Attachments
Part 1: Introduction
1 . Recent advances in scientific knowledge, clear evidence of high-impact interventions, falling costs and improved implementation know-how have given the global community the opportunity to control AIDS, tuberculosis (TB) and malaria. Controlling these diseases through smart and effective prevention, care and treatment programs will dramatically save and improve the lives of millions of people, their families, communities and countries – and alleviate the burden on development and economic growth that they represent. The global community is now at a crossroads: the choice is to maintain the current level of investment, leading to a continued high number of new infections and deaths, or to accelerate the gains to turn high-transmission epidemics into low-level endemics, saving millions of lives and preventing billions of dollars in additional costs over the long term.
2 . Over the last decade, tremendous progress has been made against AIDS, TB and malaria, achieving an impact that was unthinkable at the turn of the millennium. This achievement has been the result of the hard work of governments, health care providers, communities including persons affected by the diseases, faith-based organizations and the private sector all over the world. The resources committed by domestic and external sources have been fundamental to the progress achieved so far. In 2000, just 50,000 people were receiving antiretroviral (ARV) therapy in sub-Saharan Africa. By 2011, it was roughly 6million. Just over a decade ago, TB case detection rates were 43 percent, and the treatment success rate was just 67 percent among the 22 countries with the highest TB burden. By 2011, the TB case detection rate rose to 66 percent and the treatment success rate to 87 percent. In sub-Saharan Africa, fewer than 5 percent of households owned an insecticide-treated net in 2000. By 2010, that had increased to 53 percent, with hundreds of millions of more nets distributed since then. More important than these outcome measures, mortality patterns provide further evidence of the dramatic progress achieved against the three diseases. From 2005 to 2011, AIDS-related mortality decreased by 24 percent. The TB mortality rate declined by 41 percent from 1990 to 2011. For malaria, the global mortality rate is estimated to have decreased by 26 percent between 2000 and 2010; during this period, more than half of the deaths averted were in the ten countries with the highest malaria burden in 2000. The efforts have saved nearly three-quarters of a million children across 34 malaria-endemic African countries over the past ten years. Even more telling is that 85 percent of these lives were saved in the past five years alone, the same time period during which funding intensified nine-fold.