Unitaid

Unitaid

Founded	2006
Founders	France, Brazil, Chile, Norway and the United Kingdom
Focus	HIV/AIDS, Malaria, Tuberculosis
Location	Geneva, Switzerland
Area served	Worldwide
Method	Grants
Key people	Lelio Marmora, Executive Director[1] Marta Maurás Perez, Chair of Unitaid[2]
Revenue	$2.5 billion between 2006 and 2015, 63% of which has been raised through a solidarity levy on airline tickets[3]
Website	www.unitaid.org

Unitaid is a global health initiative that is working with partners to end the world's tuberculosis, HIV/AIDS, malaria and hepatitis C epidemics. Founded in 2006, the organization funds the final stages of research and development of new drugs, diagnostics and disease-prevention tools, helps produce data supporting guidelines for their use, and works to allow more affordable generic medicines to enter the marketplace in low- and middle-income countries. Hosted by the World Health Organization (WHO) in Geneva, Unitaid was established by the governments of Brazil, Chile, France, Norway and the United Kingdom.

As of early 2018, Unitaid manages a portfolio of over 40 grants, in more than 40 countries, and worth around US$1 billion. During 2017, Unitaid's executive board approved grants worth more than US$303 million, including significant investments in new projects focused on malaria during pregnancy and emergency rectal artesunate treatment for children with severe malaria; introduction of HIV self-testing kits in Africa, services for pediatric TB, and TB prevention for high-risk groups, namely people living with HIV and small children.

Projects in development for 2018 address HIV co-infections, and work to break down intellectual property barriers as a means of lowering medicine prices in low- and middle-income countries.

Unitaid supports programs that are implemented by organizations such as Coalition Plus, the Clinton Health Access Initiative, Elizabeth Glaser Pediatric AIDS Foundation, Expertise France, The Global Fund, Foundation for Innovative New Diagnostics, Médecins Sans Frontières,^[4] Medicines for Malaria Venture,^[5] Stop TB Partnership,^[6] TB Alliance,^[7] UNICEF and others.

Activities

Unitaid is investing heavily in "test-and-treat" technologies that allow patients to be diagnosed and treated on the spot in rural clinics instead of having to wait weeks for results to come back from central laboratories. Delays in diagnosis cause delays in treatment, giving illnesses time to become severe or fatal, and helping epidemics to spread. The test-and-treat approach, championed by global health organizations, is seen as one of the major new weapons in the post-2015 phase of the fight against the HIV/AIDS, tuberculosis and malaria epidemics.

For example:

• Tuberculosis: Unitaid has channeled $115.5 million into introducing GeneXpert testing for TB and drug-resistant TB in 27 low-income, high-burden TB countries. The GeneExpert machine identifies genetic material from tuberculosis bacteria in less than two hours, replacing a widely used older test that took two to six weeks to yield results and involved growing TB bacteria in sputum samples.^[8] One of Unitaid’s top priorities is supporting innovations to stop tuberculosis, with a new emphasis on blocking an emerging wave of multidrug-resistant forms of the disease. Since its inception, Unitaid has funded more than US$460 million in grants for TB (as of Jan. 2018), and has a slate of active TB grants worth nearly US$180 million.
• Malaria: With a $34 million investment, Unitaid is supporting work to create a private-sector market for quality-assured, rapid diagnostic tests in Kenya, Uganda, Tanzania and Nigeria.
• HIV/AIDS: Unitaid is funding a $149.3 million grant to disperse test-and-treat services for infants throughout Cameroon, Democratic Republic of Congo, Ethiopia, Kenya, Malawi, Mozambique, Senegal, Tanzania, Uganda and Zimbabwe. UNICEF and the Clinton Health Access Initiative (CHAI) are carrying out the project.

Unitaid is also investing US$72.2 million, as of early 2018, to evaluate the benefits of HIV self-testing in resource-limited settings, and to develop a market for HIV self-testing. The HIV Self-Testing Africa (STAR) project was implemented in 2015 in three African countries by partner Population Services International (PSI) and expanded to three more countries in the summer of 2017. It promotes user-friendly tests to increase the number of people who know their HIV status, and to ensure they have access to treatment and prevention services.^[9]

Unitaid's work is also supporting the "90-90-90" global targets to end the AIDS epidemic. The targets, for 2020, are for 90 percent of people living with HIV to know they are infected, for 90 percent of those infected to be on antiretroviral treatment, and for the virus to be undetectable in 90 percent of the people on treatment.

Meeting those targets will require an intensified pushback against the disease, the Joint United Nations Programme on HIV/AIDS reported, noting that maintaining efforts at current levels will not stop the epidemic from outpacing the response.^[10]

Hepatitis C (HCV) : Unitaid is channeling more than $58 million into three grant projects (2015-2019) designed to fight the viral liver disease. The projects seek to develop new and simpler diagnostics, establish innovative models for screening and treatment in HIV/HCV co-infected populations, and devise cost-reduction strategies. Approximately 399,000 people die each year from hepatitis C, mostly from cirrhosis and liver cancer. Liver diseases represent a major cause of illness and death among people living with HIV.^[11]

In May 2017, Unitaid joined the United Nations coordination group on antimicrobial resistance, recognizing the growing public health challenge drug-resistance poses in the fight against HIV/AIDS, tuberculosis and malaria. Resistance to key health products, including critical medicines and insecticides, threatens to stall, or even reverse, progress in the fight against the three diseases. Unitaid invests half its portfolio, about US$500 million (Jan. 2018), in innovative grants to combat resistance in low-and middle-income countries.^[12]

Achievements

• In December 2015, Unitaid, together with TB Alliance and their partners, launched the first specially adapted medicine for children with tuberculosis. Unitaid is now exploring how it can support acceleration of the demand and adoption of the adapted medicine to reach and treat the estimated 1 million children who get tuberculosis each year.^[13]
• In 2010, Unitaid created and invested in the Medicines Patent Pool (MPP) to negotiate voluntary licenses for HIV medicines. MPP's work helped bring about the widespread use of tenofovir for HIV treatment, which resulted in a savings of $195 million in drug costs between 2012 and 2015.^[13]
• Unitaid has invested $65 million to encourage governments to combat insecticide resistance in mosquitos by making new insecticides cheaper. The most effective way to prevent malaria is to use vector-control tools (sprays, insecticide-treated bed nets) that protect people from being bitten by parasite-infected mosquitos.^[13]
• Unitaid is working with partners to lower the cost of the world's best available HIV drugs via generic versions so that people in lower-income countries can have access to them. The optimal first-line HIV drug dolutegravir, which is more robust and less toxic to patients, is being piloted in Kenya, Nigeria and Uganda, with the aim of making it a widely available treatment.^[14]

Financing

Unitaid's revenue exceeded US$2.5 billion through 2015, out of which at least 85 percent must be distributed to low-income countries. The main donors are France, the United Kingdom, Norway, Brazil, the Bill & Melinda Gates Foundation, Spain, the Republic of Korea, Chile and Mauritius.

The single main source of income is an airline ticket tax currently in effect in ten countries: Cameroon, Chile, Congo, France, Guinea, Madagascar, Mali, Mauritius, Niger and the Republic of Korea. In France, a tax of about €1 to €45 (2017) is added to the price of each airline ticket. The higher fees are for first- or business-class passengers traveling to destinations outside Europe.^[15] In January 2013, France’s Directorate General for Civil Aviation announced that the French air ticket tax had collected 1 billion euros since its inception.^[16]

Norway allocates part of its tax on carbon dioxide emissions from aviation to Unitaid, and the United Kingdom contributes through multi-year commitments.^[17]

History

In early 2006, France’s President Jacques Chirac announced his decision to create a drug-purchase facility to advance international development projects, with France contributing 90 percent of its new airline ticket tax toward the endeavor.^[18] Chile joined the effort, establishing its own airline ticket tax to support international development. That September, Unitaid was founded by Brazil, Chile, France, Norway and the United Kingdom.

Structure

The Executive Board, Unitaid’s decision-making body, determines the organization’s objectives, monitors progress and approves budgets.

The 12-member Board is chaired by Celso Amorim, a former Minister of Foreign Affairs for Brazil, and is made up of one member each from Brazil, Chile, Norway, France, Spain and the United Kingdom, one member from Africa chosen by the African Union, one from Asia, two from civil society, one from the constituency of foundations, and one from the WHO.

Unitaid's founding Chair is Philippe Douste-Blazy, former Foreign Minister of France,

The Secretariat is currently led by an Executive Director (Lelio Marmora) and his Deputy (Philippe Duneton).

See also

• The Global Fund
• WHO
• UNICEF
• Clinton Foundation
• Stop TB Partnership
• Médecins Sans Frontières
• UNAIDS
• The Millennium Foundation
• MassiveGood
• Foundation for Innovative New Diagnostics
• Medicines Patent Pool

References

External links

• Official website