal and rectal gels; implants; injectables; microarray patches; and pills. To advance the most promising MPT candidates through the pipeline, the expert group recommended convening a global authoritative committee comprised of independent multi-disciplinary experts with a broad range of expertise to establish clear scientific and regulatory driven benchmarks. Products meeting these non-biased, standardized evaluative benchmarks, could then be presented to product developers and funders for further development.
CONCLUSIONS: Developing clear, standardized benchmarks for product evaluation would help expedite development of the most promising MPTs candidates and stimulate ongoing MPT support and scientific innovation.