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GFO Issue 271



David Garmaise

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Article Number: 1

This is almost double the figure of 8.7 million lives saved announced in July 2012

ABSTRACT Used a revised methodology, the Global Fund estimates that through programs it supports, 17 million lives have been saved. This is almost double the figure of 8.7 million lives saved announced by the Fund in July 2012.

Programs supported by the Global Fund have saved 17 million lives up to the end of 2014, according to the Results Report 2015 released by the Fund on 21 September. The Fund says that it is on track to reach 22 million lives saved by December 2016, the end of the current replenishment period (see graphic).

This is the first time since July 2012 that the Global Fund has included a lives saved figure in its results announcements. At that time, the Fund estimated that through programs it had supported, 8.7 million lives had been saved. Since then, the Fund has been working on refinements to its methodology for estimating lives saved.

In a Q&A that accompanied the results report, the Global Fund said that the increase in the number of lives saved is partly due to improved data collection and methodology and partly due to scientific advances, innovative solutions and increased global support.

The report said that by the end of 2014 programs supported by the Fund also resulted in 8.1 million people receiving antiretroviral treatment (up 22% over the previous year, according to a news release on the Fund’s website); 13.2 million people receiving TB treatment (up 11%); and 548 million mosquito nets being distributed.

The results report is an important tool for the Fund as it launches its replenishment campaign for 2017-2019.

Source: Results Report 2015, Global Fund to Fight AIDS, Tuberculosis and Malaria

“Advances in global health are transforming communities in ways that go way beyond what the numbers show,” said Mark Dybul, Executive Director of the Global Fund, in the news release. “More people on treatment means parents can actually care for their children and be productive members of a community. Fewer infections means health centers can serve people with other ailments.”

The results reported for the period ending in 2014 are different from the results that the Global Fund originally reported for 2014. (The Fund reported 2014 results on 30 November 2014, just prior to World AIDS Day; see GFO Article.) For example, originally the Fund reported that by the end of 2014 it estimated that programs supported by the Fund had put 7.3 million people on ART, had treated 12.3 million TB cases; and had distributed 450 million mosquito nets.

The Global Fund Secretariat told GFO that the reason for the discrepancies is that in the past when the Fund reported year-end results, there was actually a six-month lag in the data. The results announced for 1 December 2014 were based on data that was current in July 2014 because it takes a few months to sort through the data, which comes from many sources, discuss it with the Fund’s partners, and determine what is reasonably accurate.

When the Fund reported mid-year results in July 2015, in reality these were end-2014 numbers. The numbers reported in July 2015 correspond to the numbers reported in Results Report 2015 released on 21 September.

For the last few years, the Fund has been reviewing its methodology for calculating lives saved. In the results report, the Fund said that it is using an improved methodology “better aligned with methods used by partners.” The Global Fund said that, as in the past, the methodology uses models that analyze raw data. The models yield sophisticated estimates, not scientifically exact figures. The Fund said that a group of independent technical experts confirmed the credibility of the modeling and the estimates used by the Fund.

According to the results report, an important improvement to the methodology was the inclusion of impact of all interventions for TB and malaria, instead of limiting the data to the impact of mosquito nets and TB treatment. “This is leading to higher estimates of lives saved compared to what was recorded in previously published reports,” the Fund said.

The Global Fund said that is continuing to work with partners to further improve the methodology. This will include factoring in the impact of HIV prevention on the number of lives saved, which is currently not part of model. “This may indicate that the Global Fund underestimates the number of lives saved through its investments,” the report said. At the same time, the Fund and its partners will review some limitations in the methodology for estimating lives saved from TB and malaria which might over-estimate lives saved in certain settings.

Other results

Other highlights from the results report include that by the end of 2014 programs supported by the Global Fund have:

  • provided counseling and testing to 423 million people;
  • distributed more than 5.1 billion condoms;
  • treated more that 22 million people for STIs;
  • provided services to 3.1 million HIV-positive women to prevent transmission of HIV to unborn children;
  • treated 515 million cases of malaria;
  • averted 155 million cases of malaria; and
  • conducted indoor residual spraying in 58 million structures.

The Fund said that the number of people being treated for multidrug-resistant forms of TB has increased four-fold since 2010, reaching 210,000.

The results report said that between 2000 and 2014, the number of new HIV infections declined by 36% in countries supported by the Global Fund. “Partners express optimism that the rate of averting infections can accelerate more sharply if funding continues to grow,” the Fund said.

In addition, in countries where the Global Fund invests:

  • the number of people dying from HIV, TB and malaria has declined by one-third;
  • access to ARVs increased from 4% coverage in 2005 to 21% in 2010 and to 40% in 2014; and
  • people at risk for malaria who gained access to mosquito nets grew from 7% in 2005 to 36% in 2010 and 56% in 2014.

The Global Fund estimates that more than one-third of its investments support building health systems; and that 55-60% of its investments benefit women and girls.

The Global Fund projects an increase of $4.5 billion (or 52%) in domestic investments in health for the period 2015-2017 compared to what was invested in 2012-2014.

According to the report, in the last two years, the Global Fund has achieved savings of more than $500 million through more effective procurement, with on-time delivery improving from 36% in 2013 to 81% in 2015.

The results report includes some country case studies. In Tanzania, for example, the number of identified TB cases rose sharply between 1995 and 2005, prompting the country to declare a national emergency in 2006. The Global Fund began supporting TB programs in 2007, the report said, and joint efforts have averted 328,000 cases and saved 195,000 lives since 2000. “Tanzania has implemented a strong focus on joint TB/HIV interventions, building resilient and sustainable systems for health and improving TB detection and treatment rates,” the Fund said.

The Global Fund said that programs it supports currently save more than  two million lives a year. According to the results report, the number of lives saved in a given country in a particular year is estimated by subtracting the actual number of deaths from the number of deaths that would have occurred in a scenario where key disease interventions did not take place. “For example, in a country where studies show that 70% of smear-positive TB patients will die in the absence of treatment, if 1,000 smear-positive TB patients were treated in a particular year, yet only 100 people were recorded as dying from TB, the model can conclude that 600 lives were saved. Without treatment, 700 would have died.”

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