UNITAID strives to target underserved niches where its funding model can have an impact on the market and where UNITAID can complement the work of other health actors. UNITAID support has been focused on HIV/AIDS, tuberculosis (TB), and malaria.

UNITAID’s 2010-2012 strategy states that UNITAID funds can only be used for “the purchase and supply of high-quality medicines, diagnostics and prevention products including reasonable costs for quality control, shipping, insurance and procurement management.” The costs of a program’s implementation (operating costs, administrative expenses) must be secured separately from other donors, with the exception of a few programs designed to improve processes—including supply chain and regulatory compliance (see below).

Breakdown of Funding by Project Area and Type

From 2007 through 2010, UNITAID committed US$1.5 billion to support sixteen projects, across four project areas (see UNITAID committed funds, 2007-2010):

• HIV/AIDS
• malaria
• TB
• cross-cutting projects.

Source: UNITAID 2010 annual report

HIV/AIDS:

Over half of all funds (55%) have been committed to projects addressing HIV/AIDS treatment, primarily procurement and supply of pediatric and second-line anti-retroviral drugs (ARVs).

Malaria:

About a fifth (22%) of funding has been committed to malaria projects, primarily:

• Start-up funding to the Affordable Medicines Facility for malaria (AMFm), an innovative financing mechanism designed to expand access to artemisinin-based combination therapies (ACTs) through the public, private, and non-governmental sectors; and
• The purchase of ACTs and long-lasting insecticide-treated nets.

TB:

Most funding for TB programs has been committed to:

• Purchasing diagnostics for multi-drug resistant TB;
• Increasing access to pediatric and first-line TB drugs; and
• Creating a global stockpile of TB drugs to avoid drug stock-outs.

Cross-cutting projects:

UNITAID has funded two cross-cutting projects:

• The WHO Prequalification of Medicines Programme (PQP), a global medicines quality assurance program. UNITAID—along with other large organizations, such as UNICEF—procures large quantities of medicines for distribution in developing countries, and the PQP ensures that these medicines meet quality, safety, and efficacy standards. The PQP works to achieve this goal through its evaluation and inspection activities, and by building country capacity for sustainable manufacturing and monitoring of high-quality drugs.
• Support for projects in developing countries that received grants under Round 6 from the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund). UNITAID funds supported 42 of these developing countries to purchase drugs to treat HIV, TB, and malaria.

The 17 projects funded by UNITAID are implemented by 10 partner agencies in 94 countries (see Projects supported by UNITAID, 2007-2011).

In addition to these projects, UNITAID is also financing the Medicines Patent Pool Foundation, which aims to make new HIV medicines available at lower prices for developing countries (see below).

Breakdown of Funding by Implementing Partner

UNITAID’s key implementing partners are the Clinton Health Access Initiative (CHAI), UNICEF, and the Global Fund. Together, these three organizations received about three-quarters of the total UNITAID commitments between 2007 and 2009 (see Breakdown of funds by implementing partner, 2007-2010).

Source: UNITAID 2010 annual report. CHAI: Clinton Health Access Initiative; GDF: Global Drug Facility; GLC: WHO Green Light Committee; FIND: Foundation for Innovative New Diagnostics.

Medicines Patent Pool

In December 2009, UNITAID’s Executive Board approved the establishment of a patent pool for HIV medicines, and provided start-up funds of US$4 million. At the December 2011 Board meeting, UNITAID’s Board committed US$26.3 million for the patent pool for the 2012-15 period.

In July 2010, the patent pool became an independent legal entity, separate from UNITAID, called the Medicines Patent Pool Foundation. The foundation aims to make new medicines to treat HIV available at lower prices for low- and middle-income countries.

The Pool will work in three steps (see How the Medicines Patent Pool works).

Source: E2Pi figure, based on information from the Medicines Patent Pool Foundation

The Pool secured its first license in September 2010, from the US National Institutes of Health, on a series of patents related to the ARV darunavir, and a second license for products from Gilead Sciences in July 2011, which was amended in November 2011. The license from Gilead relates to four products:

• emtricitabine (FTC)
• elvitegravir (EVG)
• cobicistat (COBI); and
• a fixed dose combination known as the Quad (a combination of FTC, COBI, EVG, and tenofovir).

The generic company Aurobindo Pharma Limited joined the pool in October 2011, and a second generic manufacturer, Emcure Pharmaceuticals, joined in February 2012, allowing these companies to manufacture these four products.

Read more about the mission, background, and operation of the Medicines Patent Pool.