In a global reach out, scientists across the globe have urged pharmaceutical giants and governments of the world to distribute monoclonal antibodies that are used to treat life-threatening diseases in middle and low-income countries. Lab-made proteins which imitate natural antibodies in the body are known as monoclonal antibodies. These antibodies target special cells such as cancer cells and protect them against viruses and bacteria by generating a special immune response.
The first monoclonal antibody was licensed about 30 years back. To this day, 120 monoclonal antibodies have been identified to treat several chronic and life-threatening diseases. These include cancer, autoimmune diseases, infections, and even COVID-19. You’d be surprised to know that over 80% of monoclonal antibodies in the world are produced in the US and Canada. Out of this only, 20% are sold to countries accounting for 90% of the world population.
Wellcome, an independent global health foundation, and the international AIDS vaccine initiative (IAVI) said, “India is one of the best case scenarios among middle-income countries, but still the only fraction of products available in the US are available in India. In fact, no monoclonal antibody treatments for cancer are available in the public health system.”
Are These Antibodies Used and Produced in India?
Just last month, the DCGI allowed the use of itolizumab as an emergency treatment drug for COVID-19. This drug is a monoclonal antibody that has been employed since 2013 to treat severe cases of psoriasis. Another monoclonal antibody drug Tocilizumab is undergoing trials for its effectiveness against COVID-19. This drug is usually given to rheumatoid arthritis patients.
Dr. Arvinder Soin, National Lead, Indian multi-center trial on Tocilizumab, and Chairman of Medanta Liver Institute, Medanta, Gurugram, said, “Tocilizumab is approved to treat COVID-19 in patients whose condition is worsening, and the trial will also evaluate whether the drug will prevent the progression of the stable moderate disease to severe COVID-19 needing oxygen and ventilation. We have already recruited 138 patients of 180 for the Tocilizumab trial, which is being done across 14 hospitals in different cities. The majority have a moderate disease with some severe cases. The trials are going fine.”
Monoclonal antibodies are used across the globe to treat severe diseases such as cancer, Ebola, HIV, etc. But they’re also one of the most expensive pharmaceutical products and therefore, are inaccessible to most of the world population.
Dr. Pramod Kumar Jhulka, Senior Director of Max Institute of Cancer Care, and former professor and dean at AIIMS, Delhi, said, “Monoclonal antibodies are used for immunotherapy and antibody-drug conjugates to treat several cancers including melanomas, cancers of head and neck, urinary bladder, stomach, esophagus, and many others. But they are very expensive with each injection- usually given once every three weeks- priced at around Rs. 3 lakhs. They are not available in the public sector in India.”
Ways to Make Monoclonal Antibodies More Accessible:
The report highlights four ways to increase the distribution of monoclonal antibodies to the low income and middle-income countries:
- Increase the awareness and advocacy of the potential of monoclonal antibodies in treating severe diseases.
- Healthcare unions must develop ways to develop an expanded policy and pathways of regulation to increase the availability of monoclonal antibodies.
- Promote the application of the latest technologies to bring down the production costs.
- Bring more innovative market approaches and business plans to the table for expansion.