Unitaid 48th Executive Board Meeting Summary
Opening and Welcome
The 48th Executive Board meeting opened with remarks from the Board Chair and Japan’s State Minister for Foreign Affairs, Dr Kunimitsu Ayano. Board members expressed appreciation to Japan for hosting the meeting in Tokyo.
Report from the Executive Director
Board members welcomed the comprehensive report, highlighting Unitaid’s work on lenacapavir (LEN) as a key example of translating innovation into access. Chile’s Minister of Health, Dr Ximena Aguilera, and Japan’s new Board member, Ambassador Yuichi Oba, also attended. Japan contributed USD 7.2 million in 2025, with positive results noted.
The NGO Delegation commended progress in HIV prevention, maternal and child health, regional manufacturing, climate-smart innovation, and oxygen systems. NGOs emphasised ongoing work to ensure LEN access in middle-income countries, including Brazil. NGOs requested more focus on catalytic medical innovations such as near-point-of-care (nPOC) TB diagnostics, highlighting Unitaid’s role in evidence generation and rollout. The Executive Director confirmed that forthcoming integrated diagnostics proposals would address these areas. Board members requested an annual report as a communication tool, and the Secretariat confirmed work is underway. The Executive Director noted transparency constraints regarding MPP licensing and referenced the 2025 MPP evaluation.
Ecosystem Analysis
Dalberg Consultants presented a high-level mapping of Unitaid’s ecosystem, highlighting its value add, positioning relative to peers, and areas of potential overlap or competition. Board members welcomed the analysis and emphasised the importance of early alignment, particularly in fragmented market spaces. NGOs reaffirmed Unitaid’s trusted status, underscoring its risk-taking role and the need to act upstream in supporting scientific innovation – ensuring access conditions along the pathway, IP, and TRIPS work, as well as work on platforms rather than just products. NGOs said the analysis, along with the MTR, provided scaffolding for developing the next Unitaid strategy that would lean into these areas. The Secretariat noted that the exercise was not intended for future-proofing but stressed that coordination is increasingly critical and rests on institutional trust.
Mid-Term Review (MTR) of the 2023–2027 Strategy
Agulhas Consultants presented the MTR, noting that Strategic Initiatives (SIs) enhanced Unitaid’s visibility and thought leadership, despite human resource constraints. Seven recommendations were proposed, and the Secretariat outlined actions to address them.
Board members requested a clear near-term roadmap, portfolio rationalisation, and prioritisation of SIs. NGOs welcomed confirmation that Unitaid’s strategic direction remains aligned with LMICs health needs, stressing the importance of scalability and acceleration of Grant Agreement Development (GAD) processes. The proposal to strengthen SIs was supported, with emphasis on maintaining capacity and not rushing into integration. A “Friends of Unitaid” group was suggested for fundraising by the Brazil delegation, and the Board confirmed selective engagement in R&D.
Operating Model Review: The Secretariat highlighted lessons from GAD timelines and cost extensions, seeking more agile approaches. Over 90% of Global Fund-supported products are supported by Unitaid, with a forthcoming report for donor communications.
Communities and Country Stakeholder Engagement
Three CCSE options were presented; the PSC supported phased implementation of the enhanced option that includes funding CCS to bolster portfolios’ performance. Pilots will focus on LEN and one other area to be decided, with lessons to inform the next strategy. NGOs stressed that CCSE should focus on direct funding, not visibility events, and requested early pilots for LEN-LA and nPOC TB diagnostics. CSE options emphasised gradual enhancement of the current model, with regional expansion beyond Africa encouraged. Board members and NGOs requested ringfenced budget lines, accessibility, and flexible small grants mechanisms in the Global South.
Board Leadership Changes
Outgoing Chair Marisol Touraine was recognised for strengthening governance, communications, and dedication over six and a half years. Incoming Chair Anne-Claire Amprou, French Ambassador for Global Health, was welcomed. Brazil’s term as Vice Chair was extended until July 2026, coinciding with France hosting the next Board meeting to mark Unitaid’s 20th anniversary.
Proposal Review Committee (PRC)
The PRC reported record submissions for LEN (123 proposals) and noted increasing time spent on proposal and GAD reviews. Effectiveness is assessed based on outcomes rather than the proposal stage, and AI use in screening is not yet standardised.
Performance Management Framework
Four KPI changes were approved:
- Strategic Objective 2: KPI 2.1 updated for the Access Strategic Initiative; new KPI 2.3 to track Unitaid influence on WHO guidelines.
- Organisational KPIs: KPI B (carbon footprint methodology updated) and KPI F (Implementer Diversity) reframed as an ongoing annual target of 40% of grants approved since 2023 with lead implementers from the Global South. NGOs welcomed these updates.
Resource Mobilisation and Communications
Total funding stands at USD 165-170 million (core: 130-135M, specified: 36.6M). 2026 will prioritise targeted “moments” for LEN, MNCH, and medical oxygen, with year-round engagement with decision-makers. Communications efforts include increased web traffic and a community blog series. The 20th anniversary will be an opportunity to celebrate achievements and outline Unitaid’s vision. NGOs welcomed continued donor confidence amid declining global health ODA.
Next Generation Financing (NGF)
Three mechanisms to be piloted with USD 1M/year for 2 years: philanthropic platforms, catalytic blended finance, and results-based financing. NGOs emphasised strong guardrails, risk caps, equity safeguards, alignment with KPIs, and sunset/review criteria after 2026-27. Board members requested early engagement with investors and clear PSC/Board check-ins. Core public funding remains the “gold standard.”
Funding Forecast and Investment Plan
Unitaid’s early investment in LEN and long-acting formulations positions it at the forefront of prevention and treatment. Key priorities include nPOC TB diagnostics, integrated portfolio efficiency, and partnership for sustainability. NGOs requested more emphasis on IP investments and clarity on funding for MPP and WHO PQ enabler grants for 2026–2027.
Governance Working Group (GWG)
Extension requested for BOPs review on leadership positions, to be concluded by July 2026. All Board members may attend and provide input. NGOs continue as members, with the GWG term ending December 2026.
Budget Approval
The Board approved the 2026 budget, including allocations for NGF, CCSE, and CSE.
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