Author : ID4D guests
Date : August 5, 2010
Michel D. Kazatchkine became Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria in April 2007. Read more...
I am writing this blog a week after the XVIII International AIDS Conference in Vienna and only a few days after coming back from the African Union Summit in Kampala. I am writing this blog nearly 30 years after the first cases of AIDS were reported; 10 years after the International AIDS Conference in Durban brought the world’s attention to the moral outrage of the failure to provide antiretroviral treatment in much of the developing world; 10 years after member states of the United Nations agreed to achieve the Millennium Development Goals (MDGs) by 2015; and 8 years after the Global Fund was established to vastly scale up the response to AIDS, tuberculosis (TB) and malaria.
Today, we are at a defining moment in the response to AIDS, TB and malaria, and more broadly in the effort to meet the health-related MDGs.
Health is the one area of development where we have made considerable progress in the last 10 years. There has been unprecedented societal mobilization around health both in the North and in the South, political commitment, and increased financial resources.
The results achieved have truly been remarkable. In no other area has there been such direct and rapid correlation between resources and impact as in recent years’ investments in fighting AIDS, TB and malaria:
- In 2002, when the Global Fund was established, virtually no-one with AIDS was receiving antiretroviral therapy (ART) in developing countries. Today, over 5 million people have gained access to ART. AIDS mortality has decreased in most high-burden countries and the number of new HIV infections is also decreasing in most parts of the world, particularly amongst young people.
- In 2002, malaria was a neglected disease. Today, at least 10 of the most endemic countries in Africa have reported declines in new malaria cases and an impressive decline in malaria mortality of 50 to 80 per cent.
- Since 2002, TB has been diagnosed much more effectively. Six million additional people have gained access to DOTS treatment with Global Fund support. Prevalence of TB was 220 per 100,000 in 2000. We are on track to meet the international target of 124 per 100,000 by 2015. TB mortality is also declining in many countries.
The Global Fund has played a key role in this progress. Programs financed by the Global Fund are providing ART to 2.8 million people. We support ART for over 50% of people on ART in Africa and for 75% of people on ART in Asia. The Global Fund is also the major multilateral funder of prevention.
Overall, we estimate that the programs we support have saved more than 5.7 million lives. Every day, an additional estimated 4000 lives are being saved.
The Global Fund’s contribution to the MDGs extends far beyond its contribution to MDG 6. Global Fund investments to combat HIV, TB, and malaria also contribute directly to MDGs 4 and 5, and benefit the health of mothers and children. The three diseases are often rooted in poverty and, as such, affect development in general and impact on all eight MDGs.
In the next months, donors will decide if further progress will be made, allowing the world to meet the health-related MDGs. If adequate resources are provided and scale up of programs is allowed to continue at the current rate, major successes are within reach. By 2015, we can:
o prevent millions of new HIV infections;
o dramatically reduce deaths from AIDS;
o virtually eliminate transmission of HIV from mother to child;
o substantially reduce child mortality and improve maternal health;
o eliminate malaria as a public health problem in most malaria endemic countries;
o achieve significant declines in TB prevalence and mortality; and,
o further strengthen health and community systems.
These goals are realistic and we can achieve them.
In contrast, if our commitment wavers, we risk reversing the gains achieved. Without a successful Global Fund replenishment, AIDS, TB and malaria will gain force again and the world will not meet the health-related MDGs.
As an organization that provides over 50% of AIDS treatment in resource-poor countries, and two thirds of international funding for TB and malaria, the Global Fund is crucial to that effort.
Currently, it is still too early to say what the outcome of the replenishment efforts will be. The consensus, as expressed at the International AIDS Conference and African Union Summit, is that the Global Fund has proven itself and deserves support. But we are worried that this will not translate into significantly increased contributions from donors. This would have devastating consequences:
o The world would continue denying treatment to over half of the people living with HIV in urgent need of it.
o HIV, TB and malaria prevention would also be denied to millions.
o The yearly number of new HIV infections would rise again. Hundreds of thousands of children would be born with HIV every year.
o Malaria morbidity and mortality would increase again and antimalarial drug resistance would become a major problem. The goal of eliminating malaria as a public health problem would become unattainable.
o Drug- and multidrug-resistant TB would become a major global public health problem, threatening the success of TB control efforts achieved to date and leading to substantial increases in TB prevalence and mortality.
o In addition, we risk losing progress made in reducing child mortality and improving maternal health – despite the stated commitment to taking greater action.
The unique chance we have to come close to, reach, or even exceed the health-related MDGs would be lost. Ultimately, the promise by world leaders to pursue “all necessary efforts … towards the goal of universal access to comprehensive prevention programmes, treatment, care and support” would be irrevocably broken. Health inequities between rich and poor countries would grow, and the hope of millions of people for a different future would be lost.
Now is not the time to flat line funding for AIDS, TB and malaria.
Now is the time to redouble our efforts!
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Date : September 20, 2010 14:40
A very interesting blog...but if we are going to prevent millions of new HIV infections dont we at least need to start counting all those infected or being at risk of being infected? How much data is being collected over those over 49 ? Is there truly a belief that those aged over 50 don't have sex, or maybe that those aged over 50 simply "don't count"? At the very least the UN MDG database must immediately recognise the need for and start collecting age- disaggregated data. This has to change, not only to ensure the effective monitoring and evaluation of the existing MDGs but also to provide the evidence base for a more equitable and rights-based post-2015 poverty reduction framework.
Secondly, older women’s role as carers of people living with HIV and AIDS and of young children is critical to progress towards MDG 6. HelpAge found that 88% of older people caring for grandchildren in a recent study in Tanzania were widows. And in a similar study in Ethiopia two thirds were widows . Supporting older women in their caregiving roles is essential to accelerating progress on the MDGs on combating HIV and other diseases, as well as education, child mortality and hunger.
Date : August 31, 2010 11:40
To Pavan Nair
I have bachelor degree in child development under 6 ( we learn subject disease prevention for children) , I have 2 years learned health care management in english . I think you have good analysis . We need good nutrition , clean water , good care for pregnent women ... to achieved MDG .
But for epidemic I think priority should be : understand in which way this disease transfer in society ?.We will carry IEC and apply prevention methods .
Now in our city red eys epidemicis transfer .Many persons contact with patientsin the street and in the SHOP . It dangeous .They do not know about isolation .
We have high technical hospital for TB in Hanoi it call hospital A .Now we want move it to sub- urban of Hanoi with wide land and isolated from community .
The same with AIDS . SAY is GOOD . HOW TO DO ? -Is big question .
The malaria is better .in City and provinces,in newspaper we do not hear about malaria .This was terrible during my mother and father youth age .This is good new.
Thank you for listening .
Date : August 31, 2010 07:03
I think one area where the specified MDG is not likely to be achieved is infant and maternal mortality. India unfortunately contributes very high numbers since over 1.25 million children die every year before age one. This is much higher than Sub Saharan Africa. One main reason for this is poor nutrition of expectant mothers which results in anemia and birth of low weight and anemic children as also complications during and after childbirth. This is then compounded by non-availability of clean drinking water and sanitation which causes diarrhea, low immunity and subsequent respiratory tract disease. Another major cause of child mortality (children under five) is acute malnutrition. A micro-nutrient based approach may improve the situation which has been neglected for far too long. Anemia can also be tackled using this approach. Primary health care facilities need urgent up-gradation for which expenditure on health needs to hiked from the present 1% to 3% of the GDP.
Date : August 12, 2010 16:00
Dear All,
Good day!
First of all, let me thank the guest bolggers of ID4D Michel Kazatchkine, Margaret Chan, Eckhard Deutscher and Anders Nordström for initiating discussion on a most important subject to decide world fate - the MDG vis-à-vis health issues especially AIDS, TB and malaria. However, things are far from rosy as emanated from discussions in different forum. Consider the following which I have read from different sources including UN Millennium Development Goals Report 2007:
Whereas the global TB prevalence and mortality rates are declining slowly, sub-Saharan Africa is suffering from an increase in both. The increasing incidence and virulence of drug resistant strains of TB presents a major public health challenge. Drug resistant TB is present in all regions of the world and threatens the success of TB control efforts as well as those to fight HIV/AIDS. The existence of MDR-TB and now XDR-TB poses a serious threat to TB control. XDR-TB occurs when there is resistance to all the most effective anti-TB drugs. The current outbreak of XDR-TB in South Africa was originally identified in KwaZulu Natal Province. Mortality has been extremely high and rapid, with most cases having HIV-TB co-infection.
In countries where progress is lagging or where child mortality has increased, AIDS is likely to be a major contributing factor. Malaria, too, continues to kill vast numbers of children. A significant proportion of the nearly 40 per cent of children with fever in sub-Saharan Africa who received anti-malarial drugs were treated with chloroquine, which has lost some of its effectiveness due to widespread resistance.
By the end of 2006, an estimated 39.5 million people worldwide were living with HIV (up from 32.9 million in 2001), mostly in sub-Saharan Africa. Globally, 4.3 million people were newly infected with the virus in 2006, with Eastern Asia and the CIS showing the fastest rates of infection. The number of people dying from AIDS has also increased – from 2.2 million in 2001 to 2.9 million in 2006.
In 2005, an estimated 15.2 million children had lost one or both parents to AIDS, 80 per cent of them in sub-Saharan Africa. By 2010, the figure is likely to rise to more than 20 million. Several countries are making progress in providing a minimum package of services for orphans and vulnerable children, including education, health care, and social welfare and protection. But far more work is needed to provide a humane and comprehensive response to this unprecedented social problem.
I am sorry if I have essentially painted a gloomy picture.
Thanks and regards,
Pradip Dey
Date : August 11, 2010 11:06
To Dear Mr MICHEL KAZATCHKINE MICHEL KAZATCHKINE …
You said about 3 diseases: tuberculosis, malaria and HIV/AIDS. In our country they have money in National Programme and Ministry of Health uses it .
The basis for all is environment protection.
I have a chance to go to monitoring this money in fields 10 years ago .I really don’t understands how all money will be in charge of Local levels .They confusing and the Finance officer keep all money . The health care cards submits request to them.
I prefer the mobile team to go to fields and help people.
The work should be through bidding: public and private hospitals have equal rights .
I don’t think so much about money: I think about how people know the way for prevention.
This new can help you more information ,please ask ADB.
Thank you.
-------------------------
ADB -LOAN second period: Prevention transmit ion diseases in Mekong region
Gov -portal 11/8/2010 : Pri-minister have just approved the list of projects “ Prevention of transmit ion diseases in Me Kong ADB – Second period 30 millions U S D .
The MOH in collaboration with MPI prepare the project proposal.
Project have 3 big objectives: Control and limit the epidemic in regions, control and management the transmit ion diseases in community special for women and children, control HIV/AIDS
Diem Co 1355/TTg-HTQT
S & T by CThN
Date : August 7, 2010 09:13
Absolutely agree.
If the UN and all associated agencies can work to persuade the 10 million HNWI, according to the recent World Wealth Report, to reallocate some of their $39 trillion earnings in 2009,
and take advantage of the announcement on August 5th 2010 to increase contributions to charity by 40 billionaires including Bill Gates, Warren Buffet, and redistribute this money to achieve the MDG's, then the world will become a better place.
Given that we live in a world in which nearly all the global wealth is controlled by 475 million people out of 6.83 billion [ see my website: www.kelvynrichards.com........Social Ecology -a new morality: alternative choices] the poor and the stricken will never be able to buy treatments.
The resources must be redistributed for the relief of the poor, as Mandela, Annan, Ghandi, Tutu have said many times there is enough money in the world to keep everybody alive, healthy, nourished.
J.Kelvyn Richards
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