Unlimit Health. ENDING PARASITIC L>ISEASE Unlimit Health Annual Report and Financial Statements For the year ending 31 March 2023 Unlimit Health annual report and financial statements | 1 Contents List of acronyms................................-..-... Foreword bythe Interim Chair of the Board of Trustees...................... Reportof theTrustee5............................................. Our purposes and activities.......- Public Benefit Statement................................-.... Grant Making Policy...................-. . Achievements, Performance and Future Plans Goal 1: Thoseaffected by parasitic worm infections receivetreatment and care....................... Goal 2: Communities change their behaviours to reduce the risk of infection.................. . . .14 Goal 3: Environmental changes are put in place to reduce the transmission of infection........ 15 Goal 4: Everyone has access to all services that can reduce the risk of - and alleviate the problems associated with- infection............................-.- .18 Goal 5: All resources- economic and human- are effectively and sustainably managed........20 Development of 2023-2028 Strategy and Rebrand ................................. .21 Financial review.... .22 Fundraising.................................... .. 23 Reserves Policy.................................................-..-... . ..25 Investment Policy...... ..26 Principal Risks and Uncertainties....-...... .28 Structure, Governance and Managernent............. ..30 Trustees, responsibilities in relation to the financial statements.................................. .32 Reference and Administration Details.........................-.-.....- .33 IndependentAuditor's Reportto the members of Unlimit Health....................... .35 Statement of Financial Activities (incorporating an income and expenditure account). ..39 Unlimit Health annual report and financial statements | 2 Balance Sheet (Company Number11775313)................. .40 ststement of Cash Flows..... .41 Notestothefinancial statements................. ..42 Unlimit Health annual report and financial statements | 3 List OF acronyms Ncc Behaviourchange communications Expanded Special Project for Elimination of Neglected Tropical Disease Female Genital Schistosomia5iS Global Schistosomiasis Alliance ESPEN FGS GSA MDA Mass DrugAdministration Ministry/ie5 of Health Morbidity Operational Research for Bilharziasis Implementation Decisions IPilot) NTDS non-governmental organisations network Neglected Tropical Diseases Pediatric Praziquantel Consortium Preschool-aged children Praziquantel School-aged children SeriousAdverse Event MOH MORBID NNN NTDS ppc PSAC pzo SAC SAE SCIF SCI Foundation SCH Schistosomiasi5 SLT Senior Leadership Team Standard operating procedures Soil-transmitted helrninthiasis sop STH WASH Water, sanitation and hygiene World Health Organization WHO Unlimit Health annual report and financial statements14 Foreword by the Interim Chair OF the Board OF Trustees l am delighted to share this annual report, which is the very first reportof the organisation under a new name: Unlimit Health. This report providesan opportunity to reflect on pastachievements, as well as to outlinethe new 5trategyfor 2023 to 2028. It conclude5 our previou5 five-year strategy and set5 the scene for our ambitlous plans for the next five-year strategy. which was published togetherwith the launch of the new brand in February2023. I would liketothank Lord Sandy Trees, whocompleted histerm a5Chair in mid-2022, and Peter Dranfield who Stepped down as a trustee earlierthis year. They have both been instrumental in establishing SCI Foundation, now Unlimit Health, as a charity. I'm delighted to welcome ourthree newtrustees- Kathryn Ager, Arielle Dolegui and Max Seunik, plustwo new advisor5, Abena Afari and Carolynne Wheeler,who have already contributed to the new strategy for Unlimit Health Unlimit Health was born as the Schistosomiasis Control Initiative, established in 2002 bv ProfessorAlan Fenwick and his co-director Prof joanne Webster at Imperial College London. At thattime, its purpose wa5to deliver a proof-of-concept for nationally-driven programmesfor the control of schist050miasis in sub-saharan Africa. Our new name and strategy are driven bythe need to focus on elimination of schistosomiasis and related parasitic diseases, in line with the WHO Roadmap. Overthe nextfive years,whilewe will continueto 5UPPOrtthe delivery and monitoringof national treatment programmes, there will be an important shift to elevatethiswith newareas of work. These include developing a comprehensive set of targeted interventions to reach elimination of parasltic disease; a focus on technical support for multisectoral action; and increasing emphas15 on health systems strengthening and cor)tributing to health equity. I hopeyouwill enjoy readingthis report and continue to 5UPPOrtourjourney towards healthy lives, free from limiting disease. Drlustlnem Frain Interim Chair, Board of Trustees Unlimit Health annual report and financial statements | 5 Report OF the Trustees The Trustees present their report, incorporatingthe requirement5 of a strategic report, together with the financial statements of Unlimit Health Iformerly SCI Foundation - SCIF) for the year ended 31 March 2023. The report has been prepared in accordance with PartVIII of the Charities Act 2011 and constitutes a directors, reportforthe purposes of company legislation. Thefinancial statement5 and notes have been prepared in accordance withtheaccounting policies and complywiththe charitable company's Memorandum and Articles of Association, applicable law5,the Companies Act2006 and Accounting and Reporting by Charities: Statement of Recommended Practice, applicableto charities preparingtheir accounts in accordance with the Financial Reportingstandard applicable in the United Kingdom and Republic of Ireland (FRS 102). Our purposes and activitles Unlimit Health purpose The objects of the Charity are, for the public benefit: 1. To promotethe physical and mental health of people and communities In any part of the world who are affected by neglectedtropical disea5e5 a5 defined by the World Health Qrganization including, but not limited to, parasitic worm infections, schistosomia5i5 and soil-transmitted helminthiasis Icollectively "neglected tropical diseases.); 2. To relievethe need5 of people and communities in any partof the world who are suffering as a consequence of neglected tropical diseases; and 3. To advancethe education of people and communitie5 in any partof theworld who are affected by neglected tropical diseases and the public with a viewto reducing transmission and infertion. By: Supportingthe developmentof effertive and sustainable system5that seek to eliminate neglected tropical diseases. b. Supporting and evaluatingtreatment programmesfor neglected tropical diseases and generatingevidenceforoptimising programme impact; (See Table 1 below) and Providing and promoting acce55 to services that can reduce the risk of and alleviate the problems associated with neglected tropical diseases. Unlimit Health annual report and financial statements | 6 Ourgoals Our V￿OniSa worldfree ofpreventablediseas¢ In which everyone everywhere canreach thelr fullpotentml Goal 1: Those affected by parasitic worm infections receive treatment and care. Goal 2: Communities change their behaviours to reduce the risk of infection. Goal 3: Environmental changes are put in placeto reducethe transmission of infection. Goal ￿. Everyone has accessto all servicesthatcan reducethe risk of - and alleviatethe problems associated with - infection. Goal 5: All resources- economic and human- are effectively and sustainably managed. Our approach We are experts atsupporting national governments in sub-saharan Africa to deliverc05t effective and impactful health programmes. We helpto create a world that15free from preventable disease. Partnerships: We are collaborative, promoting inclusion and synergy. We act as catalysts in the creation of Successful cross-sectoral partnerships that generate the greatest impact on disease transmission. We have put in place a model of technical and financial 5UPPOrt to Ministries of Health to implement programmes in line with thelr own strategies and plans, to enhance sustainability, and strengihen health systems. 2. Operational Ex¢ellen¢e and Innovatlon: We are agile, adapting to changing local and global environments. We aim to constantly improve and innovate,to ensurethatwe optimise our efforts and use resources most cost-effectively. 3. Sustainabilitr. We ensurethat ourwork is sustainable and supports broader development. We supportgovernmentsto strengthen systems and processes, sothat they are dynamic, re5pon5ive and deliver results. We implement a holistic approach to tackle parasitic worm infections: reducing infection5 through increased access to cost- effectivetreatment; supportingenvironmental and behavioural interventionsthrough multi-sector collaboration; enhancing knowledge and capacity on treatment of severe morbidities; and investing in research and evidence. 4. Evldence-based: We generate evidence to inform decisions and guide our work. We improve processes and develop preferred practices for global health policy. We share knowledgeto ensurethateveryonecan benefitfrom improved health. Unlimit Health annual report and financial statements17 Ourvalues We are ateam of people passionate aboutcreating a world freeof preventable disease. It is importantthat everyonethat work5 at Unlimit Health, aswell as our partners and 5UPPOrters, sharethe sarne values and beliefs. Overthis reporting period we have completed a reviewof our values and haveworked to more clearly define howthe5evalues can be embedded into every aspect of ourwork. l. Equity We challenge inequity and strive towards a fair distribution of power and resources globally. We understand that ill health is rooted in social and economic inequity and injustice. 2. Inclusivlty We respect people's differences, recogni5ingthe importance of different perspectives and experiences, applying the principles of compassion and dignity. We understand that having varied perspectives and experiences is essential to achieving our mission. 3. Transparency: We aretransparent in ourdecision makingand ouractions and en5urethat decisions are informed by credible evidence. Weacknowledge thefundamental role or transparency in engendering trust, collaboration. and accountability. Prforltlessetfor the Reporting Period 2022 - 2023 In 2022-2023thethen SCI Foundation had Set outto continue todeliveron its5 strategic goals aligned with ourexistinggoals and objective5 as part of thefinal yearof the 2018-2023 Strategy. Therewas also a commitmentduringthis reporting period to develop a new strategyfor2023- 2028thatwould be responsivetothechanging landscape of NTD5 and the international development sector.The guiding principles forthe new 5-year strategywould align withthe paradlgm shifts and eliminationtargets outlined in the10-year NTD Roadmap published by the World Health Organization in 2021. Itwas acknowledged that many of thethernes outlined in the NTD Roadmap had already been incorporated into the 2018-2023 strategy. However,theirclear articulation within the Road Map further supported us building onthesethemes and approaches as the 2023-2028 Strategy was developed. Unlimit Health annual report and financial statement518 Publlc Benefit Statoment The Trustees confirm thatthey have had regard tothe Charity Commission's guidance on public benefit and the ways in which Unlimit Health delivers public benefit are explained in reporting on the Charity'sAchievements, Performance and Future Plans. Grant Making Policy Unlimit Health partners primarily with Ministries of Health to 5UPPOrt the delivery of public health intervention5 in sub-saharan Africa. Unlirnit Health works with its partners to develop programmes and determine thefinancial supportrequired. Annual contracts document the programmes and financial sUPPOrtto be provided. Thefinancial support is referred to a5 partner awards or payments in the annual reporL Achievements, Performance and Future Plans Goal 1: Those affected by parasltlc worm infections receive treatment and care. ObjKtives: Policy relevant evidence is generated and used to inform and develop elimination strategies for preventable infectious diseases. Evidence on best practice for country-led programme delivery is generated. Thesustained impact of public health programmes on parasiticworm infectionsand child health is effectively demonstrated. Thedeliveryof programmes by national authorities is supported effectively. Programme delivery is optimised through implementation and ref inement of available evidence-based tools and processes. Key Achievements: Supportedthe Ministryof Health in 12 countriesto deliverover 63 milliontreatmentsfor SCH and 5TH, provisionally reported to date. out of a targeted 64 million budgeted at the outset of financial year 202212023. Duetothe removal of many public health restriction5 imposed by countriesto mitigate thetransmission of SARS-CoV-2.the requirementfor a risk mitigation and action plan in advance of mass drug administration (MDA) was withdrawn and MDA proceeded in line with individual government guidance relating to COVID-19. Of the twelve supported countries: Despite significant global shipping delays affecting the delivery of donated drugs to many countries, the impact of late arrival was sufficiently mitigated in several countries to en5urethattreatment delivery could proceed a5 soon as PZQ arrived, usually bytakinga phased approach to MDA a5 in Cote d'lvoire, Malawi and Madagascar. Thiswas necessitated as existingPZQ stock5 in country had expiry dates precedingthe date of arrival of the next delivery and therefore had to be delivered beforeexpiry was reached. Burundi postponed their MDA and conducted Unlimit Health annual report and financial statement5 | 9 an exceptional campaign in March 2023,out with their usual schedule where it is routinely incorporated into Motherand Child Health Week5 in December. Liberia's MDA was interrupted dueto a Severe Adverse Event (SAE) resulting in the death of a child in Nimba Countyduringthetreatment campaign. Afull investigation was conducted bythe MOH in conjunction withthe local WHO office as is required in the event of an SAEto determineanyfuture considerations for implementation. Sudan's MDA continuedto be disrupted dueto ongoing political tensions in the country. Athree-phase national MDA campaign had completed Phase 1 in 2021, with Phase 2 completedduring2022 afteran initial suspension due tothe military coup in late 2021, which has been partially reported to date. Phase3 was Intended to start in early 2023 but remains inthe planningstage duetothe renewed armed conflict. Generated data on quality and performanceof prograrnme5: Unlimit Health supported five country partnersto conduct coverage evaluations surveys in Cote d'lvoire. Ethiopia, Madagascar, Malawi, and Zanzibar.Analysisforthese surveys is ongoingfor Cote d'lvoire, Ethiopia, Madagascar. and Malawi., however,completed analysis forZan2ibar has demonstrated thatthe March 2022 treatment campaign achieved the WHO recommended 75% treatment coverage threshold across both islands of Pemba and Unguja for both SAC and adult populations. Conductedtwo epidemiological surveys with MOH partners in Ethiopia (Part 2- reassessment)and Madagascar(Part1- reasses5ment),with planning underway forthree epidemiological surveys in Ethiopia (Part 3- reassessment), Madagascar (Part 2- reassessment), Cote d'lvoire(reassessment), and Democratic Republic of Congo (Part1- rea5sessment).Analysi5 of the Madagascar(Part1) survey is currently ongoing, with expected dissemination in the coming months. Data generated by these surveyswill continue to support MOH decision-making on optimisingthe delivery of treatmentsand other interventions and will be used to demonstrate impact goals aligned tothe newWHO NTD Roadmap for2030 andthe new WHO Guidelinefor Schistosomiasis. Additionally, in this period. resultswere disseminatedto MOH and partners for Ethiopia Part1 and Part2. Asthese data can be provided at the sub-lu administrative level in Ethiopia, called'kebele,, they will be utilised in the planningforthe 2024SCH treatment campaign, alongside WHO/ESPEN. Advised on the innovative design and implementation of surveys in several countries a5 part of collaboration projects: The Schistosomiasis Oversamplingstudy, acollaboration betweenfourministriesof Health. Unlimit Health,the NTD Support Centre,London School of Hygiene and Tropical Medicine (LSHTM), Swiss Tropical Public Health Institute and the Kenya Medical Research Institute. This multi-country SOS project supported survey5conducted in Cote d'lvoire, Mali, and Togo in 2022123. The outcomes will be used within a geostatistical model to determinethe optimal sampling strategiesfor SCH impact assessments to enable sub- implementation unit decision making. Unlirnit Health continuestoworkwiththe END Fund's Deworming Innovation Fund (in partnershlp with LSHTM)to supportongoing reassessment activities in Ethiopia using Unlimit Health annual report and financial statements | 10 novel designs (as mentioned above), as well a5 provide technical expertise in the interpretation of these Statistical and geostatistical mapping results for improved treatmenttargeting. Figurel showsthe resultsfromthe Ethiopia Part 2 reassessment using this innovative survey design for modelling S. mansoniprevalence. Through this figure we can seethe strong agreement betweenthe predicted and observed prevalence, supportingthe strong case in usingthis data tosupporttheefficiencyof using non- standard techniques and in resource allocation to target populations requiring interventions for schistosomiasis and STH. 4J Ex¢ludod . rnan50ni est. wevaterKe 0.00 0.02 0.05 0.10 0.20 • O.SO 0.79 1￿ 150 2(￿)krn Figure l. Geospatiallymodelledpredictedprevalence ofs. mansoni with 7km resolution. Each circlerepresents aschoolsampledcolourcodedbyprevalence to align with thepredicted prevalence shading. Additionally, within this period, Unlirnit Health performed an efficiency analysis to assess gains made when using novel re355essment data to implementtreatmentat a sub-lu level in terrns of overall cost and target treatment figure5. Thi5 analysis showed that across Zimbabwe and Ethiopia a geostatistical approach achieved an average 91% savings over traditional approaches with comparable accuracy when measuring national level prevalence, a5thisapproach required 92% fewer participantsto be sampled overall. The Dominican Republic governmentand the Pan American Health Organization (PAHO) have been workingwith Unlimit Health, Tropical Data andthe United States'centerfor Disease Control to design and conduct (November 2021) a surveyto verifytheelimination of human schistosomiasis in three historic endemic areas. Analy51S is ongoing and when ready results will indicate whether there is active transmission or whether the country can begin the WHO verlfication process for elimination. Supported MOH to share their historical and current epidemiological data in theWHOformat for reporting and openaccessthrough WHO portals (WHO Global Observatory andthe ESPEN (Expanded Special Projectfor Elimination of NTDS) Portal). Unlimit Health annual report and financial staternents111 Worked in partnershipwith two leading pharmaceutical companie5to assesstheglobal variation in force-of-infection trends of the NTD Taeniasolium, the leading cause of acquired epilepsy globally. Also assessed spatial and temporal distribution of T. soliun7and its risk factors in Uganda which provided valuable information on targeting praziquantel donated for thetreatrnentof taeniasis and cy5ticercosis.A mapping protocol thatcould be used in other settings with high likelihood of Taenia solium was also developed that could be used in other geographies. Published papers relevant to the control and eliminatioti of schistosomiasis as lead or co- authors: Wiegand RE, Fleming FM, de Vlas Sl, Odiere MR. Kinun¢hi S, KingCH, Evans D, French MD, Montgomery SP, Straily A, Utzinger l. Defining elimination as a public health problem for schistosomiasis control programmes: beyond prevalence of heavy-intensity infections. .￿E/l0.1076/51473- The Lancet Global Health.2022 Sep1;10(9):e1355-9. https://doi 30CJJ(221002i1-3 o Lo NC, Bezerra FS. Colley DG, Flemlng FM, Homeida M, Kabatereine N, Kabole FM, King CH. Mafe MA, Midzi N. Mutapi F. Review of 2022 WHO guidelines on the control and elimination of schistosomiasis. The Lancet Infectious Diseases. 2022 May17. https:1/doi.org/lO.1￿1_6lsl47I-3ogC(22J J0221-3 o Downs P, Bush S. Bannerman R, Blair L, D'souza S, Ekpo U, Gyapong M, Kar K, Kelly-Hope L, Mabey D, Mante S,TateA, Velleman Y, Molyneux D, Neglected tropical disease elimination is a relay race-let'5 not drop the baton. International health. 2022 Sep;14(Supplement_2):ii1-6. littps'.!i doi.o)1111_C.1_0931i iitliecilt,Il ih-. hll()4 o Harvey D, Shu'aibu I, Debam MT, Aba AK, Torres-vitolas CA. How can the neglected tropical disease community be inclusive and equitable in programme delivery? Reaching refugees and internally displaced persons through integrating a'leave no one behind, approach. International Health.2022 Sepi14(SupplemenL2):ii33-7. httP5:/ldoi.org110.10931inthealth/ihacOI0 Rustl.ClarkA,Woodgate M. Koch C, Moharnmed T, Steinmann P, Krentel A,Torre5- Vitolas CA.Carlin A, PavluckA. Innovateto eliminate: a prerequisite in NTD programmes. International Health. 2022 Sep;14(SupplementJ):ii20-4. IrttyL//doi. /int 11.QJQ2L￿1thl1haCOll o Ngwili N, Sentamu DN. Korir M,Adriko M, Beinamaryo P, Dione MM, Kaducu IM, Mubangizi A, Mwinzi PN, Thomas LF, Dixon MA. Spatial and temporal distribution of Taenia 501ium and its risk factors in Uganda. International journal of Infectious Diseases. 2023Apr1;129:274-84.1i':Ip£'.//doi.oJg/L1 Q161j:ijid2Q21Q2.001 o Dixon MA, IAfinskill P, Harrison WE,WhittakerC,Schmidt v, sanchezAC, Cucunuba ZM, Edia-Asuke AU, Walker M, Basanez MG. Global variation in force-of-infection trends for human Taeniasoliumtaeniasis/cysticercosis. Elife. 2022 ALJg19;11:e76988. https./Jdoi.org11Q.75541eLife 7698& Unlimit Health annual report and financial statements | 12 Ledworking groupswithin global SCH and STH communities of practice (Global Schistosomiasis Allianceand NTDS NGO Network (NNN)) inclusiveof and withthe remitto advanceWASH. Sustainability, One Health,and Monitoringand Evaluation (M&E) agendas. Actively participated in ta5kteams and workinggroups (WHO Technical Advisory Group on Schistosomiasis. STH, and NTD informatictools sub-groups, ichords, NNN) to contributeto the global agenda and providingadditional guidance documents forthe control and elirnination of 5chistosomiasi5 and STH and share best practice on prograrnme adaptionto COVID-19. Co-chaired expertadvisory committeesof SCH and STH in Tanzania to further advance programmatic adaptation and goal 5ettin%aligned to the NTD Roadmap. Led peer-participatoryworkshops at annual meetings of relevant networks (NNN, Coalition for Research on NTDs,American SocietyforTropical Medicine and Hygiene). Led andfacilitated multiple remotetrainingsessionsdesignedto build MOH and partner capacity for reassessment, impact and coverage surveys, safeguarding and FGS, promoting their ability to cascade trainingwithin each country. Improved internal knowledge management processes to promote engagement and timely sharing of lessons learned through regular, cross-functional team meetings. Provided extensive policy and communications supporttoWHO on deliveringthe Guideline on control and elimination of human schist050miasis,theWASH-NTD global strategy. NTD M&E Framework and NTD One Health Approach includingtechnical workthrough the Technical Advisory Group on Schistosomiasis and STH. updatingtheWASH and NTDstoolkit, and jointwebinar and conference presentations. UH signed an agreementwiththe WHO and Task ForceforGlobal Health to leadthe implementation of the qualitative GapAssessmentTool to asse55 programmatic progre55 and provide recommendationsto addre55existingchallenges affectingthe achievement of the 2021-30targetsestablished in the road Map for NTDS (Endingthe neglectto attainthe Sustainable Development Goals: a road map for neglected tropical diseases). UH is leading a global qualitative consultation with disease experts and national programme managers for all NTDS and diseasegroups identified in the road map concerningdiagnostics, monitoringand evaluation, advocacy and funding as well as access and logistics. Disease-specif ic and cross- Unlimit Health annual report and financial statements113 cutting (sector-level) measures will help programmes to achieve the eradication, elimination, and controltargetsfor2030. Plansfor the Next Perlod: Unlimit Health's long-term approach of workingdirectlywith Ministries of Healthto support public health interventions leadingto the reduction in morbidity associatedwith SCH and STH has putthe organi5ation in a very strong positionto supportthe development of resilient health systemsthat provide health care for all, a5 Outlined inthe Sustalnable Development Goals andthe universal health coverage agenda. As such, Unlimit Health will contlnue to: Build capacity within health Systems at all levels including Strengthening leadership, programme and financial mana8ementskills,and data analysis and data driven decision rnakin￿, and 5UPPOrt MOH capacitytoengageeffectivelywith other sectorsto deliver comprehensive interventions essential forthe control and elimination of neglected tropical disease5. Continually generate robust data to refine intervention strategies through an evidence-ba5ed approachto ensurethat programme delivery is optimised. Support programmesto monttor progress ag3instWHO NTD roadmap goalsandobjectives through the provision of technical support across a range of thernatic areas, including progressfrom control of morbiditytoelimination a5 guided byWHO and aligned to the need5 of communities. Goal 2: Communities change their behaviour5 to reduce the risk of Infection. Obiectlve&' Evidence-based behaviour change strategies for disease prevention are effectively supported and implemented by national authorities. Key Achievemen￿. Led the developmentof a 5yStematic review of behaviourchange interventionsfor schi5tOsomiasis control and elimination in low- and middle-income countrie5, in collaboration with the Global Schistosomiasis Alliance. The review has been accepted for publication by PlosNTDs and is currently undergoing editorial checks prior to publication. Unlimit Health annual report and financial statements | 14 Routine coverage evaluation surveys have been enhanced to identify andflag anysignificant presence of negative attitudes or resistance towards treatment as well as misconceptions of the disease or treatmerrt activities. Developed a quantitative examination of socio-economic and information factors conditioningtreatment update of praziquantel duringan MDA campaign in Malawi.The study is beingformatted forsubmi55ionto a peer-reviewed publication during2023. Drafted a protocol for pilotingand validating a participatory GIS mappingof risk behaviours related to the transmi55ion of and exposure to schistosomiasis in high-burden communities in Cote d'lvoire.The protocol has been reviewed and approved bythe Ministry of Health.This pilot approach will be tested in Eastern Cote d'lvoire during 2023. Cornmenced a multi-country analysis of data which determine barriersand enablersto treatment uptake in Malawi, Madagascarand Niger. Developed recommendation5for a behaviourchange communications strategyto be implemented within the second phaseof the Community Schistosomiasis Profiles project In Uganda Isee Goal 3 achievements). Developed a rnonitoring and evaluation framework for BCC programmesatthe requestof The END Fund. Plansforthe Next Period: Develop organisational approachto behaviourchange and communication and develop guidance forthe Unlimit Health team and partners. Goal 3: Environmental changes are put in place to reduce the transmission of infection. Objectives: National programmes are supported to plan and implementenvironmental strategiesfor effective and sustained elimination of preventable diseases. Control and elimination strategies for preventable infectious diseases are developed and irnplemented by national authorities in collaboration with the veterinary public health sector. Key Achievements: Completed the Community Schistosomiasis Profiles pilot project in threecommunities in Kamuli District, Eastern region, Uganda, which began in the previous reporting period.. Developed community risk mapsand schistosomiasis risk profilesthrough a participatory process Unlimit Health annual report and financial statements115 Worked with thecommunitytodevelop Community Artion Plans to reduce the risk of transmission and exposure Engaged decision makersfrom the NTD,WASH and education sectorsto agree implementation plans Securedfundingand began work to scale up theCommunitySchistOsomiasis Profiles approach and recommended interventions in six communities in Uganda: o Through The Big Give campaign raisedfundsto supportthe implernentation of interventions identified through the pilot project as key to reducing the risk of schistosomiasis tran5mi55ion and exposure, as well as extending project activities to additional communities in Kamuli in collaboration with the Ministry of Health and the Ministry of Waterand Environment. Implementation will begin inthe f inancial year 2023-24. Completedwork on updatingthejointWHO-NNN toolkit'WASH and Health working ti)y.¥l' Ig,. d 'lfj)IV 10 ELI ide for N I l ) i)rograrn me5., including new tools developed by Unlimit Health on joint analysis of WASH and NTDS data. As partof theWHO Technical Advisory Group on schist050miasis and soil-transmitted helminths,chaired a WASH sub-group. At the time of reporting, activities in progress include P051tion paper on WASH forthe control and elimination of SCH and STH, and a scoping literature review on theevidence of the links between WASH and disease transmission/prevention. Lead multilateral One Health discussionsthrough Action forGlobal Health with UK government (FCDO. DHSC, HAS, Defra). facilitatini two'policy deep dive, roundtsbles which championed geographically diverse speakers. Inputon the international pandemic Instrument directly through the civil society con5ultstion (our iiidc.o ',L. hni Ir£ (Iii to the International Negotiating Body) andthrough invited UK governmentcon5ultation (Defra, DHSC, FCDO), alongside advocatingfor a One health approachto be adopted bytheworld Bank's Pandemic Fund (our writtsn 5ubmissivi)) and included in 2023 G7's civil society recommendations (final Iloommuniqug recommends One Health in both global health and environmental justice streams). Continued to collaborate internationally with researcher5 and policy-makers, acting as lead authorfora European collaborative open-access publication of 36co-authorsfrom the NEOH network.to update thefield with ¢oro_oo.mpetenco% fLr Qne Healtli implementation acrossdisciplines and sectors.Through a 4 month consultant position with the WHO Health Security Preparedness team supported the development of a One Health workforce assessment and development operational tool as part ot the Tri rLite Zoonoses Guidance, completing interviews with global experts for a landscape review and bring invited to remain Unlimit Health annual report and financial statements116 astheonly non-UN agency memberof the steeringgroup. Helpedto build strong inter- network connectionswith the_A(".LLnfoL&nimalEt£alth coalitioii, sittingas observeron behalf of the NNN'S One Health cross-cutting group. Plans for the Next Period: Based on lessonsfrom implementation,we aimto continuetoexpand our workon WASH and One Health as part of a broaderapproach to health systems strengthening. We will increase efforts in community health in areas at high risk of parasiticdi5easetransmission and exposure. Wewill Scale up efforts based on already completedwork on WASH in Uganda and supportthe implementation of a newlydeveloped T. soilummappingprotocol. We will develop organi5ational approach to Vector control managementand developguidance forthe Unlimit Health team and partners. Unlimit Health annual report and financial statements | 17 Goal 4: Everyone has access to all services that can reduce the risk of - and alleviate the problems associated with - infection. Objective& Services forthe control and elimination of parasitic worm infections are accessed equally by all those at risk. Evidence on inclusion of morbidity management in programmingand health service delivery is generated and used effectively for policy influencing and advocacy. Morbidity managementof the effects of parasitic worm infections is effectively embedded in health services. Key Achlevement&' Unlimit Health continues to play a leadership role in the Pediatric Praziquantel Consortium (PPC)which aimstodevelop a paediatric formulation of PZQ and ensure it is sustainably accessible for the treatment of pre-school-aged children in endemic countries. Unlimit Health has: Co-ch3iredthe AccessTearn of the PPC, in shared leadershipwith the Swi55 Tropical and Public Health Institute (Swiss TPH). to identify approaches to ensure wide acceptance and equitable accesstotreatmentfor preschool-aged children suffering from Schistosomiasis. It includes aspects ranging from technologv transfers and logistics for local manufacturing, to building a sustainable funding Strategy and developing investment cases and an overall access strategy for the distribution of the new formulation in endemic countries. Led the coordination and provision of technical support on Work Package 2 of the EDCTP2 and GHIT-funded'Adoption of Levo-Praziquantel 150rngfor schistosomiasis byendemic countries,, or"ADOPT,, project. Unlimit Health worked closelywith the governments of Coted'lvoire, Kenya and Uganda tofurtherthe development of their advocacy and social mobilisation strategy and key messaging toolkits, specific to each country context and delivery platform, through workshops and stakeholderengagement.ADOPT is a collaborative project working with multiple partners within the PPC, including Merck, Lygature, Astellas, the MOH and National Medical Research Institute (KEMRI) in Kenya, the Technical University of Munich,theAfrican Institute for Health and Development,the MOH and research institute (UFHB) in Cote d'lvoire and the MOH and research institute (Makerere University) in Uganda. o Providedthought leadership at Board level tothe Consortium, resulting in an operational split within the PPC to form separate, but linked,'Research and Development, and'Access' core project teams. Unlimit Health annual report and financial statements | 18 Incorporated que5tion5 On relativewealthto measure equity of programme coverage and reach, into coverage evaluation surveys. By utilisingthese surveys a5 an opportunity to collect additional indicators (beyond age, sexand school attendance),these data can then be used to inform adaptions to prograrnmes. which will increase access to all, regardless of wealth status. Contributed to increased awareness and prioritisation of Female Genital Schistosomiasis (FGS)within the schist050miasis and broader health and NTDS community. Unlimit Health ha5: o Engagedthe UK Parliarnentand UK Governmenton FGS. includingthrough two parliamentary events and the publication of a joint policy brief."llnl ock.I ii", Èdlth Inc Qj-l);)r-Linit fQLV￿r￿LndulrI5j￿Afr￿.l., through the FGS Integration Group (FIG). Regularly participated in the Genital Schist050miasis Community of Practice, which brings together relevant partners to share research findings, tools and evidence to addre55 FGSand malegenital 5chi5tosomiasis (MGS). o Been an actlve memberof theTechnical Advisory Committeeforthe FGS Accelerated Scale Together (FAST Package) project operating across Madagascar and Ghana to create a pathway to scale of interventions that addressthe burden of FGS in girls andwomen.The projectclosed inJuly2022 with outcomes presented in Geneva. Plansforthe Next Period: As Unlimit Health continues to expand its work on the preventative interventions against NTDS. it will endeavourto ensure everyone has accessto and are ableto benefitfrom these measures, and thatthose who are already sufferingthe symptoms of infection are supported. Unlimit Health Continue to ensure that all preventative interventions are accessible to all part5 of the community in accoréance with evidence-based strategiesto leave noone behind. Provide leadership on accessto newlydeveloped technologies, such as paediatric drug formulations, to ensure that mechanisms are established for inclusivity in routine programme provision. Deliverthought leadership to tackle health inequity and enhance sustainability and health systems strengthening,throughthedevelopmentof a'Leave Noone Behind, approach to ensure inclusion of marginalised groupsin NTD programmes. Playa leading role in implementation research, advocacy and policyto promote access of women and gir15 to health services. Unlimit Health annual report and financial statements | 19 Goal 5: All resources- economic and human- are effectively and sustainably managed. Oblectlves: Increase the organisation's capacity for sustainable resource mDbili5ation to SUPPOrt all strategic goals. Develop a positive, diverse and impactful values-based organisation where all team member5 can contribute their bestwork. Invest in strategic, high-impactcommunicationsfor advocacy, public engagement, and fundraising. Ensure effective financial rnanagement and analysis of financial data for decision-making. Key Achievemen￿. Undertook a consultative and successful proce55tocreate a strong new brand forthe organisation. The new brand, Unlirnit Health, faithfully represents the core purpose of the organisation and strengthens our abilitytocommunicate effertivelywith our audience5 as well a5 raise sufficient resources to fulfil our mission. The process involved In-depth consultation internally and with our partners and allies. Financial resources were stewarded carefullyto ensure valuefor rnoney and to avoid unnecessary expenditure. Atthe requestof the MOH in Cote d'lvoire,joined theirworkinggroup on domestic resource mobilisation, participating in a roundtable event as a componentof Cote d'lvoire's Sustainability plan. Plans for the Next Perlod: Unlirnit Health (UH) will continue investing in developing and maintaining a strong and effective control framework to ensure that resources are deployed efficiently, transparently and sustainablyforthe best possible impact. UH will continue itscommitmentto supportingthe delivery of the WHO NTD Road Map 2021-2030, requiring a strongerfocus on securing sustainablefunding, and promoting programrne ownership by endemic country governments. UH Continue to develop and appropriately re50urcean income generatlonapproach thatwill Support sustainability of resourcing for del ivering UH'S new strategy, through good stewardship of existing donors, engaging new funders and strengthening existing funding relationship5through enhanced inforrnation and reporting management. o Participate in research funding appllcations for priority areas (FGS, WASH, morbidity management. One Health) and conduct an operational researchfundinglandscaping exercise that will guide operational research funding applications. Continue to build on the identified income streams that align with the organi5ational focus on sustainabillty and health systems strengthening as outlined in the Fundraising Strategy. Unlimit Health annual report and financial statements | 20 Continue to invest in strategic, high-impact, inclusive and respectful communicatlons for advocacyi public engagement, and fundralsing. Embed the outcomes achieved by the re- banding and associated brand awareness activitie5. Continue to develop a positive, dlverse and impxtful values-based organisatlon where all team member5 are engaged and able to contributetheir bestwork. Continueto build on the Investors in People Accreditation and the support network that the accreditation offers. Continue preparing monthly management accounts for discussions at the Leadership Team (SLT), and quarterly management accountsand reforecasts fordiscussion5 atSLTandthe Trustee Board Meetings.Wewill also continue workingwith the Finance, Risks and Audit Committee in yearto ensure budgets are delivered with acceptable variance5. Further develop our rlsk management and compliance processes and Internal controls and regular internal revlew meetingswith partnerstoensurethat important risks are managed appropriately. We plan lo conduct three Partner reviews and thre8 Programme Management Intemal reviews. Utilise the expertise of the retained International Travel and Risks Adviser to better manager travel risks for staff and partners travelling on UH buslness may 8ncounter. Develop the Operational Plan with accompanying KPIS in support of 2023-2028 Strateg1¢ Plan. Development of 2023-2028 Strategy and Rebrand Development of the 2023- 2028 Strategy The Leadership Team invested significanttime in the development of the 2023- 2028 strategy during the reporting period. This involved a number of dedicated retreats with external facilitation and internal and external discussion5. The strategy airns to respond to the changing environmentwithin the NTDS and also shifts in International Development. The strategy goalsare aligned to theWHO Road Map for NTD 2021-2030which articulatesthe contributionsthat the control and elimination of NTD5can maketothe Sustainable Development Goals. In addition,the objectives undereach goal of thestrategy relatetotheWHO health system strengthening building blocks to ensure that our work contributes directly to supporting resilient health systems. The Strategy and new brand were launched atan event in March 2023 ascan be accessed here. Rebranding Alongsidethe developmentof our newstrategy,we also embarked ona rebranding exercise. The name SCI Foundation had always been considered as an interim name, aswetransltioned outof Imperial College London. Forlegal reasons we were not ableto Use the name Schistosomiasis Control Initiative, but itwas considered irnportantto signal continuityaswe became an Unlimit Health annual report and financial st3tements121 independent entity and therefore SCI Foundationwas used. However, it has been clearthat continuingto use a namethat no longer represented the breadth of thework thatwe undertook, orthe overall purpose of ourwork. would be detrimental toour abilityto resource and deliveron the new strategy. A participatory approach wastaken involving inputfrom team mernber5, Board members and partners including our Ministry of Health Colleagues.Although challenging, the process was valuable in arriving at an excellent new brand that strengthens our ability to deliver. The lessons learned have been documented and published through ChariL¥ Com(u. Financial review We have reali5ed an operational surplus£1.62m (2022, E4.53m deficit), which was in linewith our Operational Plan.This meansthat Unlimit Health held total funds of £17.26m (2022, £16.18m) at year-end. These fundsare made up of restricted funds of £0.11m (2022, £0.14m), unrestricted general fund5 of £9.33m (2022, £8.08m), and designated funds of £7.82m (2022, E7.97m), and which thetrustees have earmarked, and we will draw downoverthe next twoyearstofund specific programme charitable activitie5. Unlimit Health receivedtotal income of £10.25m (2022. £7.32m) due to receiving more grants and a large increase in investment income. There was also an increase in general donations. Unlimit Health spent £8.63m overtheyear (2022, 11.85m). The decrease in expenditure was planned in line with the structured drawdown of the designatedfund5. UH has supported the delivery of 41 million treatments reported to date (2022, there were41mtreatments). Asdetailed above (Goal l KeyAchievements) several treatment campaigns are still ongoingordelayed and thereforetreatment numbersare yetto befinalised. In addition, some of our partner5 experienced delays in receiving drugs donated by other international funders, and that rneant that some partners could not carry out all the Ma55 DrugAdministrationsthat had been planned. We would have reported higherexpenditures by partners if all the partner5 had received the allocated drugs as they had requested. Thefinancial year has ended with a strong balance sheet. Atthe year end,Ca5h and cash equivalents were £17.56m (2022, 28.45m). Long term equity investments were £10.70m (2022, 3.23m). Unlimit Health annual report and financial statements | 22 Fundraising Overall donations income has grown by 7% thi5 year compared to the previous financial period, with increases both in term5 of direct income from individual donation5 and in income from Effective Altruism organizations. Trusts, foundations and other institutions contribute a smaller proportion of ourdonation income, butthis income stream hasalso grown. Individual givinz Overall income from individuals, including those giving one-off donations over £5,000, has improved significantly compared to the previous year. The excellent result was due in part to two major public fundraising campaign5. In September, the award-winning broadcaster Claudia Hammond presented our BBC Radi04Appeal. The BBC Radi04 appeal was particularly significant because it enabled us to reach directly a large audience who may not have been previously aware of ourwork.The results exceeded ourexpectations, and we raised over£29,000. In November, we participated for the second year running in the Big Give Christmas Challenge. This was our third matched fundingappeal andtheappeal soughttoraisefundsforthe next phaseofthecommunitv- led action againstdisease project in Uganda. The appeal raised over£100,000 and has enabled the next phase of the programme to go ahead. In addition to these two campaigns, regular donations from individuals increased by10% overall and donation5 from individuals inthe US Saw a steep rise. Givewell and the Effective Altruism Movement Our relationship with the Effective Altruism movement, in all its varied manifestations, remains very healthy as we continue to be 23ecognized as providing some of the most cost-effective opportunitiesforimpactonglobal health.Weareenormously gratefulto have received substantial support from a wide range of organizations including The Life You Can Save, Effective Altruism Australia, Givewell Clear Fund, Effective Altruism New Zealand/Aotearoa, Ayuda Efectiva. Giving What We Can, Efektiv Spenden, and RC Forward (Canada). Although our income from Givewell Clear Fund has fallen this year, this reduction has been entirely compensated for by a significant increase in income from the rest of the EA movement, such that overall income from Givewell Clear Fund and the rest of the Effective Altruism movement has remained constantcomparedtothe previousyear. Unlimit Health annual report and financial statement5 | 23 Trusts and Foundations Thi5 year ha5 Seen another increase in incomefrom Trusts and Foundations. A further substantial increase in incorne from these sources is anticipated forthe coming year and muchwork has been done this year to identify new prospective funders and to develop relationships with a broader range of funding institutions. Fundraising plans Our fundraising goals over the coming year are to significantly expand our income from trusts, foundations and other institutional sources to 5UPPOrt the NTD programmes of our partner ministries of health. These sources will bring in the bulk of our planned £1.2 million from new sources of income. We will also seek to further engage our growing pool of individual supporter5 and to maintain and deepen our relationshipswiththe effective altruism movementwho continue to be a significantsource of sUPPOrtfor our partner5, NTD programmes. Dlsclosure underTho Charities (Protection and Social Investment) Act 2016 Unlimit Health does not use external commercial participators for its fundraisingfunction. Unlimit Health is a member of the Fundraising Regulator and abides by all the legal frameworks, as well as the professional good fundraising practice. Inthe financial year 2022123,therewere no breaches of fundraisingstandards or law, and no complaints were received. Unlimit Health implements a robust privacyandGDPR policy (with associated systems and actions) to ensure privacy, and data is handled correctly and fairly. Unlimit Health does not make persistent approaches and engages individuals respectfully and only in compliancewith the Code of Fundraising Practice and within legal requirements. Unlimit Health does not undertaketelephoneor streetfundraising. Donations from individuals and community groups can either be solicited or unsolicited by Unlimit Health. Organisational donors are approached broadly following research thatthey are open to an approach (particularly inthe case of Trusts & Foundations; Corporates and Philanthropists, whilst statutory funding follows an established tendering/procurement process). Unlimit Health does not Plrt undue pressure on any personto give moneyorother property. Unlimit Health annual report and financial statements124 Reserves Policy Unlimit Health's mission is to supportthe development of effective and sustainable systems that will eliminate parasitic worm infections. The public health interventions required to reach elimination, including treatment of at-ri5k populations. require 5UStained implementation over multiple years. The current World Health Organisation guidance recommend5 an initial 5-6 years of annual treatment before reassessment. Unlimit Health maintains reserves to allow the Charity to continue to fulfil its objertive5 and withstand any perlod of financial uncertainty. Unlimit Health norrnally has two type5 of reserves: Restrlcted funds -The5e arise where funds have been given to Unlimit Health to fulfil particular objectives. These reserves can only be used for those particular objectives they were given for and cannot be used for the general running c05t of the Charity. Unlimit Health had Restricted Fund5 of £0.11m as at31 March 2023 (2022, £0.14m). Unrestricted funds - As at 31 March 2023, the Charity had £17.15m (2022, £16.04m) of unrestricted funds. £7.82m (2022, £7.97m of these are deslgnated and will be spent over the next two years. The balance of General Funds is £9.33m (2022, £8.08m) which are available to enable the Charity to address and financially manage the consequences of anv unforeseen events orto take advantage of fresh opportunities which further the Charity's aim5 and objectives. TheTrustees set a target level for unrestricted General Funds which the Charity aims to hold over the mediumtermfortheabove purpose5. Suchfunds henceprovide a measureof financial stability tothecharityandthereby reinforcethe reputationand abilityof thecharitytodeliveron promises. Each year the minimum level of unrestricted General Funds is reviewed by the Trustees and consideration is given to the following when deciding the level of funds required: The level required to ensure the charity can continue to meet its current and future commitments in the face of financial uncertainties, with a focus on incorne generation and the potential for unforeseen expenses. The level required to ensure the Charity ha5 the flexibility to pursue new opportunities to further the charitable aim5 of the organisation as and when they arise. The level that could be needed should any of the major risks identified by the risk framework materialise. To meetthe workingcapital requirements. The level required for an orderly transfer or cessation of activities, in the extreme and unlikely situation, that a catastrophic event occurs which might otherwise have impacted the Charities short term ability to meet its obligations to its beneficiaries, employees and creditors. Aftercareful assessment of the above, and in line with good governance practice, theTrustees have reviewed all identif led risks and have concluded that the minimum level of Free Reserves (General Funds le55 Tangible Fixed Asset5) should be maintained at a level that is higher than the costof an orderly closure of the charityandfalls between three- and four-months, worth of unrestricted expenditure budget for the following financial year. The free reserve level for 2023124 should therefore fall between £2.58m and £3.43m. The Free Reserves as of 31 March 2023 was £9J3m which is £5.90m above the higher Reserve Policy level. There is a clear plan in place and the Trustees expect that there will be a structured Unlimit Health annual report 2nd financial statements | 25 draw down of the reservesto invest in programme5, programme developmentand ourfunding model as outlined in the 2023-28Strategic Plan.The reserve level will continueto decrease inthe coming years and will be in line our Reserve Policy. Investment Policy The Unlimit Health of Trustees has delegated investment decisionsto the Finance, Risk andAudit committee.we have recruited Churches, Charities and Local AuthoritieslCCLA) Fund Managers, who are regulated by the FSA,to manageour long-term investments. Theobjectivesand policies of Unlimit Health investments are: To seek to produce the best financial return within an acceptable level of risk. The investment objective for the long-term reserves is to generate a return in excess of inflation over the longterm whilst generating an income to supplement the ongoing activitie5 of the organisation. The investrnent objective for the short-term reserves is to preserve the capital value with minimum level of risk. Assets should be readily available to meet unanticipated cash f low requirements. Unlimit Health has adopted an ethical investment policy to ensure that its investments do not conflict with its aims. Excluded are activities that have a direct impact on health e.g., tobacco and Icohol. Activities that have a direct impact on the environment e.g., illegal logging, and activities that undermine human rights e.%., sexual misconduct. CCLA Fund Managers managetwo Charities Official Investment Funds, (COIF) Charity Funds, portfolios for Unlimit Health: The Ethical Investment5 and Fixed Interest. Over the year, Ethical Fund5 did not perform very well and lost 2% of its value (2022, growth of £252,378), although this performance compares to a loss of 3% registered bythe Fund Comparator.The Fixed Interest portfolio was establlshed at the beginning of the financial year and performed worse by realising a loss of 3.97% andthis performancewas belowthe performanceof the Fund Benchmark of 2.86%1055. Fund performance isshown afterthe deduction of all fees and expenses with Income reinvested. Comparator returns are based on market indices which are notadjustedfor managementfees or expenses. The Ethical Investmentfundstotal return performance over 12 monthsto 31 March 2023 was- 2% against-3.97% for the Fund Comparator. The fund therefore outperformed thefund comparator in both Capital and income values. The Fixed Interestfundstotal return performance over12 monthsto 31 March 2023 was- 3.48% against-2.86%forthe Fund Benchmark.The Fixed Interestfundsdid not perform betterthan the Unlimit Health annual report and financial statements | 26 Fund Benchmark, but Unlimit Health believe5thatthis was a one-off and the marketconditions will continueto improve as shown in the last quarterof thefinancial year. Unlimit Health annual report and financial statements127 Princlpal Risks and Uncertalntles Risk management is central to the ability of Unlimit Health to deliver its objective5. We use multipleways of managing risksthrough the Senior Leadership Team (SLT), ProgrammesTeam, the Finance Risk &AuditCommittee (FRAC), and the Board. Central to this is rigorous budget controlthough which onlysecured funds are spent, and programmesare plannedtooptimisecash flow and control. Key funding and expenditure ratios are reviewed periodically. The SLT meets very regularly and monitors and review5 key risks. The Programmes Team reviews programme risks weekly on a country-by-country basisas part of its routine programme rnonitoring activities. Discussions are held on monthly management accounts, quarterly re- forecasts. and formal reviews.that are then presented to the Board. These regularreviews ensure that ongoing expenditures align with Unlimit Health's f inancial performance targets. The FRAC reviews risk5, challenges and keyfinancial management policies and assumptions. It ensures thatthe annual budget is adequatelyfunded and makes recommendationstothe Board for adoption. The SLT interactswith the FRAC and implementsthe scheme of delegation on i55uesthat need reportingto the FRAC. The Board leads on the reviewand approval of the Risk Regi5ter.This helps Unlimit Health to identify and assess Potential risks, and to develop effective mitigation strategies to ensure the needs of beneficiarie5 continue to be met. Unlimit Health has identified the following key risks during the reporting period in the table below. Major Risk Identif Mitigatlon Funding the new strategy For the last12 years a significant proportion of funding has been driven by a recommendation from the charity evaluator Givewell and the Effective Altruisrn movemenL Givewell has continuedto support Unlimit Health in this reporting period but has made it clear that the coming period will be the last funding cycle it will support Unlimit Health. The DevelopmentTeam and the CEO has continued to invest a significant amount of time in engaging with non-GiveWell effectivealtruism fundersto give more contextto Givewell's decision to move awayfrom fundingunlimit Healthand to dvantages we see intheapproachtaken in the new Strategy. The Development Team has developed an income generation strategy looking to maximise the opportunitie5 to access an expanded funder pool thatthe newstrategy and brand has allowed us to access. Unlimit Health has allowed an adequate level of operating reserve5to be drawn down while the newfunding strategy 15 operationalised. Unlimit Health annual report and financial statements | 28 Resourcing the new strategy and retention and management of staff Unlimit Health has set out a bold new strategy that it believes will deliver significant impact. However, a new strategy and brand doescreate a certain level of uncertaintyforthe team. Unlimit Health is reliant on it5 talented staff for its succes5 and loss of key personnel is a key risk. As a smaller organisation there 15 also more limited opportunities for career progression. Managementof Human Resources issuestaking senior5taff awayfrom delivering their core mission can also risk achieving the organisations objectives. Unlimit Health continues to create a healthy and happy workingenvironment and one wherethere is a high level of transparency. Accreditation by Investors in People and implementation of their recommendations where feasible, ensures that Unlimit Health is aligning with best practice. Unlimit Health are able to offer agile working conditions including remote workingwhich are attractive to staff. Use of external HR advisors have been used tosupport with staff issues and to assist with recruitment and focus on increasing networks to identlfy suitable candidates. However, Unlimit Health has committed to investing in an internal HR roleto optirn15ethe HR support providedtothe organisation. Delay In suppty chaln for Prazlquantel and Albendazole Global crises and the long-ter impacts of the COVID pandemic has created issues with the manufacture anddistribution of Praziquantel and Albendazole. These delays can create disruption to mass Drug Administration programmes in endemiccountries and very signif icant variances in annual expenditurewhich creates accounting challenges. Unlimit Health's Technical Director 15 an observer on the WHO Committee responsiblefor the allocation and distribution of NTD drugs and continuesto develop a good understanding of issues and challenges. The Technical Director also has a good working relationshipwith key contacts at Merck. Unlimit Health a150 aimsto communicateto all stakeholders aroundthe anticipated delay5 and support Ministries of Health with planningto mitigate where possible. Unlimit Health annual report and financial statements | 29 Structura, Govarmnce and Manasomont The SCI Foundation was incorporated as a Company Limited by Guarantee on 17 lanuary2019. It was registered as a Charity (standard registration) governed by its Articles of Association by The Charity Comrni5sion on21 February 2019. Previousto this, theSCI Foundation team existed as unitwithin the Department of Disease Epidemiologyatthe School of Public Health, Imperial College London since 2002. Unlimit Health is a charity registered in England and Wales (1182166) and 15 regulated bythe Charity Commission. In March 2023 the name of the charity was changed to Unlimit Health and Companies House andthecharity Commission were informed. Unlimit Health has a Board of Trustees committed to maintaininga high standard of governance. Four of the current Tru5tee5 held advisory roles Wlth the organisation while it was still part of Imperial College London. All Trustees are non-executive, are drawn from diverse, international backgrounds, and bringa broad range of relevant experience and ski115. Newtrustee5are appointed by othertrustees based onthe assessmentsonthe needs of the organisation set out in a skills rnatrix. Trustees normally servetwotermsof threeyears, although this can beextended under exceptional circumstances (such as where a skill cannot easily be replaced). Trainins of Tru$ttt$ Trustees are recruited for their specific skills and experience to meet organisational priorities and ensure a wide range of specialistareas.TrainingforTrustees is conducted in twoways: 1. Trustees Induction.. Each Trustee,following appointment, has an induction rneetingwiththe Chair and the Chief Executive. 2. Safeguarding training: All Trustees are given induction on Safeguarding and one Trustee is nominated as SafeguardingTrustee. The SafeguardingTru5tee has oversight of and ultimate responsibility for a comprehensive set of policies, reporting processes and organi5ation's training plans that are led through the Finance and OperationsTeam. The Safeguarding Tru5teeworks with the organisation'sCo-Lead Safeguardingofficers on both the ongoing Safeguarding processes and any incidents as they arise. Performance of the Trustees both collectively and as individuals is periodically a5ses5ed, typically everytwoyears, by an external agency. Due to COVID-19,thetrustees performance reviews in this reporting period have been delayed. With a small, focused Board of Trustees, most of the responsibilities of the Board are discharged by the whole Board. with standing items includin{. Investment:to monitor investment policy and performance. Governan¢vto monitor legal and compliance issues and appointment of new Trustees. The Board of Trustees also has separatecommittees: Finance, Rlsk and Audit: to monitor and review audit activities, the risk and control framework, and the statutory accounts/annual report. Remuneration: to monitor remuneration policy and key salary decisions. The Board of Trustees delegatesthe responsibility forthe day-to-day management of Unlimit Health to the Senior Leadership Team (SLT). Policyj Strategic and implementation plans are Unlimit Health annual report and financial statements | 30 prepared by senior managementfor consideration and approval bythe Board of Tru5tees.The SLT iscomprised of the Directors of thefive main function5: Policy and Communlcatlons. which includes development of key policy positions, advocacy and communications. Finance and Operatlons,which includes all operations, finance, assurance and reporting. Programme Strategy. which advises and supports country partners on implementation of highest quality NTD programmes. Monitoringi Evaluat5on and Research, which supports country programmes to perform high effective monitoring and evaluation strategies and generates policy relevant research. Development (from luty 2023), which includes all funding, both restricted and unrestricted and proposal development coordination work. Remuneratitirt Unlimit Health's policy on remuneration istoensurethatthe reward packageofferedto staff is competitive with other organisations in the international health and development field, to ensure that the organisation is able to recruit and retain high quality Staff. Remuneration is considered by a standing Board of Trusteescommittee, and in line with the Pay Policy. Unlimit Health also takes advice from an external human resources agency. The salary of the CEO 15 approved bythe Board of Trustees and the CEO makes recommendations tothe Board of Trustees with regards to the salaries of the Key Management Personnel (KMP). The KMP is composed of the CEO, Director of Programmes, Directorof MonitoringEvaluation and Research, Director of Development, Directorof Policy and Communication, and Directorof Financeand Operations. As of March 2023, the total employment cost of the KMP was £525,899 (2022: £422.317). The pension costforthe KMPwas £26,824(2022, £22,502). The employmentC05t increase was because of KMP headcount increase. AII UK staff are paid at leastthe London livingwage. Unlimit Health annual report and financial statements131 Trust••s' responslblllties In relatlon to the flnanclal ststements The Trustees (who are a150 directors of Unlimit Health forthe purposes of company law) are responsible for preparing the Trustees, Report and the financial statements in accordance with applicable law and United Kingdom Accountingstandards (United Kingdom GenerallyAccepted Accounting Practice).Company law requires theTrustees to preparefinancial statement5for each financial year, which give a true and fair view of the state of affairs of the charitable company and of the incoming resources and application of re50urce5, includingthe income or expenditure, of the charitable company forthat period. In preparing these financial statements, the trustees are required to: select suitable accounting policies and then applythem consistentlv; observe the method5 and principles in the Charities SORP (FRS102); make judgements and estimatesthat are reasonable and prudent; statewhether applicable UK Accounting Standards have been followed, subjecttoany departures disclosed and explained in the financial statements; prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charitable company will continue in operation. The Trusteesare responsiblefor keeping adequate accounting recordsthat disclosewith reasonable accuracy at any time the financial position of the charitable company and enable them to ensurethatthe financial Statements complywith the Cornpanies Act 2006.Theyare also responsible for safeguardingthe assets of the charitable company and hencefor taking reasonable steps for the prevention and detection of fraud and other irregularities. The Trustees are responslble for the maintenance and the integrity of the corporate and financial information included on the charitable company'5 web51te. Legislation in the United Kingdom governingthe preparation and dissemination of financial statements may differ from legislation in other jurisdictions. In so far as the Trustees are aware: there is no relevantaudit information of whichthe charitable company'5auditor is unaware; and theTrustees have taken all stepsthatthey oughtto have taken to make themselvesaware of any relevant audit information and to establish that the auditor Is aware of that information. Signed on behalf the Trustees Dr lustine M Frain Interim Chairperson and Trustee Approved on 27thluly 2023 Unlimit Health annual report and financial 5tatement5 | 32 Reference and Administration Details Charity Registration Number". 1182166 Company Registration Number.. 11775313 Registered Addressand Principal Office- Edinburgh House, 170 Kennington Lane, London, SE115DP Trustees: Professorthe Lord Trees- Chair (Resigned 16Augu5t 2022) Mrlonathan C. Gorrie- Treasurer Dr Iu5tine M Frain - Interim Chair Kathryn E. Ager (appointed 271uly 2022) Arielle Dolegui (Appointed 27 july 2022) Mr Peter Dranfield (Resigned 2 March 2023) Maxmillian P. Seunik (Appointed 27 luly2022) Chief Executive Officer: Drwendy Harrison Key Management Per50nnel'. Dr Wendy Harrison- Chief Executive Officer, Dr Fiona Fleming- Directorof Monitoring, Evaluation and Operational Research Dr Lynsey Blair- Directorof Programmes Ms Yael Velleman- Director of Policy and Communications Mrloshua Oliech- Dirertor of Finance and Operations Ms julia Hopper- Directorof Development (Appointed April 2022) Unlimit Health annual report and financial Statements | 33 Auditor Haysmacintyre LLP, Chartered Accountants,10 Queen Street Place, London EC4R 1AG Bankers: Barclays Bank,1 Churchill Place, London E14 5HP Solicitors: Russell-cooke LLP, 2 Putney Hill, London SW15 6AB Investment Managers: CCLA Fund Managers, One Angel Lane, London EC4R3AB Unlimit Health annual report and financial statements | 34 Independent Auditor's Report to the Members OF Unlimit Health. Oplnlon We have audited the financial statements of Unlimit Health for the year ended 31 March 2023 which comprise the Statement of Financial Activities, the Balance Sheet, the Statement of Cash Flows and notes to thefinancial statements, including a summaryof signif icant accounting policie5. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102 The Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice). In our opinion, the financial statements: give a true and fair view of the state of the charitable company's affairs as at 31 March of net movement infunds. includingthe incorne and expenditure, forthe yearthenended; have been properly prepared in accordance with United Kingdom Generally Accepted AccountingPractice; and have been prepared in accordance with the requirementsof the CompaniesAct2006. Baslsforopinion We conducted our audit in accordance with International Standards on Auditing (UK) (ISAS (UK)) and applicable law. Our responsibilitie5 under those standards are further described in the Auditor's responsibilities for the audit of the financial statements section of our report. We are independent of the charity in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the FRC'5 Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requlrements. We believe that the audit evidence we have obtained is suff icient and appropriate to provide a basisfor ouropinion. Conclusions relatlngto golng concern In auditingthe financial 5tatements,we haveconcludedthatthetrustees, use of the goingconcern basis of accounting in the preparation of the financial statements is appropriate. Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the charitable company's ability to continue as a goingconcern for a period of at leasttwelve months f roTll when the financial statements are authorised for issue. Our responsibilities and the responsibilities of the trustee5 Wlth respect to going concern are described in the relevant sections of this report. Unlimit Health annual report and financial statements | 35 Other InfOrn￿tIOn The tru5tee5 are responsible for the other informatlon. The other information comprises the information included inthe Report of theTrustees and the Foreword by thechair. Ouropinion on thefinancial statements does not coverthe other information and, excepttotheextent otherwise explicitly stated in our report, we do not expre55any form of assurance conclusion thereon. In connection with our audit of the f inancial statements, our responsibility 15 to read the other information and, in dolng so, consider whether the other information is materially inconsistent with the financial statement5 Qr our knowledge obtained in the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether there is a material misstatement in the financial statementsor a material mi55tatementof theotherinformation. If, based ontheworkwe have performed, we conclude that there is a material misstatement of this other information, we are required to reportthatfact. We have nothingto report in this regard. Opinions on other matters prescrlbed by the Companles Art 2006 In our opinion, based on thework undertaken in thecourse of the audit: the information given inthe Reportof theTrustees(which includesthe strategicreportand the directors, report prepared for the purposes of company law) for the financial year for which thefinancial statements are prepared is consistentwith the financial statements; and the strategic report and the directors, report included within the Report of the Trustees have been prepared in accordance with applicable legal requirements. Matters on whlch we are required to report by exception In the light of the knowledge and understanding of the charitable company and it5 environment obtained inthecourseof theaudit, we have not identified material misstatements inthe Reportof the Trustees (which incorporatesthe strategic report and the directors, report). We have nothingto report in respect of the following matters in relation to which the Companies Act 2006 requires us to reporttoyou if, in our opinion: adequate accounting records have not been kept bythe charitable company; or the charitable company financial statements are not in agreement with the accounting records and returns; or certain disclosures of trustees, remuneration Specified by law are not made; or we have not received all the information and explanations we require for our audit; or the trustee5 were not entitled to prepare the financial statements in accordance with the small companie5, regime and take advantage of the small companies, exemptions in preparingthe trustees, report and from the requirement to prepare a strategic report. Responsibilltles of trustees forthe financlal statements A5 explained more fully in the trustees, responsibilities statement 32, the trustees (who are also the directors of the charitable company for the purposes of company law) are responsiblefor the preparation of the financial statements and for being satisfied that they give a true and fair view, Unlimit Health 4nnual report and financial statements | 36 and for such internal control as the trustees determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error. In preparing the financial statements, the trustees are responsible for assessing the charitable company's ability to continue as a going concern, disc105ing, as applicable, matter5 related to going concern and using the going concern basis of accounting unless the trustees either intend to liquidate the charitable company or to cease operations, or have no realistic alternative but to do so. Auditorfs responslbllities for the audit of the financial statements Our objectives are to obtain reasonable assurance about whether the financial statements as wholearefreefrom material misstatement,whetherduetofraud or error,and tO155uean auditor's report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAS (UK) will always detect a material misstatement when it exi5t5. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate. they could reasonably be expected to influence the economic decisions of users taken onthe basi5 of these financial statement5. Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud. The extent to which our procedures are capable of detecting irregularities, including fraud is detailed below: Based on our understanding of the charitable company and the environment in which it operates, we identified thatthe principal risks of non-compliance with lawsand regulations relatedto charity and company law applicable in England and Wales, and we considered the extent to which non- compliance might have a material effect on the financial statements. WÈ also considered those law5 and regulationsthat have a direct impact on the preparation of thefinancial statements such as Companies Act2006.fundraising regulations andthe CharitiesAct2011. We evaluated management'5 incentive5 and opportunities for fraudulent manipulation of the financial statements (including the risk of override of controls), and determined that the principal risks were related to income and grant recognition. Audit procedures performed by the engagementteam included: Discussions with management Includingconsideration of known or suspected instances of non-compliancewith laws and regulation and fraud; Evaluating management's controls designed to prevent and detect irregularities: Identifying and testing journals, in particular journal entries posted with unusual account combinations, postings by unusual users or with unusual descriptions; and Challengingassumptions and judgements made by managementintheir critical accounting estimates, in particular donation recognition, recognition of grant income and the recognition of partner payments/awards and provisions for bad andlordoubtful debts Because of the Inhe￿nt Ilmltatlons of an audit. there is a risk that we will not detect all irregularitles, including those leading to a material misstatement in the financial statements or non-compliance with regulation. This risk increases the more that compliance with a law or regvlation is removed from the events Unlimit Health annual report and financial statement5 | 37 and transattions reflected in the financlal statements, as we will be less likely to become aware of instances of non-compliance. The risk Is also 8reater regarding irregularities occurring due to fraud rather than error, as fraLEd involves intentional concealment, forgery, collusion. omission or misrepresentation. A further description of our responsibilities for the audit of the f inancial statements is located on the Financial Reporting Council's website at: www.frc.or .ukJauditorsres onsibilities. This description forms part of our auditor's report. Use of our report This report is made solely to the charitable company's members, as a body, in accordance with Chapter 3 of Part16 of the Companies Act 2006. Our audit work has been undertaken so that we might state tothe charitable company's mernbers those matters we are required to state tothem in an Auditor's report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the charitable company and the charitable company's members, as a body, for our audit work, for this report, or for the opinions we have formed. Vikram Sandhu (SeniorStatutoryAuditor) For and on behalf of Haysmacintyre LLP, StatutoryAuditor 10 Queen Street Place London EC4R 1AG Date: 10 August 2023 Unlimit Health annual report and financial statements | 38 statement OF Financial Activities (incorporating an income and expenditure account) R TrEIEARè4DEDJI IAARCH2023 P*sirlBted Totslfvr IlwBtrI¢L•d Tot*1￿￿ 314IarQ3 J14Ior.22 DvnwtiunB ¥ndltyw¢s 2M13019 lo9￿39 2,123.45e 1M3J%J2 125.288 1,989200 699 7.Qy2T6 7,694J75 S228￿0) 5,228*03 427M07 427.e07 98.1 TOT￿p￿c￿lE 2A42.125 7￿03.815 10.246.040 I￿82￿22 5354.171 7,316.193 ExP￿r￿URE0 Fundraislrng and publ 432 487273 487A05 416212 18381 434893 Charftab* Patheraw8ryJ$ 93906 28.780 5M97 2￿?4￿16 0￿)7,139 2.103.408 S￿4.0￿5 1.476084 3.732M43 GE7￿8s 9,266,739 2,144.449 0th0r 96BO1B TM59￿32 6.628.350 7,427.171 4A18￿09 11,845 1.473B07 144J83 1.017.090 {5.465.149) 93S.662 14>29.487 I530￿66) IS30,5581 252J78 252,378 942,74 144J83 1m7.1J2 93SM62 (4277,1091 Transtsrb8t*owfvndg 169,89 I169￿99) 800￿0? 18OOJ071 NEri10￿￿{rH￿￿ItsS 1.112,648 S￿16) 1D87.132 14N12284} 135,155 (4277.109) Totalfv￿6 brnuoMkn48 t6,042,OS7 135.155 18.177212 20.454a21 211,454J21 t7.154,705 1D9ffj39 17264a44 16.042M57 135.155 16.1T1212 Al trans¥ty)h$Arederfwd from acb￿leS th•t￿MmenCe￿dUrfw the perbDd. AllvJ¢oBDisgd p179 and kn89es grg Inthé ststsfflenlofFlrO￿*l￿￿Ilfi#. Unlimit Health annual report and financial statements | 39 Balance Sheet (Company Number 11775313) AT31 MARCH 2023 2J 2022 FWASS Ton91￿&￿Sets In￿5￿￿￿nts 3,966 6.345 3.233.316 3.239.661 10 10.702.758 10.706,724 D¢btorB Cash JlbJnkand in hand 13 246&18 17.560,060 17h06078 B22J21 28.451.518 .273037 UIEtxroR5:amourtsfallthg wMtrlnon• >*thr 14 15.709.380) 111h40,3961 NEI cAxzhMg•Tat•mown•nts T(rtal andUSh•w￿l0nts at#*•ndofth•￿r 17,560,C6 28.451.516 Ca$hmd¢ash•oA¥•l•nts Cash albJrf( and in hand 17MO,060 28.451.516 Cashat bprlt andln hThlatthw •￿01th• pwlrAI 17.*0.060 28.451,516 Unlimit Health annual report and financial statements | 41 Notes to the Financial statements 1. Accounting policies: The principal accounting policies adopted,judgements and key sources of estimation uncertainty in the preparation of the financial statements are as follows: Baslsof preparation: The financial statements have been prepared in accordance with Accountingand Reporting by Charities: Statementof Recommended Practice applicableto charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (Second Edition, effertive1 january 2019)- (Charitie5 SORP (FRS102),the Financial Reportingstandard appllcable in the UK and Republicof Ireland (FRS102) andthecompanies Art2006. The subsidiary was dormant in this financial year, and so current year figures are for the charity alone. The Charity meets the def inition of a public benefit entity under FRS 102. Assets and liabilities are initially recognised at historical cost ortransaction value unless Otherwise stated in the relevant accounting policy note. Preparation of theaccounts asaiolngconcern: Having reviewed thefundingfacilities available tothecharitytogetherwiththe expectedfuture cashflows.thetrusteeshavea reasonable expectation that charity has adequate resources to continue it5 activities for the foreseeable future and consider that there were no material uncertaintie5 over the charitvs financial viability. Accordingly, they also continue to adopt the going concern basis in preparing the financial statements. b. Income: All income is Included in the Statement of Financial Activities (SOFA) when the charity is legally entitledtothe income after any performanceconditions have been met, the amountcan be measured reliably, and it is probable that the incomewill be received. The SORP requirements are followed in relation to positions where there 15 a time restrirtion. Fordonation5 to be recognised the charitywill have been notified of the amounts and the settlement date in writing. If there are conditions attached to the donation and this requires a level of performance before entitlement can be obtained,then income is deferred until those conditions are f ully met or the fulfilment of those conditions is within the control of the charity, and it is probable that they will be fulfilled. No amount 15 included in the financial statementsforgeneral volunteertirne in linewith the SORP (FRS 102). Investment income is earnedthrough holdingassetsfor investment purpose5. It includes dividends and interest. It is included when the amount can be measured reliably. Interest income is recognised using the effective interest method and dividend income is recognised as the charity's right to receive payment is established. Donated servlces and facilities: Donated facilities and donated professional services are recognised in income attheirfair value when their economic benef it is probable, it can be Unlimit Health annual report and financial statements142 measured reliably, and the charity hascontrol overthe item. Fair value is determined based on thevalue of the gifttothe charity. For example,the amountthe charitywould bewillingto pay in the open market for such facilities and seniices. A corresponding amount is recogni5ed in expenditure. Gifts in kind donated for resale are included at fair value, being the expected proceeds from sale less the experted costs of sale. Where estimating the fair value is practicable upon receipt it is recognised in stock and'lncome from other trading activitie5'. Upon sale, the value of the stock is charged against'lncomefrom other trading activities. andthe proceeds are rÈcognised as'lncome from other trading activities,. Where it is impracticable to fair value the items due to the volume of lowvalue itemsthey are not recognised inthefinancial statements until they are sold. This income is recognised within 'lncome from other trading activities,. d. Funda¢countinr. Unrestricted funds areavailablefor use atthe discretion of the trustees in furtherance of the general objectivesof thecharityandwhich have not been designated for other purposes. Designated funds comprise unrestricted fundsthat have been set aside by thetrusteesfor particular purposes. The aim and use of each designated fund is setout in the notestothe financial statement5. Restricted funds are funds which areto be used in accordancewith specific restrictions imposed by donors or which have been raised by the charity for particular purposes. The cost of raising and administering such funds are charged against the specif ic fund. The aim and use of each restricted fund is Set out in the note5 to the financial statements. e. Expenditure and Irrecoverable VAT: All expenditure is accounted for on an accruals basis and ha5 been classified under headlngs that aggregate all costs related to the category. Expenditure is recognised where there is a legal or constructive obligatlon to make payments tothlrd parties. it is probablethatthe settlementwill be required, and the amountof the obligation can be measured reliably. It is categorised under the following headings: Costs of raising funds include5 direct staff costs, external costs such as advertising and marketing and other costs associated with attracting voluntary income. Cost of raising funds also includes investment managerfee5 and costs associated with attractingtrading income. Charitable activities are for improving the health of the poorest and most rnarginalised societies in the world through the elimination of parasitic worm infections. We do this by 5UPPOrting governments in sub-saharan African countrie5 to develop effective and sustainable programmes against these diseases. Costs of charitable activitie5 include costs directly associated with delivering public health interventions such as ma55 drug administration that support the control and elimination of parasitic worm infections and an apportionmentof overhead, support, and governance costs. Irrecoverable VAT Is charged asan expenseagainstthe activityfor which expenditure arose. f. Allocatlon of support costs: Support costs are those functions that assist the work of the charity but do not directly undertake charitable activities. Support cost5 include finance, H.R., Unlimit Health annual report and financial statements | 43 l.T., general office and premises,and governancecosts which supportthe charitable activitie5 of the charity. These costs have been allocated between costof raisingfunds and expenditure on charitable activities.The bases on which support costs have been allocated are setout in note 6. g. Critical accounting judgement and key sources of estimatlon uncertainty. In the application of the accounting policies, Trustees are required to make judgements, estimates and a55umptions about the carrying value of assets and liabilities that are not readily apparent from other sources. The estimates and underlying assumptions are based on historical experience and otherfactorsthat are considered to be relevanL Actual results may differ from these estimates. The estimates and underlyingassumptions are reviewed on an ongoing basis. Revisionsto accounting estimates are recognised in the period in which the estimate is revised if the revision affects only that period, or in the period of the revision and future periods if the revision affected current andfuture periods. There are no estimates orjudgementswhich theTrustees consider are subject to signif icant uncertainty. h. Operatingleases: Operating lease rentals arechargedtothestatementof Flnancial Activitie5 over the period of the lease. Tangible fixed assets: Tangible fixed assets are stated at cost (or deemed cost) or valuation le55 accumulated depreciation and accumulated impairment losses. Cost includes costs directly attributable to makingthe asset capable of operating as intended. Depreciation is provided on all tangible fixed assets, at rates calculated to write off the cost. less estimated residual value, of each asset on a systematic basis over its expected usef ul life as follows: Office furniture,fittings and equipment, computerequipment. Fixed asset investment&. Investments are reco8ni5ed initially at fair value which is normally the transartion price excluding transaction costs. Subsequently. they are measured at fair value with changes recognised in 'net gains l (losses) on investments, in the SOFA If the shares are publicly traded or their fair value can otherwise be measured reliably. Other investments are measured at cost less impairment, Investments in subsidiaries are measured atcost less impairment k. Debtor&' Trade debtors and other debtorsare recognised atthe settlementamount due. Prepayments arevalued atthe amount prepaid net of anytrade discounts due.Accrued income is valued attheamount due. Cashat bank and in hand.cash at bank and in hand includes cash andshortterm highly liquid investmentSWith a short maturity date of three months or less. Creditorsand provisionkcreditors and provisions are recognised wherethecharity has a present obligation resulting from a past event that will probably result in the transfer of funds Unlimit Health annual report and financial statements | 44 to a third party andthe amount dueto settle the obligation can be measured orestimated reliably. Creditor5 and provisions are normally recognised at their settlement amount. ForelgnCurrency.Thefunctional and presentation currency is pound55terling. Transactions denominated in foreign currencies are normally translated into Sterling using the opening exchange rateforthe month of thetransaction; however,the rate on theday of the transaction will be used if it is significantly different. Monetary assets and liabilitie5 denominated in foreign currencies at the balance sheet date are translated at the rates ruling at that date. All exchange differences are taken to the Statement of Financial Activitie5. o. Pensions: The Trust operates a defined contribution pension Scheme whichemployeesare entitled tojoin and isfunded bycontributions from the employee and employer. The contributions madeforthe accounting period aretreated as an expense asthey become payable. Unlimit Health annual report and financial statements | 45 NOTES TO THE FINANCIAL STATEMENTS l¢ontlnuedl 202a 31*42 tog. 2.1214S8 I,W.852 124368 1N9.201 7AI3,378 ).￿8 7fi94.276 7M3273 91H12 5.180,&Yt 48.589 S228.603 C￿￿k￿y1[￿¢￿e 18A83 5.224803 InEorne rt¢4n ID*sthents 288.179 139.428 427.￿7 288.179 139828 427.607 911S) 6.040 98.19) 92.1S &040 98.197 Isststed*fCha￿kne￿￿￿: 21AXI 19.0fi0 84.497 187.1Q4 Unlimit Health annual report and financial statements | 46 NOTES TO THE FINANCIAL STATEMENTS (c￿￿nued} FI)R THEyE￿ 31 PIARCH2023 FIJR THEYEAR END￿31 MhRCH 2023 Supportcogts Staff Ct¢t$ othor Dlrnct Totsl •) AN*LYsfs l￿E12 Rewtlk r•lanunlO-Zwitbwr f*5earppn$*s of£3.021 wert paidon behoWoforreSmbur5wJ f0rattendan￿ attrustsgmèèting812022-.£3431. The$e¢osts h8¥p gO￿uP4V￿ts rèttultirtg mor•trus*es represents¥￿ nèBdJ An￿d￿TrIg￿￿ oftho chorftyand A pnn(¥pioof¢ne In•orsonmeelw B ￿¥1. 2023 31 2022 7.198 7.138 7,138 A31 2￿23 7.138 A31 20212 ¢h¥tued iny At31 k*rch VJ2$ (7931 12M79) 17931 17931 N•tW VAIU A31 2023 ?￿8$ 2023 2Di2 Varketwlup #t31 Marth 2022 3233P16 8￿00￿00 I830￿58} 10.702.758 2.98OM3B prol￿10￿￿10n rewlualon Vark•t￿lUe 1131 20 252J78 3,233 J16 Hi¥tr)rfcal th$tot31 ￿[Ch 2OTJ 11￿CK)￿o0 3.000,000 In%•sknènts •rfy h¢ld*s Incom?unlts thaCOFCharfdgs EtrIE41 CThFch￿le8 In¢orn•bJnd rnonHg9d byC¢LAF¢JnO Vanag•ré Llmlt4d DIStslbuuoThg from the of£288.179wer rb¢•lb*d durfDgthts5e•rl20L'.£92.150 Unlimit Health annual report and financial statements | 49 NOTES TO THE FINANCIAL STATEMENTS {¢ontlnuèd) FOR TIEVE￿ B4D&I31 M*RCH 2023 The Ch8rftyhold6 100% ofthè £1 $harecaF4tal ofSCIF Son4ce$ Llmiied, re¥sl8red in Ety￿Thd and Wales Iwrnpany rOg￿tra10n Numbor 121906121. The companyw¥¥ domiant¢Jurfng the ￿&T0￿d probitiu8 ￿ar. 12. T•utitAI UnllmltHtalth Is a r8gistered c*arftywd.there*Jr¢, is notlL8ble lo irKomelJx*rtt+wv8tknn 18xon intknme frorn d)athble a¢0￿,8¥ Itfolls ￿l￿[n ts *riou8 0￿mptIOnS a￿lIa￿e lo reg￿tered ¢hBriU•s. 13. D￿lT(lIs 2023 2022 Trade deblO1S Other debbrs 839 25P59 33256 764.0( 822J21 8.443 237.336 246.615 Prepa5Th6nts and aCcft￿d Income 14. CREDifoRS:*ffltyJnts duewmlthl t•w yaar 2023 2022 Trode abdiY)rs Ohercredlbr5 indudins layation 8nd sodal ¥e¢uvty Grant¢omrniknènts CUU815 Defeffed In￿M• 370x173 87259 237,146 68,045 70,7S7 5.195271 5.709?60 79,017 11.456,188 11.840,396 I& CREDrriiRS..knounbfalllnyikn4ft•r on• yvr 2023 2022 DÈteNod Income 5.539,698 5,539.698 4.495.890 4,495.890 Th? rnwèmo7ts in dvf•rr•dkncom• ar•arttyB•d a• fdlty*•: 2023 2022 Bwughlktrward dgfurred Income kn¢oMe rele4¥ed in the ￿Or detsrRd 11.456.188 12,359,388) 1.638.169 10,734,969 128.916 1126.9161 11.456.188 11.456.188 ¢arrtéd tO￿ard d818rred incoffle 16. RlP•JS At31 March 2022 At31 lknrth 2023 In¢ty Lknre*tri¢¢•d Dtrsignated Funds Gentral Funds 7,9e6,470 8,075,587 16,042.057 1142,4661 826.352 1968.8181 7,824,004 9,330,701 17,154.705 2.442,128 2.442.125 1530,5581 1530.S5BI 169M99 169099 R•stvkt•d knd Gronts 135.155 16,177212 7,803,915 10246,040 (7,659.532 18,628,350 1169A99 109.639 17264.344 1530.5561 Unlimit Health annual report and financial statements | 50 NOTES TO THE FINANCIAL STATEMENTS {¢ontlnued) FOR THEYEAR 84D&J 31 MPACH 2023 Ifj. FUNDS Icontlnu8dJ At31 M•r¢h 2021 In*strnonl At 31 M•r¢h 2023 In¢omg Ex￿nd￿￿T* Trnn$f•r• iknr•8trlct•d Funds Desl9naled Funds Gener81 Funds 14.871,380 5,582,941 20,454,321 16.904.910) 15222611 17,427.1711 7,966.470 8,075,587 16.042.057 1,962.022 1,962M22 252,378 252378 800,507 800￿07 R•strkt•d fvnds ants 5.354,171 7.316.193 14,418.5091 111,845.6801 1800,507} 135.155 16,177212 20,454,321 252.378 D￿Ignated fijnds represents balance oftranshrs from Imperial College, and wlll be used forthèritsble ofa¢bsities o*r the n9y1￿0 y&aT5. 17. ANALY818 OFFUND BALANCES BETWEEN I￿AsSEr3 Al 31 Ilarch 2023 f*Mral C*8tgnat•d Fund8 nds Rostrkt•d Funda Total TaThgible fixd as$8ts InN*sbnents 3.906 10,702.758 4.1e3,676 15,539,898) 9,330,701 3.966 10.702,758 12.097.318 (6.539.698) 17.264.344 Ng¢current$$$ets Cr•dltL7rs:knounts falllng due atsr¢ne >ear 109,639 7024.004 109.839 7024.004 31 March 2022 G8noral O•$lwMt•d FurhJ• R•¥trict•d Fund* Total T8ngiblo assets In¥g$tr)8nls 6.345 3233,316 9,331,816 14.495,8901 8,075,587 8.345 3233,316 17.433.441 4.495.890) 16.177.212 Nel cuffent asseL4 125,155 7,968,470 c￿01tr1￿.' knounts tslling due 8ftoron8 yaar 135.155 7,96e,470 18. ¢APffAL COMMIIM8lfS Commitrn¢nts fvjr capllal e>pendI￿￿ f¢rwhlch no Pr￿lS1On5 hale been made in thes& fin8ndal ststements wereas follows: 2023 2022 A￿th0￿9￿ and contracled for Unlimit Health annual report and financial statements | 51 NOTES TO THE FINANCIAL STATEMENTS (continu•d) FOR THEYEAR ENDED 31 MARCH 2023 19. oP&￿TI￿ LEASE ¢OMmrrM￿s 2023 2022 Lo￿& Bulldlngs Land & Buldknos L&as8s whith e¥•ire'. Within one sear In one to 21.525 11.025 59.401 knrfi￿ s¢ars 32.550 59.401 20. MEMBERS. LIABILtrY In the e￿nto1 the compgny belng wound up. theywlll each habt a liabilbtyof £1. 21. PENSION CI)MMrrm￿s Unllrnit Heallh operates a Gwup pension arrangement. The o¥er811 pension char9e fortro 5earwas £87.46912022: £89.S981. A 31 March 2023. no eonbibutions were outstanding12022.' £ nill. 22. RECONCIUAnoN OFNET MOVEMENT IN14j￿ TO CASH INFLOVI 2023 2022 Netmob*m•ni In funds 1.087.132 14.277.109) Inbestment In￿rne IGainsyIos5es on Inwslm¢nls DepreciaOon E>thange rate IgainyIoss Increaselldecreasel in creditors Ilnereaseyd8crease in deb*rs 1427,6071 530.558 2,379 1153,0431 15.087.2281 575,7(M 198,1901 1252,3781 793 142,8981 15,934,933 1,469,662 Not C•sh genorat•d byoporatlNJ a¢￿¥ttl•8 3A72.105 12,734,814 23. RELAT&) PARTYTRANSACTIONS Thare were no ￿latsd patytransactlons in the cu￿ent or precedlng accounting pei*)d$. Unlimit Health annual report and f inancial statements152