Annex B
BRIEFING ON UNITAID
BACKGROUND
UNITAID, initiated by Brazil, Chile, France,
Norway and the United Kingdom, now has 27 member countries, 19
of which are in Africa. UNITAID is an innovative funding facility,
benefiting particularly from contributions on air tickets levies.
Its Secretariat and Trust Fund are hosted by WHO.
UNITAID's mission is to contribute to scaling
up access to treatment for HIV/AIDS, malaria and tuberculosis
for people primarily in low income countries by leveraging quality
drug- and diagnostic- price reductions and accelerating the pace
at which these are made available. UNITAID achieves impact by
applying its market dynamics toolkit comprising of pool procurement,
volume price negotiation (including cost plus negotiation) and
supporting the pre-qualification of drugs.
UNITAID works strategically with partners who
can contribute and add value to achieving UNITAID's goals and
objectives. Current partners include the Clinton Foundation, a
not-for-profit corporation engaged in humanitarian efforts, the
Global Fund, Stop TB Partnership, UNICEF and WHO Joint Prequalification
Programme.
Hitherto, UNITAID has focused its interventions
in the following niche areas: Paediatric and Second Line ARVs,
Acceleration of Prevention of Mother to Child Transmission (PMTCT)
and scale up of linkages to paediatric HIV/AIDS care and treatment;
Scaling-up of ACT drugs for malaria treatments, and treatments
for tuberculosis (First Line TB: Transitional Grants& Strategic
Rotating Stockpile; UNITAID Support to Paediatric TB and; MDR-TB
Scale-up Initiative).
For 2006-07, UNITAID's budget was US$383.2 million.
As stipulated in UNITAID's Constitution, 85% UNITAID's funds are
allocated to low income countries.
ACTIONS
In its first year of operation, through strategic
alliances with partners, UNITAID has already demonstrated via
the actions presented below how its added value can be effectively
leveraged:.
— ARV against HIV/AIDS for children
This Project was initiated in November 2006,
in partnership with the Clinton HIV/AIDS Initiative, with a budget
of US$ 35.9 million to be executed until December 2007. Its main
objectives included the expansion of HIV/AIDS treatment and care
to 100,000 children, the stimulation of market competition and
the development of paediatric formulations and fixed-dose combinations
and the contribution to price reductions of antiretrovirals and
monitoring and diagnostic tests. Up to present, the Project has
reduced the price of ARVs on average by 40%, facilitated the introduction
of triple paediatric FDCs and other paediatric formulations, and
is funding the supply of diagnostics and treatment for more than
102,000 children, including more than 62,000 new treatments, in
38 developing countries. The UNITAID Board has approved a project
extension for 2008, and gave a political "green light"
for extending it until 2010. The extension for 2008 has a budget
of US$ 58.6 million.
— Second line ARV against HIV/AIDS
This Project commenced in May 2007, in partnership
with the Clinton HIV/AIDS Initiative, with an approved budget
of US$ 45 million for that year, benefiting 26 countries. The
Project's ultimate objective is to influence the market to reduce
the price of key second line drugs. Whilst promoting price reduction,
the Project is stimulating market competition and incentivising
new manufactures of antiretrovirals. UNITAID is currently supplying
second line antiretrovirals for 56,000 patients in 20 countries.
The UNITAID Board has approved a budget of US$ 64 million for
2008 and the Project is expected to continue its price negotiation
and supply activities until 2009.
— Acceleration of Prevention of Mother-to-Child
Transmission (PMTCT) and Scale-up of Paediatric HIV Care and treatment
for 2007-08
The overall objective of this Initiative undertaken
by UNITAID together with UNICEF and WHO is to contribute to the
acceleration of the global scale up of national PMTCT programmes
with the explicit associated benefits of improved maternal and
child health and survival in the context of universal access to
HIV prevention, treatment, care and support services. With UNITAID
funds of US$ 20.8 million for the procurement and delivery of
high quality HIV drugs, diagnostics and related PMTCT commodities,
including more efficacious ARV combination regimens, for a period
of 24 months to recipients in seven low-income countries (Burkina
Faso, Cote d'Ivoire, India, Malawi, Rwanda, Tanzania and Zambia)
and one low-middle-income country (Cameroon), the women and infants
reached will be closely monitored against the specific targets
set.
— ACT scale up
UNITAID, in partnership with UNICEF and WHO,
delivered more than 1.4 million treatments in Burundi and Liberia,
which faced risks of disruption in treatments in 2007. The close
collaboration between UNITAID and its partners made it possible
for the medicines to reach Liberia eight days before the expected
delivery date. For Burundi, actual delivery date was within three
days of expected delivery.
In late December 2007, UNITAID finalized a Memorandum
of Understanding (MOU) with UNICEF and the Global Fund to scale
up the delivery of ACTs in 8 countries through various grants
under Rounds 1 to 5. This scale up Project amounts to US$ 65.4
million and will support the identified grants for the remainder
of the grants' life. The beneficiary countries are: Ethiopia,
Ghana, Madagascar, Mozambique, Sudan, Zambia, Cambodia and Indonesia.
UNITAID has also committed to provide US$ 21.5 million for 13
countries (Cote d'Ivoire, Djibouti, Eritrea, Gambia, Guinea, Guinea
Bissau, Mali, Mauritania, Namibia, Somalia, Bangladesh, Cambodia
and China) through the Global Fund Round 6 grants.
— First-line treatments against tuberculosis—(1st
Line TB—Transitional Grants & Strategic Rotating Stockpile)
UNITAID, in collaboration with the Stop TB Partnership's
Global Drug Facility (GDF), is supporting: through transitional
grants, the minimization of the risk of stock-outs. Furthermore,
through the establishment of Strategic rotating Stockpile(s),
lead times and the overall treatment costs for drug deliveries
have been reduced and cost containment of anti-TB drugs in the
short-term (2007-08) has been achieved, with a view to securing
price reduction in the medium-term (2009).
— Paediatric formulations against tuberculosis—(Paediatric
TB: Development of new child-friendly formulations for children
under Age 4 & provision of appropriate strength paediatric
drugs for children under Age 15)
In January 2007, UNITAID provided financial
support to the Global Drug Facility (GDF) of the Stop TB Partnership
for the provision of appropriate-strength paediatric drugs for
children less than 15 years of age and to ensure the development
of new child-friendly formulations for infants under 5 years of
age. A total supply of 150,000 paediatric anti-Tuberculosis treatments
for children in 20 countries was provided.
With the financial support of UNITAID, GDF has
been able, through pooled procurement, to generate significant
price reductions for paediatric anti-TB drugs. UNITAID's funds
have contributed to expand the supply of paediatric anti-TB drugs
to approximately 600,000 children in an estimated 40 countries.
This will be supplied over a 3-year period (2008-10).
— Treatments against multidrug-resistant
tuberculosis— (MDR-TB Scale-up Initiative)
UNITAID, in collaboration with the Stop TB Partnership
and the Global Fund to Fight AIDS, TB and Malaria, is helping
to increase access to, and affordability of, quality-assured 2nd
Line anti-TB drugs for use in MDR-TB control. UNITAID's funding
would make it possible (through GDF) to procure and supply an
estimated 4,716 patient treatments to MDR programmes in 17 countries
by the end of 2011.
To date, this partnership has achieved: the
establishment of a Rotating stockpile production initiated by
procurement agent; a continuation of joint activities with WHO
prequalification programme; and the securing of competitive prices
via direct negotiation.
— Support for the prequalification of
drugs
UNITAID is a major funder of the WHO Prequalification
Programme with US$ 1 million in 2006 and US$ 6 million in 2007
to support its mission in influencing the market by facilitating
and speeding up the pace at which prequalified key HIV/AIDS-,
tuberculosis- and malaria- medicines are made available. The Project
also carries out testing and sampling of medicines funded by UNITAID
projects, an activity which is being developed with national regulatory
agencies, with the objective not only of certifying the quality
of drugs, but also of strengthening national capacities.
UNITAID and the Global Fund to Fight HIV/AIDS,
Tuberculosis and Malaria
UNITAID responded to a request from the Global
Fund to Fight HIV/AIDS, Tuberculosis and Malaria (GF) for the
purchase of drugs under Round 6, Phase 1, to an amount of US$
52.5 million. It has been agreed that UNITAID funds will be used
exclusively to finance 2nd line ARVs to an amount of US$ 8.7 million,
ACTs to an amount of US$ 21.5million, MDR TB drugs to an amount
of US$ 10.3million, Paediatric ARV to an amount of US$ 12.0 million.
The Global Fund allocations to beneficiary countries will be consistent
with UNITAID eligibility criteria (at least 85% to low income
countries).
Last update: 30 January 2008
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