1. What inspired you to set up UNITAID?
UNITAID is rooted in a belief that I share with my friends President Lagos of Chile and President Lula of Brazil, that we cannot achieve the Millennium Development Goals using traditional means. After the Monterrey Summit on Financing for Development, that I adamantly wished to attend despite the fact that I was in the middle of my re-election campaign in France, I asked one of our most brilliant economists, Jean-Pierre Landau, to conceive of concrete proposals for action. Everyone knew that traditional public assistance was insufficient to meet the many development challenges in a globalized world. It was time to act. And I did.
2. What were you hoping to achieve?
First, I wanted to a pragmatic response to the challenges of financing for development. What exactly is this? Insignificant amounts when compared to the colossal sums in circulation. My idea was to show that with a little effort we could change things, make things happen. This is how I decided, against much opposition, to create a solidarity tax on airline tickets and use the proceeds to improve universal access to health care.
3. Why global heath when there is so much more to achieve about poverty?
Health care was the obvious choice for two main reasons: first, it is clear that there can be no development if people have no access to healthcare. I feel it is more than an injustice, a scandal, and a threat that millions of men, women and children, are excluded from health care when treatment exists. Such a divide is intolerable.
4. What was revolutionary and ground breaking about the initiative?
First, the financing mode had to be found: a solidarity tax on airline tickets paved the way. Apart from the GAVI, no other form of innovative financing had ever existed before. We thus proved that it is possible to combine solidarity, efficiency and economic rationality. As far as I know, no passenger has decided to avoid French airports because of the €4 taken from the ticket price to fight tuberculosis, AIDS, and malaria. Studies have proven that the tax in no way harms economic growth.
Furthermore, beyond its means of funding, the very nature of UNITAID is revolutionary. By influencing market mechanisms before rather than after purchase, great advances have been made possible. It is partly thanks to UNITAID that healthcare is one of the Millennium Development Goals currently in the process of being achieved.
5. How do you see its achievements and impact in the past six years?
Through its original mode of financing and means of intervention, UNITAID has helped revolutionize public health in developing countries, particularly in Africa. It is astounding to see that the prices of certain drugs have dropped by nearly 80%. I am also very impressed by advances in child healthcare. With UNITAID, we can finally imagine a generation of children without AIDS. The results are clear. There is reason to be proud.
6. Can you recount an anecdote from the process that led to the creation UNITAID?
Such opposition! If we had listened to all the different experts – and there are more than enough whenever it comes to taking action – I was going to single-handedly bankrupt the entire airline industry and all the airlines! It is a shame to note that certain still believe this. The facts however won’t budge. Air France who had vigorously opposed the introduction of the solidarity tax – which affects all passengers equally regardless of which company they fly – now promotes the tax.
7. What in your mind is the next step and what is UNITAID’s potential future in global health and development?
We must continue to advocate for the adoption of the solidarity tax on airline tickets. Its safety and effectiveness have been proven. A dozen countries have already adopted it. Others, such as Japan or Morocco, are exploring the possibility of doing so. Perhaps UNITAID could even expand its activities to diseases other than the three “killers”. Cancer would seem to be a prime candidate. This debate however, belongs to UNITAID’s Board of Directors, presided by my friend Philippe Douste-Blazy who has taken on this project with remarkable determination. I would like to applaud his work along with his management team, all of whom are doing a wonderful job under difficult conditions.