Lives changed

Downstream patient outcomes were estimated based on the pooled risk analysis developed for the 2020 update of the WHO Latent Tuberculosis Infection Guidelines, and represent relative risk for people living with HIV when comparing 3HP to the current standard-of-care, isoniazid preventive therapy.

Money saved

Impact was estimated based on actual price reductions for 3HP over the course of the volume guarantee.

Public health

Vitamin A deficiency affects approximately 500 million people globally, mainly in Africa and Asia. It is particularly prevalent in low- and middle-income countries (LMICs) due to food insecurity and limited dietary diversity.

A deficiency in vitamin A has particularly adverse consequences for women of reproductive age and children, leading to blindness, impaired growth, and increased severity of infectious diseases.

In children, vitamin A deficiency significantly increases the risk of illness and death from common infections such as diarrhoea and measles. It is also the leading preventable cause of blindness. In women of reproductive age, vitamin A deficiency increases the risk of maternal night blindness, infection, and other adverse outcomes during pregnancy and lactation.

Market situation

The vitamin A market frequently sees severe price volatility and supply insecurity due to market disruptions.

Although fortification with vitamin A is mandatory in many countries, edible oil millers often face significant challenges to fortify their products when the price of vitamin A increases or supplies become scarce. This makes it difficult for millers to plan ahead, procure consistently, and fortify oil in adequate volumes.

This first-of-its-kind partnership supports predictable vitamin A prices in an important market where fortified food is a big contributor to ensuring people benefit from vitamin A.

Public health

On 11 March 2020, the World Health Organization (WHO) declared COVID-19 a pandemic. COVID-19 remains the most widespread public health crisis in more than a century. By the end of 2021, it had claimed more than 14.9 million excess deaths, either directly or indirectly.

COVID-19 spread quickly around the world, leading to lockdowns and restrictions on movement. This made it even more difficult for people in low- and middle-income countries to access vital health products for conditions like HIV, malaria and tuberculosis. As a result, all three diseases saw increased case numbers and deaths.

The pandemic also took its toll on vaccination programmes. Gavi, the Vaccine Alliance reported that basic vaccine coverage fell by 1% in 2021, following a 4% drop in 2020.

Market situation

During the initial phase of the COVID-19 pandemic, demand outstripped supply for even the most basic medical products, leaving many countries struggling to provide vital equipment to frontline workers.

This situation was most acute in low- and middle-income countries (LMICs). Restricted supply, export bans and volatile prices meant that many countries were unable to access COVID-19 supplies. Countries were being quoted prices for some items of up to 20 times what they were pre-pandemic.

UNICEF is the world’s largest procurement agent of essential supplies on behalf of LMICs, country programmes and development partners. It has played a leading role in helping ensure access to products to tackle COVID-19 on top of its regular work procuring vaccines and other items on behalf of countries.

Public health

Malaria is a life-threatening illness caused by parasites transmitted to people bitten by infected female Anopheles mosquitos. The World Health Organization (WHO) estimates that malaria claimed 567,000 lives in 2019. Africa is disproportionately affected by malaria, accounting for approximately 95% of the cases and 96% of the deaths worldwide in that same year; 80% of those deaths were in children under five.

Insecticide-treated nets (ITNs) help prevent the spread of malaria by providing a physical barrier between mosquitos and sleeping people. However, growing resistance among mosquitos to pyrethroids – the main insecticide class used in standard ITNs – is hindering progress. According to WHO, 78 of the 88 malaria-endemic countries, covering all regions of sub-Saharan Africa, reported mosquito resistance to at least one of the four commonly-used insecticide classes in the period 2010-2019. Millions more people are at risk as standard nets become less effective in high resistance areas.

Market situation

While the price of standard nets has reduced substantially over the past decade, next-generation nets are more expensive. Despite its benefits, uptake of this new net was expected to be slow due to market-related barriers, including slow prioritisation, adoption uncertainty, and higher prices related to production. Many countries were cautious about buying next-generation nets as data from randomised controlled trials in Tanzania and Benin were being collected ahead of publication in 2022 and 2023 respectively.

In 2018, BASF’s Interceptor^® G2 net was the only dual-active ingredient net using pyrethroid and chlorfenapyr, a new class of insecticide in public health. This made a volume guarantee the ideal instrument to address the high-price low-volume dynamic and support accelerated introduction of the nets ahead of expected growth in the market for dual-active ingredient nets.

Lives changed

Impact was based on projections developed by malaria modelling experts at Imperial College London. The figures provided by Imperial represent the impact of switching from standard long-lasting insecticide-treated nets to Interceptor^® G2 nets within the countries where the nets are distributed.

Money saved

The price of individual nets varies by size. Impact was estimated based on actual price reductions for an average-sized net over the course of the volume guarantee.

Markets shaped

We work with partners, including donors, procurers and ministries of health, to track changes in health markets where our investments are supporting access to products. We monitor for changes to policy, procurement practices and supplier movement, all of which affect markets and contribute to the long-term sustainability of impact. To quantify change against a baseline, we used publicly available indicators as proxies for market-wide change.