Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

UNITAID Operations Report to EB12

971 views

Published on

This report was presented to the 12th session of the Executive Board, on 9 June 2010. It contains the most recent data on the performance of Operations Unit, including an overview of the HIV/AIDS, malaria and tuberculosis portfolio.

Published in: Health & Medicine
  • Be the first to comment

  • Be the first to like this

UNITAID Operations Report to EB12

  1. 1. OPERATIONS & MARKET DYNAMICS UPDATES 12th Executive Board Geneva, 8-9 June 2010
  2. 2. <ul><li>Portfolio Overview </li></ul><ul><li>Legal Agreements </li></ul><ul><li>Trends 2007-2009 </li></ul><ul><li>B . Updates on Project Progress </li></ul><ul><ul><li>EB Approval Status </li></ul></ul><ul><ul><li>Key Performance Indicators </li></ul></ul><ul><ul><li>Market Levers </li></ul></ul><ul><ul><li>Eligibility Criteria </li></ul></ul><ul><ul><li>Regional grouping </li></ul></ul><ul><ul><li>Top 5 countries </li></ul></ul><ul><ul><li>C. Update on Other Activities </li></ul></ul><ul><ul><li>Validation Tools </li></ul></ul><ul><ul><li>Viral Load </li></ul></ul><ul><ul><li>Evaluation of Projects </li></ul></ul><ul><ul><li>D. Challenges and Outlook </li></ul></ul><ul><ul><li>Transition of Projects </li></ul></ul><ul><ul><li>Outlook </li></ul></ul>SUMMARY
  3. 3. <ul><li>A. Portfolio Overview </li></ul>
  4. 4. OVERVIEW: Current Legal Agreements
  5. 5. ALLOCATION OF FUNDS: HIV/AIDS
  6. 6. ALLOCATION OF FUNDS: TB
  7. 7. ALLOCATION OF FUNDS: MALARIA
  8. 8. ALLOCATION OF FUNDS: TRANSVERSAL
  9. 9. <ul><li>TRENDS: 2007-2009 </li></ul>
  10. 10. TRENDS BY NICHE *Excludes PMTCT diagnostics and OI medicines. Estimated patients treated or number of products provided, 2007-2009
  11. 11. TRENDS BY NICHE *As reported to UNITAID through Partner annual reports Monies spent (US$) by partners on medicines and diagnostics, 2007-2009*
  12. 12. TRENDS BY NICHE *As reported to UNITAID through CHAI annual reports Prices paid (US$) per patient per year for two leading 2 nd line regimens, 2007-2009* 41% reduction, 2007-2009 43% reduction, 2007-2009
  13. 13. TRENDS BY NICHE *As reported to UNITAID through CHAI annual reports Prices paid (US$) per patient per year for a leading paediatric regimen, 2008-2009* 53% reduction, 2008-2009
  14. 14. <ul><li>B. Updates on Project Progress Activities </li></ul><ul><ul><ul><ul><ul><li>EB Approval Status </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Key Performance Indicators </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Market Levers </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Eligibility Criteria </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Regional grouping </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Top 5 countries per niche </li></ul></ul></ul></ul></ul>
  15. 15. Approved Projects EB10/EB11 TB: 2 HIV: 2 Signed MoUs EB10/EB11 HIV: 2 MoU extensions (2 nd line and Paediatric HIV/AIDS Projects); TB: MDR-TB diagnostics (FIND/GDF/GLI). Pending MoUs 3 MoUs, Combined ceiling of US$ 54,114,575 EB APPROVAL STATUS ESTHERAID Phase 2 15,498,374 MDR-TB Acceleration of Access Initiative : Strategic Revolving Fund 22,232,201 MDR TB Scale-Up Initiative (inclusion of India ) 16,384,000 Total 54,114,575
  16. 16. <ul><ul><li>Price reductions on key paediatric, 1 st line (TDF) & 2 nd line ARVs have facilitated treatment of 66,366 children and 133,322 adults through CHAI in 2009; </li></ul></ul><ul><ul><li>18 UNITAID priority medicines prequalified through UNITAID funded WHO/UN Prequalification programme in 2009 (29 prequalified since 2007); </li></ul></ul><ul><ul><li>TB medicines stockpiles in 2009 have reduced delivery lead times by over 50% for MDR-TB rotating stock pile; and </li></ul></ul><ul><ul><li>UNITAID funding to TGF and UNICEF has created a market for fixed dose combination ACTs. </li></ul></ul>KEY PERFORMANCE INDICATORS Area 1 - Strategy
  17. 17. <ul><ul><li>HIV/AIDS: nearly 600,000 patients in 46 countries from 2006 to 2009; </li></ul></ul><ul><ul><li>TB: 1.5 million treatments purchased for 72 countries from 2007-2009; </li></ul></ul><ul><ul><li>Malaria: nearly 19 million ACTs and 20 million LLINs purchased for countries with high malaria burden from 2007 to 2009. </li></ul></ul>KEY PERFORMANCE INDICATORS Area 3 – Health outcomes
  18. 18. MARKET LEVER: ACCESS <ul><li>HIV/AIDS </li></ul><ul><li>Pediatric ARV: Over 260.000 treatments since 2006, including 66,366 new children on ART in 2009 (3% above the target) </li></ul><ul><li>Second-Line ARV: ~67,490 second line and ~49,834 tenofovir regimen patients in 2 countries since 2009; </li></ul><ul><li>PMTCT (component I ): 184,170 treatments for pregnant women new in 2009. </li></ul><ul><li>Malaria </li></ul><ul><li>ACT treatments: 16.6 million treatments delivered as of cumulative to December 2009 with a further 2 million patients treated through support to TGF; 8.3 million treatments were provided in 2009 </li></ul><ul><li>A2S2: financial facility for production of target 40 metric tonnes of Artemisia on track </li></ul><ul><li>20 million LLINs delivered to countries as of January 2010. This represents the total number expected to be delivered; </li></ul><ul><li>TB </li></ul><ul><li>Pediatric TB: 373,960 treatments delivered in 2009 (since 2007 668,141) </li></ul><ul><li>First Line: 41,703 treatments delivered in 2009 (since 2007 785,080) </li></ul><ul><li>MDR-TB: ~ 1,535 treatments delivered in 2009 (since 2007 3,133) </li></ul>
  19. 19. MARKET LEVER: AVAILABILITY <ul><li>HIV/AIDS </li></ul><ul><li>Proportion of generic suppliers being used in CHAI supplier selection process for paediatric ARV FDCs increased to 84% in 2009 (from 75% in 2007) </li></ul><ul><li>TB </li></ul><ul><li>Peds TB - 1 additional supplier (total of 2) for the key paediatric products and 2 suppliers for 5 products </li></ul><ul><li>MDR-TB drugs - from 2 to 7 manufacturers/11 MDR products with more than 2 sources </li></ul><ul><li>MDR-TB Diagnostics - 2 additional suppliers identified for rapid speciation and 1 for Line Probe Assay </li></ul>
  20. 20. MARKET LEVER: QUALITY <ul><li>18 UNITAID priority formulations prequalified out of 44 prequalified medicines (39 generics) in 2009. </li></ul><ul><ul><li>10 ARVs </li></ul></ul><ul><ul><li>5 anti-TB </li></ul></ul><ul><ul><li>3 ACTs </li></ul></ul><ul><li>FDC formulations </li></ul><ul><ul><li>TB: First line 4 FDC (RHZE), 3FDC (RHE) and 2 FDC (R150/H75) and Pyrazinamide 400 mg </li></ul></ul><ul><ul><li>8 out of 9 of the ACTs prequalified since 2007 are FDCs </li></ul></ul><ul><li>3 medicines quality control laboratories were prequalified </li></ul><ul><ul><li>1 in Kenya </li></ul></ul><ul><ul><li>2 in Singapore </li></ul></ul><ul><li>13 out of 42 HIV and Malaria diagnostic tests evaluated and accepted as Priority Products </li></ul>
  21. 21. RECIPIENT COUNTRIES INCOME CLASSIFICATION WB Classification 2009 (based on quantities)   LI LMI UMI WB 2009 87.2% 9.6% 3.2%
  22. 22. INCOME CLASSIFICATION BY NICHE HIV/AIDS Tuberculosis Malaria (based on value) % LI 88 LMI 7 UMI 5 TOTAL % LI 87 LMI 10 UMI 3 TOTAL % LI 94 LMI 6 UMI 0 TOTAL
  23. 23. REGIONAL GROUPING RECIPIENT COUNTRIES HIV/AIDS Tuberculosis Malaria (based on quantities) Region % AFR 91.24% AMR 0.35% EMR 0.52% EUR 0.18% SEAR 5.46% WPR 2.25% TOTAL 100.00% Region % AFR 49.43% AMR 0.04% EMR 16.73% EUR 4.47% SEAR 27.81% WPR 1.53% TOTAL 100.00% Region % AFR 88.99% AMR 0.00% EMR 9.97% EUR 0.00% SEAR 0.40% WPR 0.64% TOTAL 100.00%
  24. 24. DALYS for comparison DALY rates ('000)*, 2004 <ul><ul><li>*per 100,000 population </li></ul></ul>34 15 58 81 263 HIV 10 5 10 42 142 TB Country Malaria Brazil 24 Chile 10 France 1 Norway 0 United Kingdom 0
  25. 25. HIV/AIDS Top 5 Recipient Countries, Value (US$) *All countries have a generalized HIV epidemic. 10,792 10,288 3,522 18,906 9,450 DALY rates ('000), 2004 WHO Region Income group Country* US$ % total value AFR LI Uganda 49,057,563 12% AFR LI Zambia 47,699,645 12% AFR LI Nigeria 40,502,211 10% AFR LI Kenya 36,531,323 9% AFR LI Mozambique 24,541,801 6%     TOTAL 198,590,564 50%
  26. 26. TUBERCULOSIS Top 5 Recipient Countries, Value (US$) *Support for India is for TGF Round 6 and additional support in the MDR-TB was approved by EB 10 and this support will make India the leading recipient. 1144 2042 474 252 652 DALY rates ('000), 2004 WHO Region Income group Country US$ % total value SEAR LI India* 17,342,126 15 EUR LMI Azerbaijan 9,977,861 9 SEAR LI Myanmar 6,317,182 6 AFR LI Kenya 5,571,026 5 SEAR LI Bangladesh 5,182,437 5     TOTAL 39%
  27. 27. Top 5 Recipient Countries, Value (US$) MALARIA MALARIA 2,347 5,806 3,148 6,467 6,230 DALY rates ('000), 2004 WHO Region Income group Country US$ % total value AFR LI Nigeria 30,550,000 10 AFR LI Democratic Republic of the Congo 25,850,000 9 EMR LI Sudan 20,778,979 7 AFR LI Guinea 15,740,344 5 AFR LI Ethiopia 13,883,410 5     TOTAL 94,601,102 35
  28. 28. <ul><li>C. Update on Other Activities </li></ul><ul><ul><ul><ul><ul><li>Validation Tools </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Viral Load </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Evaluation of Projects </li></ul></ul></ul></ul></ul>
  29. 29. <ul><li>Pilot tested on a TB project Narrowing the Gap: Expanding and accelerating access to diagnostics for patients at risk of multi-drug resistant tuberculosis (MDR-TB). The partners for this project are: </li></ul><ul><li>a. WHO-GLI (Global Laboratories Initiative) </li></ul><ul><li>b. GDF (Global Drug Facility) </li></ul><ul><li>c. FIND (Foundation for Innovative New Diagnostics) </li></ul><ul><li>January 2010 : Swiss Tropical Institute incorporated the Secretariat comments, with partners feedback, into its final submission </li></ul><ul><li>Post January 2010 : </li></ul><ul><li>- Secretariat resources strengthened – Director DFA, Director MDO, Coordinator Market Dynamics </li></ul><ul><li>-Drawing on the expanded in-house expertise; ongoing discussions on how to further refine the tools, main topics: </li></ul><ul><ul><ul><li>at what stage of the proposal/project cycle would the assessment add most value </li></ul></ul></ul><ul><ul><ul><li>human resource requirements </li></ul></ul></ul><ul><ul><ul><li>assessing complex partnerships </li></ul></ul></ul><ul><li>Next steps </li></ul><ul><li>Roll out plan to be developed by September 2010 </li></ul><ul><li>Application of tools on new projects </li></ul><ul><li>Further refinements to be made </li></ul>VALIDATION TOOLS
  30. 30. <ul><li>Follow up on EB11: </li></ul><ul><li>Explore ways of working together to prepare a comprehensive proposal that is innovative and with geographical scope </li></ul><ul><li>Key topics for clarification </li></ul><ul><ul><li>Expectations and priorities on market impact and public health needs </li></ul></ul><ul><ul><li>1 versus 3 proposals approach </li></ul></ul><ul><li>In-person meeting on 16 April: </li></ul><ul><ul><li>3 proponents are interested in moving with initiative </li></ul></ul><ul><ul><li>Outstanding Points : </li></ul></ul><ul><ul><ul><li>Collaborative approach confirmed </li></ul></ul></ul><ul><ul><ul><li>Identification of funds for technical assistance required </li></ul></ul></ul><ul><li>Proposed schedule: submission of proposal to EB 13 in November 2010 </li></ul>VIRAL LOAD
  31. 31. EVALUATIONS 2010/2011 <ul><li>Steps Taken: </li></ul><ul><li>Identified 9 projects for which the MoUs have a provision for evaluation; </li></ul><ul><li>Preliminary discussions with Partners held; </li></ul><ul><li>Terms of Reference for evaluations written, discussed with and commented on by WHO Office of Internal Oversight; </li></ul><ul><li>Next Steps: </li></ul><ul><li>Tender for evaluation providers by project type and select evaluation teams; </li></ul><ul><li>Improve capacity for M&E related to project implementation in the Secretariat; </li></ul><ul><li>Implement evaluations from Q3 2010 into 2011. </li></ul>
  32. 32. <ul><li>D. Challenges and Outlook </li></ul><ul><ul><ul><ul><ul><li>Transition of Projects </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Maximizing Returns </li></ul></ul></ul></ul></ul>
  33. 33. TRANSITION OF PROJECTS <ul><li>Ended in 2009 and transition is ongoing </li></ul><ul><li>Second Line ARV : EB9 approved US$ 120 million for 2010-11. Transition is on track, and scaled down from 24 countries in 2009 to 17 in 2010. </li></ul><ul><li>Ending in 2010 and transition support required </li></ul><ul><li>PMTCT 1 ending in June 2010. 2 year proposal not approved by EB11. Bridge funding is being required for 2010-2011 (12 months). It's not yet certain that all countries will transition within this period. </li></ul><ul><li>Paediatric ARV funds available until December 2010. Bridge funding request for 2011-12 being submitted to EB12 in the amount of US$ 150.8 million. A &quot;green light status&quot; of US$ 83 million for 2011 is proposed to the Board. </li></ul><ul><li>Ending in 2011 and transition support required </li></ul><ul><li>First Line TB ending in December 2011. 18 of 19 countries have transitioned, 11 of which to the GF </li></ul>
  34. 34. <ul><li>Implementation of the UNITAID 2010-2012 Strategy </li></ul><ul><ul><li>Funding requirements (PMTCT 1, Paediatric TB, Viral Load) </li></ul></ul><ul><ul><li>Smooth transition of projects to other sources: </li></ul></ul><ul><ul><ul><li>Stronger Transition strategy built into new projects </li></ul></ul></ul><ul><ul><ul><li>On going projects: Increase Partners accountability </li></ul></ul></ul><ul><ul><li>Evaluation of projects: on going process 2010-2011 </li></ul></ul><ul><ul><li>Initiate new Calls for Proposals: availability of funds </li></ul></ul><ul><li>Maximizing returns </li></ul><ul><ul><li>Strategic interventions </li></ul></ul><ul><ul><ul><li>Fostering Partnerships </li></ul></ul></ul><ul><ul><ul><ul><li>Price reduction/sustainability </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Improve demand forecasting </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Fostering relationships with suppliers </li></ul></ul></ul></ul><ul><ul><ul><li>Patent Pool: better products and lower prices for HIV/AIDS </li></ul></ul></ul>OUTLOOK
  35. 35. <ul><li>Thank you </li></ul>

×