Results Report 2021

In 2021, the Global Fund celebrates 20 years since we were founded. During that time, we have made remarkable progress against HIV, TB and malaria. But over the last year, the impact of the COVID-19 pandemic has been devastating. For the first time in the Global Fund’s history, key HIV, TB and malaria programmatic results declined.

The Global Fund’s Results Report 2021 details how our partnership moved swiftly to support countries to respond to the COVID-19 pandemic and to adapt lifesaving HIV, TB and malaria programs so they could safely continue. In more than 120 countries and regions around the world, we are also making urgent reinforcements to systems for health needed to defeat today’s pandemics and prepare for tomorrow’s.

Key Results and Lives Saved

Health programs supported by the Global Fund partnership had saved 44 million lives as of the end of 2020. Overall, the number of deaths caused by AIDS, TB and malaria each year have been reduced by 46% since 2002 in countries where the Global Fund invests.

44 million lives saved

The coverage of treatment and prevention interventions for HIV, TB and malaria in countries where the Global Fund invests has grown since we were created in 2002. However, malaria prevention progress has slowed in recent years. We also don’t yet know the full impact of the COVID-19 pandemic on HIV, TB and malaria treatment and prevention coverage.

We measure our progress against the targets in the global plans for HIV, tuberculosis and malaria and in Sustainable Development Goal 3: Health and well-being for all.

That achievement is the result of efforts by a wide array of actors comprising the Global Fund partnership, including governments, multilateral agencies, bilateral partners, civil society groups, people affected by the diseases, and the private sector.

HIV: State of the Fight

Key HIV results for 2020 in countries where the Global Fund invests:

Together with PEPFAR and other partners, our efforts to implement WHO’s “treat all” guidance and the UNAIDS “90-90-90” strategy have significantly increased the number of people living with HIV who know their HIV status, the number of people on antiretroviral therapy and the number of people on antiretroviral therapy who have viral suppression.

The Global Fund is supporting countries to adapt HIV services to counter the impact of COVID-19, including multimonth dispensing of antiretroviral drugs to ensure continued treatment; multimonth dispensing of HIV prevention supplies such as condoms, lubricants, needles, syringes and PrEP; and providing prevention and outreach services via digital platforms and social media. But the impact of COVID-19 was severe. Key prevention and testing services declined by 11% and 22% respectively compared to the previous year.

HIV infections among women aged 15 to 24

Adolescent girls and young women remain a key focus for Global Fund’s response to HIV. We have significantly increased our investments, focusing on the 13 priority countries where HIV burden is highest. In these countries, new HIV infections among adolescent girls and young women have dropped by 41% since 2010 in the 13 priority countries. A drop in new HIV infections among young women and girls aged 15-24 was recorded by all countries except for Zambia, which saw a rise in the new infections between 2010 to 2020. However, even for Zambia, that rise can largely be accounted for by the increase in population among youth 15-24 years, as the incidence rate among young women and girls in this group continued to decline.

HIV trends in deaths and infections

In countries where the Global Fund invests, AIDS-related deaths have been reduced by 65% and new infections have been reduced by 54% since 2002. Eight countries have surpassed the UNAIDS “90-90-90” 2020 testing and treatment targets; however, most countries missed this target. As the COVID-19 pandemic continues, it is unclear if the decrease in testing and prevention services in 2020 will lead to increased deaths and infections.

Investing for impact

The Global Fund provides 25% of all international financing for HIV programs (10% of available resources) and has invested US$22.7 billion in programs to prevent and treat HIV and AIDS and US$3.8 billion in TB/HIV programs as of June 2021. Since 2020, the Global Fund has provided additional funding through the COVID-19 Response Mechanism to countries to mitigate the impact of COVID-19 on the HIV response.

Over the 20 years of the existence of the Global Fund partnership, the world has made extraordinary progress in the fight against HIV. To continue that momentum and regain lost ground due to COVID-19, we must scale up and expand successful programs to prevent, test and treat HIV.

Tuberculosis:
State of the Fight

Key TB results in 2020 in countries where the Global Fund invests:

The Global Fund is working with the Stop TB Partnership and WHO to find more “missing” people with TB – people who go undiagnosed, untreated and unreported, and could die or continue to spread the disease to others without treatment. Over one million additional cases were notified by the end of 2019.

While COVID-19 surpassed TB as the world’s leading infectious disease killer in 2020, TB – another airborne disease that was once a global pandemic – remains the second biggest, with more than 1.4 million people dying of the disease in 2019 (including HIV-positive people).

TB trends in deaths and cases

In countries where the Global Fund invests, TB deaths (excluding HIV-positive deaths) since the Global Fund was founded in 2002 have been reduced by 28%. But as the COVID-19 pandemic continues, it is unclear if the decrease in testing and treatment services in 2020 will lead to increased deaths and infections.

Investing for impact

The Global Fund provides 77% of all international financing for TB (12% of total available resources) and has invested US$7.8 billion in programs to prevent and treat TB as of June 2021. Since 2020, the Global Fund has provided additional funding through the COVID-19 Response Mechanism to countries to mitigate the impact of COVID-19 on the TB response.

To end both COVID-19 and TB as epidemics, we must fight both diseases at the same time, increasing investments in the same tools, health workers and systems for health needed to fight TB and COVID-19 and prepare for future airborne pandemics.

Malaria:
State of the Fight

Key malaria results in 2020 in countries where the Global Fund invests:

Through leveraging economies of scale, working with partners and negotiating directly with manufacturers, we reduced the cost of an insecticide-treated mosquito net by 36% and the average cost of artemisinin-based combination (ACT) therapies by 39% between 2014 and 2020. Savings generated through the reduction in treatment costs alone enabled us to provide more than 59.8 million additional antimalarial treatments.

Great progress was made in malaria control between 2000 and 2017, with a reduction in overall cases and deaths, but that momentum has stalled. COVID-19 has exacerbated that challenge, knocking us further off track.

Malaria trends in deaths and cases

Since 2010, the highest malaria burden countries have achieved significant declines in the overall number of deaths as well as in driving down incidence rates. In countries where the Global Fund invests, malaria deaths have reduced by 45% between 2002 and 2019 (latest available data).

Investing for impact

The Global Fund provides 56% of all international financing for malaria programs (39% of total available resources) and has invested more than US$14.7 billion in malaria control programs as of June 2021. Since 2020, the Global Fund has provided additional funding through the COVID-19 Response Mechanism to countries to mitigate the impact of COVID-19 on the malaria response.

Despite the challenges brought about by COVID-19, the pandemic has produced a wave of innovations and adaptations to continue the fight against malaria. The certification of El Salvador as malaria-free in February 2021 shows that the target of eliminating malaria is still within reach – but we must work even harder to regain lost progress and adapt to the disruption caused by the COVID-19 pandemic.