The vision of the Global Fund is to achieve a world free of the burden of HIV, TB and malaria. The strategy is to invest for impact.
The impact of investments in health can be measured in many ways, including how many lives are saved, and the rate of decline in HIV, TB and malaria, and other methods. In a broad sense, the real impact of investments in health is the vitality and economic strength of communities and countries where the burden of disease is retreating.
The Global Fund partnership supports programs that have saved more than 20 million lives as of the end of 2015. The partnership was on track to save 22 million lives by the end of 2016. (The year-end results for 2016 will be announced later in 2017.)
In 2000, AIDS, TB and malaria appeared to be unstoppable. Hard work by many partners has succeeded in reversing the situation, by creating significant advances in prevention and increased access to treatment and care for people affected by the diseases. Investments by the Global Fund partnership have grown aggressively, supporting a dramatic expansion of antiretroviral therapy, treatment of TB patients, and distribution of insecticide-treated nets, as well as building resilient and sustainable systems for health.
Our partnership has set new performance targets for the Global Fund Strategy 2017-2022. Programs supported by the Global Fund will save 14 million lives in the three-year period beginning in 2017, bringing the total lives saved by the Global Fund partnership to 36 million by the end of 2019. Those programs will also avert up to 194 million new infections or cases of HIV, TB and malaria.
The number of AIDS-related deaths is declining. In countries where the Global Fund invests, the death rate declined more than 45 percent, from 1.9 million in 2004 to 1.1 million in 2015.
The rapid increase in access to antiretroviral (ARV) therapy in countries supported by the Global Fund, from 3.3 percent coverage in 2005 to 21 percent in 2010 and 45 percent coverage in 2015, has been a tremendous contributing factor.
The number of HIV infections is falling. Between 2000 and 2015, the number of HIV infections declined by 37 percent in countries supported by the Global Fund. Partners express optimism that the rate of averting infections can accelerate more sharply if funding continues to grow. Another important factor is the expansion of national coverage of prevention of mother-to-child transmission, reaching 49 percent coverage in 2010 and 76 percent in 2015.
The number of deaths from TB declined 31 percent between 2000 and 2015 in countries where the Global Fund invests. (Deaths from co-infection of HIV and TB are not included in that number.)
The number of deaths from TB in 2015 would have been more than three times higher in the absence of interventions. The global burden of TB is disproportionately borne by 30 high-burden countries, and efforts on treatment and prevention are being concentrated there.
The decline in deaths was supported by an increase in the number of TB cases detected and treated over the past decade.
The number of deaths globally caused by malaria declined 48 percent between 2000 and 2015. The number of lives saved by malaria treatment and prevention has grown steadily each year. Children under the age of five are the most vulnerable to malaria, because their immune systems are still developing effective resistance to the disease. Pregnant women are also vulnerable, because their immune systems are weakened during pregnancy. Protecting young children and pregnant women is paramount to any disease strategy.
The innovation of a long-lasting insecticidal mosquito net, at a relatively low cost, has greatly expanded protection for children and families. With more than 795 million mosquito nets distributed through 2016, people at risk for malaria who gained access to mosquito nets grew from 7 percent in 2005 to 35 percent in 2010 and 62 percent in 2015 in countries where the Global Fund invests.
Mosquito nets are just one tool, however, and a comprehensive approach to reducing deaths from malaria includes other preventive measures such as indoor residual spraying. More important, access to artemisinin-based combination therapies (ACTs) and to rapid diagnostic tests has improved dramatically. Cases of malaria treated rose to a cumulative 668 million through 2016.
Published 20 July 2017