unitaid an innovative mechanism for scaling up access to medicines and diagnostics for hiv/aids,...
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UNITAID An innovative mechanism for scaling up access to medicines and diagnostics for HIV/AIDS, tuberculosis and malaria
Jorge Bermudez, Executive Secretary, UNITAIDWHO/UNICEF Technical Briefing Seminar on Essential Medicines Policies,
18 November 2009, Geneva
Building the way
The Leading Group on Innovative Financing (Paris
Conference 2006):
Sixth plenary session of the Leading Group
Innovative mechanisms: a long way forward2000 - The Millennium Development Goals2002 - Monterrey International Conference on
Financing for Development2004 - The Global Action against Hunger and
Poverty 2005 - New York Declaration on Innovative
Sources of Financing for Development
55 member countries and 3 observer countries, major international organizations and NGOs
– a platform for discussion and promotion of innovative financing
New resources, New sectors, New mechanisms (Proof by example: why expand innovation?). Paris, 28-29 May 2009
Medicines are in the North, patients in the South
Less developed countries represent:
84% of the world population
Less than 11% of the global health expenditure
More than 93% of the disease burden globally
A global challenge for Health…
UNITAID's role within Global Health System
• Aligns with major internationally-agreed goals, such as the Millennium Development Goals
• Complements work of other global health actors
• Funds and works through Implementing Partners engaged in improving access to health products
• Engages with NGOs and civil society to ensure that the needs of patients and communities are met
• Ensures partners work meets country demand and
procedures and aligns with national health systems
Rationale: Why UNITAID?:
• Strategically deployed funds in time-limited interventions
• Credible funding commitments necessary for sustained market impact
• Targeted interventions in global markets to improve patient access to health products
• Leverage investments to produce global public goods that generate positive externalities
• Ability to transition at the end of the project is essential to ensure sustainability
Official signature of the five founding countries when UNITAID was launched, on 19 September 2006, at the United Nations General Assembly, New York
Five founding countries (September 2006)
From 5 founding countries (2006): Brazil, Chile, France, Norway, UK
Now (2009): supported by 29 countries and the Gates foundation
UNITAID membership
5 further countries in the final stages of negotiation and to join shortly
Resource Mobilization:
• Funding from multiple countries from both North and South
• Predictable funding gives UNITAID flexibility to respond quickly
• UNITAID will pursue measures that increase funding through– Strengthen donor commitments– Increased number of country contributors– Support the Voluntary Solidarity Contributions on airline tickets,
through the Millennium Foundation
Long term financing = commitment to projects = ability to impact markets
A flexible 'air tax' approach
Mission, Goals & Objectives:
Using innovative, global market based approaches to improve public health by increasing access to quality products to treat, diagnose and prevent HIV/AIDS, tuberculosis, malaria and related co-morbidities in developing countries.
GOAL Objectives
To support adaptation of products targeting specific populations
To assure availability in sufficient quantities and timely delivery to patients
To ensure affordable and sustainably priced products
To increase access to efficacious, safe and assured quality products that address Public Health problems
Mission
UNITAID’s mission is to contribute to scaling up access to treatment for HIV/AIDS, malaria and tuberculosis, primarily for people in low-income countries, by leveraging price reductions for quality diagnostics and medicines and accelerating the pace at which these are made available.
[Constitution]
93 countries already receive UNITAID support…
HIV / AIDS49 recipient countries
Malaria29 recipient countries
Tuberculosis72 recipient countries
- Pediatric ARV- Second line ARV-PMTCT
US$476 m
- ACT- LLIN- AMFm
US$318 m
- First line TB- Paediatric TB- MDR-TB- Diagnostics
US$211 m
- Cross cutting programs: US$109 m for PQ of drugs & diagnostics and transversal programs
UNITAID funded projects worldwide
Tuberculosis Malaria HIV/AIDS
Americas 3 0 9Asia 24 4 6Europe 6 0 2North Africa and the Middle East
7 0 2
Sub Saharan Africa 32 25 29Total 72 29 49
Public health impact?!
Identify Public Health problems Identify Market
shortcomings
- Propose interventions to address market shortcomings
- Assess the Expected Market impact
Additional Complementary Efficient Globally equitable Pro-health approach to
intellectual property Transparent Effective Flexible Innovative Forward looking
Public health impact?!
Identify Public Health problems Identify Market
shortcomings
- Propose interventions to address market shortcomings
- Assess the Expected Market impact
Additional Complementary Efficient Globally equitable Pro-health approach to
intellectual property Transparent Effective Flexible Innovative Forward looking
Refining current strategy
Deliveries by the end of 2008
QUANTITIES DOLLAR VALUES
Malaria
$ Value
HIV/AIDS 148'968'528
TB 28'559'294
Malaria 9'865'711
Total US$ 187'393'532
Number of treatments deliveredUpdate end 2008 - WB income classification
LI LMI UMI Total
HIV/AIDS 404,443 64,680 10,817 479,940
TB 889,398 91,673 11,277 992,348
Malaria 10,049,374 259,276 0 10,308,650
Total 11,343,215 415,629 22,094 11,780,938
Dollar amount
Now (partnering with CHAI):Fixed dose combination
3 tablets a dayUS$ 60 per patient per year
Before: Single dose syrups
16 bottles of syrup monthlyUS$ 200 per patient per year
Better products at lower pricePediatric ARVs
Better products at lower priceTuberculosis
• A rotating stockpile that treats 5800 patients a year
• New faster diagnostics that can detect MDR-TB in just two days (previous test took six weeks)
• Investing in prevention with long lasting insecticide treated bed nets
• Provision of ACTs at lower costs
• UNITAID's recentcommitment to the AMFm
Better products at lower price
Malaria
What is a Patent Pool?
What is a Patent Pool?
Portfolio of patents and other relevant IP held by various actors made available on a non-exclusive basis to third parties, (e.g. generic manufacturers) against the payment of royalties.
Patent Pools come in different shapes and forms and are set up for different purposes
While we learn from existing 'standards' pool, the ARV Patent Pool Initiative is quite different
2006 2008
Currently working on
a full implementation plan.
CIPIH 2006 recommendation:
"Patent pools of upstream technologies may be useful in some circumstances to promote innovation relevant
to developing countries.”
and
proposed to UNITAID to set up a medicines patent pool.
May 2008
WHO Global Strategy and Plan of Action included Patent Pools
July 2008
UNITAID EB
‘Green light 'to establish a medicines patent pool
2009
History of Medicines Patent Pool
Patents on New ARVs
21
Product +/- Expiry date
Atazanavir (Novartis) 2017
Darunavir (Tibotec) 2023
Etravirine (Tibotec) 2019
Fosamprenavir (GSK) 2018
Raltegravir (MSD) 2025
Ritonavir hs (Abbott) 2024
Tenofovir DF (Gilead) 2018
Maraviroc (Pfizer) 2019
22
President Obama on humanitarian licensing
• Increase Access to Affordable Drugs: Barack Obama and Joe Biden believe that people in developing countries living with HIV/AIDS should have access to safe, affordable generic drugs to treat HIV/AIDS. They will break the stranglehold that a few big drug and insurance companies have on these life-saving drugs. They support the rights of sovereign nations to access quality-assured, low-cost generic medication to meet their pressing public health needs under the WTO’s Declaration on Trade Related Aspects of Intellectual Property Rights (TRIPS). Barack Obama and Joe Biden also support the adoption of humanitarian licensing policies that ensure medications developed with U.S. taxpayer dollars are available off-patent in developing countries.
http://www.barackobama.com/pdf/issues/FactSheetAIDS.pdf
23
Similar thinking in different settings…
• “On the part of rich countries, there is excessive zeal for protecting knowledge through an unduly rigid assertion of the right to intellectual property, especially in the field of health care.”
– *“Encyclical Letter Caritas In Veritate Of The Supreme Pontiff Benedict XVI To The Bishops Priests And Deacons Men And Women Religious The Lay Faithful And All People Of Good Will On Integral Human Development In Charity And Truth,” June 29, 2009.
– http://www.vatican.va/holy_father/benedict_xvi/encyclicals/documents/hf_ben-xvi_enc_20090629_caritas-in-veritate_en.html.
Take the Plunge!–(…)–Today patent pools are a favoured system in technology sectors that require common standards, such as the MPEG-2, DVD-video, DVD-ROM and radio. Medicines, though, are trickier terrain.–(…)–UNITAID may be able to pull it off with some luck and lots of hard work. (…) They have a delicate and onerous task before them. Millions of people are waiting hopefully at the patent poolside."
–Latha Jishnu/ New Delhi July 23, 2008
What next?
