In 2009 …
THE 2010 Global Fund Report was last week released with the reassuring disclosure that at least 3,600 lives have been saved per day during 2009, and an estimated total of 4.9 million to date through Global-Fund supported programmes since the establishment of the entity in 2002. Impressed with such a record emanating from the Results Report, Executive Director of UNAIDS, Mr Michel Sidibé, has lauded the performance of the Global Fund, adding that such results clearly show that the world’s investments are making a difference.

Commenting ahead of the March 24 Initial Replenishment  Review meeting to be held in The  Hague, Mr. Sibidé, who strongly drew attention to the fact that AIDS is not over in any part of the world, unequivocally stated:  “Without a fully funded Global Fund, our shared dream of universal access to HIV prevention, treatment care and support could become our worst nightmare — putting the lives of millions of people currently on treatment  in jeopardy and millions of pregnant women, in a position not to be able to protect their babies from becoming infected.”

At the initial Replenishment Review meeting to be held in The Hague next week, the Global Fund will present three resource scenarios for consideration to donors, each with an indication of the results that could be expected in terms of achievements on the ground at the end of the replenishment period. The different scenarios range from US$ 13 to 20 billion for the three-year period.

The Results Report forms part of the documentation for donors in preparation for the Global Fund’s replenishment conference in October 2010 in New York, where the organization will ask donors for financial contributions for 2011-2013. This is the third time since the Global Fund was established in 2002 that donors are being asked to replenish its finances.

Established as a public-private partnership to mobilize and intensify the international response to the three global epidemics  and help achieve the UN Millennium Development Goals (MDGs), the Global Fund has disbursed US $10 billion for HIV, TB and Malaria efforts through December 2009.

By the end of 2009, Global Fund-supported programmes provided antiretroviral treatment to 2.5 million people, treatment to 6 million people who had active TB, and had distributed 104 million insecticide-treated nets to prevent malaria. In addition to averting at least 3,600 deaths daily, the programmes prevent thousands of new infections, and alleviate untold suffering and economic loss for poor families in 144 countries.

The coming years will see even more results, as half of the total disbursements by the Global Fund were delivered in 2008 and 2009. In addition, much of the US$ 5.4 billion of financing approved in the last two rounds of proposals (8 and 9) will reach countries in 2010 and 2011, and will continue to significantly boost health outcomes.

The progress in combating AIDS, TB and malaria as a result of these investments has also had a positive impact on child mortality and maternal health. The MDGs call for halting and reversing the major diseases as well as reducing child mortality and improving maternal health by 2015.

Global Fund grants have made significant contributions to 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 per cent of deaths among women of childbearing age and malaria alone accounts for 16 to 18 per cent of child deaths.

Results by disease, up to December 2009
HIV
2.5 million people are currently on antiretroviral therapy (ART), a level of coverage        deemed unattainable less than a decade ago.

*  AIDS mortality has declined in many high-burden countries.

*  The Global Fund contributed about one-fifth of all disbursements by bi- and multilaterals for the HIV response in low- and middle-income countries in 2008.

*  1.8 billion condoms distributed.

*  105 million HIV counseling and testing sessions provided.

*  790,000 HIV-positive pregnant women in low- and middle-income countries received antiretroviral prophylaxis to prevent mother-to-child transmission– which represents 45 percent of coverage of women in need.

*  4.5 million basic care and support services provided to orphans and other children made vulnerable by AIDS.

Tuberculosis
*  Around 6 million people with active TB were treated by December 2009.

*  1.8 million TB/HIV services provided – a 150 percent increase since the end of 2008, contributing to the decline of TB prevalence and mortality rates in many countries.

*  The Global Fund provides 63 percent of the external financing for TB and multidrug-resistant TB (MDR-TB) control efforts in low- and middle-income countries – it is by far the major source of international funding for tuberculosis.

*  Today, countries are on track to meet the international target of halving TB prevalence by 2015.

Malaria
*  104 million insecticide-treated nets distributed to prevent malaria; more than 19 million indoor residual spraying of insecticides in dwellings; 108 million cases of malaria treated in accordance with national treatment guidelines.

*  An increasing number of countries reporting a reduction in malaria deaths of more than 50 percent. At least ten of the most endemic countries in Africa have reported declines in new malaria cases and an impressive decline in child mortality of 50 to 80 percent.

*  In 2008, the Global Fund contributed 57 percent of international disbursements for malaria control – which makes it, by far, the major source of international funding for malaria.

*  In Africa, Swaziland and some island states and territories are now aspiring to enter the malaria pre-elimination stage.  

Progress in meeting Millennium Development Goals
The report points out that continued, substantial increases in long-term financial commitments by donors will be needed to consolidate the gains and to reach the MDGs by 2015.

Within that time-frame, 2010 is decisive.

Funds committed now will benefit programs which will have effect on the ground from 2012 to 2015. The numbers show that countries are approaching a positive tipping point: if they continue on this path, the returns will be exponential and the world will reverse the AIDS, TB and malaria epidemics.

“In health, 2010 is a pivotal year to finance the final stretch of the effort to reach the Millennium Development Goals,” says Professor Kazatchkine. “We have made unprecedented progress but it is fragile. If we lose momentum now there will be a heavy price to pay. A failure to continue the scale-up of investments in health will betray the trust of millions.”