The Medicines Patent Pool and Roche have signed an agreement to increase access in 138 developing countries to Roche’s valganciclovir, a key oral medicine to treat cytomegalovirus (CMV), a viral infection that can cause blindness in people with HIV, by making it up to 90% cheaper than current prices. The companies also will enter into licensing and technology transfer negotiations to encourage the development of internationally approved quality generic versions of valganciclovir.

The most widely used treatment for CMV in developing countries requires injections directly to the eye, which can be painful and also difficult to administer on a large scale.

“There is a vicious cycle with CMV: since the current treatment options are either unaffordable or inconvenient, HIV clinics rarely screen for the disease. Because clinics rarely screen for CMV, there is little demand for treatment and therefore little demand for easier to administer, affordable solutions. As a result, preventable blindness continues to occur in people living with HIV, especially in Asia,” said Dr. David Heiden, a CMV expert working with Seva and Pacific Vision Foundations.

“CMV infection occurs when people have severely weakened immune systems. With timely initiation of antiretroviral therapy, HIV-related CMV has almost disappeared in developed countries, but in resource-limited settings many people still are not getting treated or start treatment late,” said Dr. Nathan Ford, of the World Health Organization (WHO) HIV/AIDS department.

The Medicines Patent Pool will also work with other key stakeholders to develop long-term treatment strategies for scaling up the use of valganciclovir for treatment of HIV-related CMV in developing countries.

In addition, the companies have agreed on the licensing of the antiretroviral saquinavir, if a significant medical need is identified. The WHO recommends saquinavir as an alternative ARV in special situations and where other preferred treatments are not available.