In Cameroon, With UNITAID

I’m in Cameroon for the next few days, on a trip with some excellent bloggers (Baratunde Thurston, Cheryl Contee and Jill Filipovic). We are tagging along with Phillipe Douste-Blazy, the former French foreign minster, and current UN under-secretary general and chairman of UNITAID. Douste-Blazy is in Cameroon this week to visit UNITAID funded projects and programs to fight HIV/AIDS, Malaria and TB.

UNITAID–if you are a reader of this blog, you’ve probably heard of it, but not quite sure what it does. Compared to groups like UNICEF or the World Health Organization, it is a relatively unknown organization, at least in the United States.

UNITAID is a pioneer in what is called “innovative financing” for global health. In practice, this means fundraising that is not exclusively dependent on 1) outlays from donor governments 2) donations from large philanthropies.

The main way that UNITAID raises its funds is through a small levy on airline tickets in a few countries: France, Norway, the Republic of Korea, Mali, Niger and Cameroon.  The “tax” ranges from 1 euro per ticket to as much as 40 euros per ticket (for a first class international ticket to France.)  Over $2 billion has been raised through this ticket levy since 2006.

With those funds UNITAID does a few things. They are able to buy AIDS, TB, and Malaria medicines in bulk, which helps drive down the cost. They also help to create markets for medicines in which the market would otherwise not exist.

Pediatric HIV/AIDS medicines is a good example of how this works. In the western world the transmission of HIV from pregnant mother to child has virtually been eliminated. This means that in rich countries there is almost no demand for specialized pediatric HIV/AIDS treatment so no drug companies much bothered to develop affordable anti-retro viral medicines for children.

In 2007 UNITAID stepped in to back the development of cheap pediatric HIV/AIDS medicines with the promise of purchasing large quantities of these medicines for distribution in the developing world.  Today, 8 out of 10 children on HIV treatment in the world are using treatments backed by UNITAID.

That’s just one example of the kind of unglamorous but life saving work that UNITAID accomplishes. Its other major activity is the “medicines patent pool.”

The idea behind this is pretty simple: Western drug companies hold most of the patents for HIV drugs. Understandably, they are reluctant to share these patents with makers of cheaper, generic versions of their medicines. The thing is, developing world countries can’t afford to pay for the name brands. The new “patent pool” is a voluntary system that lets makers of licensed drug patents share their patents to generic drug manufacturers for sale least developed countries.  UNITAID then pays a small royalty fee to the drug companies.

This significantly drives down the cost of medicines for poor countries like Cameroon. At the same time, it is a new revenue stream (albeit small) for patent holders that would otherwise not receive royalties on these patents at all. The patent pool kicked off in July when Gilead Sciences, a major American manufacturer of HIV drugs, added patents to the pool.

So that’s the short story on UNITAID. In the next few days we are visiting several UNITAID funded projects in Yaounde and surrounding towns, with a special focus on the prevention of mother to child transmission of HIV/AIDS.

Stay tuned.