The Global Fund to Fight AIDS, Tuberculosis and Malaria
  • Questions and Answers

    What is AIDS?

    AIDS (acquired immune deficiency syndrome) is a medical condition. People develop AIDS because HIV has damaged their natural defenses against disease.

    What is HIV?

    HIV is a virus. Viruses infect the cells that make up the human body and replicate (make new copies of themselves) within those cells. A virus can also damage human cells, which is one of the things that can make a person ill.

    HIV can be passed from one person to another. Someone can become infected with HIV through contact with the bodily fluids of someone who already has HIV.

    HIV stands for the 'Human Immunodeficiency Virus'. Someone who is diagnosed as infected with HIV is said to be 'HIV+' or 'HIV-positive'.

    Why is HIV dangerous?

    The immune system is a group of cells and organs that protect your body by fighting disease. The human immune system usually finds and kills viruses fairly quickly.

    So if the body's immune system attacks and kills viruses, what's the problem?

    Different viruses attack different parts of the body - some may attack the skin, others the lungs, and so on. The common cold is caused by a virus. What makes HIV so dangerous is that it attacks the immune system itself - the very thing that would normally get rid of a virus. It particularly attacks a special type of immune system cell known as a CD4 lymphocyte.

    HIV has a number of tricks that help it to evade the body's defenses, including very rapid mutation. This means that once HIV has taken hold, the immune system can never fully get rid of it.

    There isn't any way to tell just by looking if someone's been infected by HIV. In fact a person infected with HIV may look and feel perfectly well for many years and may not know that they are infected. But as the person's immune system weakens they become increasingly vulnerable to illnesses, many of which they would previously have fought off easily.

    The only reliable way to tell whether someone has HIV is for them to take a blood test, which can detect infection from a few weeks after the virus first entered the body.

    When HIV causes AIDS…

    A damaged immune system is not only more vulnerable to HIV, but also to the attacks of other infections. It won't always have the strength to fight off things that wouldn't have bothered it before.

    As time goes by, a person who has been infected with HIV is likely to become ill more and more often until, usually several years after infection, they become ill with one of a number of particularly severe illnesses. It is at this point in the stages of HIV infection that they are said to have AIDS - when they first become seriously ill, or when the number of immune system cells left in their body drops below a particular point. Different countries have slightly different ways of defining the point at which a person is said to have AIDS rather than HIV.

    How long does HIV take to become AIDS?

    AIDS is an extremely serious condition, and at this stage the body has very little defense against any sort of infection.

    Without drug treatment, HIV infection usually progresses to AIDS in an average of ten years. This average, though, is based on a person having a reasonable diet. Someone who is malnourished may well progress to AIDS and death more rapidly.

    Antiretroviral medication can prolong the time between HIV infection and the onset of AIDS. Modern combination therapy is highly effective and, theoretically, someone with HIV can live for a long time before it becomes AIDS. These medicines, however, are not widely available in many poor countries around the world, and millions of people who cannot access medication continue to die.

    How is HIV passed on?

    HIV is found in the blood and the sexual fluids of an infected person, and in the breast milk of an infected woman. HIV transmission occurs when a sufficient quantity of these fluids get into someone else's bloodstream. There are various ways a person can become infected with HIV.

    Ways in which you can be infected with HIV :

    * Unprotected sexual intercourse with an infected person: sexual intercourse without a condom is risky, because the virus, which is present in an infected person's sexual fluids, can pass directly into the body of their partner. This is true for unprotected vaginal and anal sex. Oral sex carries a lower risk, but again HIV transmission can occur here if a condom is not used - for example, if one partner has bleeding gums or an open cut, however small, in their mouth.

    * Contact with an infected person's blood: if sufficient blood from an infected person enters someone else's body then it can pass on the virus.

    * From mother to child: HIV can be transmitted from an infected woman to her baby during pregnancy, delivery and breastfeeding. There are special drugs that can greatly reduce the chances of this happening, but they are unavailable in much of the developing world.

    * Use of infected blood products: many people in the past have been infected with HIV by the use of blood transfusions and blood products which were contaminated with the virus - in hospitals, for example. In much of the world this is no longer a significant risk, as blood donations are routinely tested.

    * Injecting drugs: people who use injected drugs are also vulnerable to HIV infection. In many parts of the world, often because it is illegal to possess them, injecting equipment or works are shared. A tiny amount of blood can transmit HIV, and can be injected directly into the bloodstream with the drugs.

    It is not possible to become infected with HIV through :

    * sharing crockery and cutlery 
    * insect / animal bites 
    * touching, hugging or shaking hands 
    * eating food prepared by someone with HIV 
    * toilet seats

    How many people are currently living with HIV?

    The Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) estimates that approximately 33.4 million people were living with HIV in 2008.

    It is estimated that some 2.7 million people were newly infected with the virus in 2008 and 2 million people died of AIDS-related illnesses.

    Sub-Saharan Africa is the most affected region. Some 1.9 million people were newly infected with HIV in 2008, bringing to 22.4 million the total number of people living with the virus. Unlike other regions, the majority of people (60%) living with HIV in sub-Saharan Africa are women.

    Antiretroviral Therapy

    What is antiretroviral treatment?

    This is the main type of treatment for HIV or AIDS. It is not a cure, but it can stop people from becoming ill for many years. The treatment consists of drugs that have to be taken every day for the rest of someone's life. To understand more about treatment you need to have some basic knowledge of HIV and AIDS.

    Antiretroviral treatment for HIV infection consists of drugs which work against HIV infection itself by slowing down the replication of HIV in the body. The drugs are often referred to as:

    * antiretrovirals 
    * anti-HIV drugs 
    * HIV antiviral drugs

    What is combination therapy?

    For antiretroviral treatment to be effective for a long time, it has been found that you need to take more than one antiretroviral drug at a time. This is what is known as combination therapy.

    When HIV replicates (makes new copies of itself) it often makes mistakes. This means that within any infected person there are many different strains of virus. Occasionally, a new strain is produced that happens to be resistant to the effects of an antiretroviral drug. If the person is not taking any other type of drug then the resistant strain is able to replicate quickly and the benefits of treatment are lost.

    Taking two or more antiretrovirals at the same time vastly reduces the rate at which resistance develops.

    The Global Fund

    What is the Global Fund to Fight AIDS, Tuberculosis and Malaria?

    The Global Fund to Fight AIDS, Tuberculosis and Malaria was created in 2002 to dramatically increase resources to fight three of the world’s most devastating diseases and to channel the money to areas of greatest need.

    The Global Fund is a unique global public/private partnership between governments, civil society, the private sector and affected communities that represents a new approach to international health financing. The Global Fund works in close collaboration with other bilateral and multilateral organizations to supplement existing efforts dealing with the three diseases.

    The Global Fund provides almost a quarter of international funding to fight AIDS, as well as three-fifths of international funding to fight malaria and tuberculosis.

    What makes the Global Fund different?

    The guiding principle which underlies every aspect of grant funding at the Global Fund is the concept of country ownership. Each country is responsible for determining its own needs and priorities, based on consultation with an empowered group of stakeholders which includes not only government, but also the private sector, nongovernmental organizations (NGOs), civil society and people living with or affected by the diseases. This multistakeholder approach is key to ensuring that monies reach those for whom it is intended: the men, women and children suffering from AIDS, tuberculosis or malaria.

    The Global Fund was created around the concept of “performance-based funding.” Essentially this means that only those grant recipients who can demonstrate measurable and effective results will be able to receive additional funding. In other words, initial funding is awarded solely on the basis of the technical quality of applications, but continued and renewed funding is dependent upon proven results and targets achieved.

    In order to measure performance, the Global Fund has put in place a rigorous system of measurement and evaluation. This begins at the time a grant agreement is signed, when targets and indicators are agreed upon between recipients and the Global Fund. Results are tracked at every point in the process, from disbursement requests to performance updates and on through requests for continued funding at the two-year point of the grant.

    Since targets are set according to the resource levels and ambitions of each country, the Global Fund’s performance-based funding system provides a platform for grant recipients to demonstrate – and prove – their achievements.

    What has the Global Fund accomplished so far?

    As of end 2009, the Global Fund’s funding commitments totaled US$ 18.4 billion. The organization currently has a portfolio of more than 600 grants in 144 countries. These resources have rapidly translated into essential services for millions of people around the world. So far, programs supported by the Global Fund have provided AIDS and TB treatment to 2.5 million people and 6 million people, respectively, and distributed 104 million insecticide-treated nets for the prevention of malaria. To date, these programs have averted 4.9 million deaths worldwide.

  • Access to Life / Rwanda

    © Gilles Peress / Magnum Photos

    Despite its troubled recent history, Rwanda’s rapid effort to combat AIDS has made free lifelong treatment available to 63,000 people—up from 4,000 people who had started treatment just five years ago. Rwanda stands out as one of the success stories in Africa, and is a model for how health care can reach all communities. Yet AIDS remains a serious health problem in a country rebuilding from war and genocide.

    View story: Access to Life / Rwanda 

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    The Access to Life Exhibition is a powerful component to the worldwide campaign.

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