Integrated Regional Information Networks - October 15, 2009

Fundraiser UNITAID has collected an estimated US$1.2 billion since 2006 for the treatment of HIV, tuberculosis and malaria, mainly from a small levy on airline tickets bought in 34 participating countries, most of them in Africa.

"With the current financial crisis it is going to be very difficult to achieve the MDGs [UN Millennium Development Goals] through official government aid, so innovative methods of financing the fight against these diseases must be sought," said Philippe Douste-Blazy, chair of UNITAID and a UN special advisor on innovative development financing at the first UNITAID implementers' meeting in the Kenyan capital, Nairobi, on 15 October.

A World Bank report in April projected that the global economic downturn could put the treatment of more than 1.7 million people in the developing world at risk by the end of 2009 through drug shortages, treatment interruptions and higher burdens of AIDS-related diseases.

According to Douste-Blazy, the airline levy gives participating developing nations an opportunity to contribute to treatment in their countries rather than depending on handouts from the developed world. "The idea is for funding not to move only from the North to the South, but also from the South to the South," he said.

Beth Mugo, Kenya's Minister for Public Health and Sanitation, told delegates it was time African governments played a bigger role in health financing. "We need long-term financing for health, and we must put pressure on our leaders to implement their Abuja pledge [made at an African Union Summit in the capital of Nigeria in 2001] to dedicate 15 percent of the budget to health," she said. "Few are doing so - in Kenya for example, only seven percent of our national budget is spent on health."

Cote d'Ivoire, Niger, Madagascar and Mauritius are applying the airline levy, while Benin, Burkina Faso and Kenya have said they will introduce it. The levy ranges from US$1 to $2 on economy-class tickets, and up to $40 on business- and first-class fares.

The funds are channelled through NGOs like the Clinton HIV/AIDS Initiative (CHAI), which has used the money to put 170,000 children in 38 countries on antiretroviral drugs (ARVs).

From 2010 individuals will be able to make a voluntary contribution of as little as US$2 when purchasing air tickets, booking hotel rooms or renting cars as part of a new initiative being launched by UNITAID in partership with the Millennium Foundation for Innovative Finance for Health, formed by the UN in 2008.

Strengthening African health systems

The meeting in Nairobi will discuss other ways in which UNITAID and its partner countries can finance the scale-up of HIV, tuberculosis and malaria treatment, but participants also stressed the urgent need for Africa's public health systems to become more efficient.

"In this part of the world we have weak public health systems; we have problems diagnosing these diseases, and when we do diagnose them we have difficulty finding qualified staff to treat patients," said David Okello, Kenya country representative for the UN World Health Organisation (WHO).

There were also calls for greater efficiency in the approval and distribution of essential drugs across the continent. "When providing more drugs, we need to make sure that systems exist to ensure they reach the patients," Okello pointed out.

The UNIADS country coordinator for Kenya, Erasmus Morah, argued that a single medicines agency for Africa would improve the efficiency of drug evaluation and supervision.

"This would replace the fragmented system that currently exists, put an end to manufacturers running from country to country to seek product approval, and reduce the time patients must wait for new drugs."

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