New Unitaid Head Gets High Marks – but Can He Save the Organization?

Luis Pizarro, Unitaid’s newly-appointed Executive Director comes to the organization with sizeable depth and breadth of experience – as the leader of Geneva’s Drugs for Neglected Diseases Initiative (DNDi) and before that, leadership of ventures in Africa, Asia and the Americas.

However, his main challenge at Unitaid will be steadying the financially troubled organization, which has raised less than half of the funds needed to sustain its annual investment budget of $300 million for 2026. And it faces a shortfall of more than $800 million in the current five-year $1.5 billion budget cycle (2023-2027).  

The crisis follows the loss of support for Unitaid’s innovative financing model, built upon the world’s first solidarity fund taxing airline tickets and certain financial transactions. The model was pioneered two decades ago by France, Unitaid’s leading donor, in the birthing of the organization in 2006. 

But the Solidarity Fund for Development was abolished last year in the wake of French legislation redirecting the airline tax revenues and fees to the general budget.  That leaves Unitaid heavily exposed to the vagaries of donor whims in annual fund-raising cycles.

Meanwhile, Unitaid’s longtime director, Philippe Duneton, who was instrumental in the foundation of the agency in 2006, is stepping down. 

First in a series of leadership changes in Geneva 

Despite the criticism of opacity around the leadership selection process, response to Pizarro’s appointment was upbeat. 

The Chilean-born and French trained medical doctor has a CV well suited to the task at hand. Prior to joining DNDi, he was the first CEO of the French-based health NGO Solthis, developing it into a leading actor in West and Central Africa through upheavals such as the 2014-2016 Ebola outbreak. Between 2020-2022, Pizarro served briefly as head of Unitaid’s HIV portfolio at the height of the COVID pandemic before taking over the helm at DNDi. 

“I have only positive things to say, I think he’ll do a great job,” one long-time Geneva health policy actor told Health Policy Watch, on condition of anonymity. “But with French funding at risk, his main job will be fundraising, I think.”

“In a sense this is the first piece of the puzzle in terms of finding new leadership for Geneva institutions,” added Thiru Balasubramanian, Geneva representative of Knowledge Ecology International (KEI), a US-based NGO focused on equitable access to medicines and vaccines.

“The Global Fund and WHO are still in the hunt of course, and now, DNDi.

“And perhaps Gavi will be as well,”  he said, referring to as-yet-unconfirmed reports that Gavi’s Executive Director, Sania Nishtar, might leave her current post to compete in the race for Director General of WHO.

Overlapping mandates  

Unitaid was established in 2006 by France, Brazil, Chile, Norway, and the United Kingdom as a collaborative initiative hosted by the WHO. 

As Unitaid’s primary architect, France became the agency’s dominant donor, contributing more than $2 billion, which accounts for roughly 56% of the organisation’s overall funding since its inception. 

However, in light of the recent cutbacks in official development assistance by European governments, as well as the United States, critics now are questioning whether the WHO-hosted Unitaid can justify its current model, including some 110, mostly Geneva-based, employees. 

That model involves an institutional mandate and administrative system separate from Gavi, the Vaccine Alliance and The Global Fund to Fight AIDS, Tuberculosis and Malaria – while the two larger organizations serve as the platform for scaleup and rollout of the innovations that Unitaid trials and tests. 

French ‘toy’ or essential global health tool?

Speaking to Health Policy Watch earlier this month, French Minister Delegate for Foreign Affairs, in charge of international partnerships, Éléonore Caroit, affirmed that the Unitaid model remains relevant and that France would remain Unitaid’s “leading partner.”

“Unitaid has an ‘end-to-end’ mandate – identifying, coordinating, and funding the interventions that make efficient, low-cost rollout possible – which then allows the Global Fund and Gavi to take those solutions to scale”.

Unitaid’s work and that of these other bodies is therefore complementary, not duplicative, she argued.

“Merging these entities and their mandates would risk a loss of specificity and expertise, an excessive concentration of missions in one place, and ultimately, less impact for the people who need it most,” Caroit warned.

However, not everyone remains so convinced.  

One one seasoned Geneva health expert described Unitaid as a ‘French toy’ saying it is “likely to close soon.” 

Image Credits: @ProfJanabi , @Unitaid.