Unitaid’s response to the COVID-19 pandemic
Unitaid has moved quickly to leverage its expertise in the global response to COVID-19.
As co-leads of the Therapeutics pillar of the Access to COVID-19 Tools (ACT) Accelerator, Unitaid is at the forefront of global efforts to ensure equitable access to treatments for COVID-19, including medical oxygen.
We are also members of the Diagnostics Partnership, working with partners to ensure low and middle-income countries have access to the COVID-19 tests they need.
Ensuring equitable access to health products is at the heart of what Unitaid does, acting with firm commitment to the principle that ‘no one safe until everyone is’.
Since March 2020, our efforts have delivered concrete results, most notably:
- Co-leading the COVID-19 Oxygen Emergency Taskforce, which has concluded vital agreements with industry and made an investment of US$ 83 million to enhance oxygen access in low- and middle-income countries, increasing liquid oxygen availability, repairing broken oxygen equipment, upskilling biomedical engineers, and supporting countries to identify needs and develop strategic national oxygen roadmaps.
These investments will drive long term benefits and will keep on saving lives beyond the pandemic.
- Delivery of over 16 million injectable doses and 13.5 million tablets of dexamethasone for treatment of severe COVID-19 to 46 low- and middle-income countries.
- Supporting, through the Medicines Patent Pool, licensed generic manufacturing base of outpatient oral antivirals (Merck, Pfizer) for approximately 100 low- and middle-income countries, accounting for over half of the world’s population.
- Making 170 million rapid diagnostic tests available for use in low- and middle-income countries, together with Diagnostics Partnership stakeholders, and halving the cost of COVID-19 rapid tests to less than US$ 2.50.
- Investing to expand local manufacturing capacity of Antigen Rapid Diagnostic Test (Ag RDT) and building genomic sequencing capacity that helped enable the early detection of the Omicron variant in Southern Africa.
- Supporting partners and countries with donations of pulse oximeters and funding for PPE in the field to ensure our work in other key areas continues.
Mid-term evaluation of Unitaid’s Covid-19 portfolio of investments
Unitaid commissioned an independent mid-term evaluation of its portfolio of Covid-19 investments spanning the period March 2020 to December 2021. Led by Cambridge Economic Policy Associates (CEPA), the evaluation covered 27 investments valued at US$ 155 million. The principal objective of the evaluation was to assess Unitaid’s contribution to the global response to COVID-19 using standard review criteria: strategic relevance, internal and external coherence, efficiency, effectiveness, sustainability/scalability and impact.
The evaluation also presented an opportunity for Unitaid to apply lessons learned to shape the direction of future investments. A mixed-methods approach was adopted involving a review of formal documents (both investment specific and overarching global documents), nearly 150 stakeholder interviews at the global and country level* and several workshops (internal and external).
*Country consultees included Cameroon, India, Kenya, Senegal
Access to COVID-19 Tools (ACT) Accelerator
The urgent need for effective tools to bring an end to the pandemic
The Access to COVID-19 Tools (ACT) Accelerator was launched in April 2020 by the World Health Organisation, bringing together global health actors and private sector partners to make diagnostics, therapeutics, and vaccines for COVID-19 accessible to everyone who needs them worldwide.
ACT-A Therapeutics Partnership
Overcoming challenges to make COVID-19 treatments available
From stopping mild symptoms from worsening to preventing hospitalised patients from dying, we cannot afford to live without effective treatments for COVID-19.
The Therapeutics Pillar of the ACT Accelerator is co-convened by Unitaid and Wellcome, and aims to find the most promising treatments and ensure that low- and middle-income countries can access the benefits too.
Treatments are urgently needed even as vaccines are becoming available. Global access to COVID-19 vaccines is uneven and we need to treat those who are still falling ill and who are unable to get vaccinated.
The Therapeutics Pillar is working to ensure that treatments coming through the pipeline are available, affordable and suitable for use in low-resource settings.
Therapeutics Pillar 2021 Strategy
As set out in the updated ACT-A investment case for 2021, the Therapeutics Pillar needs $3.2 billion to cover four main areas of work:
- Support and monitor research and development into novel antivirals, repurposed medicines, and monoclonal antibodies.
- Facilitate country-preparedness and ensure market readiness.
- Procure treatments, as and when they are proven effective.
- Expand access to oxygen, via the COVID-19 Oxygen Emergency Taskforce.
Donations to the ACT-Accelerator can be tracked here.
Together with UNICEF, the Therapeutics Pillar secured 2.9 million treatment courses of dexamethasone – the first proven life-saving therapy for hospitalised patients – for people in low-and middle-income countries in July 2020, just weeks after the UK RECOVERY trial results showed it to be effective in cutting mortality.
Nearly 20 low- and middle-income countries in Africa, the Middle East, Asia, and Latin America have placed orders so far, with more expected throughout 2021.
- ACT Accelerator moves to expand access to dexamethasone for low- and middle-income countries for COVID-19 treatment, 2 July 2020.
COVID-19 Oxygen Emergency Taskforce
Since the start of the pandemic, affordable and sustainable access to oxygen has been a growing challenge in low- and middle-income countries.
For patients who are critically ill with COVID-19 and require oxygen support, access to oxygen alongside treatments like dexamethasone can be lifesaving.
Together with WHO and Wellcome, Unitaid launched the COVID-19 Oxygen Emergency Taskforce in February 2021.
The taskforce brings together key organisations that have been working to improve access to oxygen since the start of the pandemic including WHO, UNICEF, the Global Fund, the World Bank, CHAI, and PATH.
Building on these efforts, partners will focus on three key objectives as a part of an emergency response plan:
- Coordination: Connecting partners who are supporting countries to assess their oxygen needs and implement the best oxygen solutions.
- Support: The first part of an initial $20 million from Unitaid and Wellcome is being used to support work by CHAI and PATH in nine countries in Africa to address gaps in infrastructure, supply, and maintenance.
- Access to funding: Supporting at-risk countries to develop funding proposals to access the Global Fund’s C19RM mechanism and the World Bank’s COVID-19 emergency response.
- Industry: Working with industry to address market barriers that are hindering the oxygen response, including the conclusion of groundbreaking deals with Air Liquide and Linde to increase oxygen access in low- and middle-income countries.
The PATH COVID-19 Oxygen Needs Tracker gives real-time estimates of the daily oxygen needs in low- and middle-income countries.
- R2-2023-e Additional contribution from Canada, May 2023.
- Improving access to novel COVID-19 treatments: Launch of Member States briefing on how to navigate interfaces between public health and intellectual property, 11 April 2023.
- R23-2022-e Extension of investments in Unitaid’s COVID-19 Test-and-Treat and Medical Oxygen Portfolios, December 2022.
- World Pneumonia Day: Unitaid’s work to enhance global access to medical oxygen will contribute to reducing childhood mortality, 14 November 2022.
- Canada contributes Can$ 25 million to Unitaid to expand sustainable access to medical oxygen, 22 September 2022.
- US$ 83 million of investments from Unitaid to address global inequities in access to oxygen will drive long term benefits, Unitaid urges other donors to commit more funding for medical oxygen, 21 June 2022.
- Unitaid commits US$ 56 million to boost access to medical oxygen globally, calls on other donors to close US$ 1 billion gap, 17 March 2022.
- The ACT-A Oxygen Emergency Taskforce…one year on, 23 February 2022.
- Unprecedented cooperation with global oxygen suppliers paves way to increase access for low- and middle-income countries to address COVID-19 crisis, 15 June 2021.
- COVID-19 oxygen emergency impacting more than half a million people in low- and middle-income countries every day, as demand surges, 25 February 2021.
COVID-19 clinical trials
Unitaid is funding adaptive clinical activities for the COVID-19 response to address evidence gaps.
The AGILE project is an early-stage clinical trial platform that is identifying potential new candidates and repurposed therapeutics for the prevention or treatment of COVID-19, thereby enabling larger trials to move more quickly and efficiently. The main evaluations are being done through the University of Liverpool and their networks.
ANTICOV is an open-label, adaptive platform trial of the safety and efficacy of several potential treatments, including antiviral therapies, for mild to moderate cases of COVID-19. The trial is led by DNDi and involves countries in Sub-Saharan Africa, including Burkina Faso, Cameroon, Equatorial Guinea, Ethiopia, Guinea, Mali, Mozambique, Sudan, and Uganda.
- UNifeed: Unitaid’s COVID-19 treatments investment, 4 June 2021.
- ANTICOV: largest clinical trial in Africa for people with mild COVID-19 to test new drug combination, 27 April 2021.
- Unitaid supports ANTICOV, an adaptive platform trial in Africa to treat mild to moderate cases of COVID-19, 24 November 2020.
COHIVE is an observational study assessing the impact of COVID-19 in people living with HIV, clarifying the risks for this cohort, and informing outcomes with repurposed treatments for COVID-19 transmission risks.
The COVER HCW study of 1,700 healthcare workers in South Africa is led by Ezintsha. The aim is to evaluate COVID-19 prophylaxis for highly-exposed frontline workers using immediately-available generic drugs.
Potential treatments for COVID-19
Unitaid is closely monitoring the pipeline of potential new COVID-19 treatments.
See our recent statements on the following:
- Unitaid welcomes new agreements from CHAI to accelerate access to affordable COVID-19 antiviral nirmatrelvir/ritonavir in low- and middle-income countries, 13 May 2022.
- Global Fund, United States and Unitaid Launch “Test-and-Treat” Programs at Second Global COVID-19 Summit, 12 May 2022
- Unitaid statement on the MPP agreements for local production of generic versions of the oral COVID-19 antiviral nirmatrelvir, 24 March 2022.
- Canada commits an additional $20 million CAD contribution to Unitaid to further enhance global access to COVID-19 treatments, 10 March 2022.
- Unitaid statement on WHO guidelines for COVID-19 antiviral molnupiravir, 3 March 2022.
- WHO-Unitaid statement on the MPP licensing agreement for molnupiravir, 27 Octobre 2021.
- Unitaid statement on molnupiravir as a treatment for mild and moderate COVID-19, 1 October 2021.
- Unitaid’s statement on the recommendation of casirivimab/imdevimab for COVID-19 treatment, 24 September 2021.
- Joint Statement from Unitaid and the World Health Organization (on behalf of the Access to COVID-19 Tools Accelerator) regarding availability of tocilizumab, 18 August 2021.
- Unitaid statement on WHO recommendations for tocilizumab and sarilumab, 7 July 2021.
Monoclonal antibodies are a promising treatment for COVID-19 currently being tested in clinical trials around the world.
The ACT-A Therapeutics Pillar, in collaboration with the Bill & Melinda Gates Foundation (on behalf of the COVID-19 Therapeutics Accelerator), reserved manufacturing capacity for the development of Eli Lilly’s potential COVID-19 monoclonal antibody for low-and middle-income countries.
COVID-19 Therapeutics Accelerator partners are monitoring the science of new COVID-19 variants closely, and determining how these strains may impact the initiative’s portfolio of current and potential future investments.
ACT-A Diagnostics Partnership
Facilitating access to Rapid Diagnostic Tests in low- and middle-income countries
Why is testing so important?
Without mass testing around the world, COVID-19 will continue to spread. Testing plays a vital role in identifying clusters of cases and preventing onward transmission, when combined with contact tracing and quarantine.
The ACT-A Diagnostics Partnership is co-convened by FIND and the Global Fund, with Unitaid leading the market-preparedness workstream.
The Partnership aims to accelerate development of high-performing, affordable, rapid diagnostic tests (RDTs), prepare markets to accelerate their
implementation, and support the cost of test procurement and deployment in low- and middle-income countries.
Currently testing rates in high-income countries are 60 times higher than in low-income countries – the Diagnostics Partnership aims to boost capacity of low- and middle-income countries to test their populations.
Antigen RDTs are a game-changer in the fight against COVID-19, enabling quick results that do not rely on complex and expensive laboratory equipment.
Rapid tests are designed to be used in a variety of settings, but are particularly useful in remote health centres with limited or no testing resources.
FIND’s Test Tracker shows testing rates in countries by income category and geographical location.
Expanding manufacturing capacity
In January 2021, agreements were concluded that halved the cost of antigen rapid diagnostic tests for low- and middle-income countries and expanding geographical manufacturing capacity.
The agreement with Premier Medical Corporation (PMC) in India is the first in a set of investments in research and development, including technology transfer and manufacturing scale-up.
With support from FIND and Unitaid, the company is expanding and automating manufacturing capacity so that antigen rapid diagnostic tests can be made available to low- and middle-income countries for less than US$2.50 per test.
Bolstering local manufacturing capacity and technology transfer
A second round of agreements were announced in July 2021, and focused on the transfer of technology and expansion of local manufacturing capacity.
These agreements signed with DCN Dx to transfer know-how to WAMA Diagnóstica in Brazil, and Bionote and Mologic to transfer know-how to DIATROPIX of the Institut Pasteur de Dakar in Senegal mark a concrete step forward in increasing access to testing in low- and middle-income countries.
Both sets of agreements were concluded following an EOI launched by FIND and Unitaid in July 2020.
Preparing countries to use rapid tests
Diagnostics Partnership members came together in September 2020 to facilitate access to 120 million rapid tests for low-and middle-income countries.
Unitaid, CHAI, and the Africa Centres for Disease Control and Prevention (Africa CDC) combined resources to engage in country-preparedness to enable the roll out of these tests in up to 20 countries in Africa.
- Key stakeholders convene ahead of the G20 second health working group to strengthen global collaboration in research and accelerate regional manufacturing for diagnostics, 16 April 2023.
- FIND, Unitaid and partners from the access to COVID-19 tools (ACT) Accelerator diagnostics pillar call on the G20 and G7 to prioritize diagnostics in its pandemic preparedness and response plans, 20 June 2022.
- FIND and Unitaid, through the ACT-Accelerator, seek organizations to advocate and raise awareness on COVID-19 testing and treatment solutions, 12 January 2022.
- FIND and Unitaid invest US$ 50 million to speed lifesaving testing and treatment solutions to the COVID-19 pandemic’s frontlines, 9 November 2021.
- FIND and Unitaid invest to support technology transfer and boost local production of COVID-19 rapid tests in low- and middle-income countries, 15 July 2021.
- Cost of rapid COVID-19 tests halved as global investment ensures availability of high volumes for low- and middle-income countries, 22 January 2021.
- Global partnership to make available 120 million affordable, quality COVID-19 rapid tests for low- and middle-income countries, WHO, 28 September 2020.
- FIND and Unitaid launch call for expression of interest to accelerate availability and manufacturing scale-up of rapid diagnostic tests for COVID-19, 9 July 2020.
Supporting our partners through the pandemic
Unitaid’s efforts to transform the fight against major diseases continue, even in the context of COVID-19.
Unitaid and partners have been collaborating to protect the gains made against diseases such as HIV/AIDS, tuberculosis, and cervical cancer – and to advance 21st century solutions to meet these challenges.
Unitaid has supported partners with the provision of PPE and donations of pulse oximeters to aid with the COVID-19 response in several low- and middle-income countries, as well as rapidly responding to help project teams hire staff to cover those who are self-isolating and adapt to providing remote healthcare.
Keep in touch
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Hervé Verhoosel | +44 7729 618634 | firstname.lastname@example.org
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