Invitation to local manufacturers of liquid oxygen to submit an expression of interest (“EOI”) for financial and technical support to improve access and affordability of liquid and medical oxygen in Sub-Saharan African countries.

Call for Expression of Interest (CEI)

The purpose of this CEI is to identify opportunities to support local suppliers interested in increasing availability and affordability of medical oxygen for public procurers.

Closing Date: 5pm (GMT), 30 July 2022

Webinar on this EOI

Please join Unitaid and MedAccess for a webinar providing potential applicants with more information on the EOI.

Date: 20 July 2022 at 12pm CEST

Join via Zoom: https://unitaid.zoom.us/j/84130020292

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

Boilerplate Press Release by Oxygen Donors

Today, Unitaid urgently calls on other donors to commit more funding for medical oxygen to help close the US$1 billion funding gap in the oxygen response. Its US$ 83 million of total investments to date to address global inequities in access to oxygen will drive long term benefits for low- and middle-income countries. But more funding is needed to save lives now and support countries prepare for future health emergencies.

Unitaid joined a total of 5 donor countries, multilateral organizations, and foundations that announced examples of their collective contributions to address the large shortfalls in access to oxygen for patients, including those hospitalized with COVID-19, in low- and lower-middle-income countries (LMICs) around the world. Addressing global inequities in access to oxygen, since the beginning of the pandemic, Unitaid has invested US$ 83 million towards increasing liquid oxygen availability, repairing broken oxygen equipment, upskilling biomedical engineers, and supporting countries to identify needs and develop strategic national oxygen roadmaps.

Even prior to COVID-19, access to medical oxygen was inadequate to meet the needs of health systems in most LMICs. In addition to COVID-19 patients, there is a vast patient population who also need oxygen therapy, including newborns in respiratory distress, children with pneumonia, sepsis, and/or congenital heart disease, adults with tuberculosis, malaria, and/or HIV/AIDS and/or chronic respiratory conditions like COPD, and patients requiring surgery.

Prior to the pandemic, much of the world took access to oxygen for granted — however, headlines reporting oxygen shortages, and their tragic consequences, have changed this. Access to oxygen has become a key plank of the COVID-19 pandemic response. Oxygen is an essential treatment for severe COVID-19 – 75 percent of people hospitalized can survive with oxygen therapy alone. Without oxygen, these patients cannot survive.

During the pandemic, donors around the world have mobilized more than US$800 million in grant financing to help LMICs avert oxygen shortages. These investments have already helped millions of patients, and will be vital components of systems needed to respond to future health emergencies. But, they are not enough. An additional US$1 billion is needed to prevent further oxygen shortages in LMICs in the next year alone. More support from governments, foundations, high net worth individuals, and the private sector would be warmly welcomed by Unitaid. People sick with severe COVID-19 or other conditions must not be left to die simply due to a lack of oxygen in medical facilities.

Donors making announcements today include the Government of Germany, The Global Fund, the Skoll Foundation, Unitaid, and the U.S. Agency for International Development.

Unitaid Press Release

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

  • Unitaid’s investments of US$ 83 million in access to medical oxygen have spurred significant progress and will drive long term benefits for low- and middle-income countries
  • As Chair of the ACT-A Oxygen Emergency Taskforce, Unitaid is urging other donors to commit more funding to further enhance global access to medical oxygen, save lives now and prepare for future health emergencies
  • To enhance country preparedness and sustainably diversify the oxygen market, Unitaid and MedAccess are working to identify opportunities to support local and regional suppliers of liquid oxygen interested in increasing availability and affordability of medical oxygen for public procurers 

Geneva, 21 June 2022 – Unitaid has invested US$ 83 million to date to address global inequities in access to oxygen in response to the COVID-19 pandemic, filling an immediate access gap for safe and affordable oxygen to those who needed it most and laying the groundwork to improve access to oxygen over the long term.

These investments support the work of the Access to COVID-19 Tools Accelerator (ACT-A) Oxygen Emergency Taskforce, led by Unitaid, to expand sustainable access to adequate, affordable oxygen solutions such as bulk liquid oxygen, oxygen generation systems and other important oxygen equipment in low- and middle-income countries (LMICs).

The Unitaid-funded grants have helped to increase liquid oxygen supplies, lower costs, strengthen infrastructure, expand technical capacity, and ensure safe use of medical oxygen.

As part of broader partner efforts to assess the oxygen needs of over 100 countries and access funding available through the Global Fund, the World Bank and other partners’ funding mechanisms, Unitaid’s investments directly supported this work in 18 countries.

Among other significant progress and achievements made to date, Unitaid has procured more than US$ 15 million in emergency supplies, delivering nearly 30,000 cylinders, 2,000 concentrators, more than 5,000 pulse oximeters – an essential portable device that can detect low oxygen in the blood – and 3 PSA plants for oxygen, to 33 countries.

Thanks to Unitaid’s leadership, an agreement with two major gas companies, Air Liquide and Linde Group, was successfully brokered securing ~15% price reductions for bulk liquid oxygen versus current pricing, between 10 to 15% reductions for cylinders and up to 43% reductions in filled cylinder pricing, paving the way for long term agreements for access to liquid oxygen. With this, 19 tanks for bulk liquid oxygen for LMICs were reserved and countries such as Zambia and Ghana, were able to meet surge demand across several hospitals.

Unitaid is now exploring how to support countries to build robust oxygen systems that can meet current needs and prepare for future health emergencies, and to ensure the market is ready to respond to demand surges. For that purpose, Unitaid and MedAccess, will launch in the coming days a call for expressions of interest* to local and regional manufacturers of liquid and gaseous oxygen to receive financial and technical support to expand affordable oxygen supply in sub-Saharan Africa.  The end goal is to identify opportunities to support suppliers and increase the availability and affordability of medical oxygen for countries.

But more funding is needed to scale-up medical oxygen supply and prepare countries for future health threats.

Oxygen is a lifesaving treatment but also a high-return health investment that will keep on saving lives beyond the pandemic and significantly reduce deaths among newborns, children, women in childbirth, and adults with both communicable and non-communicable diseases.

Investing in oxygen will pay dividends now and going forward, as a critical foundation for future health emergencies. Therefore, Unitaid urgently calls on other donors for more funding in medical oxygen to help close the US$1 billion funding gap in the oxygen response.

* The call for expression of interest will be published here.

About the Access to COVID-19 Tools Accelerator (ACT-A) Oxygen Emergency Taskforce (Oxygen Taskforce)

The Oxygen Taskforce was launched in February 2021 to bring together key partners already working to address critical oxygen gaps, as part of a coordinated COVID-19 response. The Oxygen Taskforce is led by Unitaid, under the Therapeutics Pillar of the Access to COVID-19 Tools Accelerator. Partner organizations include Unitaid, WHO (and the Biomedical Consortium it coordinates), UNICEF, The Global Fund, the World Bank, UNOPS, the Every Breath Counts coalition, CHAI, PATH, Save the Children, The Bill and Melinda Gates Foundation, Access to Medicine Foundation, the Pan American Health Organization (PAHO), and the Africa Centre for Disease Control and Prevention.

Media contact:

For more information and media requests:

Sarah Mascheroni

Communications officer

Email: mascheronisa@unitaid.who.int

Mobile: +41 79 728 73 11

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

The COVID-19 pandemic has shown that access to timely, accurate diagnostics is fundamental to effective healthcare. The Access to COVID-19 Tools (ACT) Accelerator is a unique but time-limited partnership that was set up to respond to the acute phase of the COVID-19 pandemic.

G7 and G20 countries, have so far pledged US$ 18.3 billion to the ACT-Accelerator, of which US$ 12.36 billion has been pledged to the vaccines pillar, COVAX. The G7 in its Health Ministers’ Communiqué (20 May 2022, Berlin) stated:

“We underline our support for all four pillars of the ACT-Accelerator, including its COVAX facility and recognize that supporting the ACT-Accelerator by all means, including with adequate funding, is central to end the acute pandemic.”

The ACT-Accelerator has played a critical role in delivery of diagnostics, therapeutics and vaccines. Investments by ACT-Accelerator partners will deliver benefits for global health programmes beyond COVID-19.

Testing and sequencing allow us to track disease evolution and spread, and facilitate access to treatments. As world leaders including the G7 and G20 are aligning efforts for future pandemic preparedness and creating a G7 Pact for Pandemic Readiness, FIND, Unitaid and ACT-Accelerator Diagnostics Pillar partners call on both G7 and G20 to reaffirm commitments relating to diagnostics as part of the 100 Days Mission put forward during the UK G7 Presidency in 2021:

  • Ensure enhanced surveillance systems are in place for early threat detection
  • Point-of-care testing platforms are developed and rolled out worldwide to diagnose disease outbreaks as they happen
  • Manufacturing capacity is established globally, in a coordinated and distributive framework for rapid technology transfer to minimize over-reliance on any one source and keep supply pipelines open
  • Testing systems are linked to rapid public health interventions, breaking chains of transmission in real time – and keeping health systems from being overwhelmed
  • Worldwide testing is actionable and accompanied by linkages to treatment and care through accelerated development of vaccines and therapeutics, which can be rolled out in 100 days
  • Global equitable access to tests, vaccines and therapeutics, including medical oxygen, is assured

Addressing shortfalls in diagnostic testing must be an urgent priority. Deficiencies in testing affect not only people’s lives, but communities and economies as well as our ability to ensure we can manage existing and future outbreaks of diseases, as COVID-19 showed clearly. Strong global leadership and political will is needed to accelerate change and lead the world towards a better future.

Media contact:

For more information and media requests:

Sarah Mascheroni

Communications officer

Email: mascheronisa@unitaid.who.int

Mobile: +41 79 728 73 11

Unitaid Strategy 2023-2027

Official response from ACT-Accelerator therapeutics partners to the IFPMA

This response was sent on 19 May 2022

Dear Mr Cueni,

We note your letter dated 9 May 2022 and are in agreement that our continued collaboration will be vital in supporting countries to introduce lifesaving COVID-19 therapeutics.

As partners in the Therapeutics Pillar, we are all committed to ensuring that vulnerable people everywhere can benefit from rapid access to effective COVID-19 therapeutics. We recognize the continued engagement of pharmaceutical partners with the ACT-A Therapeutics Pillar and their work on enabling development and commercialization of needed products, as well as, via voluntary license processes, supporting development of generic products. These are some of the critical steps on the pathway to ensuring we maximize the impact of emerging therapeutics. We remain hopeful that the pipeline will continue to advance the search for the most suitable pharmaceutical solutions to this fast-evolving pandemic as we work to resolve current roadblocks and support countries’ pandemic responses.

ACT-A partners (WHO, Unitaid, Global Fund, UNICEF, Wellcome) are committed to our ongoing collaboration with industry – but more is needed to achieve equitable access for all. We have engaged with originator companies that are developing and bringing to market various therapeutics, consistently calling for broad access principles that can enable a scaled-up response in countries in need.

We have discussed with the pharmaceutical partners the need to support affordable and transparent pricing policies. Early visibility on pricing terms and availability of originator products can support countries to adequately plan and forecast, simplify procurement processes and increase the speed of the response.

We also seek sustained product access via support to expanded generic production and access in all low- and middle-income countries. We have seen progress in both these areas, but we need more to achieve our shared objectives.

In each of the areas of equitable geographic access, affordable pricing, pricing transparency, and expanded generic production, we have experienced impediments which have slowed down deployment of these new products.  We therefore continue to urge IFPMA and pharmaceutical companies to continue to collaborate with ACT-A partners on a pathway for equitable access for all low- and middle-income countries.

An overall approach to product allocation was developed in late 2021, communicated to countries in February 2022, and to date has been launched for three different products, including a preliminary allocation for nirmatrelvir-ritonavir. Product allocation processes are only used when needed, including when supply is insufficient to meet demand. They are based upon the product’s specific use case and, therefore, can only be issued following a WHO recommendation. A major operational challenge for countries to express clear demand for new products is transparency in geographic access and pricing information. A short description of the allocation approach is included in annex to this letter.

To ensure prompt and adequate uptake as products become ready for use, we are working to support country-level deployment. Building on the ongoing work to support early adoption with cross-pillar efforts (Unitaid/FIND country projects), ACT-A partners are mobilizing an additional US$120 million, as announced at the second Global COVID-19 Summit on May 12, for procurement and country-uptake of oral antivirals and diagnostics to prevent hospitalizations and deaths from COVID-19 for those at highest risk. Together with USAID, ACT-A partners will support more than 20 countries to support uptake of test-and-treat programs; efforts that can be reinforced if additional funding is made available.

Finally, we should recognize that countries and ACT-A partners are facing significant budget constraints and uncertainty which impedes deployment of these new products, in addition to the waning political attention to the pandemic and low diagnostic usage. Your support for ACT-A partners and work with manufacturers to expand equitable geographic access, affordable pricing, pricing transparency, and expanded generic production is appreciated and will support effective deployment of new therapeutics.

The ACT-A Therapeutics pillar’s priority remains to secure access, procure affordable products recommended by WHO guidelines, and support prompt and adequate deployment of these life-saving tools. We look forward to continuing to work together to achieve these objectives.

Yours sincerely,

Mr Philippe Duneton

Executive Director, Unitaid

Dr Mariângela Batista Galvão Simão

Assistant Director-General, World Health Organization

Mr Peter Sands

Executive Director, The Global Fund

Annex A: Overview of product allocation methodology and status

Based on principles of equity, transparency, and ethics, as in the vaccine allocation strategy, and recognizing the different context of therapeutic medicines, an approach for equitable allocation was developed in late 2021 for COVID-19 therapeutic products. The development of the approach was accelerated and communicated to countries in February 2022 in anticipation of the release of tocilizumab. The allocation rounds were launched in mid-February and the supply agreement was signed on 15 March 2022.

Therapeutics allocation is initiated through an interactive portal that is accessible by country stakeholders. The portal is secured for multiple reasons including data privacy for countries; however, final allocation plans are shared transparently with countries, procurement partners and the relevant manufacturers. Respective manufacturers work closely with the ACT-A teams to optimize deliveries to countries, facilitate regulatory processes and other technical and operational activities.

The process captures complex variables, including adjusted needs estimates that identify appropriate target groups per the WHO treatment guidelines. It automates estimates to avoid long exercises at country level and also uses prioritization criteria to enhance supplies or timing to countries that are the most vulnerable. A typical allocation process takes 2-4 weeks to allow sufficient response times for countries.

In situations where constraints exist, they are also taken into account to ensure the best possible stewardship of therapeutics products such as avoiding over-supply. Constraints vary and can include supply, finance or country capacity to deliver necessary services e.g., ICU capacity for medicines used for hospitalized patients. Allocation exercises require a minimum amount of information and are best launched when there is sufficient visibility to the country on the terms, timing and quantities available. Three different products have been launched via the Therapeutics Allocation Mechanism, including a preliminary allocation for nirmatrelvir-ritonavir where information remains pending.

Unitaid welcomes new agreements from CHAI to accelerate access to affordable COVID-19 antiviral nirmatrelvir/ritonavir in low- and middle-income countries

Geneva – Unitaid welcomes the Clinton Health Access Initiative (CHAI) announcement on agreements with leading generic manufacturers to make nirmatrelvir/ritonavir available to low- and middle-income countries (LMICs) at under US$25 per treatment course. The agreements also settle on production guarantee and allocation capacity for 4.5 million treatment courses per month for LMICs.

Pfizer’s oral COVID-19 treatment — a combination of nirmatrelvir and ritonavir tablets sold under the name Paxlovid — was strongly recommended by the World Health Organization (WHO) last month, based on evidence on prevention of hospitalization and death for mild-to-moderate COVID-19 patients at high risk of developing severe forms of the disease, when administered in early stages of the infection.

These agreements represent an important step in the global COVID-19 response, building on the groundwork Unitaid and partners of the Access to COVID-19 Tools (ACT) Accelerator’s therapeutics pillar have laid to ensure equitable, rapid and affordable access to new treatment options. Focused efforts are aimed at introducing those treatments in LMICs alongside adequate testing to realize the promise of test-and-treat strategies in decentralized settings.

The ACT-Accelerator therapeutics pillar has worked closely with the Medicines Patent Pool, originator and generic companies, to make nirmatrelvir/ritonavir accessible from both originator and generic companies, as access to originator product is essential to avoid delay in the uptake of this important treatment while generic manufacturers work towards WHO prequalification. The pillar is making sure all measures are taken to accelerate the generic pathway in order for a robust and functional generic market to provide a sustainable supply of quality-assured products at a lower price to LMICs as soon as possible.

But continuous support is needed to expand production of generic versions of medicines and ensure that systems are in place for these products to be promptly adopted by countries.

While uncertainties remain a challenge regarding the evolving epidemiology, predictability on potential generic prices and volumes, as announced by CHAI today, are key for planning and simplifying country adoption.

“These agreements are pivotal to ensure timely access to optimal treatment for those at high risk of developing severe or critical COVID-19 in low resource settings.”, Unitaid Executive Director Dr Philippe Duneton said. “Supporting countries in securing access for efficient emerging treatment options, as well as their deployment in the most effective way, is Unitaid and ACT-A therapeutics pillar partners’ priority.”

Media contact:

For more information and media requests:

Sarah Mascheroni

Communications officer

Email: mascheronisa@unitaid.who.int

Mobile: +41 79 728 73 11

Global Fund, United States and Unitaid Launch “Test-and-Treat” Programs at Second Global COVID-⁠19 Summit

GENEVA, WASHINGTON – The Global Fund, the United States and Unitaid, together with FIND and other ACT-Accelerator partners, are launching over US$120 million in support to countries for test-and-treat programs to prevent hospitalizations and deaths from COVID-19 for those most at risk in low- and middle-income countries. The announcement was made at the Second Global COVID-⁠19 Summit, which placed an emphasis on supporting locally led solutions to both immediate and long-term challenges, including the deployment of tests and treatments, especially for the highest-risk populations.

Test-and-treat programs will save lives, reduce global inequities in access to COVID-19 testing and treatment, help strengthen formal and community systems for health in low- and middle-income countries, protect front-line health workers, and mitigate the knock-on impact of COVID-19 on programs to fight HIV, TB and malaria.

The Global Fund will procure up to US$80 million in COVID-19 rapid test kits and oral antiviral drugs, and USAID will provide US$20 million in technical assistance for piloting test-and-treat fast-paced implementation in eight countries. Unitaid will provide an additional US$22 million to expand and accelerate the introduction of new treatments through the ongoing Unitaid–FIND early-adoption test-and-treat programs launched in late 2021. These combined investments of US$122 million will support test-and-treat implementation in over 20 low- and middle-income countries globally.

“Getting more people to test for the virus is fundamental to containing transmission, identifying the emergence of variants and getting people on new treatments,” said Peter Sands, Executive Director of the Global Fund. “We are extremely grateful to the United States and ACT-Accelerator partners for their renewed commitment to support the global response to the pandemic. Successful test-and-treat programs can save many lives, but success will require scaling up testing, deploying new COVID-19 antiviral drugs, and ramping up technical assistance to enable those most at risk to gain rapid access to tests and treatments.”

“This new co-investment is a critical step toward equitable access to optimal treatment alongside adequate tests for those at high risk of developing severe or critical COVID-19 in low-resource settings,” said Unitaid Executive Director Dr. Philippe Duneton. “We now have treatment options that can prevent hospitalizations and deaths and will be key in the response to the pandemic. Supporting countries in securing access for these emerging options, as well as their deployment in the most effective way, is our priority.”

Media contact:

For more information and media requests:

Sarah Mascheroni

Communications officer

Email: mascheronisa@unitaid.who.int

Mobile: +41 79 728 73 11

Mid-term evaluation of Unitaid’s COVID-19 portfolio of investments