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Our evaluation of the impact of Unitaid's support for treating children living with HIV demonstrated the pivotal role the organisation had in creating a market for paediatric antiretroviral (ARV) medicine, and also showed how the benefits gained from lower prices and wider treatment far outweighed the costs of the interventions.

Strength in numbers

Our evaluation focused on identifying and quantifying the impacts of Unitaid's support, which included acting as purchaser of paediatric ARVs for 40 low income countries from 2006 to 2014, and more recently providing technical support to countries following the transition of funding to other partners. We analysed the approaches taken by the Clinton Health Access Initiative (CHAI), the implementing partner of the project, to pool procurement between countries. We then assessed how this approach had allowed countries to access new and improved medicines at lower prices by analysing market procurement data. We also measured the extent to which improved treatment had created greater benefits in terms of lives saved over the costs of treating individuals by applying the latest methods for assessing costs and benefits of health interventions.

A sustainable market

Our evaluation showed that the project was critical to enabling nearly 450,000 additional children to be treated for HIV, and delivered cost savings equivalent to 2.5 dollars for every dollar spent. In addition, Unitaid demonstrated that a market could exist for treating children, which previously was not supported by manufacturers because of the dispersed demand across many low income countries meant they could not sustainably invest. This catalysed countries and other funders to increase their support, meaning that far more children have been treated for HIV since the projects were concluded.

This evaluation demonstrates how CEPA draws on its understanding of health market dynamics to effectively deliver high-profile projects for its clients.