Deadline: 13-Mar-23
Unitaid is pleased to announce this call for proposals aimed at mitigating antimalarial drug resistance in Africa through interventions that rapidly diversify artemisinin-based combination therapy (ACT) use.
Areas of Work
- Proposals are being solicited for the following interventions:
- Multi-country, large-scale product introduction support to accelerate demand and adoption of ASPY, and generate evidence for resistance management strategies like multiple first line ACTs.
- Multi-country, large-scale product introduction support is needed to support ACT diversification. Support would serve to increase demand for ACTs with limited uptake i.e., ASPY, create early market volumes needed to support efforts of global health partners and to reduce prices, and in parallel address key knowledge gaps. The latter includes demonstrating how to implement ASPY alongside other ACTs while adhering to the specific dosing weight bands, as well as evaluating the feasibility, and cost-effectiveness/willingness to pay for multiple first-line treatment strategies. Strategies can include rotating ACTs, “mosaic” models, or diversifying ACTs by region or age group. Other innovative strategies that consider sub-national tailoring or implementing multiple first-line treatments across the public and private sectors could also be considered. As part of designing suitable strategies, country specific assessments of the ACT landscape are needed to guide approaches. Evidence generated from multi-country projects would therefore be important inputs into WHO policy recommendations and operational guidance, as well as generating evidence to support country-level scale-up.
- In general, commodity costs for procurement volumes are assumed to be covered through routine country grants of the Global Fund and PMI. Consideration is being given to a time-limited co-payment or other market shaping interventions for ASPY to allow countries to deploy more expensive ACTs without compromising overall treatment coverage.
Impact they are seeking
- Through this Call for Proposals, Unitaid aims to improve access to health products of public health importance in low- and middle-income countries, and in particular:
- To contribute to diversifying the use of health products in low- and middle- income countries (LMICs);
- To increase their affordability in LMICs;
- To generate demand and increase their adoption and use in LMICs;
- To create guidance around multiple first-line treatment strategies for malaria.
- The objectives outlined above will lead to: (1) better health outcomes due to additional people being treated, or due to people receiving effective treatments (2) financial savings/efficiencies due to the availability and use of more affordable products, and (3) improved and more equitable access by making products available and/or affordable in LMICs. The goal is to enable widespread access to affordable health products through scale-up by governments and partners, to contribute to the global health response to diseases that predominantly affect people in LMICs.
Settings of Interest
- Countries with evidence of partial artemisinin resistance
- Priority countries are those where resistance has already been detected including Eritrea, Rwanda, Tanzania, Kenya and Uganda
- Countries with concerns of reduced or declined efficacy
- In countries such as Burkina Faso, the Democratic Republic of Congo, and Angola, treatment failures have recently been reported at some sites, however the method of detection used is not recommended by WHO. Until it is known whether methodological issues may have confounded results in these countries, these countries remain a potential concern, and there is still a need to reduce AL use while increasing the uptake of other available ACTs.
- Countries without evidence of partial artemisinin resistance or reduced efficacy
- In countries where resistance has yet to be reported, there is still a need to reduce the reliance on AL and remove barriers to utilizing other available ACTs. Countries for consideration include those with a high resistance risk, high malaria transmission rates, country willingness and readiness to diversify ACT use (e.g., product registration or existing inclusion in national guidelines), diversity of the implementation setting, and a country’s market size in relation to their ability to generate the volumes needed to achieve scale to lower prices.
For more information, visit Unitaid.