Deadline: 24THJUNE 2016
Tuberculosis (TB) is one of the top 10 causes of death in children: over 140 000 children die each year due to this largely curable disease. Whilst an estimated 1 million children need TB treatment each year, only 359 000 cases of TB in children were reported in 2014. Until now, no child-friendly TB medicines in the right doses and formulations were available. Children who did receive treatment often received inappropriate medicines, including split or crushed adult tablets. The lack of appropriate diagnostic and treatment options highlights – and reinforces – the neglect of children with TB.
From 2012 to 2016, UNITAID has funded the STEP-TB project. Through this project, implementing partners TB Alliance and WHO led the development of appropriately formulated TB medicines in the right doses for children and improved the understanding of the paediatric TB market. The launch of the first new child-friendly formulations was announced in December 2015, as a direct result of this project. These fixed-dose combinations (FDC) of the three most commonly used drugs to treat drug-sensitive TB (rifampicin, isoniazid, and pyrazinamide) are dissolvable and flavoured, offer simpler treatment, and facilitate correct dosing, improving adherence and child survival.
In the absence of better, child-friendly TB diagnostics on the short-term horizon, innovative strategies are required to enable the scale-up of the new paediatric treatment options, reaching more children to shape and grow a more sustainable market.
Under this call, UNITAID is soliciting proposals to address market-specific challenges, with a view to improving the health of this market on the following dimensions:
  • Demand and adoption: i.e., countries, programmes, providers, and end users rapidly introduce and adopt the most cost-effective products within their local context; and
  • Delivery: i.e., supply chain systems (including quantification, procurement, storage, and distribution) function effectively to ensure that products reach end users in a reliable and timely way.
Specific examples of work that may be supported could include:
  • Facilitate adoption of new medicines to displace current suboptimal treatment
Work to incorporate the new formulations into countries’ TB strategies, supply planning, forecasting and treatment protocols; accelerate regulatory approval and registration of new products in-country, where required.
  • Expand access to better TB medicines to reach more children in need
Support integrated delivery approaches to reach more children with TB, for example by: leveraging active case-finding strategies; developing and piloting innovative methods of demand generation and integration of TB into other health care services for children, including private sector; developing innovative approaches or strategies to improve detection or reporting of TB in children (including application of diagnostic tools and strategies in innovative ways), with a focus on approaches that could be implemented within the next two years.
UNITAID is focused on investing in areas that generate the greatest impact and Value for Money. Applicants are required to clearly outline the logic of their proposal. This includes defining specific objectives for the proposal. Furthermore, how these objectives translate into a set of project activities, which support the generation of tangible, measurable outputs and outcomes which are relevant to the Call for Proposals. The proposal must also make the case for how these outputs and outcomes can contribute to wider impact.
UNITAID recognizes the efforts of partners in this area, as well as the need for further support of this fragile market. Proposals should demonstrate how work to create and stabilize the market for better paediatric TB treatment would be coordinated with (and complementary to) partners’ efforts.
Finally, applicants should be clear about the underlying assumptions made in their proposed approach, and should highlight any major risks or other factors that may affect the delivery of results.
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