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The Global Fund and the President’s Emergency Plan for AIDS Relief: Fighting HIV/AIDS Worldwide

Since the first case in 1981, more than 78 million people have become infected with Human Immunodeficiency Virus (HIV), and over 39 million people have died of Acquired Immunodeficiency Syndrome (AIDS). An advanced stage HIV infection leads to a diagnosis of AIDS. HIV has no cure, but antiretroviral therapy (ART) can help control the virus, prevent AIDS, and allow infected people to lead healthy lives. The global response to HIV has averted 30 million new HIV infections and nearly 8 million AIDS-related deaths since 2000. There are currently 36.9 million people living with HIV, 70 percent of whom are in sub-Saharan Africa. HIV is the leading cause of death from a single infectious agent.[1] It also weakens the immune system, leaving individuals vulnerable to opportunistic infections such as tuberculosis.

Global Investments in HIV/AIDS

The Global Fund is the world’s largest global health financier and provides resources to in-country partners for large-scale programs that provide lifesaving prevention, treatment and care for people living with HIV/AIDS. Partnerships have been integral to the Global Fund’s model since its founding more than 10 years ago. For the fight against HIV/AIDS, the Global Fund partners with the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), which has a key in-country presence to help build capacity and provide technical assistance. The Global Fund and PEPFAR are the two leading global financiers of the HIV/AIDS response, accounting for approximately 80 percent of international HIV/AIDS assistance. [2]

Successes in the Fight against HIV/AIDS

For the first time since the disease’s discovery, health leaders can foresee an end to AIDS as a major public health threat, with steady, robust funding maintained. Highlights of progress include:

  • In 2014, there were an estimated 2 million new HIV infections — a 35 percent reduction in incidence since 2001.[1]
  • New HIV infections among children have declined by 58 percent since 2000.[1]
  • ART access has grown sharply, helping AIDS- related deaths fall to 1.2 million in 2013 — a 42 percent reduction since their peak in 2004.[1]
  • In 2015, the number of people put on HIV treatment through Global Fund-supported programs was scaled up by 14.5 percent, for a total of 9.2 million people on ARV.[3]
  • The Global Fund has also provided funding for
    3.6 million pregnant women to receive ART for the prevention of mother-to-child transmission.[3]
  • As of December 2015, over 17 million people receive HIV treatment thanks to robust international aid and increasing domestic financing.[1]
  • By the end of 2014, $20.2 billion had been invested in HIV/AIDS in low-and middle-income countries, 57 percent of which was provided by low-and middle-income countries themselves.[1]

Strategically Fighting HIV/AIDS

While the overall incidence rate of HIV and the number of AIDS-related deaths are falling globally, the epidemic continues to disproportionately affect marginalized populations. Many vulnerable groups have HIV prevalence rates 10 or 20 times that of the general population.[4] The Global Fund’s funding model is designed to reach these key populations by targeting areas where transmission rates are highest, thereby allowing its partners to better serve these populations.

Additionally, tuberculosis is a major cause of death among people living with HIV/AIDS. Some recent co- infection data reveals the following:

  • Tuberculosis-related deaths among people living with HIV have fallen 32 percent since 2004, but remains the cause for an estimated one in three AIDS-related deaths worldwide.[1]
  • There are estimated to be 1.1 million people who have tuberculosis and HIV co- infection
  • The burden of co-infection is particularly high in sub-Saharan Africa and a growing concern in Asia, where two-thirds of tuberculosis-infected people live.[5]
  • The World Health Organization (WHO) estimates that joint HIV/tuberculosis programs saved an estimated 1.3 million lives from 2005-2012, but co-infection remains an ongoing concern.[1]
  • WHO estimates that as much as an additional $1 billion in annual funding is necessary to support HIV/tuberculosis interventions.[6]

New Tools and Strategies for Prevention

Recent studies show that ART not only has the potential to save the life of the person receiving it, but also lowers the risk of passing the virus to an uninfected person by as much as 96 percent.[7] An effective vaccine remains elusive, but by scaling up the existing interventions — including treatment as prevention, medical male circumcision, and services for pregnant women to prevent transmission to their babies — incidence could be decreased by as much as 47 percent, according to the latest modeling.[8] Similarly, by strategically increasing focus on interventions for communities most affected by the virus, the world stands to make tremendous inroads in the years ahead.

[1] UNAIDS
[2] Kaiser Family Foundation
[3] Global Fund Results
[4] amfAR 2010
[5] WHO HIV/TB Co-Infection
[6] WHO Global TB Report 2012
[7] AIDS Info 2011
[8] National Center for Biotechnology Information 2013