The Gates Foundation and the Pan American Health Organization are both working on ways to make weight-loss drugs like Novo Nordisk's Wegovy and Eli Lilly's Mounjaro more accessible in lower-income countries, the global health groups told Reuters.
In separate interviews, Microsoft founder Bill Gates and PAHO director Dr Jarbas Barbosa said for the first time that their organizations were each seeking strategies to remedy the unequal availability of the highly effective but expensive treatments.
About 70% of the roughly one billion people with obesity live in low and middle-income countries which may struggle to meet the costs of tackling the epidemic and associated health problems like diabetes and heart disease.
In response to a question about the treatments, Gates said his Foundation would take any drug that was effective in high-income countries "and figure out how to make it super, super cheap so that it can get to everyone in the world".
For example, it is currently working with Indian drug manufacturer Hetero to help bring cheaper copies of a new HIV prevention drug to the market in lower-income countries for $40 a year.
Low-cost copies
From next year, the active ingredient in Novo Nordisk's blockbuster Wegovy drug, semaglutide, comes off patent in countries including China and India. Generic manufacturers are already working on low-cost copies.
The brand-name weight-loss drugs are primarily sold in wealthier countries, where prescriptions cost hundreds of dollars per month.
The Gates Foundation could also potentially support clinical trials to test how these medicines affect different populations and provide the data needed to broaden access, Gates said.
Any entry into obesity would represent a new arena for the Gates Foundation, which remains focused on fighting the deadliest diseases in low-income countries, like malaria.
Vials of Eli Lilly's Mounjaro, a tirzepatide injection drug used for treating type 2 diabetes and weight loss, are seen in a fridge at a health clinic in Hyderabad, India. (Reuters)
Obesity's role in chronic illness has created a new urgency around addressing rising global rates, although it is still not the biggest problem facing most of the countries where the Foundation operates, Gates said.
The World Health Organization estimates that the economic costs of overweight and obesity will reach $3 trillion by 2030 if nothing is done to contain it.
WHO recommended in draft guidelines this year using weight-loss drugs as an obesity treatment for adults, but criticized their manufacturers over cost and lack of availability.
Its Americas arm, PAHO, manages a fund that helps push down medicine prices by guaranteeing bulk orders on behalf of its 35 member states.
Using the fund, which is financed by the member states, is an option for weight-loss drugs, Barbosa told Reuters. He said it could also help manufacturers clear regulatory requirements rather than applying in each country for approval.
"We are starting the conversation," he said, adding that PAHO is developing recommendations for how best to use the drugs and plans to speak to Novo, Lilly and generic drugmakers within the next couple of weeks.
Eli Lilly declined to comment. Novo Nordisk said in a statement that it recognised the "unmet need" for its treatments.
"We are deeply committed to serving patients around the world," the Danish company said.