The Challenge
HIV/AIDS, tuberculosis (TB) and malaria are
preventable and treatable diseases that disproportionately affect the world’s
poor. Sub-Saharan Africa is the hardest hit region, accounting for 90% of
malaria deaths, more than 70% of all people living with HIV and 28%of all TB
cases.
The human impact of these
diseases is undeniable, but their socioeconomic impact is also severe. HIV and
TB often affect people in their most productive years. Businesses are losing
their workers, governments are losing their civil servants and families are
losing not only their loved ones but also their breadwinners.
The world has battled malaria
and TB for centuries, but the immense human toll of AIDS in the late 1990s
injected a new urgency into global prevention and treatment efforts. Though the
resources to fight these diseases have increased exponentially throughout most
of the 2000s, funding remains insufficient for global disease control.
Infectious diseases are particularly challenging, because even once progress
has been made against them, they can rebound quickly if global efforts to fight
them stagnate or stop.
Weak health systems further
complicate the fight against these diseases, especially in sub-Saharan Africa.
The shortage of health workers, for example, is a major hurdle in expanding
treatment and prevention efforts. Sub-Saharan Africa accounts for 24% of the
global burden of disease, but only 3% of the world’s health workforce. Health
workers at all levels of delivery, as well as the systems, supplies, and
facilities that support them, must be strengthened to tackle infectious diseases
and to ensure better basic health care and outcomes overall.
The
Opportunity
New momentum in the fight
against HIV/AIDS, TB and malaria has helped millions of people get access to
prevention and treatment services. Antiretroviral medication for people living
with HIV/AIDS now generally costs less than $200 per patient per year, down
from nearly $10,000 only ten years ago. The four tools for malaria elimination
(insecticide-treated bed nets, anti-malarial treatment, indoor residual
spraying and preventative treatment for pregnant women) are also extremely
affordable. For example, bed nets cost $10 to buy and distribute, while
treatment costs $2 or less per dose. TB infection can be prevented and treated
as well. In many countries where TB is endemic, $5-50 will buy a full six-month
course of treatment to cure TB.
The increase in global resources
to fight these three diseases has led to real results. Global malaria deaths
have declined by 60% in last 15 years, saving 6.2 million lives (95% which are children).
In 2014, 13 countries reported no cases of the disease and six countries
reported fewer than 10 cases. Life-saving antiretroviral treatment has meant
that an AIDS diagnosis is no longer a death sentence for millions of people. In
2015, 15 million people around the world were receiving antiretroviral
treatment for HIV/AIDS, up from just under 700,000 in 2000. 10.7 million
of them lived in sub-Saharan Africa. Meanwhile, global deaths due to AIDS have
dropped consistently in that time, down from 2.4 million in 2004 to 1.2 million
in 2014. Thanks to effective diagnosis and treatment of TB, the MDG
target to halt and reverse TB incidence has also been achieved on a worldwide
basis (in each of the six WHO regions and in 16 of the 22 high-burden countries
that collectively account for 80% of TB cases), and 43 million lives have
been saved since 2000.
In order to make faster progress
on eventually ending these infectious disease pandemics – while also preparing
for new and emerging threats, such as Ebola – we need a continued scale-up of
resources from both donors and from high-burden countries’ own domestic
funding. We also need a smarter deployment of treatment and prevention
strategies, and concerted efforts to strengthen the health systems around these
programs.
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