To sign on to this letter, please email your name or the name of your organization to Lucy Cheshire at lucy_chesire@yahoo.com.

Dear UNITAID Executive Board,

We write as members of civil society to draw attention to a grave and urgent situation – the unexplainable delay of board approved grants to address the global MDR-TB crisis and a final endorsement of a proposal on paediatric TB medicines access. A series of grants for the Stop TB Partnership have been unnecessarily sidelined and/or delayed which threatens to exacerbate the spread of MDR-TB, derail the supply of paediatric drugs and undermine market shaping activities that are already underway or planned for both these crucial niches.

Historically UNITAID has taken a leadership role by being one of three global funding mechanisms committed to addressing MDR-TB and correcting the market failures in paediatric TB medicines supply. Over the past year the UNITAID Board approved over US $160 million in grants to address MDR-TB and pediatric TB. Tragically it appears UNITAID has chosen to delay or even halt the disbursement of these grants:

Expand TB (Access to MDR Diagnostics): An amendment was approved in May 2009 to the original project which increased the number of targeted countries and brought the total budget to $86,000,000 USD. No signature has been given to release the funding regardless of Stop TB’s compliance with all requests from the UNITAID Secretariat. There has been reassurance from the Executive Secretary of UNITAID that the signing would commence soon. It is imperative to speed this delayed process, as new diagnostics will help detect MDR in resource limited countries.

Treatment (MDR-TB): An amendment to the original agreement was approved in May 2009 to increase the number of patients receiving 2nd line drugs by 10,000. With a total budget of $54,046,000 this again has been delayed as a signature has not been delivered. All necessary paperwork has been submitted to the UNITAID Secretariat, but the project has failed to receive an approving signature.

Strategic Revolving Fund (MDR-TB): With a total budget of $22 million, this mechanism was approved a year and a half ago, and four projects plans have been requested by UNITAID. GDF has submitted all requirements, yet no response has been given which has severely delayed the process.

Pediatric Treatment: Final Board endorsement, despite a positive recommendation from the IEAG, of a four year project proposal for 58 countries valued at US$ 33 million and designed to correct key market failures for paeditric TB medicines access, has been severely delayed.

Through the board approved grants, UNITAID gives patients hope, gives the donor community a smart investment opportunity to save lives and correct market failures, and the global community a reason to scale-up awareness and political commitment to combating this deadly epidemic. While HIV and Malaria grants continue to be administered in a productive fashion, it is unconscionable to neglect a disease that claims the lives of 90% of PLWHA and produces drug resistant strains that threatens the world to return to a pre-antibiotic era. It would be a true blemish on UNITAID’s credibility and a big blow to progress made in the fight against TB if the above grants do not move forward with alacrity.

We urgently request that UNITAID:

1. Immediately release the funding for the above three grants approved for the STOP TB Partnerships and confirm its endorsement of the Paeditric TB proposal so that a final Agreement and first disbursement of funds can occur without further delay;
2. Re-affirm its commitment to scaling up treatment for MDR-TB by reviewing the WHO 2010 MDR-TB Report findings at the next board meeting and establish treatment goals for UNITAID, and
3. Give MDR-TB and paeditric TB equal funding priority in the UNITAID portfolio.

The fight against MDR-TB and effective pediatric care has reached a defining moment, with the great gains made by UNITAID set to be reversed without quick and decisive action. The Executive Board of UNIATID can keep the world on the path of progress toward defeating TB.

We urge you to do so.