Africa - Global Fund Results. 15/7/10

AllAfrica

15 July 2010

Washington, DC — According to a new report from the Global Fund to Fight AIDS, TB, and Malaria, the Fund's efforts have contributed to saving an estimated 4.9 million lives by December 2009.

The coming years will see even more results, as half of the total disbursements by the Global Fund were delivered in 2008 and 2009. Much of the US$ 5.4 billion of financing approved in Rounds 8 and 9 will reach countries in 2010 and 2011, and will continue to significantly boost health outcomes.

This is among the findings of a extensive series of detailed reports from the Fund presented at its meeting earlier this year, and available at http://www.theglobalfund.org/en/replenishment/hague/documents

This AfricaFocus Bulletin contains the executive summary of the document Innovation and Impact and a summary of one of the additional documents, which analyzes the mixed results of African government pledges to provide additional funding. That report finds that the percentage of the average government expenditure on health, as a percentage of total government expenditure, rose only marginally from 8.8% in 2001 to 9.0% in 2007, despite the 15% commitment of the Abuja Declaration. But a number of countries showed substantially greater increases. By 2007 three countries had met the 15% target (Djibouti, Botswana and Rwanda).

Another AfricaFocus Bulletin, sent out by e-mail today and available on the web at http://www.africafocus.org/docs10/hiv1007a.php, contains excerpts from a UNAIDS press release and from the 2010 UNAIDS Outlook report, outlining new recommendations for "Treatment 2.0" as well as noting progress in HIV/AIDS prevention, particularly among young people in Africa.

Editor's Note

For previous AfricaFocus Bulletins on health issues, see http://www.africafocus.org/healthexp.php

The Global Fund 2010

Innovation and Impact Results Summary

For this and other reports on the current status and record of Global Fund programs, see http://www.theglobalfund.org/en/replenishment/hague/documents

Executive Summary

1. Every day, programs supported by the Global Fund save at least 3,600 lives, prevent thousands of new infections and alleviate untold suffering.

2. The Global Fund to Fight AIDS, Tuberculosis and Malaria is a public-private partnership established in 2002 to mobilize and intensify the international response to three global epidemics and thereby help achieve the Millennium Development Goals (MDGs). From its founding through December 2009, the Global Fund Board approved proposals totaling US$ 19.2 billion, and disbursed US$ 10 billion for HIV, tuberculosis (TB) and malaria control efforts. To maximize impact, every dollar donated goes to fund programs in country. The Global Fund has no country offices, and its operating expenses are almost entirely covered by the interest earned on the Trustee account at the World Bank.

3. The results and impact outlined in the report are the achievements of all the partners that collaborate as part of the Global Fund model. The success of the Global Fund relies on the financial pledges of donors, the technical guidance of - and collaboration with - multilateral partners, and particularly the management and implementation of programs by in-country partners including governments, civil society organizations and the private sector.

4. HIV. At the end of December 2009, programs financed by the Global Fund were providing antiretroviral therapy (ART) to 2.5 million people. Approved HIV proposals have totaled close to US$ 10.8 billion covering 140 countries. The Global Fund is estimated to have contributed about one-fifth of all disbursements by bi- and multilaterals for the HIV response in low- and middle-income countries in 2008. In addition to providing ART, programs funded by the Global Fund have also distributed 1.8 billion male and female condoms and have provided 790,000 HIV-positive pregnant women with treatment to prevent mother-to-child transmission of HIV, as well as 4.5 million basic care and support services to orphans and other children made vulnerable by AIDS, and 105 million HIV counseling and testing sessions. There is a growing body of evidence showing that Global Fund financing - alongside that of other financiers - has resulted in declines in AIDS mortality in countries in which provision of ART has been scaled up rapidly, accompanied by other significant impacts, such as improved survival and productivity of key professionals and other workers, and systemwide improvements in health care delivery.

5. Tuberculosis. Through 2009, programs funded by the Global Fund have provided treatment to 6 million people who had active TB. The Global Fund provides 63 percent of the external financing for TB and multidrugresistant TB (MDR-TB) control efforts in low- and middle-income countries. Approved TB proposals have totaled close to US$ 3.2 billion covering 112 countries, contributing 48 percent of the projected coverage required to achieve the Stop TB Partnership targets for the detection and treatment of new smear-positive TB cases. TB programs supported by the Global Fund have also provided 1.8 million TB/HIV services. In many countries in which the Global Fund supports programs, TB prevalence is declining, as are TB mortality rates.

6. Malaria. By the end of 2009, Global Fund-supported programs had distributed 104 million insecticide-treated nets (ITNs) to prevent malaria. They also supported indoor residual spraying of insecticides in dwellings more than 19 million times and treated 108 million cases of malaria in accordance with national treatment guidelines. Approved malaria proposals have totaled US$ 5.3 billion covering 83 countries. In 2008, the Global Fund contributed 57 percent of international disbursements for malaria control. Global Fund investments have played a critical role in introducing and expanding coverage of novel, effective malaria treatments in many countries where drug resistance to older treatments is high. In conjunction with re-energized national and international efforts to combat malaria, increased Global Fund financing is having a substantial impact on malaria morbidity and mortality worldwide, with an increasing number of countries reporting a reduction in malaria deaths of more than 50 percent.

7. The Global Fund supports community-based interventions. Since 2003, these efforts have delivered 138 million community outreach prevention services for at least one of the three diseases and provided 11.3 million "person-episodes" of training for health and community workers.

8. These combined efforts saved an estimated 4.9 million lives by December 2009 and restored hope for the 33 million people living with HIV, the hundreds of millions of people who contract malaria or who are at risk each year, and the 9.4 million who contract active TB annually. The coming years will see even more results, as half of the total disbursements by the Global Fund were delivered in 2008 and 2009. Much of the US$ 5.4 billion of financing approved in Rounds 8 and 9 will reach countries in 2010 and 2011, and will continue to significantly boost health outcomes.

Having a wider impact: Strengthening health systems and contributing to progress on the Millennium Development Goals

9. The Global Fund investments to combat HIV, TB and malaria are having a much wider impact - beyond individuals, their families and communities. They are major investments in health systems - bolstering infrastructure, strengthening laboratories, expanding human resources, augmenting skills and competencies of health workers, and developing and supporting monitoring and evaluation (M&E) activities. These enhancements, in turn, improve the sustainability of services, increase national capacity to expand programs further and increase countries' ability to improve services for other health issues. Ultimately, the investments translate into a healthier population and increased productivity, enabling countries to further their development.

10. These investments have helped accelerate progress towards the MDGs by contributing directly to MDGs 4, 5, 6 and 8, and indirectly to the others. The US$ 19.2 billion of approved investment by the Global Fund is a direct contribution to MDG 6 ("Combat HIV/AIDS and malaria and other diseases"). In addition, major contributions have also been made to MDG 4 (on child mortality) and MDG 5 (on maternal mortality) by reducing the largest causes of mortality among women and children. This is particularly the case in sub-Saharan Africa, where HIV, TB and malaria are responsible for 52 percent of deaths among women of childbearing age and malaria alone accounts for 16 to 18 percent of child deaths.