Civil Society and UNITAID: An introduction | Pharmaceutical Drug | Management Of Hiv/Aids

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Access to medicines is a major challenge for people in developing countries. With the right medicines, diseases such as HIV and AIDS, tuberculosis (TB), and malaria are treatable. Yet for millions of poor people, affordable medicines remain out of reach. UNITAID was established in 2006 as a new public health financing mechanism and a South-North collaboration. It is partially funded through an innovative airline tax that ensures stable long-term financing. UNITAID uses this unique feature to intervene in the market to make medicines for HIV, TB, and malaria affordable and available to people in low- and middle-income countries. Civil society (NGOs and communities affected by the diseases) plays an important role in influencing UNITAID policies and strategies. This document has been produced for the Civil Society Delegations to the UNITAID Board, and aims to encourage more civil society organisations to engage, so that UNITAID benefits from our collective inputs.
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  Civil Society and  UNITAID   An introduction Access to medicines remains a major challenge for people in developing countries. With the right medicines, diseases such as HIV and AIDS, tuberculosis (TB), and malaria are treatable. Yet for millions of poor people, affordable medicines are out of reach.UNITAID was established in 2006 as a new public health financing mechanism and a South–North collaboration. It is partially funded through an innovative airline tax that ensures stable long-term financing. UNITAID uses this unique feature to intervene in the market to make medicines for HIV, TB, and malaria affordable and available to people in low- and middle-income countries.Civil society (NGOs and communities affected by the diseases) has two seats with voting rights on the executive board, and plays an important role in influencing UNITAID policies and strategies. This document aims to encourage more civil society organisations to engage, so that UNITAID benefits from our collective inputs. T   o m  G r   e  e n w o  o  d   /    O x f    a m Woman in Asia holding an antiretroviral pill CONTENTS About UNITAID ã What is UNITAID?ã How does UNITAID inuence the market dynamics of health products? Encouraging innovation: the UNITAID medicines patent pool initiativeHow is UNITAID governed?Civil society and UNITAID ã The UNITAID civil society delegations ã Role of civil society in UNITAID ã Increasing civil society engagement    What is UNITAID?  An international financing mechanism, intervening for market impact to scale up access to treatment of HIV and AIDS, TB, and malaria in developing countries.Established in 2006, UNITAID is an international drug-purchasing facility that raises money from a combination of taxes on airline tickets and long-term government funding. It uses this funding to improve access to medicines in developing countries for three major diseases: HIV/AIDS, TB, and malaria. UNITAID does this by improving the market dynamics for treatments, prevention, and diagnostics in order to reduce prices, improve quality and accessibility, and reduce the length of time between the launch of a health product and its availability in the world’s poorest countries. UNITAID is also a vehicle to encourage follow-on innovation, to ensure medicines are available in formulations and combinations that are best suited to the target populations and treatment conditions in developing countries. See  www.unitaid.eu for full information about UNITAID.Since UNITAID’s inception, the civil society group has concentrated its efforts to ensure that UNITAID reduces the prices and improves the availability of relevant medicines and commodities. Since 2006, UNITAID has committed more than US$730m to support 16 projects in 93 countries. How does UNITAID influence the market dynamics of health products? UNITAID has identified the following areas in which market intervention would scale up access to prevention and treatment: ã Paediatric and Second Line Antiretroviral medicines (ARVs); ã Prevention of Mother to Child Transmission (PMTCT), with linkages to paediatric HIV and AIDS care and treatment; ã Artemisinin Combination Therapy (ACT) medicines for malaria treatments; ã Medicines and diagnostics for tuberculosis (First Line and Paediatric TB, and MDR-TB);ã Supporting the WHO Pre-Qualication Programme. UNITAID’s activity focuses on reducing prices, encouraging the availability of appropriate medicines, improving quality, and strengthening the delivery of medicines. Reducing prices UNITAID seeks to reduce prices by engaging with the pharmaceutical industry, and by strengthening efficiency and enhancing generic competition. Price reductions mean that UNITAID and other funding agencies are able to provide more treatments with the same budget. For example, the 60 per cent price reductions obtained for paediatric AIDS medicines since November 2006 have enabled three times as many HIV-positive children to be treated for the same amount of money. Since UNITAID’s inception, the civil society delegations have concentrated their efforts to ensure that UNITAID reduces the prices and improves the availability of relevant medicines and health goods. Since 2006, UNITAID has committed more than US$730m to support 16 projects in 93 countries. About UNITAID  UNITAID also aims to act as a catalyst for manufacturers, especially generics, to invest in increasing production capacity for MDR- TB medicines and to get quality assurance for those products. The larger purchase volumes associated with increased demand should help drive production costs down through economies of scale, eventually leading to price reductions. This will go a long way to ensure that the 800,000 MDR-TB patients targeted in the Global Plan II to Stop TB 2006–2015 have access to treatment at an affordable price. Where intellectual property rules block access to affordable products, civil society’s advocacy has helped to ensure that UNITAID’s constitution allows it to support compulsory licensing as specified by the exibilities within TRIPS (Trade-Related  Aspects of Intellectual Property Rights). A major new initiative to manage intellectual property is the UNITAID Patent Pool, initially for HIV medicines (see below). Encouraging the availability of appropriate medicines  A key goal of UNITAID is to create incentives for the development of new medicines and diagnostics that are better adapted to patients’ needs. UNITAID and its partner, the Clinton HIV/AIDS Initiative (CHAI), have been able to stimulate the production of nine new affordable child-friendly generic HIV medicines. The UNITAID-CHAI partnership has reached approximately 100,000 children per year with the treatments they need.However, while this is an important achievement, research and development for paediatric HIV treatments, diagnostics (and vaccines) is still woefully inadequate 1  and more actions are urgently needed. Improving quality UNITAID addresses quality issues through its support for the WHO Pre-Qualication Programme. In 2008, it allocated US$40m for the pre-qualification of UNITAID-funded medicines, field sampling, and quality testing of products supplied to users – as well as for capacity building at country level. See: http://apps.who.int/prequal/ Strengthening delivery UNITAID funds proposals that reduce order-to-delivery lead times, and reduce risks of stockouts (temporary lack of medicines in a health facility/medical store). UNITAID does not work in countries, but encourages its partners to strengthen national supply chains. Stockouts are caused by many factors. UNITAID’s contribution to improving availability lies in assuring a better functioning market for necessary products through the use of its resources and the expertise of its implementers and partners. 1 http://www.msfaccess.org/main/medical-innovation/introduction-to-medical-innovation/current-challenges/ Price reductions obtained for paediatric AIDS medicines have enabled three times as many HIV-positive children to be treated for the same amount of money.Civil society’s advocacy has helped to ensure that UNITAID can support compulsory licensing of medicines, where intellectual property rules block access to affordable products. Civil Society and UNITAID: An Introduction   3  In July 2008, the UNITAID Executive Board decided in principle to establish a voluntary patent pool for medicines. The initial focus of the Patent Pool will be on the development of formulations of existing ARVs better suited to the realities of poor settings. What is the patent pool?  A patent pool is a system where patent owners voluntarily give their patents to a central organisation that then licenses them to other companies and researchers. Companies, including generics, and researchers who want to use the patents to develop new versions of the medicines can access the patents in the Pool in exchange for paying a fair royalty to the patent owners. The Pool acts as a ‘one-stop shop’ for managing the negotiations and receiving and paying the royalties. Three potential benefits of the patent pool: 1. More affordable medicines: By allowing different manufacturers to make needed products, the patent pool will encourage competition and bring down prices. This means that they will be available to more people. 2. More appropriate medicines, easier to take: Treatment, especially for HIV, requires combinations of more than one medicine, which may be produced by different companies. Thus, if a company wanted to develop such a combination, it would have to enter into lengthy negotiations with the many patent-holders. A patent pool will enable companies to access all the patents in the pool and to manufacture the new and improved treatment in return for a royalty payment. 3. Paediatric HIV treatments:  By bringing together different patents, the Pool will allow companies to work together to develop new medicines for children, which are currently badly needed. Civil society is working to: ã Build international popular and political support for the UNITAID medicines patent pool; ã Encourage pharmaceutical companies and universities to join the UNITAID patent pool.For more information about the UNITAID HIV/AIDS medicine patent pool, visit www.unitaid.eu/en/ The-Medicines-Patent-Pool-Initiative.html For more information about the Patent Pool campaign in the UK and a series of animations explaining the pool, visit http://www.stopaidscampaign.org.uk Stop AIDS Campaign Action Card being handed to former UK Under-Secretary of State for International DevelopmentStudent Stop AIDS Societies UK campaigns stunt, creating the HIV ribbon symbol in a swimming pool to demonstrate the need for a patent pool for HIV medicines E  mm a  C r  i    t    c h  l    e  y  /   A n  d  r   e wA i    t    c h  i    s  o n 2   0   0   9  L   y n  d   a L   a i   r   d  2   0   0   9   Encouraging innovation: Medicines Patent Pool initiative
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