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UNITAID actions and main achievements

UNITAID actions and main achievements A new innovative mechanism for scaling up access to medicines and diagnostics for HIV/AIDS, TB and malaria XVII International AIDS Conference Satellite Forum ANRS France – Ministry of Health Brazil (Mexico, 4 th August 2008) Jorge Bermudez

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UNITAID actions and main achievements

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  1. UNITAID actions and main achievements A new innovative mechanism for scaling up access to medicines and diagnostics for HIV/AIDS, TB and malaria XVII International AIDS Conference Satellite Forum ANRS France – Ministry of Health Brazil (Mexico, 4th August 2008) Jorge Bermudez Executive-Secretary, UNITAID

  2. Context for UNITAID • The MDGs (New York, 2000) • Monterrey consensus on financing for development (18 to 22 March 2002, 50 Member States) • 44 countries discussing innovative ways for financing development • The Global Action against Hunger and Poverty (20 September 2004, 111 Member States) • The Paris Declaration on Aid Effectiveness (2 March 2005, 100 member States) • Global Health landscape • Globalization, Trade and Health "There is a ‘fundamental imbalance’ with the world spending US$900bnon defense; around US$325bn on agricultural subsidies and only US$50bn to US$60bn on aid." James Wolfensohn Former President of the World Bank

  3. Why UNITAID ? • Unaddressed issues at stake: medicines for children, second-line treatments • A plus to existing initiatives, supporting the worst affected and most vulnerable countries • A new and innovative mechanism for financing treatment • Long-term funding: manufacturer-attractive • Global forecastingensures supply; a comprehensive approach to access addressing demand and supply factors • Building solid and strong partnerships with current initiatives • A multi-dimensional approach (addressing quality, regulation, IPR, pricing, in-country support for supply systems) • Influencing the Health Agenda

  4. Five founding countries (Sept. 2006) Official signature of the five founding countries when UNITAID was launched, on 19 September 2006, at the United Nations General Assembly, New York

  5. Five founding countries (Sept. 2006) Official signature of the five founding countries when UNITAID was launched, on 19 September 2006, at the United Nations General Assembly, New York

  6. Countries contributing to UNITAID Countries that implemented the air tickets levy • Tax adopted : • France • Chile • Cote d’Ivoire • Congo • Mali • Madagascar • Mauritius • Niger • Republic of Korea • Norway (CO2 tax on kerosene) • Budget contribution : • Spain • United Kingdom Countries committed to implement the tax: Benin, Brazil, Burkina Faso, Cameroon, Cyprus, Gabon, Guinea, Liberia, Mali, Morocco, Namibia, Central African Republic, Senegal, Sao Tome & Principe, Togo Countries committed to implement a budget contribution : South Africa

  7. Impact of the levy: the French exemple Tax received on each ticket by UNITAID (in France) Economy class First class or business Flight in France or in Europe 1 € 10 € International flight 4 € 40 € Impact of the air tickets levy: an example Antimalarial treatment for 2 children ex: flight Paris - Berlin 1 HIV-positive child under treatment for 1 year ex: flight Paris - Dakar An aircraft with 300 passengers on board leaving from Paris will cover the treatment for 1 person with multi drug resistant tuberculosis (approx. 4.000 $) or 60 HIV-positive children for one year Furthermore… no economic impact on air traffic

  8. UNITAID use of funds allows to: 1/ Impact markets and reduce prices: more drugs for same budget ex: price reduction on pediatric (- 40%) and 2nd line ARVs (-25% to – 50%) 2/ Have manufactured medicines better adapted to patient needsex: first fixed dose combinations for pediatric ARVs in 2007 3/ Contribute to address quality issues (incentive for manufacturers to invest) ex: support to WHO program for prequalification of products 4/ Deliver rapidlymedicines in the countries in need (basic model - medicines instead of funds) ex: treatments already provided in a number of countries for ARV, TB and ACT UNITAID added value

  9. More than 80 countries already receive UNITAID support… UNITAID ongoing actions HIV / AIDS 51 recipient countries Malaria 22 recipient countries Tuberculosis 58 recipient countries - ACT - First line TB - Pediatric TB - MDR-TB - Pediatric ARV - Second line ARV - PMTCT

  10. 51 recipient countries from UNITAID funds against HIV/AIDS SEARO India WPRO Cambodia China Lao Papua New Guinea Vietnam AMRO Dominican Rep. Guyana Haiti Jamaica OECS (Anguilla, Dominica, St Lucia, Antigua & Barbuda, Grenada, St Christopher & Nevis, British Virgin Islands, Montserrat, St Vincent & Grenadines) EURO Moldova Serbia EMRO Djibouti Morocco Tunisia AFRO Angola Benin Botswana Burkina Faso Burundi Cameroon Chad DRC Cote d'Ivoire Ethiopia Ghana Guinea Kenya Lesotho Liberia Malawi Mali Mozambique Namibia Nigeria Rwanda Senegal Swaziland Tanzania Togo Uganda Zambia Zimbabwe

  11. Existing market impact by UNITAID Disease Niche AVAILABILITY QUALITY PRICE Main market impact Additional nb of products Nb of new productions lines* New drugs pre qualified in 2007 Price reduction HIV Pediatric ARV 11 2 (FDC) 1 Av. 60% FDCs in 26 countries + price reduction 2nd line ARV 6 12 2 (+ 8) Av. 30% Accelerated access to TDF/3TC + Price reduction PMTCT - - - Specific pack Diagnostics (ped.) 1 - - - Availability Co-trimoxazole 1 1 (+2) - - GMP RUTF 1 2 (Africa) - GMP TB 1st line TB N/A N/A N/A Price stabilization Price containment/Stockpile establishment Pediatric TB 1 1 6 Cost savings/price discounts due to pool procurement. Further reductions targeted. Availability/PreQ incentives MDR-TB (2nd line) 2 2 2 Price reductions targeted for 2010 Stockpile establishment/PreQ incentives Malaria ACT scale up 1 1 1(+ 7) - * Nb of new products developed X nb of manufacturers

  12. UNITAID initiatives have already driven major price reductions (partnering with CHAI) Change in peds ARV prices (AZT FDC vs. individual syrups) US$/patient per year Change in 2nd-line ARV prices (TDF+3TC) US$/patient per year $130 $315 50% 50% $66 $159 2006 Q1 2008 Q1 2008 2006

  13. Better products at lower price Before: Single dose syrups16 bottles of syrup monthly 200 $ per patient per year Now (UNITAID-CHAI): Fixed dose combination3 tablets a day 60 $per patient per year

  14. Consolidate current niches and necessary transitions with partners Identify areas to expand (diagnostics…) VSC (a worldwide citizenship solidarity contribution) Moving towards a patent pool UNITAID: challenges ahead

  15. www.unitaid.eu

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