2022 was a year of rapid acceleration in the Global Fund partnership’s fight against HIV, TB and malaria. Programs to tackle the three diseases registered a solid recovery after being disrupted by the COVID-19 pandemic. After seeing the gains of the last two decades sharply reversed during 2020 and only a partial recovery the following year, in 2022 we put more people on antiretroviral treatment for HIV than ever before, we found and put on treatment more people with TB than ever before, and we distributed a record number of mosquito nets to prevent malaria. Overall, most of our prevention and treatment programs exceeded pre-COVID-19 pandemic results.
The Global Fund Results Report 2023 details how our investments continued to deliver lifesaving services for people affected by HIV, TB and malaria. Our partnership also played a critical role in supporting countries and communities to accelerate their recovery from the COVID-19 pandemic and build resilient and sustainable systems for health that can respond to current and future health threats.
Since our creation, health programs supported by the Global Fund partnership have saved 59 million lives.
59 million lives saved
The coverage of prevention and treatment interventions for HIV, TB and malaria in countries where the Global Fund invests has increased rapidly since our founding in 2002. In 2022, HIV prevention services increased by 22% compared to 2021. The number of people diagnosed and treated for TB increased by 26%, and the number of cases of malaria treated increased by 11%. The Global Fund is investing to get the world back on track toward ending AIDS, TB and malaria and making the world more equitable and safer from future threats.
We measure our progress against the targets in the global plans for HIV, TB and malaria and in the Sustainable Development Goal 3 of health and well-being for all. Our achievements are the result of efforts by a wide array of actors comprising the Global Fund partnership, including governments, multilateral agencies, bilateral partners, the private sector, civil society groups, and people affected by the three diseases.
Despite our remarkable turnaround in programmatic results since the COVID-19 pandemic, we remain off the trajectory required to achieve the Sustainable Development Goal 3 (SDG 3) target of ending AIDS, TB and malaria by 2030. Across all three diseases, and especially TB and malaria, we will not achieve the 2030 target unless we take extraordinary steps. We must invest more, become smarter in how we invest, not least by accelerating the deployment of innovations to those who need them most, and we must redouble our efforts to end the stark inequities that fuel these diseases.
Combined mortality rate: progress towards global targets
Combined incidence rate: progress towards global targets
In 2022, there was an accelerated recovery of HIV testing services for groups in greatest need. 15.3 million people were reached with HIV prevention services, including 6.8 million members of key populations and 7.6 million young people (including 3.6 million adolescent girls and young women). The Global Fund supports the procurement of innovative tools such as long-acting pre-exposure prophylaxis (PrEP) including injectable cabotegravir (CAB-LA) as well the dapivirine vaginal ring. We also invest in fostering community engagement and leadership to reach key and vulnerable populations that are at a much higher risk of acquiring HIV than the general population.
24.5 million people were on lifesaving antiretroviral therapy in countries where the Global Fund invests in 2022, up from 17.5 million in 2017. The percentage of people in need of antiretroviral therapy who received it has significantly increased in recent years, from 48% in 2015 to 78% in 2022. We are also investing in innovative efforts to address the burden of pediatric HIV by supporting countries to adopt a dolutegravir-based treatment formulation for children. Together with the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and other partners, our efforts to implement WHO’s “treat all” guidance and the UNAIDS “95-95-95” strategy have significantly increased the number of people diagnosed with HIV and started on antiretroviral therapy.
In 2022, the Global Fund supported countries to recover from the impact of COVID-19 and continue to grow their HIV programs. Despite this progress, 39 million people were living with HIV, 1.3 million people were newly infected with the virus, and 630,000 people died of AIDS-related causes in 2022. We need to take bold action to get back on track and achieve the SDG target of ending AIDS as a public health threat by 2030.
Adolescent girls and young women remain a key focus for the Global Fund’s response to HIV. Targeted HIV investments in 13 priority countries have led to a 67% reduction in the HIV incidence rate amongst adolescent girls and young women since 2010. In 2022, 2.5 million adolescent girls and young women were reached with HIV prevention programs in these priority countries where the HIV burden is highest. The Global Fund has also invested in HIV prevention targeting boys and men, including voluntary medical male circumcision programs as well as efforts to address harmful cultural and social norms that influence HIV transmission.
In countries where the Global Fund invests, AIDS-related deaths have been reduced by 72% since the Global Fund was founded in 2002 and new infections have been reduced by 61%. In the absence of prevention measures and antiretroviral drugs, deaths would have increased by 169% and new HIV infections by 125% in the same period. The fight against HIV is an inspiration and platform for defeating all other infectious diseases – those we face right now, including COVID-19, and those that will likely emerge in the future.
The Global Fund provides 28% of all international financing for HIV programs and has invested a total of US$25.5 billion in programs to prevent and treat HIV and AIDS and US$4.6 billion in TB/HIV programs as of June 2023. Since 2020, the Global Fund has provided additional funding through C19RM to countries to mitigate the impact of COVID-19 on the HIV response.
Since the Global Fund partnership was created in 2002, the world has made extraordinary progress in the fight against HIV. Today, we have the knowledge and tools to prevent every new HIV infection and each AIDS-related death. The recovery of Global Fund-supported HIV programs from the impact of COVID-19 is accelerating. Looking ahead, the Global Fund is focused on getting back on track to meet the Sustainable Development Goal target for 2030 – to end AIDS for good.
Many countries are still off track to achieve the target of ending AIDS as a public health threat by 2030, particularly in relation to the number of new HIV infections still occurring. COVID-19 mostly impacted HIV prevention services, which are critical to reducing HIV transmission. By taking bold action now, we can reverse this trend and get back on track to end AIDS by 2030.
In 2022, TB programs achieved a sharp acceleration and remarkable recovery following severe disruptions caused by the COVID-19 pandemic in 2020 and 2021.
In the countries where the Global Fund invests, the number of people with TB who were diagnosed and treated in 2022 surpassed the numbers reported in 2019 – the most recent high before COVID-19 caused disruption across TB programs. In 2022, there was a sharp increase in TB screening and testing in the countries where the Global Fund invests. 6.7 million people with TB were diagnosed and treated in 2022, surpassing the number reported in 2019 (5.8 million).
But TB – a preventable and curable disease – still kills one person every 20 seconds. The perils of drug-resistant TB are becoming ever more present, and millions of people continue to live with and die from TB without ever receiving a diagnosis. The Global Fund’s commitment to ending TB continues to drive progress despite these challenges.
We are investing in key innovations such as diagnostic tools like mobile X-rays and lower-cost molecular diagnostics. We are also investing in new treatments, such as the bedaquiline, pretomanid, linezolid and moxifloxacin (BPaLM) combination therapy for drug-resistant TB and the new short-course tuberculosis preventive treatment called 3HP.
In countries where the Global Fund invests, TB deaths (excluding people living with HIV) since the Global Fund was founded in 2002 have been reduced by 16% as of 2022, while new TB cases (all forms) have dropped by 4%. In the absence of TB control measures, deaths would have increased by 143% and TB cases by 36% in the same period.
The Global Fund provides 76% of all international financing for TB and has invested US$9.2 billion in programs to prevent and care for people with TB and US$1.5 billion in TB/HIV programs as of June 2023. Since 2020, the Global Fund has provided additional funding through C19RM to help countries mitigate the impact of COVID-19 on the TB response.
To end TB as a public health threat, we must increase investments in evidence-based tools, health workers and systems for health needed to fight TB and prepare for other future health threats.
COVID-19 severely impacted efforts to meet the target to end TB by 2030, reversing years of slow but steady progress. In 2022, many countries had accelerated their progress in the fight against the disease, reporting increases in the number of people tested and treated for TB. Despite this progress, we are still off track to end TB as a public health threat by 2030. To get there, we must do more. An all-in response to TB today actively contributes to building a safer, healthier and more equitable world tomorrow.
Malaria remains a daunting global health challenge. Climate change is fueling its spread, and malaria is adapting to evade prevention and treatment efforts. Through innovation and sustained, targeted investments to support those most at risk for the disease, the Global Fund is fighting back to save lives and make progress on the path toward malaria elimination. In 2022, Global Fund-supported malaria programs recovered from declines in 2020 and 2021.
Malaria has shown that we must stay ahead of it to eliminate it. Together with the U.S. President’s Malaria Initiative (PMI) and other partners, in 2022 the Global Fund invested in tools, partnerships and innovations to combat insecticide and drug resistance and make our interventions more cost-effective. Harnessing innovation, strengthening disease surveillance systems and testing new products proven to be safe and effective – such as next-generation nets, insecticides, treatments or vaccines – are essential in this ongoing fight against the disease.
Since 2010, countries with the highest malaria burden have achieved significant declines in the overall number of deaths and have been able to drive down incidence rates. In countries where the Global Fund invests, malaria deaths have reduced by 27% between 2002 and 2022. In the absence of malaria control measures, deaths would have increased by 91% and malaria cases by 76% in the same period.
The Global Fund provides 65% of all international financing for malaria programs and has invested more than US$17.9 billion in malaria programs as of June 2023. Since 2020, the Global Fund has provided additional funding through C19RM to help countries mitigate the impact of COVID-19 on the malaria response.
As proved by Azerbaijan, Tajikistan and Belize – certified malaria-free by WHO in 2023 – the target of eliminating malaria is still within reach. But we must work even harder to regain lost progress and ensure that crises such as conflict and climate change do not derail our efforts.
Malaria remains a daunting global health challenge, and we are off track to meet the target of ending the disease as a public health threat by 2030. It is imperative to get back on track to fight malaria, to protect our gains and end this disease once and for all. With investments to accelerate the deployment of innovative tools, scale up interventions and strengthen critical health system capabilities, like disease surveillance, community health workers and last-mile logistics, we are fighting back.
Resilient and sustainable systems for health are the foundation for defeating today’s infectious diseases and the basis for preventing, preparing for and responding to future pandemics. The Global Fund is the world’s largest multilateral provider of grants for strengthening systems for health. Between 2021 and 2023, we are investing US$1.5 billion a year in formal and community health systems. By financing key components of a resilient health system, such as community health workers, laboratory systems, oxygen infrastructure, data and supply chain management, the Global Fund supports countries to address other health priorities and prepare for the next major health threat. Our community-focused programming and inclusive governance model allow our grants to reach remote and vulnerable populations, including those marginalized by poverty, stigma, discrimination or criminalization.
The Global Fund rapidly stepped up to respond to the COVID-19 pandemic in low- and middle-income countries. The interventions we have made in the fight against COVID-19 not only mitigated the impact of the pandemic on the three diseases but also helped avert many infections and deaths while building sufficient defenses that have helped prepare countries for future health threats. The Global Fund’s response to the COVID-19 pandemic and beyond has evolved over more than three years. With some overlap between components, it has covered control and containment of COVID-19; mitigation of the effect of COVID-19 on HIV, TB and malaria; and long-term investments in health systems strengthening to support pandemic preparedness.
As the COVID-19 pandemic declined in 2022, the world witnessed the expansion of other crises that affected global health. These multiple, interconnected and colliding crises that included climate change, conflict, debt, widening inequalities within and between countries, as well as an alarming erosion of human rights, made our efforts to get back on track against the three diseases much more challenging. The Global Fund’s Strategy, “Fighting Pandemics and Building a Healthier and More Equitable World,” aims to respond to these challenges by putting a greater focus on equity, sustainability, program quality and innovation while taking determined action to tackle human rights and gender-related barriers.
Since 2002, the Global Fund has provided US$15 billion to support crucial HIV, TB and malaria prevention and treatment services and strengthen health systems in challenging operating environments, or countries or regions that experience infectious disease outbreaks, natural disasters, armed conflicts or civil unrest, weak governance, climate change-related crises and/or mass displacement.
To end HIV, TB and malaria as public health threats and address emerging dangers to global health security, we need to reach the most vulnerable people with prevention and treatment services, wherever they are.
The Global Fund galvanizes the world to invest in the fight against the deadliest infectious diseases while challenging the injustice that continues to fuel them. Since our founding in 2002, the Global Fund has disbursed more than US$60.4 billion to respond to HIV, TB, malaria and COVID-19 and for programs to strengthen systems for health across more than 120 countries as of June 2023. In 2022, the Global Fund disbursed a record US$5.2 billion to fight HIV, TB and malaria, support C19RM activities, and strengthen the systems for health that underpin any pandemic response. These investments helped save many lives from HIV, TB, malaria and COVID-19 and accelerated the recovery from the impact of COVID-19 on the programs we support.
The Global Fund Results Report 2023 presents selected programmatic results (e.g., people on antiretroviral therapy, people treated for TB, mosquito nets distributed) achieved by supported programs in 2022. The programmatic results are reported routinely to the Global Fund by the supported programs. The data collected by our technical partners are also used for cross-checking and triangulation and for furnishing national data for selected services to align with the Global Fund partnership’s approach in results reporting. The Global Fund also uses official disease burden and impact estimates developed and published by our technical partners, including the World Health Organization and UNAIDS, as the basis for measuring impact.