Call for Proposals: Accelerate & Promote Responsible Introduction of new DR-TB Drugs and Regimens

Deadline: 10-Jan-24

Unitaid is pleased to announce this call for proposals aimed at maximizing the number of people cured from drug-resistant TB by supporting introduction and scale-up of new treatment regimens.

This must be done in the context of quality care that takes into account people-centered approaches, community-driven demand creation, and innovative case-finding. Interventions should promote practices to optimize access while deterring antimicrobial resistance (AMR).

Unitaid and other global health and development partners are actively engaging and coordinating on the best strategies for timely and broad access to the shorter and better regimens including leveraging the work of Unitaid’s current investments in TB. Unitaid-funded work includes driving TB detection to primary and community levels, integrating digital technologies and adherence support into TB programs, enabling targeted next-generation sequencing for resistance surveillance and clinical decision-making, optimizing drug-resistant treatment for children, and market shaping to support affordable and timely supply. Even with these efforts and the efforts of the global community to accelerate the programmatic scale-up of better, shorter regimens, several gaps and challenges remain.

The ultimate goal is to create conditions for the best health outcomes by enabling people-centred and community-driven approaches to find and get more people into quality care. Unitaid recognizes civil society leadership and meaningful engagement with communities as critical for responsible demand creation, including understanding care-seeking (and barriers to access), increasing diagnostic and treatment literacy, and ensuring responsible use of new drugs and regimens.

Scope

• Under this call, Unitaid is soliciting proposals to accelerate and expand access to BPaL/M and – subject to available evidence and inclusion in WHO recommendations – other shorter regimens in the pipeline within a quality package of care (drug-susceptibility testing, digital technology and adherence support, and safety monitoring/pharmacovigilance) by supporting demand creation and generation activities and innovative strategies for case finding while combating AMR.

Areas of work

• Multi-country and regional product introduction and implementation support for the shorter DR-TB regimens and supportive tools defined as part of a quality care package to drive demand and expand access to the maximum number of people with DR TB.  Geographical focus is LMICs with consideration of burden of TB, and specifically DR TB.
• Proposals should include at least one of the areas of work listed below.
  • Area 1: interventions encompassing community-led strategies for stimulating demand while simultaneously advancing human rights, equity, and quality of services within the national TB programs and where feasible the broader health systems and private sector with a focus on:
    • Raising awareness and building capacity of communities to drive demand creation
    • Developing community-led monitoring, training, advocacy and communication tools and networks that ensure appropriate and tailored materials for different stakeholders (i.e., communities, health providers, local governments, etc.) including translation.
    • Conducting coordinated campaigns at global, regional, national, and subnational levels that promote uptake, access, and awareness of a comprehensive package of care
    • Establishing greater accountability nationally based on WHO’s Multisectoral Accountability Framework and the commitments set forth in the UN HLM on Tuberculosis in 2023.
    • Strengthening linkages and referral networks with other relevant programs and sectors to increase and maximize the reach of TB tools and services beyond national TB programs
  • Area 2: Interventions to support countries in implementing innovative and targeted strategies for enhancing quality of TB services and care, case-finding and/or resistance monitoring considering:
    • Sub-national tailoring of implementation across the public and private sectors with consideration of faster, sustainable scale-up
    • Approaches for diverse country contexts determining feasibility, cost-effectiveness, and willingness
    • Measures and policies to broaden access to lifesaving medicines, while safeguarding long-term efficacy of key TB medicines that could have implications for AMR more broadly
    • In general, commodity costs related to programmatic introduction should be covered, where possible, through routine country grants of the Global Fund, USAID, PEPFAR or domestic expenditures. Proposals should therefore clearly indicate how the proposed activities will integrate with existing programs and planned efforts to support a holistic approach.

Impact they are seeking

• Through this Call for Proposals, Unitaid aims to reduce DR-TB cases and deaths by effectively treating DR-TB disease and breaking the chain of transmission and in particular:
  • To contribute to facilitating the implementation of the better shorter regimens for DR-TB in the context of a more comprehensive and supportive approach that will support sustained effectiveness of current tools while creating the environment for new tools;
  • To generate demand and increase the accelerated adoption and use of these tools for DR-TB in LMICs;
  • Generating real-world experience regarding optimal strategies and delivery models for implementation, case-finding and resistance monitoring
• The objectives outlined will lead to:
  • better health outcomes due to additional people being treated, or due to people receiving effective treatments;
  • financial savings/efficiencies due to the availability and use of a quality-of-care approach; and
  • improved and more equitable access by making products available and/or affordable in LMICs.
• The goal is to enable widespread access to a holistic care package for DR-TB through scale-up by governments and partners, to contribute to the global health response to diseases that predominantly affect people in LMICs.

Criteria

• Unitaid considers working with communities a critical part of generating demand and strongly encourages adopting inclusive approaches, and the early and continued meaningful engagement of communities towards improving the lives and health of the most vulnerable people.
• Unitaid sees value in proposals from South-based lead implementers with experience in leading the implementation of large-scale multi-country projects that support access to health products in LMICs. They also support the meaningful inclusion of South-based sub-implementers, where feasible and relevant, in proposed project implementation consortia.
• Unitaid is committed to climate and environmental action in its investments and expect its partners to make similar commitments. Proposals should clearly indicate:
  • Efforts that will be made to minimize carbon emissions from project activities (mandatory);
  • Potential opportunities to contribute to broader climate and/or environmental co-benefits, in synergy with core project objectives (optional).
• Proposals should be carefully targeted, reflecting focused interventions to address key challenges regarding prevention, diagnosis, and treatment of drug-resistant TB in LMICs and access to health products. Proposals are expected to target one or both of the specified areas of work. Proposals may, but do not have to, cover all activities described within the area of work. Proposals should clearly indicate the level of effort and budget for each activity.
• Proposals should demonstrate value for money and measurable impact. Proposals should also include analysis of pathways to impact, scalability, and sustainability of key interventions.
• Areas out of scope for this Call include: product development, full-scale implementation, and/or delivery of products.

For more information, visit Unitaid.