Negotiating public-health driven licences is the core work of the Medicines Patent Pool, and is based on an assessment of needed HIV medicines from both a clinical perspective and in terms of where patents may post barriers to generic competition.

To date, the MPP has secured licences for eleven WHO preferred first-line and second-line treatments for both adults and children over three years of age: lopinavir/ritonavir (LPV/r) for paediatric use, tenofovir alafenamide (TAF), dolutegravir (DTG) for both paediatric and adult care, atazanavir (ATV), tenofovir disoproxil fumarate (TDF), emtricitabine (FTC), elvitegravir (EVG), cobicistat (COBI), abacavir (ABC) for paediatric use and darunavir (DRV).

The MPP has also sub-licensed to generic manufacturers, who are already beginning to produce and supply HIV medicines at a lower cost. As of January 2015, the Medicines Patent Pool had signed sub-licensing agreements with ten key generic manufacturers: Aurobindo Pharma Limited, Cipla, Desano, Emcure Pharmaceuticals, Hetero Labs, Laurus Labs, Micro Labs, Mylan, Shasun Pharma Solutions and Shilpa Medicare.

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