UNITAID is an innovative global health initiative largely financed by a levy on air tickets. Established in 2006 by the governments of Brazil, Chile, France, Norway and the United Kingdom, it provides sustainable funding to tackle inefficiencies in markets for medicines, diagnostics and prevention for HIV/AIDS, TB and malaria in developing countries. Since 2006 UNITAID has provided funding to partners to carry out two-dozen projects and has committed 1.5 billion USD.
In September 2011, UNITAID completed its first five years of activity. Against the background of evolving global health architecture and uncertain financial and funding environment, the UNITAID Board commissioned an independent evaluation of its activities to date to help inform its thinking and positioning for the next period. The objectives of the evaluation were to; i. to assess UNITAID’s effectiveness and determine how to build on its achievements, particularly by overcoming bottlenecks and challenges, ii. to examine how UNITAID can play a more effective role in the future in using market-based approaches to improve public health by increasing access to quality products to treat, diagnose and prevent HIV, TB, and malaria in developing countries iii. to feed into UNITAID’s current strategy development process.
Our evaluation team began work in April 2012 and carried out an extensive – but necessarily rapid – evaluation, so that the report could be fed in to the strategy process scheduled for the latter half of 2012. The final report was submitted to the UNITAID Board and approved in December 2012 and the findings and recommendations have indeed been fed to the ongoing strategy development process in 2013.
At the heart of the evaluation was an attempt to answer three basic related questions: Is UNITAID doing the right things, in the right way, to have the greatest impact?
The evaluation framework identified 30 key evaluation questions and defining indicators, sources of information, and analytical methods for each question. The framework helped to identify the range of documents to be reviewed and the key informants for each topic.
Data for the evaluation was gathered through an intensive process. This included a thorough review of secondary evidence on UNITAID, including UNITAD documents and procedures, Board minutes, project documentation, and literature. It also included over 100 in-depth and semi-structured interviews with a range of stakeholders. Country visits were made to Kenya and Cameroon, and multiple visits were made to UNITAID headquarters in Geneva.
The evaluation methods included in-depth assessments of UNITAID projects against objective criteria, assessments of organisational performance against UNITAID’s published mandated functions and analysis of performance against a theory of change for UNITAID.
“UNITAID has been doing the right things to contribute to significant positive outcomes in the fight against diseases…the evaluation finds that over the course of the evaluation period, UNITAID has validated its business model of identifying, selecting and funding market-shaping interventions carried out by implementing partners” – from the Independent 5-year evaluation.
Image © Malindi-Kenya. Photo Credit: Joseph Clifford