This publication was produced at the request of MSF OCG, under the management of the Vienna Evaluation Unit. It was prepared independently by Hugues Juillerat, Sharon McClenaghan and Glenn O’Neil of TRAASS International.

The objective of this lessons learnt exercise was to assess the advantages and disadvantages of the UNITAID grant governance and management model for project achievements in terms of medical (and related) outcomes, strategic decisions, the potential for collaboration between multiple MSF entities and to leverage the learnings for replication in future projects. The exercise showed that the project directly delivered a new, more effective, simpler and much cheaper treatment to patients across seven countries. The holistic approach of the project that went beyond direct treatment also brought considerable results that will benefit potentially HCV infected patients worldwide. These results include the drastically reduced costs of medicines, availability of simplified models of care, their validation by the WHO, activated MoHs and greater interest in HCV in general. The evaluators concluded that there was a catalyst role of the grant, even if the extent of this role is debated within MSF. Nevertheless, there was general consensus that the grant did accelerate MSF’s actions on HCV and led to adopting a common and “joined-up” approach for HCV. It was found that the involvement of an external donor and partner (in this case UNITAID) was a key trigger for such a common approach – by requiring uniform indicators, data, focal points, etc. The governance and management set-up largely facilitated the achievements of the project with some limitations, mostly linked to the diverse elements of the project creating occasional obstacles for communications for those involved.