Novartis AG agreed to allow generic drug makers in seven middle-income nations to produce a leukemia treatment, the first time a voluntary license has been granted for a patented cancer drug as part of a public health initiative.

The oral drug, nilotinib, is used to treat chronic myeloid leukemia, and may be made in Egypt, Guatemala, Indonesia, Morocco, Pakistan, the Philippines and Tunisia, according to the Medicines Patent Pool, a United Nations-backed public health organization. Patents on the drug are either pending or in force in those countries.

“It’s not enormous in terms of the impact it’ll have, but it is enormous in what it represents,” Charles Gore, executive director of the Medicines Patent Pool, said in an interview on Thursday. “Being the first public health license in non-communicable diseases and especially in cancer, is really significant.”

Cancer kills about 10 million people a year, accounting for one in six deaths, according to the World Health Organization. Its impact is often higher in poorer nations, where the cost of treatment means that many of those who need the drugs can’t access them.

“Sometimes they’re simply not available. They’re not registered, partly because the originators don’t see that there’s any real market there,” Gore said. “In other countries it’s just simply too expensive.”
Chronic myeloid leukemia is a cancer that starts in the blood-forming cells found in bone marrow, before spilling into the general blood stream.

The Medicines Patent Pool aims to boost access to medicine for people in poor and middle-income nations. It now plans to seek companies to make nilotinib in the seven countries.