Multipurpose prevention technologies (MPTs)

Overview

Multipurpose prevention technologies (MPTs) are interventions that offer concurrent protection against pregnancy, HIV and/or other STIs in a single product, such as a drug, biologic, microbicide, device or combination. By combining prevention methods into products designed for user-controlled administration, MPTs offer the potential to streamline and democratise preventive healthcare, reducing health provider visits and putting options in the hands of those who need them. However, much of this research remains in its early stages. There is growing interest in diverse formulations, which cater to end-user preferences for discreet, user-controlled and/or long-acting options. These technologies are especially useful in LMICs, where addressing multiple indications at once, in a convenient user-centric design, would help to address health risks in particular populations and regions.

Unmet needs

Further development of diverse MPT options is essential to improve global SRH outcomes, with condoms currently the only genuine MPT available.  Long-acting delivery systems such as subdermal implants, vaginal rings, and injectable formulations, as well as on-demand gels, fast-dissolving inserts and pills have shown promise in studies. However, most remain at the early stages of development. Collaboration across academic, biotech, and pharmaceutical sectors is crucial to overcoming the challenges to creating effective, widely available MPT solutions.

Funding

Funding for MPTs peaked in 2018 when we first began collecting data and decreased in both 2022 and 2023, falling from nearly $60m in 2021 to just $29m in 2023, its lowest ever level of funding.

Both the 2018 and 2021 peaks, and the subsequent declines were the result of changes in industry’s microbicide funding, the latter following failed product trials. Despite a partial rebound in 2021, industry funding has now fallen by more than 99% from its peak of nearly $46m in 2018, after the failure of a leading industry candidate.

In industry’s absence, the US NIH has become the dominant funder, responsible for a little over half of the non-industry total. USAID provided most of the remaining funding – a total of $34m over six years – making it the only other funder to invest more than $10m (across all years) in MPT R&D. As things stand, after the dismantling of USAID, none of this funding is slated to continue past 2025, further reducing the already critically small number of significant investors.

In 2022 and 2023, around a third of contraceptive MPT funding was invested in devices and device/drug combinations – mostly intravaginal rings – leaving it as the largest product area following the drop in industry’s microbicide funding.

Biologics funding grew from nothing to $1.6m in 2022 and then doubled in 2023 to $3.3m – by far its highest level of funding ever. This sharp growth in biologics-based MPTs was mainly thanks to new US NIH funding for antibody-based contraceptive MPTs, which leverage monoclonal human contraceptive antibodies (HCAs) – naturally occurring antibodies with strong sperm-agglutinating and -immobilising activity.

In contrast to contraceptive R&D, funding for MPTs, which are non-hormonal and user-controlled, has both fallen, with both categories down by more than $40m since 2018. This doesn’t appear to reflect the intended role of MPTs and is mostly due to a handful of reductions in industry funding for microbicides (which are typically both non-hormonal and user-controlled) rather than a deliberate shift in priorities. Funding for hormonal products is basically unchanged since 2018, while there has been substantial growth in non-user-controlled options, mostly Gates- and NIH-backed multi-purpose implants and injectables. Funding across all product areas also remained exclusively for female-targeted products, with zero reported funding for R&D targeting male-focused MPTs to date.

With the decline in industry funding, which focused on prevention of STIs other than HIV, around three-quarters of the remaining MPT investment was indicated for dual protection against pregnancy and HIV. Most of the other 2023 funding went to MPTs targeting HIV alongside other STIs, with very little for either HIV-specific or non-contraceptive (targeting HIV and other STIs) MPTs.

With such a small pipeline of products in development (only 21 as of 2025 and just five in clinical trials), and without ongoing USAID funding, and potential further reductions in US government funding, this area of research is now seriously under threat, and an absence of new products likely to continue.

Funding for MPTs

Product landscape & pipeline

The iMPT Product Development Database – available here – is an interactive database of the R&D pipeline for MPTs. It is coordinated by iMPT, a project of CAMI-health.