1. UnitaidExplore: a fast track to innovation
2. Preventing cervical cancer: “a disease that nobody should be dying of today.”
3. In brief: HIV self-testing; long-acting medicines
UnitaidExplore: a fast track to innovation
Unitaid has just launched UnitaidExplore, a fast, flexible process for finding and funding small projects with the potential to spark big impact in global health.
“Unitaid as a whole is innovation in global health. That’s what we do,” Director of Strategy Janet Ginnard said. “With UnitaidExplore we’re testing other ways to support innovation, maybe reaching new partners or advancing novel ideas.”
The strategy team’s Jennah Kriebel and Javier Elkin helped develop the new funding mechanism. Its first search, announced in February, is for innovations that can increase access to oxygen therapy. They spoke with the Hummingbird newsletter about UnitaidExplore:
Q: What is UnitaidExplore?
Javier: We see opportunities for Unitaid to respond to the pace of innovation in new ways, sometimes investing in smaller things that can still offer transformative change. To do that we needed to create a new mechanism. That mechanism is UnitaidExplore.
Jennah: We’re trying to reach non-traditional partners, widen the types of innovators that Unitaid interacts with, and take some smart chances in a quicker time frame.
Q: So, timing is an important factor in innovation?
Jennah: The external world matters. Doing a thing at the right moment can make the difference as to whether an innovation is transformative, or just a good idea.
Q: What is the scope of UnitaidExplore projects?
Javier: We are aiming for investments that are between $500,000 and $2 million, and between six months and two years in length. Instead of doing grants-based financing, we’re going to be doing milestone-based contracting. We’re funding results rather than activities.
Q: UnitaidExplore has just launched its first call for proposals, for oxygen therapy. Can you tell us about that?
Javier: Ideally we would have some kind of device that would completely change the landscape, or even the first steps toward a device that could solve several of the problems that we are seeing--being able to operate off grid, requiring very low maintenance, resisting certain conditions—while providing high-quality oxygen to a range of patients for a range of conditions. That would be a huge step in the right direction.
Q: We understand that UnitaidExplore hopes to forge relationships with a broad spectrum of problem solvers. What kinds of non-traditional partners might have good ideas for global health?
Jennah: Deep tech, for example. It’s a technology space that can be applied across lots and lots of verticals. That community is always looking for ways their tech could fit into different places. I think we’re going to see a flood of good will where people say, ‘I would love to help.’
Preventing cervical cancer: “a disease that nobody should be dying of today.”
Cervical cancer is a preventable disease that kills over 300,000 women a year. In May, the World Health Assembly is set to adopt a new global strategy to eliminate it, and Unitaid is well prepared to lead the way on one of the pillars of the plan: creating access to affordable, quality screening and treatment services.
Smiljka de Lussigny. Photo: Momcilo Orlovic/Unitaid
Programme manager Smiljka de Lussigny oversees two Unitaid initiatives that have been developing high-performance tools for testing and removal of precancerous lesions and working to integrate them into countries’ health services. The topic is close to her heart; she lost one of her closest friends to cervical cancer.
“My friend was diagnosed very late. It was already too late to treat her, and she died very quickly,” Ms. de Lussigny said.
“Our problem will be not only how we introduce the tools,” Ms. de Lussigny said. “The biggest thing the community needs to resolve is how to get these women to think about cervical health. We have women who usually do not have gynecological exams or pap smears. How do we bridge that?”
Nine out of ten women who die from cervical cancer live in low- and middle-income countries; yet it can be readily prevented through human papillomavirus (HPV) vaccination in young girls and regular screening for cervical changes in women.
“Cancer is scary. When you speak to women about it, they say, ‘That’s incurable, I cannot even think about that. I have too many problems. I have money to earn, children to take care of,’ and they hesitate to go for the screening,” Ms. de Lussigny said. “I understand why they feel that way; because the cancer services are underdeveloped, expensive, and rarely available, covered by insurance, or funded by the government. In many of these settings, people consider a cancer diagnosis as a death sentence. But we also need to start spreading the message that this cancer can actually be prevented.”
Despite the difficult starting point, de Lussigny says she is delighted to see a movement emerging among countries’ most influential women—First Ladies—to draw attention to cervical cancer and push for better services.
“The First Ladies are mobilizing around cervical cancer because it is a women’s issue,” Ms. de Lussigny said. “It aligns with the whole subject of equity, the subject of women’s empowerment, the subject of stopping preventable death among women.”
At a summit last year in Niger, 37 African First Ladies issued a call to action to address the continent’s cancer crisis, citing cervical cancer in particular. On a local level, the First Ladies of all 47 counties in Kenya recently endorsed the country’s first advocacy guide on cervical cancer.
Kenya’s First Lady Margaret Kenyatta spoke at the guide’s launch. “This event brings much hope because we’ve heard stories of untold suffering, emotional trauma, increased financial burden of women and their families,” she said.
Virtually all cervical cancers are caused by HPV, a very common sexually transmitted infection. The draft elimination strategy calls for 90 percent of girls to be fully vaccinated by age 15, for 70 percent of women to be screened using a high-performance test between ages 34 and 45, and for 90 percent of women with cervical disease to be treated.
“In the places we’ve started with the new tools—Lesotho, Uganda and Zimbabwe, for example--the results are just transformational,” Ms. de Lussigny said. “What stays with me is the smiles of the health workers, because they could actually provide women with help they should have had before and prevent a disease that nobody should be dying of today.”
About eight million people living with HIV are unaware that they are infected with the virus. Unitaid has been reaching that group with self-testing, a discreet, affordable gateway to early diagnosis and lifesaving treatment. Unitaid just signed an extension of its Self-Testing Africa (STAR) Initiative, which is making important strides in closing the testing gap. When Unitaid began investing in HIV self-testing in 2015, only one country had a policy, and there were no World Health Organization pre-qualified test kits available for procurement. Today 79 countries have policies in place, and another 47 countries are developing them. Finding the undiagnosed people living with HIV and linking them up with treatment is seen as central to ending the HIV epidemic by a UN target date of 2030. Population Services International leads the STAR Initiative, with new consortium members PATH and Jhpiego. With the extension, new countries come into the project, including Cameroon, India, Indonesia, Mozambique, Nigeria, Tanzania and Uganda, which together account for nearly 40 percent of the testing gap in low- and middle-income countries.
Unitaid sees enormous potential in long-acting medicines for improving lives and ending epidemics. New Unitaid investments are developing long-acting injections to treat HIV, prevent malaria and tuberculosis and cure hepatitis C. Long-acting formulations offer a simpler way of administering medicines that frees patients from daily pills and makes it easier for them to stay on treatment. Unitaid and partners participated in the third annual Long-Acting Injectables & Implantables Conference in February, hosted by the Controlled Release Society in California. The event provided a forum for partners to examine ways that long-acting medicines could be applied to global health challenges. Among the participants were University of Liverpool and University of Washington, who are partnering with Unitaid on long-acting medicines initiatives.