UNITAID actions and main achievements Investing in the quality of medicines XVII International AIDS Conference Satellite Forum WHO – Essential Medicines for HIV/AIDS (Mexico, 4 th August 2008) Jorge Bermudez Executive-Secretary, UNITAID

UNITAID use of funds allows to: 1/ Impact markets and reduce prices: more drugs for same budget ex: price reduction on pediatric (- 40%) and 2 nd line ARVs (-25% to – 50%) 2/ Have manufactured medicines better adapted to patient needs ex: first fixed dose combinations for pediatric ARVs in / Contribute to address quality issues (incentive for manufacturers to invest) ex: support to WHO program for prequalification of products 4/ Deliver rapidly medicines in the countries in need (basic model - medicines instead of funds) ex: treatments already provided in a number of countries for ARV, TB and ACT UNITAID added value

More than 80 countries already receive UNITAID support… UNITAID ongoing actions HIV / AIDS 51 recipient countries Malaria 22 recipient countries Tuberculosis 58 recipient countries - Pediatric ARV - Second line ARV - PMTCT - ACT- First line TB - Pediatric TB - MDR-TB

Existing market impact by UNITAID (+ 8) Availability--1 Diagnostics (ped.) GMP-1 (+2)1 Cotrimoxazole GMP-3 (Africa)1 RUTF N/A Additional nb of products AVAILABILITYPRICEQUALITY Price containment/Stockpil e establishment Price stabilization N/A 1 st line TB FDC + price reduction Av. 40%12 (FDC) Pediatric ARV HIV Price reduction 23% in LMIC 49% in LIC 12 2 nd line ARV Specific pack-- PMTCT Main market impact Price reduction since Nov New drugs pre qualified in 2007 Nb of new productions lines* NicheDisease -1(+ 7)1 ACT scale up Malaria Stockpile establishment/PreQ incentives Price reductions targeted for MDR-TB (2 nd line) TB Availability/PreQ incentives Cost savings/price discounts due to pool procurement. Further reductions targeted. 1 Pediatric TB * Nb of new products developed X nb of manufacturers

Unit of measure *Footnote Source:Source Working Draft - Last Modified 15/11/ :50:45 Printed 06/11/ :27:01 2 Availability Quality Delivery No. patients treated UNITAID-funded drugs Price UNITAID’s market dynamic objectives Indicator KPI defined for pediatric ARV Rationale for using that KPI Number of treatments provided Measure the percentage of children needing treatment who receive pediatric ARVs Percentage of access to Paediatric FDC drugs Measure the percentage of children who need/receive treatment who receive pediatric ARVs Average lowest factory price available to countries for a set of products Illustrate the impact of each option on price for a set of products / regimens Percentage of “priority” drugs pre-qualified by a stringent authority Measure the number of “priority” drugs (exact list of drugs to be defined) that are pre-qualified by WHO, FDA or the EMEA Average number of weeks between the date an order was placed and when it was received Average lead time between the date an order was placed (PO) and the date when it was received (AWB) Indicators – Paediatric ARV

CONFIDENTIAL Document Date This report is solely for the use of client personnel. No part of it may be circulated, quoted, or reproduced for distribution outside the client organization without prior written approval from McKinsey & Company. This material was used by McKinsey & Company during an oral presentation; it is not a complete record of the discussion. Working Draft Last Modified 15/11/ :50:45 W. Europe Standard Time Printed 06/11/ :27:01 Romance Standard Time Board presentation - Supporting slides.ppt UNITAID initiatives have already driven major price reductions (partnering with CHAI) Change in peds ARV prices (AZT FDC vs. individual syrups) US$/patient per year 2006Q % $66 $130 Change in 2 nd -line ARV prices (TDF+3TC) US$/patient per year 2006 Q % $159 $315

Unit of measure *Footnote Source:Source Working Draft - Last Modified 15/11/ :50:45 Printed 06/11/ :27:01 2 Now (UNITAID-CHAI): Fixed dose combination 3 tablets a day 60 $per patient per year Before: Single dose syrups 16 bottles of syrup monthly 200 $ per patient per year Better products at lower price

 Consolidate current niches and necessary transitions with partners  Identify areas to expand (diagnostics…)  VSC (a worldwide citizenship solidarity contribution)  Moving towards a patent pool UNITAID: challenges ahead

CONFIDENTIAL Document Date This report is solely for the use of client personnel. No part of it may be circulated, quoted, or reproduced for distribution outside the client organization without prior written approval from McKinsey & Company. This material was used by McKinsey & Company during an oral presentation; it is not a complete record of the discussion. Working Draft Last Modified 15/11/ :50:45 W. Europe Standard Time Printed 06/11/ :27:01 Romance Standard Time Board presentation - Supporting slides.ppt