Impact

The goal of the Global Fund partnership is to reduce the burden of the three diseases. Although it is still early to see a significant global reduction, some of the most exciting results in 2008 have shown the impact of HIV treatment and malaria prevention and treatment on adult and child mortality. This suggests that the Global Fund model, with its combination of additional finance, inclusive partnerships, high coverage of services and funding based on results, is taking hold in countries and having an impact on the burden of disease.

See below examples of impact on HIV/AIDS, tuberculosis and malaria in selected countries.

Malaria

Country	Evidence of impact	Services supported
Rwanda	64% decline in child malaria cases 66% decline in child malaria deaths (Facility data, 2005-2007) Declining treatment demand	By end 2007, more than 2.4 million Insecticide Treated Nets* were distributed, achieving 60% coverage National ACT roll-out
Zanzibar	52% decline in child mortality (2002-2005) 77% decline in out-patient malaria cases (2002-2005) Significant decline in ACT drug demand due to improved diagnosis and almost no new malaria cases reported	Introduced ACT treatment in 2003 Comprehensive 90% ITN coverage Household spraying: 90% coverage NGO training on net use
Burundi	45% decline in malaria incidence (2000-2005) Independent review showed impact of malaria interventions on new cases	One of first countries to introduce effective ACT treatment, 3.9 million cases treated More than 1 million ITNs distributed
Eritrea	71% decline in malaria deaths (2000-2006) 91% decline in outpatient malaria cases (2000-2006) 42% decline in malaria cases in facilities (2005-2006)	ITN coverage increased to 60% Introduced ACT treatment in 2007 Strengthened community-based activities: community health workers, diagnosis and education programs
Mozambique, Swaziland, South Africa	87 to 96% reduction in malaria incidence 82 to 87% reduction in malaria mortality 53 to 94% reduction in malaria parasite prevalence Declining demand for drugs	5 million people protected by indoor residual spraying (IRS) Universal coverage with effective drugs
Bhutan	20% decline in reported malaria cases (2005-2008) 28% decline in malaria mortality in health facilities (2005-2008)	110,000 ITNs distributed by end 2009 83,000 structures given IRS in hard-to-reach areas
Namibia	79% decline in estimated malaria incidence (2000-2007) 82% decline in malaria mortality (2000-2007)	52% population coverage with IRS in 2008 Nearly 750,000 LLINs distributed (2005-2009) ACT introduced as first-line treatment in 2005
Sao Tome and Principe	98% reduction in reported malaria mortality (2004-2007) 95% decline in reported malaria cases (2004-2007)	ACT introduced as first-line drug in 2003 80% population coverage with IRS in 2007 78.3% of households owning at least one ITN in 2007
Zambia	Decline in anemia prevalence in children: 14% (2006) to 4% (2008) 61% decline in the number of inpatient malaria cases (2001-2008) 66% decline in the number of malaria deaths in health facilities (2001-2008)	ACT introduced in 2003; nationwide coverage achieved in 2004 5.6 million ITNs were distributed (62% of households owned at least one ITN in 2008, up from 38% in 2006) 61% of children under five and 50% of pregnant women slept under an ITN among households with at least one net Nearly tenfold increase in IRS coverage (2003-2008)

Tuberculosis

Country	Evidence of impact	Services supported
China	38% decline in tuberculosis prevalence to 2006 38% decline in tuberculosis mortality to 2006	DOTS: Increased coverage leading to case detection rate increas
Viet Nam	11% decline in estimated TB prevalence 13% decline in TB mortality 82% case detection 92% treatment success rate	Strengthened diagnostic capacity Increased access to DOTS for ethnic minorities, the poor, prisoners and those in the private sector Implementation of TB/HIV collaborative work Initiation of MDR TB activities
Morocco	20% decline in estimated TB incidence 20% decline in estimated TB prevalence 19% decline in estimated TB mortality 89% TB case detection rate 87% TB treatment success rate	Intensified efforts to maintain gains in TB control and reach cases that may be more difficult to detect
Philippines	12% decline in estimated TB incidence 17% decline in estimated TB prevalence 24% decline in TB mortality 75% TB case detection rate 88% TB treatment success rates	Comprehensive package of public-private mix DOTS Treatment of MDR-TB and TB/HIV Full geographic coverage of DOTS

HIV/AIDS

Country	Evidence of impact	Services supported
Malawi	10% decline in overall adult mortality within 8 months of starting ART 35% decline among those with higher In 2006, 250 deaths averted among health workers (saving over 1000 staff-days per week) after starting ART	3.7 million VCT sessions held in 2009 37,000 HIV-positive pregnant women received a complete course of ART prophylaxis for PMTCT 170,000 adults and children on ART (45% coverage of eligible population)
Thailand	33% decline in HIV prevalence among youth and 41% among injecting drug users from 2004 to 2008 reporting Increased survival rate on ARV, 90-96.8%	ARV program strengthening
Ethiopia	Steep decline in AIDS mortality following ART scale-up in Addis Ababa: 50% decline in population-level AIDS deaths (2001-2007)	163,000 people on ART (53% coverage of eligible population) 5.6 million young people reached by school-based health education programs 51,000 teachers benefited from life-based health education programs 5.3 million VCT sessions held in 2009
Dominican Republic	HIV prevalence (2002-2007): 47% decline for women (aged 15 to 24) 38% decline for men (aged 15 to 24)	2 million people reached with HIV prevention including 800,000 from most at-risk populations 1.4 million HIV counseling and testing sessions

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